Senate Bill sb0456
CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                                   SB 456
    By Senator Bennett
    21-624-04                                            See HB 43
  1                      A bill to be entitled
  2         An act relating to the school capital outlay
  3         surtax; amending s. 212.055, F.S.; authorizing
  4         counties to use a portion of surtax revenues
  5         for certain operational purposes under certain
  6         circumstances; providing requirements and
  7         limitations; providing for future repeal;
  8         providing an effective date.
  9  
10  Be It Enacted by the Legislature of the State of Florida:
11  
12         Section 1.  Section 212.055, Florida Statutes, as
13  amended by section 91 of chapter 2003-402, Laws of Florida, is
14  amended to read:
15         212.055  Discretionary sales surtaxes; legislative
16  intent; authorization and use of proceeds.--It is the
17  legislative intent that any authorization for imposition of a
18  discretionary sales surtax shall be published in the Florida
19  Statutes as a subsection of this section, irrespective of the
20  duration of the levy. Each enactment shall specify the types
21  of counties authorized to levy; the rate or rates which may be
22  imposed; the maximum length of time the surtax may be imposed,
23  if any; the procedure which must be followed to secure voter
24  approval, if required; the purpose for which the proceeds may
25  be expended; and such other requirements as the Legislature
26  may provide. Taxable transactions and administrative
27  procedures shall be as provided in s. 212.054.
28         (1)  CHARTER COUNTY TRANSIT SYSTEM SURTAX.--
29         (a)  Each charter county which adopted a charter prior
30  to January 1, 1984, and each county the government of which is
31  consolidated with that of one or more municipalities, may levy
                                  1
CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                                   SB 456
    21-624-04                                            See HB 43
 1  a discretionary sales surtax, subject to approval by a
 2  majority vote of the electorate of the county or by a charter
 3  amendment approved by a majority vote of the electorate of the
 4  county.
 5         (b)  The rate shall be up to 1 percent.
 6         (c)  The proposal to adopt a discretionary sales surtax
 7  as provided in this subsection and to create a trust fund
 8  within the county accounts shall be placed on the ballot in
 9  accordance with law at a time to be set at the discretion of
10  the governing body.
11         (d)  Proceeds from the surtax shall be applied to as
12  many or as few of the uses enumerated below in whatever
13  combination the county commission deems appropriate:
14         1.  Deposited by the county in the trust fund and shall
15  be used for the purposes of development, construction,
16  equipment, maintenance, operation, supportive services,
17  including a countywide bus system, and related costs of a
18  fixed guideway rapid transit system;
19         2.  Remitted by the governing body of the county to an
20  expressway or transportation authority created by law to be
21  used, at the discretion of such authority, for the
22  development, construction, operation, or maintenance of roads
23  or bridges in the county, for the operation and maintenance of
24  a bus system, for the payment of principal and interest on
25  existing bonds issued for the construction of such roads or
26  bridges, and, upon approval by the county commission, such
27  proceeds may be pledged for bonds issued to refinance existing
28  bonds or new bonds issued for the construction of such roads
29  or bridges;
30         3.  For each county, as defined in s. 125.011(1), used
31  for the development, construction, operation, and maintenance
                                  2
CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                                   SB 456
    21-624-04                                            See HB 43
 1  of roads and bridges in the county; for the expansion,
 2  operation, and maintenance of bus and fixed guideway systems;
 3  and for the payment of principal and interest on bonds issued
 4  for the construction of fixed guideway rapid transit systems,
 5  bus systems, roads, or bridges; and such proceeds may be
 6  pledged by the governing body of the county for bonds issued
 7  to refinance existing bonds or new bonds issued for the
 8  construction of such fixed guideway rapid transit systems, bus
 9  systems, roads, or bridges and no more than 25 percent used
10  for nontransit uses; and
11         4.  Used by the charter county for the planning,
12  development, construction, operation, and maintenance of roads
13  and bridges in the county; for the planning, development,
14  expansion, operation, and maintenance of bus and fixed
15  guideway systems; and for the payment of principal and
16  interest on bonds issued for the construction of fixed
17  guideway rapid transit systems, bus systems, roads, or
18  bridges; and such proceeds may be pledged by the governing
19  body of the county for bonds issued to refinance existing
20  bonds or new bonds issued for the construction of such fixed
21  guideway rapid transit systems, bus systems, roads, or
22  bridges. Pursuant to an interlocal agreement entered into
23  pursuant to chapter 163, the governing body of the charter
24  county may distribute proceeds from the tax to a municipality,
25  or an expressway or transportation authority created by law to
26  be expended for the purpose authorized by this paragraph.
