Amendment
Bill No. CS/CS/HB 1205

Amendment No. 939405

CHAMBER ACTION
Senate		House
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1	Representative Wood offered the following:
2
3	Amendment (with title amendment)
4	Remove everything after the enacting clause and insert:
5	Section 1.  Section 212.055, Florida Statutes, is amended
6	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	Notwithstanding the provisions of this section, the maximum
19	aggregate rate for any county for the total of all discretionary
20	sales surtaxes imposed by this section is 1.5 percent. Taxable
21	transactions and administrative procedures shall be as provided
22	in s. 212.054.
23	(1)  CHARTER COUNTY TRANSPORTATION TRANSIT SYSTEM SURTAX.--
24	(a)  Each charter county that has which adopted a charter
25	prior to January 1, 1984, and each county the government of
26	which is consolidated with that of one or more municipalities,
27	may levy a discretionary sales surtax, subject to approval by a
28	majority vote of the electorate of the county or by a charter
29	amendment approved by a majority vote of the electorate of the
30	county.
31	(b)  The rate shall be up to 1 percent.
32	(c)  The proposal to adopt a discretionary sales surtax as
33	provided in this subsection and to create a trust fund within
34	the county accounts shall be placed on the ballot in accordance
35	with law at a time to be set at the discretion of the governing
36	body.
37	(d)  Proceeds from the surtax shall be applied to as many
38	or as few of the uses enumerated below in whatever combination
39	the county commission deems appropriate:
40	1.  Deposited by the county in the trust fund and shall be
41	used for the purposes of development, construction, equipment,
42	maintenance, operation, supportive services, including a
43	countywide bus system, and related costs of a fixed guideway
44	rapid transit system;
45	2.  Remitted by the governing body of the county to an
46	expressway, transit, or transportation authority created by law
47	to be used, at the discretion of such authority, for the
48	development, construction, operation, or maintenance of roads or
49	bridges in the county, for the operation and maintenance of a
50	bus system, for the payment of principal and interest on
51	existing bonds issued for the construction of such roads or
52	bridges, and, upon approval by the county commission, such
53	proceeds may be pledged for bonds issued to refinance existing
54	bonds or new bonds issued for the construction of such roads or
55	bridges;
56	3.  Used by the charter county for the development,
57	construction, operation, and maintenance of roads and bridges in
58	the county; for the expansion, operation, and maintenance of bus
59	and fixed guideway systems; and for the payment of principal and
60	interest on bonds issued for the construction of fixed guideway
61	rapid transit systems, bus systems, roads, or bridges; and such
62	proceeds may be pledged by the governing body of the county for
63	bonds issued to refinance existing bonds or new bonds issued for
64	the construction of such fixed guideway rapid transit systems,
65	bus systems, roads, or bridges and no more than 25 percent used
66	for nontransit uses; and
67	4.  Used by the charter county for the planning,
68	development, construction, operation, and maintenance of roads
69	and bridges in the county; for the planning, development,
70	expansion, operation, and maintenance of bus and fixed guideway
71	systems; and for the payment of principal and interest on bonds
72	issued for the construction of fixed guideway rapid transit
73	systems, bus systems, roads, or bridges; and such proceeds may
74	be pledged by the governing body of the county for bonds issued
75	to refinance existing bonds or new bonds issued for the
76	construction of such fixed guideway rapid transit systems, bus
77	systems, roads, or bridges. Pursuant to an interlocal agreement
78	entered into pursuant to chapter 163, the governing body of the
79	charter county may distribute proceeds from the tax to a
80	municipality, or an expressway or transportation authority
81	created by law to be expended for the purpose authorized by this
82	paragraph. Any charter county that has entered into interlocal
83	agreements for distribution of proceeds to one or more
84	municipalities in the county shall revise such interlocal
85	agreements no less than every 5 years in order to include any
86	municipalities that have been created since the prior interlocal
87	agreements were executed.
88	(2)  LOCAL GOVERNMENT INFRASTRUCTURE SURTAX.--
89	(a)1.  The governing authority in each county may levy a
90	discretionary sales surtax of 0.5 percent or 1 percent. The levy
91	of the surtax shall be pursuant to ordinance enacted by a
92	majority of the members of the county governing authority and
93	approved by a majority of the electors of the county voting in a
94	referendum on the surtax. If the governing bodies of the
95	municipalities representing a majority of the county's
96	population adopt uniform resolutions establishing the rate of
97	the surtax and calling for a referendum on the surtax, the levy
98	of the surtax shall be placed on the ballot and shall take
99	effect if approved by a majority of the electors of the county
100	voting in the referendum on the surtax.
