Florida Senate - 2006 COMMITTEE AMENDMENT
Bill No. CS for SB 2312
Barcode 023236
CHAMBER ACTION
Senate House
.
.
1 Comm: RCS .
04/25/2006 10:28 AM .
2 .
.
3 .
.
4 ______________________________________________________________
5
6
7
8
9
10 ______________________________________________________________
11 The Committee on Government Efficiency Appropriations (Posey)
12 recommended the following amendment:
13
14 Senate Amendment (with directory and title amendments)
15 On page 8, between lines 13 and 14,
16
17 insert:
18 (7) VOTER-APPROVED INDIGENT CARE SURTAX.--
19 (a)1. The governing body in each county that has a
20 population of fewer than 800,000 residents may levy an
21 indigent care surtax pursuant to an ordinance conditioned to
22 take effect only upon approval by a majority vote of the
23 electors of the county voting in a referendum. The surtax may
24 be levied at a rate not to exceed 0.5 percent, except that if
25 a publicly supported medical school is located in the county,
26 the rate shall not exceed 1 percent.
27 2. Notwithstanding subparagraph 1., the governing body
28 in each county that has, as of April 1, 2004, an estimated
29 population of at least 300,000 but not more than 400,000
30 residents and levies the local government infrastructure
31 surtax at the rate of 1 percent, pursuant to subsection (2),
1
7:02 PM 04/20/06 s2312c1c-ge24-j01
Florida Senate - 2006 COMMITTEE AMENDMENT
Bill No. CS for SB 2312
Barcode 023236
1 may levy, by ordinance subject to approval by a majority vote
2 of the electors of the county voting in a referendum to be
3 held November 7, 2006, an indigent care surtax at a rate that
4 may not exceed 0.5 percent.
5 3.2. Notwithstanding subparagraphs 1. and 2.
6 subparagraph 1., the governing body of any county that has a
7 population of fewer than 50,000 residents may levy an indigent
8 care surtax pursuant to an ordinance conditioned to take
9 effect only upon approval by a majority vote of the electors
10 of the county voting in a referendum. The surtax may be levied
11 at a rate not to exceed 1 percent.
12 (b) A statement that includes a brief and general
13 description of the purposes to be funded by the surtax and
14 that conforms to the requirements of s. 101.161 shall be
15 placed on the ballot by the governing body of the county. The
16 following questions shall be placed on the ballot:
17
18 FOR THE. . . .CENTS TAX
19 AGAINST THE. . . .CENTS TAX
20
21 (c)1. The ordinance adopted by the governing body
22 providing for the imposition of the surtax must set forth a
23 plan for providing health care services to qualified
24 residents, as defined in paragraph (d). The plan and
25 subsequent amendments to it shall fund a broad range of health
26 care services for indigent persons and the medically poor,
27 including, but not limited to, primary care and preventive
28 care, as well as hospital care. It shall emphasize a
29 continuity of care in the most cost-effective setting, taking
30 into consideration a high quality of care and geographic
31 access. Where consistent with these objectives, it shall
2
7:02 PM 04/20/06 s2312c1c-ge24-j01
Florida Senate - 2006 COMMITTEE AMENDMENT
Bill No. CS for SB 2312
Barcode 023236
1 include, without limitation, services rendered by physicians,
2 clinics, community hospitals, mental health centers, and
3 alternative delivery sites, as well as at least one regional
4 referral hospital where appropriate. It shall provide that
5 agreements negotiated between the county and providers shall
6 include reimbursement methodologies that take into account the
7 cost of services rendered to eligible patients, recognize
8 hospitals that render a disproportionate share of indigent
9 care, provide other incentives to promote the delivery of
10 charity care, and require cost containment, including, but not
11 limited to, case management. The plan must also include
12 innovative health care programs that provide cost-effective
13 alternatives to traditional methods of service delivery and
14 funding.
15 2. In addition to the uses specified or services
16 required to be provided under this subsection, the ordinance
17 adopted by a county that has a population of fewer than 50,000
18 residents may pledge surtax proceeds to service new or
19 existing bond indebtedness incurred to finance, plan,
20 construct, or reconstruct a public or not-for-profit hospital
21 in such county and any land acquisition, land improvement,
22 design, or engineering costs related to such hospital, if the
23 governing body of the county determines that a public or
24 not-for-profit hospital existing at the time of issuance of
25 the bonds authorized under this subparagraph would, more
26 likely than not, otherwise cease to operate. The plan required
27 under this paragraph may, by an extraordinary vote of the
28 governing body of such county, provide that some or all of the
29 surtax revenues and any interest earned must be expended for
30 the purpose of servicing such bond indebtedness. Such county
31 may also use the services of the Division of Bond Finance of
3
7:02 PM 04/20/06 s2312c1c-ge24-j01
Florida Senate - 2006 COMMITTEE AMENDMENT
Bill No. CS for SB 2312
Barcode 023236
1 the State Board of Administration pursuant to the State Bond
2 Act to issue bonds under this subparagraph. A jurisdiction may
3 not issue bonds under this subparagraph more frequently than
4 once per year. Any county that has a population of fewer than
5 50,000 residents at the time any bonds authorized in this
6 subparagraph are issued retains the authority granted under
7 this subparagraph throughout the terms of such bonds,
8 including the term of any refinancing bonds, regardless of any
9 subsequent increase in population which would result in such
10 county having 50,000 or more residents.
11 (d) For the purpose of this subsection, the term
12 "qualified residents" means residents of the authorizing
13 county 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; 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 shall serve as
25 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
4
7:02 PM 04/20/06 s2312c1c-ge24-j01
Florida Senate - 2006 COMMITTEE AMENDMENT
Bill No. CS for SB 2312
Barcode 023236
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.
11 4. Disburse the funds, including any interest earned,
12 to service any bond indebtedness authorized in this subsection
13 upon directive from the authorizing county, which directive
14 may be irrevocably given at the time the bond indebtedness is
15 incurred.
16 (f) Notwithstanding any other provision of this
17 section, a county may not levy local option sales surtaxes
18 authorized in subparagraph (a)2. this subsection and
19 subsections (2) and (3) in excess of a combined rate of 1.5
20 percent.
21 (g) Notwithstanding any other provision of this
22 section, a county may not levy local option sales surtaxes
23 authorized in subparagraphs (a)1. and 3. and subsections (2)
24 and (3) in excess of a combined rate of 1 percent or, if a
25 publicly supported medical school is located in the county or
26 the county has a population of fewer than 50,000 residents, in
27 excess of a combined rate of 1.5 percent.
28
29
30 ==== D I R E C T O R Y C L A U S E A M E N D M E N T ====
31 And the directory clause is amended as follows:
5
7:02 PM 04/20/06 s2312c1c-ge24-j01
Florida Senate - 2006 COMMITTEE AMENDMENT
Bill No. CS for SB 2312
Barcode 023236
1 On page 2, line 1, delete that line
2
3 and insert:
4 Section 1. Subsections (1) and (7) and paragraph (e)
5 of
6
7
8 ================ T I T L E A M E N D M E N T ===============
9 And the title is amended as follows:
10 On page 1, line 29, after the semicolon,
11
12 insert:
13 authorizing the governing body of certain
14 counties to levy a voter-approved indigent care
15 surtax; providing conditions; prescribing the
16 maximum rate of the surtax; prescribing the
17 maximum rate of a combination of discretionary
18 sales surtaxes;
19
20
21
22
23
24
25
26
27
28
29
30
31
6
7:02 PM 04/20/06 s2312c1c-ge24-j01