27         (2)  LOCAL GOVERNMENT INFRASTRUCTURE SURTAX.--
28         (a)1.  The governing authority in each county may levy
29  a discretionary sales surtax of 0.5 percent or 1 percent.  The
30  levy of the surtax shall be pursuant to ordinance enacted by a
31  majority of the members of the county governing authority and
                                  3
CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                                   SB 456
    21-624-04                                            See HB 43
 1  approved by a majority of the electors of the county voting in
 2  a referendum on the surtax.  If the governing bodies of the
 3  municipalities representing a majority of the county's
 4  population adopt uniform resolutions establishing the rate of
 5  the surtax and calling for a referendum on the surtax, the
 6  levy of the surtax shall be placed on the ballot and shall
 7  take effect if approved by a majority of the electors of the
 8  county voting in the referendum on the surtax.
 9         2.  If the surtax was levied pursuant to a referendum
10  held before July 1, 1993, the surtax may not be levied beyond
11  the time established in the ordinance, or, if the ordinance
12  did not limit the period of the levy, the surtax may not be
13  levied for more than 15 years. The levy of such surtax may be
14  extended only by approval of a majority of the electors of the
15  county voting in a referendum on the surtax.
16         (b)  A statement which includes a brief general
17  description of the projects to be funded by the surtax and
18  which conforms to the requirements of s. 101.161 shall be
19  placed on the ballot by the governing authority of any county
20  which enacts an ordinance calling for a referendum on the levy
21  of the surtax or in which the governing bodies of the
22  municipalities representing a majority of the county's
23  population adopt uniform resolutions calling for a referendum
24  on the surtax.  The following question shall be placed on the
25  ballot:
26  
27        ....FOR the               ....-cent sales tax
28        ....AGAINST the           ....-cent sales tax
29  
30         (c)  Pursuant to s. 212.054(4), the proceeds of the
31  surtax levied under this subsection shall be distributed to
                                  4
CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                                   SB 456
    21-624-04                                            See HB 43
 1  the county and the municipalities within such county in which
 2  the surtax was collected, according to:
 3         1.  An interlocal agreement between the county
 4  governing authority and the governing bodies of the
 5  municipalities representing a majority of the county's
 6  municipal population, which agreement may include a school
 7  district with the consent of the county governing authority
 8  and the governing bodies of the municipalities representing a
 9  majority of the county's municipal population; or
10         2.  If there is no interlocal agreement, according to
11  the formula provided in s. 218.62.
12  
13  Any change in the distribution formula must take effect on the
14  first day of any month that begins at least 60 days after
15  written notification of that change has been made to the
16  department.
17         (d)1.  The proceeds of the surtax authorized by this
18  subsection and any interest accrued thereto shall be expended
19  by the school district or within the county and municipalities
20  within the county, or, in the case of a negotiated joint
21  county agreement, within another county, to finance, plan, and
22  construct infrastructure and to acquire land for public
23  recreation or conservation or protection of natural resources
24  and to finance the closure of county-owned or municipally
25  owned solid waste landfills that are already closed or are
26  required to close by order of the Department of Environmental
27  Protection. Any use of such proceeds or interest for purposes
28  of landfill closure prior to July 1, 1993, is ratified.
29  Neither the proceeds nor any interest accrued thereto shall be
30  used for operational expenses of any infrastructure, except
31  that any county with a population of less than 75,000 that is
                                  5
CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                                   SB 456
    21-624-04                                            See HB 43
 1  required to close a landfill by order of the Department of
 2  Environmental Protection may use the proceeds or any interest
 3  accrued thereto for long-term maintenance costs associated
 4  with landfill closure. Counties, as defined in s. 125.011(1),
 5  and charter counties may, in addition, use the proceeds and
 6  any interest accrued thereto to retire or service indebtedness
 7  incurred for bonds issued prior to July 1, 1987, for
 8  infrastructure purposes, and for bonds subsequently issued to
 9  refund such bonds. Any use of such proceeds or interest for
10  purposes of retiring or servicing indebtedness incurred for
11  such refunding bonds prior to July 1, 1999, is ratified.
12         2.  For the purposes of this paragraph,
13  "infrastructure" means:
14         a.  Any fixed capital expenditure or fixed capital
15  outlay associated with the construction, reconstruction, or
16  improvement of public facilities which have a life expectancy
17  of 5 or more years and any land acquisition, land improvement,
18  design, and engineering costs related thereto.
19         b.  A fire department vehicle, an emergency medical
20  service vehicle, a sheriff's office vehicle, a police
21  department vehicle, or any other vehicle, and such equipment
22  necessary to outfit the vehicle for its official use or
23  equipment that has a life expectancy of at least 5 years.
24         c.  Any expenditure for the construction, lease, or
25  maintenance of, or provision of utilities or security for,
26  facilities as defined in s. 29.008.
