HB 0055

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

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