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