27         3.  Notwithstanding any other provision of this
28  subsection, a discretionary sales surtax imposed or extended
29  after the effective date of this act may provide for an amount
30  not to exceed 15 percent of the local option sales surtax
31  proceeds to be allocated for deposit to a trust fund within
                                  6
CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                                   SB 456
    21-624-04                                            See HB 43
 1  the county's accounts created for the purpose of funding
 2  economic development projects of a general public purpose
 3  targeted to improve local economies, including the funding of
 4  operational costs and incentives related to such economic
 5  development. The ballot statement must indicate the intention
 6  to make an allocation under the authority of this
 7  subparagraph.
 8         (e)  School districts, counties, and municipalities
 9  receiving proceeds under the provisions of this subsection may
10  pledge such proceeds for the purpose of servicing new bond
11  indebtedness incurred pursuant to law. Local governments may
12  use the services of the Division of Bond Finance of the State
13  Board of Administration pursuant to the State Bond Act to
14  issue any bonds through the provisions of this subsection.  In
15  no case may a jurisdiction issue bonds pursuant to this
16  subsection more frequently than once per year. Counties and
17  municipalities may join together for the issuance of bonds
18  authorized by this subsection.
19         (f)1.  Notwithstanding paragraph (d), a county that has
20  a population of 50,000 or less on April 1, 1992, or any county
21  designated as an area of critical state concern on the
22  effective date of this act, and that imposed the surtax before
23  July 1, 1992, may use the proceeds and interest of the surtax
24  for any public purpose if:
25         a.  The debt service obligations for any year are met;
26         b.  The county's comprehensive plan has been determined
27  to be in compliance with part II of chapter 163; and
28         c.  The county has adopted an amendment to the surtax
29  ordinance pursuant to the procedure provided in s. 125.66
30  authorizing additional uses of the surtax proceeds and
31  interest.
                                  7
CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                                   SB 456
    21-624-04                                            See HB 43
 1         2.  A municipality located within a county that has a
 2  population of 50,000 or less on April 1, 1992, or within a
 3  county designated as an area of critical state concern on the
 4  effective date of this act, and that imposed the surtax before
 5  July 1, 1992, may not use the proceeds and interest of the
 6  surtax for any purpose other than an infrastructure purpose
 7  authorized in paragraph (d) unless the municipality's
 8  comprehensive plan has been determined to be in compliance
 9  with part II of chapter 163 and the municipality has adopted
10  an amendment to its surtax ordinance or resolution pursuant to
11  the procedure provided in s. 166.041 authorizing additional
12  uses of the surtax proceeds and interest.  Such municipality
13  may expend the surtax proceeds and interest for any public
14  purpose authorized in the amendment.
15         3.  Those counties designated as an area of critical
16  state concern which qualify to use the surtax for any public
17  purpose may use only up to 10 percent of the surtax proceeds
18  for any public purpose other than for infrastructure purposes
19  authorized by this section.
20         (g)  Notwithstanding paragraph (d), a county in which
21  40 percent or more of the just value of real property is
22  exempt or immune from ad valorem taxation, and the
23  municipalities within such a county, may use the proceeds and
24  interest of the surtax for operation and maintenance of parks
25  and recreation programs and facilities established with the
26  proceeds of the surtax.
27         (h)  Notwithstanding any other provision of this
28  section, a county shall not levy local option sales surtaxes
29  authorized in this subsection and subsections (3), (4), and
30  (5) in excess of a combined rate of 1 percent.
31         (3)  SMALL COUNTY SURTAX.--
                                  8
CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                                   SB 456
    21-624-04                                            See HB 43
 1         (a)  The governing authority in each county that has a
 2  population of 50,000 or less on April 1, 1992, may levy a
 3  discretionary sales surtax of 0.5 percent or 1 percent.  The
 4  levy of the surtax shall be pursuant to ordinance enacted by
 5  an extraordinary vote of the members of the county governing
 6  authority if the surtax revenues are expended for operating
 7  purposes.  If the surtax revenues are expended for the purpose
 8  of servicing bond indebtedness, the surtax shall be approved
 9  by a majority of the electors of the county voting in a
10  referendum on the surtax.
11         (b)  A statement that includes a brief general
12  description of the projects to be funded by the surtax and
13  conforms to the requirements of s. 101.161 shall be placed on
14  the ballot by the governing authority of any county that
15  enacts an ordinance calling for a referendum on the levy of
16  the surtax for the purpose of servicing bond indebtedness.
17  The following question shall be placed on the ballot:
18  
19        ....FOR the               ....-cent sales tax
20        ....AGAINST the           ....-cent sales tax
21  
22         (c)  Pursuant to s. 212.054(4), the proceeds of the
23  surtax levied under this subsection shall be distributed to
24  the county and the municipalities within the county in which
25  the surtax was collected, according to:
26         1.  An interlocal agreement between the county
27  governing authority and the governing bodies of the
28  municipalities representing a majority of the county's
29  municipal population, which agreement may include a school
30  district with the consent of the county governing authority
31  
                                  9
CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                                   SB 456
    21-624-04                                            See HB 43
 1  and the governing bodies of the municipalities representing a
 2  majority of the county's municipal population; or
 3         2.  If there is no interlocal agreement, according to
 4  the formula provided in s. 218.62.