101	2.  If the surtax was levied pursuant to a referendum held
102	before July 1, 1993, the surtax may not be levied beyond the
103	time established in the ordinance, or, if the ordinance did not
104	limit the period of the levy, the surtax may not be levied for
105	more than 15 years. The levy of such surtax may be extended only
106	by approval of a majority of the electors of the county voting
107	in a referendum on the surtax.
108	(b)  A statement which includes a brief general description
109	of the projects to be funded by the surtax and which conforms to
110	the requirements of s. 101.161 shall be placed on the ballot by
111	the governing authority of any county which enacts an ordinance
112	calling for a referendum on the levy of the surtax or in which
113	the governing bodies of the municipalities representing a
114	majority of the county's population adopt uniform resolutions
115	calling for a referendum on the surtax. The following question
116	shall be placed on the ballot:
117
	_____FOR the _____-cent sales tax
118
	_____AGAINST the _____-cent sales tax
119
120
121	(c)  Pursuant to s. 212.054(4), the proceeds of the surtax
122	levied under this subsection shall be distributed to the county
123	and the municipalities within such county in which the surtax
124	was collected, according to:
125	1.  An interlocal agreement between the county governing
126	authority and the governing bodies of the municipalities
127	representing a majority of the county's municipal population,
128	which agreement may include a school district with the consent
129	of the county governing authority and the governing bodies of
130	the municipalities representing a majority of the county's
131	municipal population; or
132	2.  If there is no interlocal agreement, according to the
133	formula provided in s. 218.62.
134
135	Any change in the distribution formula must take effect on the
136	first day of any month that begins at least 60 days after
137	written notification of that change has been made to the
138	department.
139	(d)1.  The proceeds of the surtax authorized by this
140	subsection and any interest accrued thereto shall be expended by
141	the school district or within the county and municipalities
142	within the county, or, in the case of a negotiated joint county
143	agreement, within another county, to finance, plan, and
144	construct infrastructure and to acquire land for public
145	recreation or conservation or protection of natural resources
146	and to finance the closure of county-owned or municipally owned
147	solid waste landfills that are already closed or are required to
148	close by order of the Department of Environmental Protection.
149	Any use of such proceeds or interest for purposes of landfill
150	closure prior to July 1, 1993, is ratified. Neither the proceeds
151	nor any interest accrued thereto shall be used for operational
152	expenses of any infrastructure, except that any county with a
153	population of less than 75,000 that is required to close a
154	landfill by order of the Department of Environmental Protection
155	may use the proceeds or any interest accrued thereto for long-
156	term maintenance costs associated with landfill closure.
157	Counties, as defined in s. 125.011(1), and charter counties may,
158	in addition, use the proceeds and any interest accrued thereto
159	to retire or service indebtedness incurred for bonds issued
160	prior to July 1, 1987, for infrastructure purposes, and for
161	bonds subsequently issued to refund such bonds. Any use of such
162	proceeds or interest for purposes of retiring or servicing
163	indebtedness incurred for such refunding bonds prior to July 1,
164	1999, is ratified.
165	2.  For the purposes of this paragraph, the term
166	"infrastructure" means:
167	a.  Any fixed capital expenditure or fixed capital outlay
168	associated with the construction, reconstruction, or improvement
169	of public facilities that have a life expectancy of 5 or more
170	years and any land acquisition, land improvement, design, and
171	engineering costs related thereto.
172	b.  A fire department vehicle, an emergency medical service
173	vehicle, a sheriff's office vehicle, a police department
174	vehicle, or any other vehicle, and such equipment necessary to
175	outfit the vehicle for its official use or equipment that has a
176	life expectancy of at least 5 years.
177	c.  Any expenditure for the construction, lease, or
178	maintenance of, or provision of utilities or security for,
179	facilities as defined in s. 29.008.
180	d.  Any fixed capital expenditure or fixed capital outlay
181	associated with the improvement of private facilities that have
182	a life expectancy of 5 or more years and that the owner agrees
183	to make available for use on a temporary basis as needed by a
184	local government as a public emergency shelter or a staging area
185	for emergency response equipment during an emergency officially
186	declared by the state or by the local government under s.
187	252.38. Such improvements under this sub-subparagraph are
188	limited to those necessary to comply with current standards for
189	public emergency evacuation shelters. The owner shall enter into
190	a written contract with the local government providing the
191	improvement funding to make such private facility available to
192	the public for purposes of emergency shelter at no cost to the
193	local government for a minimum period of 10 years after
194	completion of the improvement, with the provision that such
195	obligation will transfer to any subsequent owner until the end
196	of the minimum period.
