HB 0297

CS

CHAMBER ACTION

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

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