 5  
 6  Any change in the distribution formula shall take effect on
 7  the first day of any month that begins at least 60 days after
 8  written notification of that change has been made to the
 9  department.
10         (d)1.  If the surtax is levied pursuant to a
11  referendum, the proceeds of the surtax and any interest
12  accrued thereto may be expended by the school district or
13  within the county and municipalities within the county, or, in
14  the case of a negotiated joint county agreement, within
15  another county, for the purpose of servicing bond indebtedness
16  to finance, plan, and construct infrastructure and to acquire
17  land for public recreation or conservation or protection of
18  natural resources.  However, if the surtax is levied pursuant
19  to an ordinance approved by an extraordinary vote of the
20  members of the county governing authority, the proceeds and
21  any interest accrued thereto may be used for operational
22  expenses of any infrastructure or for any public purpose
23  authorized in the ordinance under which the surtax is levied.
24         2.  For the purposes of this paragraph,
25  "infrastructure" means any fixed capital expenditure or fixed
26  capital costs associated with the construction,
27  reconstruction, or improvement of public facilities that have
28  a life expectancy of 5 or more years and any land acquisition,
29  land improvement, design, and engineering costs related
30  thereto.
31  
                                  10
CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                                   SB 456
    21-624-04                                            See HB 43
 1         (e)  A school district, county, or municipality that
 2  receives proceeds under this subsection following a referendum
 3  may pledge the proceeds for the purpose of servicing new bond
 4  indebtedness incurred pursuant to law. Local governments may
 5  use the services of the Division of Bond Finance pursuant to
 6  the State Bond Act to issue any bonds through the provisions
 7  of this subsection.  A jurisdiction may not issue bonds
 8  pursuant to this subsection more frequently than once per
 9  year.  A county and municipality may join together to issue
10  bonds authorized by this subsection.
11         (f)  Notwithstanding any other provision of this
12  section, a county shall not levy local option sales surtaxes
13  authorized in this subsection and subsections (2), (4), and
14  (5) in excess of a combined rate of 1 percent.
15         (4)  INDIGENT CARE AND TRAUMA CENTER SURTAX.--
16         (a)  The governing body in each county the government
17  of which is not consolidated with that of one or more
18  municipalities, which has a population of at least 800,000
19  residents and is not authorized to levy a surtax under
20  subsection (5), may levy, pursuant to an ordinance either
21  approved by an extraordinary vote of the governing body or
22  conditioned to take effect only upon approval by a majority
23  vote of the electors of the county voting in a referendum, a
24  discretionary sales surtax at a rate that may not exceed 0.5
25  percent.
26         (b)  If the ordinance is conditioned on a referendum, a
27  statement that includes a brief and general description of the
28  purposes to be funded by the surtax and that conforms to the
29  requirements of s. 101.161 shall be placed on the ballot by
30  the governing body of the county.  The following questions
31  shall be placed on the ballot:
                                  11
CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                                   SB 456
    21-624-04                                            See HB 43
 1  
 2                     FOR THE. . . .CENTS TAX
 3                   AGAINST THE. . . .CENTS TAX
 4  
 5         (c)  The ordinance adopted by the governing body
 6  providing for the imposition of the surtax shall set forth a
 7  plan for providing health care services to qualified
 8  residents, as defined in paragraph (d).  Such plan and
 9  subsequent amendments to it shall fund a broad range of health
10  care services for both indigent persons and the medically
11  poor, including, but not limited to, primary care and
12  preventive care as well as hospital care. The plan must also
13  address the services to be provided by the Level I trauma
14  center. It shall emphasize a continuity of care in the most
15  cost-effective setting, taking into consideration both a high
16  quality of care and geographic access. Where consistent with
17  these objectives, it shall include, without limitation,
18  services rendered by physicians, clinics, community hospitals,
19  mental health centers, and alternative delivery sites, as well
20  as at least one regional referral hospital where appropriate.