197	3.  Notwithstanding any other provision of this subsection,
198	a discretionary sales surtax imposed or extended after the
199	effective date of this act may provide for an amount not to
200	exceed 15 percent of the local option sales surtax proceeds to
201	be allocated for deposit to a trust fund within the county's
202	accounts created for the purpose of funding economic development
203	projects of a general public purpose targeted to improve local
204	economies, including the funding of operational costs and
205	incentives related to such economic development. The ballot
206	statement must indicate the intention to make an allocation
207	under the authority of this subparagraph.
208	(e)  School districts, counties, and municipalities
209	receiving proceeds under the provisions of this subsection may
210	pledge such proceeds for the purpose of servicing new bond
211	indebtedness incurred pursuant to law. Local governments may use
212	the services of the Division of Bond Finance of the State Board
213	of Administration pursuant to the State Bond Act to issue any
214	bonds through the provisions of this subsection. Counties and
215	municipalities may join together for the issuance of bonds
216	authorized by this subsection.
217	(f)1.  Notwithstanding paragraph (d), a county that has a
218	population of 50,000 or less on April 1, 1992, or any county
219	designated as an area of critical state concern on the effective
220	date of this act, and that imposed the surtax before July 1,
221	1992, may use the proceeds and interest of the surtax for any
222	public purpose if:
223	a.  The debt service obligations for any year are met;
224	b.  The county's comprehensive plan has been determined to
225	be in compliance with part II of chapter 163; and
226	c.  The county has adopted an amendment to the surtax
227	ordinance pursuant to the procedure provided in s. 125.66
228	authorizing additional uses of the surtax proceeds and interest.
229	2.  A municipality located within a county that has a
230	population of 50,000 or less on April 1, 1992, or within a
231	county designated as an area of critical state concern on the
232	effective date of this act, and that imposed the surtax before
233	July 1, 1992, may not use the proceeds and interest of the
234	surtax for any purpose other than an infrastructure purpose
235	authorized in paragraph (d) unless the municipality's
236	comprehensive plan has been determined to be in compliance with
237	part II of chapter 163 and the municipality has adopted an
238	amendment to its surtax ordinance or resolution pursuant to the
239	procedure provided in s. 166.041 authorizing additional uses of
240	the surtax proceeds and interest. Such municipality may expend
241	the surtax proceeds and interest for any public purpose
242	authorized in the amendment.
243	3.  Those counties designated as an area of critical state
244	concern which qualify to use the surtax for any public purpose
245	may use only up to 10 percent of the surtax proceeds for any
246	public purpose other than for infrastructure purposes authorized
247	by this section. A county that was designated as an area of
248	critical state concern for at least 20 consecutive years prior
249	to removal of the designation, and that qualified to use the
250	surtax for any public purpose at the time of the removal of the
251	designation, may continue to use up to 10 percent of the surtax
252	proceeds for any public purpose other than for infrastructure
253	purposes for 20 years following removal of the designation,
254	notwithstanding subparagraph (a)2. After expiration of the 20-
255	year period, a county may continue to use up to 10 percent of
256	the surtax proceeds for any public purpose other than for
257	infrastructure if the county adopts an ordinance providing for
258	such continued use of the surtax proceeds.
259	(g)  Notwithstanding paragraph (d), a county having a
260	population greater than 75,000 in which the taxable value of
261	real property is less than 60 percent of the just value of real
262	property for ad valorem tax purposes for the tax year in which
263	an infrastructure surtax referendum is placed before the voters,
264	and the municipalities within such a county, may use the
265	proceeds and interest of the surtax for operation and
266	maintenance of parks and recreation programs and facilities
267	established with the proceeds of the surtax throughout the
268	duration of the surtax levy or while interest earnings accruing
269	from the proceeds of the surtax are available for such use,
270	whichever period is longer.
271	(h)  Notwithstanding any other provision of this section, a
272	county shall not levy local option sales surtaxes authorized in
273	this subsection and subsections (3), (4), and (5) in excess of a
274	combined rate of 1 percent.
275	(3)  SMALL COUNTY SURTAX.--
276	(a)  The governing authority in each county that has a
277	population of 50,000 or less on April 1, 1992, may levy a
278	discretionary sales surtax of 0.5 percent or 1 percent. The levy
279	of the surtax shall be pursuant to ordinance enacted by an
280	extraordinary vote of the members of the county governing
281	authority if the surtax revenues are expended for operating
282	purposes. If the surtax revenues are expended for the purpose of
283	servicing bond indebtedness, the surtax shall be approved by a
284	majority of the electors of the county voting in a referendum on
285	the surtax.
