| 1 | Representative Kendrick offered the following: |
| 2 |
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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. |
| 133 |
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| 134 |
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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. |