21  It shall provide that agreements negotiated between the county
22  and providers, including hospitals with a Level I trauma
23  center, will include reimbursement methodologies that take
24  into account the cost of services rendered to eligible
25  patients, recognize hospitals that render a disproportionate
26  share of indigent care, provide other incentives to promote
27  the delivery of charity care, promote the advancement of
28  technology in medical services, recognize the level of
29  responsiveness to medical needs in trauma cases, and require
30  cost containment including, but not limited to, case
31  management. It must also provide that any hospitals that are
                                  12
CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                                   SB 456
    21-624-04                                            See HB 43
 1  owned and operated by government entities on May 21, 1991,
 2  must, as a condition of receiving funds under this subsection,
 3  afford public access equal to that provided under s. 286.011
 4  as to meetings of the governing board, the subject of which is
 5  budgeting resources for the rendition of charity care as that
 6  term is defined in the Florida Hospital Uniform Reporting
 7  System (FHURS) manual referenced in s. 408.07.  The plan shall
 8  also include innovative health care programs that provide
 9  cost-effective alternatives to traditional methods of service
10  delivery and funding.
11         (d)  For the purpose of this subsection, the term
12  "qualified resident" means residents of the authorizing county
13  who are:
14         1.  Qualified as indigent persons as certified by the
15  authorizing county;
16         2.  Certified by the authorizing county as meeting the
17  definition of the medically poor, defined as persons having
18  insufficient income, resources, and assets to provide the
19  needed medical care without using resources required to meet
20  basic needs for shelter, food, clothing, and personal
21  expenses; or not being eligible for any other state or federal
22  program, or having medical needs that are not covered by any
23  such program; or having insufficient third-party insurance
24  coverage.  In all cases, the authorizing county is intended to
25  serve as the payor of last resort; or
26         3.  Participating in innovative, cost-effective
27  programs approved by the authorizing county.
28         (e)  Moneys collected pursuant to this subsection
29  remain the property of the state and shall be distributed by
30  the Department of Revenue on a regular and periodic basis to
31  the clerk of the circuit court as ex officio custodian of the
                                  13
CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                                   SB 456
    21-624-04                                            See HB 43
 1  funds of the authorizing county. The clerk of the circuit
 2  court shall:
 3         1.  Maintain the moneys in an indigent health care
 4  trust fund;
 5         2.  Invest any funds held on deposit in the trust fund
 6  pursuant to general law;
 7         3.  Disburse the funds, including any interest earned,
 8  to any provider of health care services, as provided in
 9  paragraphs (c) and (d), upon directive from the authorizing
10  county. However, if a county has a population of at least
11  800,000 residents and has levied the surtax authorized in this
12  subsection, notwithstanding any directive from the authorizing
13  county, on October 1 of each calendar year, the clerk of the
14  court shall issue a check in the amount of $6.5 million to a
15  hospital in its jurisdiction that has a Level I trauma center
16  or shall issue a check in the amount of $3.5 million to a
17  hospital in its jurisdiction that has a Level I trauma center
18  if that county enacts and implements a hospital lien law in
19  accordance with chapter 98-499, Laws of Florida. The issuance
20  of the checks on October 1 of each year is provided in
21  recognition of the Level I trauma center status and shall be
22  in addition to the base contract amount received during fiscal
23  year 1999-2000 and any additional amount negotiated to the
24  base contract. If the hospital receiving funds for its Level I
25  trauma center status requests such funds to be used to
26  generate federal matching funds under Medicaid, the clerk of
27  the court shall instead issue a check to the Agency for Health
28  Care Administration to accomplish that purpose to the extent
29  that it is allowed through the General Appropriations Act; and
30         4.  Prepare on a biennial basis an audit of the trust
31  fund specified in subparagraph 1. Commencing February 1, 2004,
                                  14
CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                                   SB 456
    21-624-04                                            See HB 43
 1  such audit shall be delivered to the governing body and to the
 2  chair of the legislative delegation of each authorizing
 3  county.
 4         (f)  Notwithstanding any other provision of this
 5  section, a county shall not levy local option sales surtaxes
 6  authorized in this subsection and subsections (2) and (3) in
 7  excess of a combined rate of 1 percent.
 8         (5)  COUNTY PUBLIC HOSPITAL SURTAX.--Any county as
 9  defined in s. 125.011(1) may levy the surtax authorized in
10  this subsection pursuant to an ordinance either approved by
11  extraordinary vote of the county commission or conditioned to
12  take effect only upon approval by a majority vote of the
13  electors of the county voting in a referendum.  In a county as
14  defined in s. 125.011(1), for the purposes of this subsection,
15  "county public general hospital" means a general hospital as
16  defined in s. 395.002 which is owned, operated, maintained, or
17  governed by the county or its agency, authority, or public
18  health trust.
19         (a)  The rate shall be 0.5 percent.
20         (b)  If the ordinance is conditioned on a referendum,
21  the proposal to adopt the county public hospital surtax shall
22  be placed on the ballot in accordance with law at a time to be
23  set at the discretion of the governing body.  The referendum
24  question on the ballot shall include a brief general
25  description of the health care services to be funded by the
26  surtax.
