HB 0297

CS

CHAMBER ACTION

1	The Committee on Local Government & Veterans' Affairs recommends
2	the following:
3
4	Committee Substitute
5	Remove the entire bill and insert:
6	A bill to be entitled
7	An act relating to the indigent care surtax; amending s.
8	212.055, F.S.; allowing small counties having a specified
9	population to levy an indigent care surtax; providing
10	procedures; providing uses of the surtax; providing a
11	maximum tax rate; providing an effective date.
12
13	Be It Enacted by the Legislature of the State of Florida:
14
15	Section 1.  Subsection (7) of section 212.055, Florida
16	Statutes, is amended to read:
17	212.055  Discretionary sales surtaxes; legislative intent;
18	authorization and use of proceeds.--It is the legislative intent
19	that any authorization for imposition of a discretionary sales
20	surtax shall be published in the Florida Statutes as a
21	subsection of this section, irrespective of the duration of the
22	levy. Each enactment shall specify the types of counties
23	authorized to levy; the rate or rates which may be imposed; the
24	maximum length of time the surtax may be imposed, if any; the
25	procedure which must be followed to secure voter approval, if
26	required; the purpose for which the proceeds may be expended;
27	and such other requirements as the Legislature may provide.
28	Taxable transactions and administrative procedures shall be as
29	provided in s. 212.054.
30	(7)  VOTER-APPROVED INDIGENT CARE SURTAX.--
31	(a)1.  The governing body in each county that has a
32	population of less than 800,000 residents may levy an indigent
33	care surtax pursuant to an ordinance conditioned to take effect
34	only upon approval by a majority vote of the electors of the
35	county voting in a referendum. The surtax may be levied at a
36	rate not to exceed 0.5 percent, except that if a publicly
37	supported medical school is located in the county, the rate
38	shall not exceed 1 percent.
39	2.  Notwithstanding subparagraph 1., the governing body of
40	any county that has a population of fewer than 50,000 residents
41	may levy an indigent care surtax pursuant to an ordinance
42	conditioned to take effect only upon approval by a majority vote
43	of the electors of the county voting in a referendum. The surtax
44	may be levied at a rate not to exceed 1 percent.
45	(b)  A statement that includes a brief and general
46	description of the purposes to be funded by the surtax and that
47	conforms to the requirements of s. 101.161 shall be placed on
48	the ballot by the governing body of the county. The following
49	questions shall be placed on the ballot:
50
51	FOR THE. . . .CENTS TAX
52	AGAINST THE. . . .CENTS TAX
53
54	(c)1.  The ordinance adopted by the governing body
55	providing for the imposition of the surtax must set forth a plan
56	for providing health care services to qualified residents, as
57	defined in paragraph (d). The plan and subsequent amendments to
58	it shall fund a broad range of health care services for indigent
59	persons and the medically poor, including, but not limited to,
60	primary care and preventive care, as well as hospital care. It
61	shall emphasize a continuity of care in the most cost-effective
62	setting, taking into consideration a high quality of care and
63	geographic access. Where consistent with these objectives, it
64	shall include, without limitation, services rendered by
65	physicians, clinics, community hospitals, mental health centers,
66	and alternative delivery sites, as well as at least one regional
67	referral hospital where appropriate. It shall provide that
68	agreements negotiated between the county and providers shall
69	include reimbursement methodologies that take into account the
70	cost of services rendered to eligible patients, recognize
71	hospitals that render a disproportionate share of indigent care,
72	provide other incentives to promote the delivery of charity
73	care, and require cost containment, including, but not limited
74	to, case management. The plan must also include innovative
75	health care programs that provide cost-effective alternatives to
76	traditional methods of service delivery and funding.
77	2.  In addition to the uses specified or services required
78	to be provided under this subsection, the ordinance adopted by a
79	county that has a population of fewer than 50,000 residents may
80	pledge surtax proceeds to service new or existing bond
81	indebtedness incurred to finance, plan, construct, or
82	reconstruct a public or not-for-profit hospital in such county
83	and any land acquisition, land improvement, design, or
84	engineering costs related to such hospital, if the governing
85	body of the county determines that a public or not-for-profit
86	hospital existing at the time of issuance of the bonds
87	authorized under this subparagraph would, more likely than not,
88	otherwise cease to operate. The plan required under this
89	paragraph may, by an extraordinary vote of the governing body of
90	such county, provide that some or all of the surtax revenues and
91	any interest earned must be expended for the purpose of
92	servicing such bond indebtedness. Such county may also use the
93	services of the Division of Bond Finance of the State Board of
94	Administration pursuant to the State Bond Act to issue bonds
95	under this subparagraph. A jurisdiction may not issue bonds
96	under this subparagraph more frequently than once per year. Any
97	county that has a population of fewer than 50,000 residents at
98	the time any bonds authorized in this subparagraph are issued
99	retains the authority granted under this subparagraph throughout
100	the terms of such bonds, including the term of any refinancing
101	bonds, regardless of any subsequent increase in population which
102	would result in such county having 50,000 or more residents.
103	(d)  For the purpose of this subsection, "qualified
104	residents" means residents of the authorizing county who are:
105	1.  Qualified as indigent persons as certified by the
106	authorizing county;
107	2.  Certified by the authorizing county as meeting the
108	definition of the medically poor, defined as persons having
109	insufficient income, resources, and assets to provide the needed
110	medical care without using resources required to meet basic
111	needs for shelter, food, clothing, and personal expenses; not
112	being eligible for any other state or federal program or having
113	medical needs that are not covered by any such program; or
114	having insufficient third-party insurance coverage. In all
115	cases, the authorizing county shall serve as the payor of last
116	resort; or
117	3.  Participating in innovative, cost-effective programs
118	approved by the authorizing county.
119	(e)  Moneys collected pursuant to this subsection remain
120	the property of the state and shall be distributed by the
121	Department of Revenue on a regular and periodic basis to the
122	clerk of the circuit court as ex officio custodian of the funds
123	of the authorizing county. The clerk of the circuit court shall:
124	1.  Maintain the moneys in an indigent health care trust
125	fund.
126	2.  Invest any funds held on deposit in the trust fund
127	pursuant to general law.
128	3.  Disburse the funds, including any interest earned, to
129	any provider of health care services, as provided in paragraphs
130	(c) and (d), upon directive from the authorizing county.
131	4.  Disburse the funds, including any interest earned, to
132	service any bond indebtedness authorized in this subsection upon
133	directive from the authorizing county, which directive may be
134	irrevocably given at the time the bond indebtedness is incurred.
135	(f)  Notwithstanding any other provision of this section, a
136	county may not levy local option sales surtaxes authorized in
137	this subsection and subsections (2) and (3) in excess of a
138	combined rate of 1 percent or, if a publicly supported medical
139	school is located in the county or the county has a population
140	of fewer than 50,000 residents, in excess of a combined rate of
141	1.5 percent.
142	Section 2.  This act shall take effect upon becoming a law.

CODING: Words stricken are deletions; words underlined are additions.