HB 0457, Engrossed 1 2003
   
1 A bill to be entitled
2          An act relating to the indigent care and trauma center
3    discretionary sales surtax; amending s. 212.055, F.S.;
4    reviving, reenacting, and amending the indigent care and
5    trauma center discretionary sales surtax; requiring a
6    biennial audit of a certain trust fund; requiring delivery
7    of the audit report to certain entities; deleting a future
8    expiration provision; providing an effective date.
9         
10          Be It Enacted by the Legislature of the State of Florida:
11         
12          Section 1. Notwithstanding the provisions of section 11 of
13    chapter 2000-312, Laws of Florida, subsection (4) of section
14    212.055, Florida Statutes, shall not stand repealed on October
15    1, 2005, as scheduled by such law, but that subsection, as
16    amended by section 13 of chapter 2000-312, Laws of Florida, is
17    revived and reenacted, and paragraph(g) of said subsection is
18    amended, to read:
19          212.055 Discretionary sales surtaxes; legislative intent;
20    authorization and use of proceeds.--It is the legislative intent
21    that any authorization for imposition of a discretionary sales
22    surtax shall be published in the Florida Statutes as a
23    subsection of this section, irrespective of the duration of the
24    levy. Each enactment shall specify the types of counties
25    authorized to levy; the rate or rates which may be imposed; the
26    maximum length of time the surtax may be imposed, if any; the
27    procedure which must be followed to secure voter approval, if
28    required; the purpose for which the proceeds may be expended;
29    and such other requirements as the Legislature may provide.
30    Taxable transactions and administrative procedures shall be as
31    provided in s. 212.054.
32          (4) INDIGENT CARE AND TRAUMA CENTER SURTAX.--
33          (a) The governing body in each county the government of
34    which is not consolidated with that of one or more
35    municipalities, which has a population of at least 800,000
36    residents and is not authorized to levy a surtax under
37    subsection (5), may levy, pursuant to an ordinance either
38    approved by an extraordinary vote of the governing body or
39    conditioned to take effect only upon approval by a majority vote
40    of the electors of the county voting in a referendum, a
41    discretionary sales surtax at a rate that may not exceed 0.5
42    percent.
43          (b) If the ordinance is conditioned on a referendum, a
44    statement that includes a brief and general description of the
45    purposes to be funded by the surtax and that conforms to the
46    requirements of s. 101.161 shall be placed on the ballot by the
47    governing body of the county. The following questions shall be
48    placed on the ballot:
49         
50          FOR THE. . . .CENTS TAX
51          AGAINST THE. . . .CENTS TAX
52         
53          (c) The ordinance adopted by the governing body providing
54    for the imposition of the surtax shall set forth a plan for
55    providing health care services to qualified residents, as
56    defined in paragraph (d). Such plan and subsequent amendments to
57    it shall fund a broad range of health care services for both
58    indigent persons and the medically poor, including, but not
59    limited to, primary care and preventive care as well as hospital
60    care. The plan must also address the services to be provided by
61    the Level I trauma center. It shall emphasize a continuity of
62    care in the most cost-effective setting, taking into
63    consideration both a high quality of care and geographic access.
64    Where consistent with these objectives, it shall include,
65    without limitation, services rendered by physicians, clinics,
66    community hospitals, mental health centers, and alternative
67    delivery sites, as well as at least one regional referral
68    hospital where appropriate. It shall provide that agreements
69    negotiated between the county and providers, including hospitals
70    with a Level I trauma center, will include reimbursement
71    methodologies that take into account the cost of services
72    rendered to eligible patients, recognize hospitals that render a
73    disproportionate share of indigent care, provide other
74    incentives to promote the delivery of charity care, promote the
75    advancement of technology in medical services, recognize the
76    level of responsiveness to medical needs in trauma cases, and
77    require cost containment including, but not limited to, case
78    management. It must also provide that any hospitals that are
79    owned and operated by government entities on May 21, 1991, must,
80    as a condition of receiving funds under this subsection, afford
81    public access equal to that provided under s. 286.011 as to
82    meetings of the governing board, the subject of which is
83    budgeting resources for the rendition of charity care as that
84    term is defined in the Florida Hospital Uniform Reporting System
85    (FHURS) manual referenced in s. 408.07. The plan shall also
86    include innovative health care programs that provide cost-
87    effective alternatives to traditional methods of service
88    delivery and funding.
89          (d) For the purpose of this subsection, the term
90    "qualified resident" means residents of the authorizing county
91    who are:
92          1. Qualified as indigent persons as certified by the
93    authorizing county;
94          2. Certified by the authorizing county as meeting the
95    definition of the medically poor, defined as persons having
96    insufficient income, resources, and assets to provide the needed
97    medical care without using resources required to meet basic
98    needs for shelter, food, clothing, and personal expenses; or not
99    being eligible for any other state or federal program, or having
100    medical needs that are not covered by any such program; or
101    having insufficient third-party insurance coverage. In all
102    cases, the authorizing county is intended to serve as the payor
103    of last resort; or
104          3. Participating in innovative, cost-effective programs
105    approved by the authorizing county.
106          (e) Moneys collected pursuant to this subsection remain
107    the property of the state and shall be distributed by the
108    Department of Revenue on a regular and periodic basis to the
109    clerk of the circuit court as ex officio custodian of the funds
110    of the authorizing county. The clerk of the circuit court shall:
111          1. Maintain the moneys in an indigent health care trust
112    fund;
113          2. Invest any funds held on deposit in the trust fund
114    pursuant to general law; and
115          3. Disburse the funds, including any interest earned, to
116    any provider of health care services, as provided in paragraphs
117    (c) and (d), upon directive from the authorizing county.
118    However, if a county has a population of at least 800,000
119    residents and has levied the surtax authorized in this
120    subsection, notwithstanding any directive from the authorizing
121    county, on October 1 of each calendar year, the clerk of the
122    court shall issue a check in the amount of $6.5 million to a
123    hospital in its jurisdiction that has a Level I trauma center or
124    shall issue a check in the amount of $3.5 million to a hospital
125    in its jurisdiction that has a Level I trauma center if that
126    county enacts and implements a hospital lien law in accordance
127    with chapter 98-499, Laws of Florida. The issuance of the checks
128    on October 1 of each year is provided in recognition of the
129    Level I trauma center status and shall be in addition to the
130    base contract amount received during fiscal year 1999-2000 and
131    any additional amount negotiated to the base contract. If the
132    hospital receiving funds for its Level I trauma center status
133    requests such funds to be used to generate federal matching
134    funds under Medicaid, the clerk of the court shall instead issue
135    a check to the Agency for Health Care Administration to
136    accomplish that purpose to the extent that it is allowed through
137    the General Appropriations Act; and
138          4. Prepare on a biennial basis an audit of the trust fund
139    specified in subparagraph 1. Commencing February 1, 2004, such
140    audit shall be delivered to the governing body and to the chair
141    of the legislative delegation of each authorizing county.
142          (f) Notwithstanding any other provision of this section, a
143    county shall not levy local option sales surtaxes authorized in
144    this subsection and subsections(2) and (3) in excess of a
145    combined rate of 1 percent.
146          (g) This subsection expires October 1, 2005.
147          Section 2. This act shall take effect upon becoming a law.