27         (c)  Proceeds from the surtax shall be:
28         1.  Deposited by the county in a special fund, set
29  aside from other county funds, to be used only for the
30  operation, maintenance, and administration of the county
31  public general hospital; and
                                  15
CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                                   SB 456
    21-624-04                                            See HB 43
 1         2.  Remitted promptly by the county to the agency,
 2  authority, or public health trust created by law which
 3  administers or operates the county public general hospital.
 4         (d)  Except as provided in subparagraphs 1. and 2., the
 5  county must continue to contribute each year an amount equal
 6  to at least 80 percent of that percentage of the total county
 7  budget appropriated for the operation, administration, and
 8  maintenance of the county public general hospital from the
 9  county's general revenues in the fiscal year of the county
10  ending September 30, 1991:
11         1.  Twenty-five percent of such amount must be remitted
12  to a governing board, agency, or authority that is wholly
13  independent from the public health trust, agency, or authority
14  responsible for the county public general hospital, to be used
15  solely for the purpose of funding the plan for indigent health
16  care services provided for in paragraph (e);
17         2.  However, in the first year of the plan, a total of
18  $10 million shall be remitted to such governing board, agency,
19  or authority, to be used solely for the purpose of funding the
20  plan for indigent health care services provided for in
21  paragraph (e), and in the second year of the plan, a total of
22  $15 million shall be so remitted and used.
23         (e)  A governing board, agency, or authority shall be
24  chartered by the county commission upon this act becoming law.
25  The governing board, agency, or authority shall adopt and
26  implement a health care plan for indigent health care
27  services.  The governing board, agency, or authority shall
28  consist of no more than seven and no fewer than five members
29  appointed by the county commission.  The members of the
30  governing board, agency, or authority shall be at least 18
31  years of age and residents of the county.  No member may be
                                  16
CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                                   SB 456
    21-624-04                                            See HB 43
 1  employed by or affiliated with a health care provider or the
 2  public health trust, agency, or authority responsible for the
 3  county public general hospital. The following community
 4  organizations shall each appoint a representative to a
 5  nominating committee:  the South Florida Hospital and
 6  Healthcare Association, the Miami-Dade County Public Health
 7  Trust, the Dade County Medical Association, the Miami-Dade
 8  County Homeless Trust, and the Mayor of Miami-Dade County.
 9  This committee shall nominate between 10 and 14 county
10  citizens for the governing board, agency, or authority.  The
11  slate shall be presented to the county commission and the
12  county commission shall confirm the top five to seven
13  nominees, depending on the size of the governing board.  Until
14  such time as the governing board, agency, or authority is
15  created, the funds provided for in subparagraph (d)2. shall be
16  placed in a restricted account set aside from other county
17  funds and not disbursed by the county for any other purpose.
18         1.  The plan shall divide the county into a minimum of
19  four and maximum of six service areas, with no more than one
20  participant hospital per service area. The county public
21  general hospital shall be designated as the provider for one
22  of the service areas.  Services shall be provided through
23  participants' primary acute care facilities.
24         2.  The plan and subsequent amendments to it shall fund
25  a defined range of health care services for both indigent
26  persons and the medically poor, including primary care,
27  preventive care, hospital emergency room care, and hospital
28  care necessary to stabilize the patient. For the purposes of
29  this section, "stabilization" means stabilization as defined
30  in s. 397.311(29). Where consistent with these objectives, the
31  plan may include services rendered by physicians, clinics,
                                  17
CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                                   SB 456
    21-624-04                                            See HB 43
 1  community hospitals, and alternative delivery sites, as well
 2  as at least one regional referral hospital per service area.
 3  The plan shall provide that agreements negotiated between the
 4  governing board, agency, or authority and providers shall
 5  recognize hospitals that render a disproportionate share of
 6  indigent care, provide other incentives to promote the
 7  delivery of charity care to draw down federal funds where
 8  appropriate, and require cost containment, including, but not
 9  limited to, case management. From the funds specified in
10  subparagraphs (d)1. and 2. for indigent health care services,
11  service providers shall receive reimbursement at a Medicaid
12  rate to be determined by the governing board, agency, or
13  authority created pursuant to this paragraph for the initial
14  emergency room visit, and a per-member per-month fee or
15  capitation for those members enrolled in their service area,
16  as compensation for the services rendered following the
17  initial emergency visit. Except for provisions of emergency
18  services, upon determination of eligibility, enrollment shall
19  be deemed to have occurred at the time services were rendered.
20  The provisions for specific reimbursement of emergency
21  services shall be repealed on July 1, 2001, unless otherwise
22  reenacted by the Legislature. The capitation amount or rate
23  shall be determined prior to program implementation by an
24  independent actuarial consultant. In no event shall such
25  reimbursement rates exceed the Medicaid rate. The plan must
26  also provide that any hospitals owned and operated by
27  government entities on or after the effective date of this act
28  must, as a condition of receiving funds under this subsection,
29  afford public access equal to that provided under s. 286.011
30  as to any meeting of the governing board, agency, or authority
31  the subject of which is budgeting resources for the retention
                                  18
CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                                   SB 456
    21-624-04                                            See HB 43
 1  of charity care, as that term is defined in the rules of the
 2  Agency for Health Care Administration. The plan shall also
 3  include innovative health care programs that provide
 4  cost-effective alternatives to traditional methods of service
 5  and delivery funding.
 6         3.  The plan's benefits shall be made available to all
 7  county residents currently eligible to receive health care
 8  services as indigents or medically poor as defined in
 9  paragraph (4)(d).
10         4.  Eligible residents who participate in the health
11  care plan shall receive coverage for a period of 12 months or
12  the period extending from the time of enrollment to the end of
13  the current fiscal year, per enrollment period, whichever is
14  less.
15         5.  At the end of each fiscal year, the governing
16  board, agency, or authority shall prepare an audit that
17  reviews the budget of the plan, delivery of services, and
18  quality of services, and makes recommendations to increase the
19  plan's efficiency.  The audit shall take into account
20  participant hospital satisfaction with the plan and assess the
21  amount of poststabilization patient transfers requested, and
22  accepted or denied, by the county public general hospital.
23         (f)  Notwithstanding any other provision of this
24  section, a county may not levy local option sales surtaxes
25  authorized in this subsection and subsections (2) and (3) in
26  excess of a combined rate of 1 percent.
27         (6)  SCHOOL CAPITAL OUTLAY SURTAX.--
28         (a)1.  The school board in each county may levy,
29  pursuant to resolution conditioned to take effect only upon
30  approval by a majority vote of the electors of the county
31  
                                  19
CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                                   SB 456
    21-624-04                                            See HB 43
 1  voting in a referendum, a discretionary sales surtax at a rate
 2  that may not exceed 0.5 percent.
 3         2.(b)  The resolution shall include a statement that
 4  provides a brief and general description of the school capital
 5  outlay projects to be funded by the surtax. If applicable, the
 6  resolution must state that the district school board has been
 7  recognized by the State Board of Education as having a Florida
 8  Frugal Schools Program. The statement shall conform to the
 9  requirements of s. 101.161 and shall be placed on the ballot
10  by the governing body of the county. The following question
11  shall be placed on the ballot:
12  
13        ....FOR THE               ....CENTS TAX
14        ....AGAINST THE           ....CENTS TAX
15  
16         3.(c)  The resolution providing for the imposition of
17  the surtax shall set forth a plan for use of the surtax
18  proceeds for fixed capital expenditures or fixed capital costs
19  associated with the construction, reconstruction, or
20  improvement of school facilities and campuses which have a
21  useful life expectancy of 5 or more years, and any land
22  acquisition, land improvement, design, and engineering costs
23  related thereto. Additionally, the plan shall include the
24  costs of retrofitting and providing for technology
25  implementation, including hardware and software, for the
26  various sites within the school district. Surtax revenues may
27  be used for the purpose of servicing bond indebtedness to
28  finance projects authorized by this subsection, and any
29  interest accrued thereto may be held in trust to finance such
30  projects. Neither the proceeds of the surtax nor any interest
31  accrued thereto shall be used for operational expenses. If the
                                  20
CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                                   SB 456
    21-624-04                                            See HB 43
 1  district school board has been recognized by the State Board
 2  of Education as having a Florida Frugal Schools Program, the
 3  district's plan for use of the surtax proceeds must be
 4  consistent with this subsection and with uses assured under
 5  the Florida Frugal Schools Program.
 6         4.(d)  Any school board imposing the surtax shall
 7  implement a freeze on noncapital local school property taxes,
 8  at the millage rate imposed in the year prior to the
 9  implementation of the surtax, for a period of at least 3 years
10  from the date of imposition of the surtax. This provision
11  shall not apply to existing debt service or required state
12  taxes.
13         5.(e)  Surtax revenues collected by the Department of
14  Revenue pursuant to this subsection shall be distributed to
15  the school board imposing the surtax in accordance with law.
16         (b)1.  Notwithstanding the provisions of paragraph (a),
17  the school board in any county may use up to 50 percent of the
18  revenues generated by the surtax for operational purposes
19  solely for salaries and benefits for teachers. However, in
20  addition to the requirements of paragraph (a), the resolution
21  providing for the imposition of the surtax shall specify the
22  percentage of surtax revenues to be used solely for salaries
23  and benefits for teachers as authorized by this paragraph. The
24  plan setting forth the use of surtax proceeds shall include
25  uses solely for salaries and benefits for teachers. The plan
26  shall provide criteria to account for use of proceeds solely
27  for salaries and benefits for teachers and shall provide for
28  an annual report by the school board documenting such use.
29         2.  The school board of any county which has levied the
30  surtax authorized in this subsection before July 1, 2004, and
31  wishes to use a percentage of surtax revenues solely for
                                  21
CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                                   SB 456
    21-624-04                                            See HB 43
 1  salaries and benefits for teachers as provided in this
 2  paragraph may do so only pursuant to a new resolution
 3  conditioned to take effect only upon approval by a majority
 4  vote of the electors of the county voting in a referendum as
 5  provided in subparagraph (a)2. However, the amount of surtax
 6  revenues authorized for use solely for salaries and benefits
 7  for teachers under this subparagraph shall be available only
 8  to the extent such revenues are not otherwise dedicated to
 9  service bond indebtedness in such counties as provided in
10  paragraph (a), if applicable.
11         3.  This paragraph is repealed July 1, 2008.
12         (7)  VOTER-APPROVED INDIGENT CARE SURTAX.--
13         (a)  The governing body in each county that has a
14  population of less than 800,000 residents may levy an indigent
15  care surtax pursuant to an ordinance conditioned to take
16  effect only upon approval by a majority vote of the electors
17  of the county voting in a referendum. The surtax may be levied
18  at a rate not to exceed 0.5 percent, except that if a publicly
19  supported medical school is located in the county, the rate
20  shall not exceed 1 percent.
21         (b)  A statement that includes a brief and general
22  description of the purposes to be funded by the surtax and
23  that conforms to the requirements of s. 101.161 shall be
24  placed on the ballot by the governing body of the county. The
25  following questions shall be placed on the ballot:
26  
27                     FOR THE. . . .CENTS TAX
28                   AGAINST THE. . . .CENTS TAX
29  
30         (c)  The ordinance adopted by the governing body
31  providing for the imposition of the surtax must set forth a
                                  22
CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                                   SB 456
    21-624-04                                            See HB 43
 1  plan for providing health care services to qualified
 2  residents, as defined in paragraph (d). The plan and
 3  subsequent amendments to it shall fund a broad range of health
 4  care services for indigent persons and the medically poor,
 5  including, but not limited to, primary care and preventive
 6  care, as well as hospital care. It shall emphasize a
 7  continuity of care in the most cost-effective setting, taking
 8  into consideration a high quality of care and geographic
 9  access. Where consistent with these objectives, it shall
10  include, without limitation, services rendered by physicians,
11  clinics, community hospitals, mental health centers, and
12  alternative delivery sites, as well as at least one regional
13  referral hospital where appropriate. It shall provide that
14  agreements negotiated between the county and providers shall
15  include reimbursement methodologies that take into account the
16  cost of services rendered to eligible patients, recognize
17  hospitals that render a disproportionate share of indigent
18  care, provide other incentives to promote the delivery of
19  charity care, and require cost containment, including, but not
20  limited to, case management. The plan must also include
21  innovative health care programs that provide cost-effective
22  alternatives to traditional methods of service delivery and
23  funding.
24         (d)  For the purpose of this subsection, "qualified
25  residents" means residents of the authorizing county who are:
26         1.  Qualified as indigent persons as certified by the
27  authorizing county;
28         2.  Certified by the authorizing county as meeting the
29  definition of the medically poor, defined as persons having
30  insufficient income, resources, and assets to provide the
31  needed medical care without using resources required to meet
                                  23
CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                                   SB 456
    21-624-04                                            See HB 43
 1  basic needs for shelter, food, clothing, and personal
 2  expenses; not being eligible for any other state or federal
 3  program or having medical needs that are not covered by any
 4  such program; or having insufficient third-party insurance
 5  coverage. In all cases, the authorizing county shall serve as
 6  the payor of last resort; or
 7         3.  Participating in innovative, cost-effective
 8  programs approved by the authorizing county.
 9         (e)  Moneys collected pursuant to this subsection
10  remain the property of the state and shall be distributed by
11  the Department of Revenue on a regular and periodic basis to
12  the clerk of the circuit court as ex officio custodian of the
13  funds of the authorizing county. The clerk of the circuit
14  court shall:
15         1.  Maintain the moneys in an indigent health care
16  trust fund.
17         2.  Invest any funds held on deposit in the trust fund
18  pursuant to general law.
19         3.  Disburse the funds, including any interest earned,
20  to any provider of health care services, as provided in
21  paragraphs (c) and (d), upon directive from the authorizing
22  county.
23         (f)  Notwithstanding any other provision of this
24  section, a county may not levy local option sales surtaxes
25  authorized in this subsection and subsections (2) and (3) in
26  excess of a combined rate of 1 percent or, if a publicly
27  supported medical school is located in the county, in excess
28  of a combined rate of 1.5 percent.
29         Section 2.  This act shall take effect July 1, 2004.
30  
31  
                                  24
CODING: Words stricken are deletions; words underlined are additions.