286	(b)  A statement that includes a brief general description
287	of the projects to be funded by the surtax and conforms to the
288	requirements of s. 101.161 shall be placed on the ballot by the
289	governing authority of any county that enacts an ordinance
290	calling for a referendum on the levy of the surtax for the
291	purpose of servicing bond indebtedness. The following question
292	shall be placed on the ballot:
293
	_____FOR the _____-cent sales tax
294
	_____AGAINST the _____-cent sales tax
295
296
297	(c)  Pursuant to s. 212.054(4), the proceeds of the surtax
298	levied under this subsection shall be distributed to the county
299	and the municipalities within the county in which the surtax was
300	collected, according to:
301	1.  An interlocal agreement between the county governing
302	authority and the governing bodies of the municipalities
303	representing a majority of the county's municipal population,
304	which agreement may include a school district with the consent
305	of the county governing authority and the governing bodies of
306	the municipalities representing a majority of the county's
307	municipal population; or
308	2.  If there is no interlocal agreement, according to the
309	formula provided in s. 218.62.
310
311	Any change in the distribution formula shall take effect on the
312	first day of any month that begins at least 60 days after
313	written notification of that change has been made to the
314	department.
315	(d)1.  If the surtax is levied pursuant to a referendum,
316	the proceeds of the surtax and any interest accrued thereto may
317	be expended by the school district or within the county and
318	municipalities within the county, or, in the case of a
319	negotiated joint county agreement, within another county, for
320	the purpose of servicing bond indebtedness to finance, plan, and
321	construct infrastructure and to acquire land for public
322	recreation or conservation or protection of natural resources.
323	However, if the surtax is levied pursuant to an ordinance
324	approved by an extraordinary vote of the members of the county
325	governing authority, the proceeds and any interest accrued
326	thereto may be used for operational expenses of any
327	infrastructure or for any public purpose authorized in the
328	ordinance under which the surtax is levied.
329	2.  For the purposes of this paragraph, "infrastructure"
330	means any fixed capital expenditure or fixed capital costs
331	associated with the construction, reconstruction, or improvement
332	of public facilities that have a life expectancy of 5 or more
333	years and any land acquisition, land improvement, design, and
334	engineering costs related thereto.
335	(e)  A school district, county, or municipality that
336	receives proceeds under this subsection following a referendum
337	may pledge the proceeds for the purpose of servicing new bond
338	indebtedness incurred pursuant to law. Local governments may use
339	the services of the Division of Bond Finance pursuant to the
340	State Bond Act to issue any bonds through the provisions of this
341	subsection. A jurisdiction may not issue bonds pursuant to this
342	subsection more frequently than once per year. A county and
343	municipality may join together to issue bonds authorized by this
344	subsection.
345	(f)  Notwithstanding any other provision of this section, a
346	county shall not levy local option sales surtaxes authorized in
347	this subsection and subsections (2), (4), and (5) in excess of a
348	combined rate of 1 percent.
349	(4)  INDIGENT CARE AND TRAUMA CENTER SURTAX.--
350	(a)1.  The governing body in each county the government of
351	which is not consolidated with that of one or more
352	municipalities, which has a population of at least 800,000
353	residents and is not authorized to levy a surtax under
354	subsection (5), may levy, pursuant to an ordinance either
355	approved by an extraordinary vote of the governing body or
356	conditioned to take effect only upon approval by a majority vote
357	of the electors of the county voting in a referendum, a
358	discretionary sales surtax at a rate that may not exceed 0.5
359	percent.
360	2.  If the ordinance is conditioned on a referendum, a
361	statement that includes a brief and general description of the
362	purposes to be funded by the surtax and that conforms to the
363	requirements of s. 101.161 shall be placed on the ballot by the
364	governing body of the county. The following questions shall be
365	placed on the ballot:
366
367	FOR THE. . . .CENTS TAX
368	AGAINST THE. . . .CENTS TAX
369
370	3.  The ordinance adopted by the governing body providing
371	for the imposition of the surtax shall set forth a plan for
372	providing health care services to qualified residents, as
373	defined in subparagraph 4. Such plan and subsequent amendments
374	to it shall fund a broad range of health care services for both
375	indigent persons and the medically poor, including, but not
376	limited to, primary care and preventive care as well as hospital
377	care. The plan must also address the services to be provided by
378	the Level I trauma center. It shall emphasize a continuity of
379	care in the most cost-effective setting, taking into
380	consideration both a high quality of care and geographic access.
381	Where consistent with these objectives, it shall include,
382	without limitation, services rendered by physicians, clinics,
383	community hospitals, mental health centers, and alternative
384	delivery sites, as well as at least one regional referral
385	hospital where appropriate. It shall provide that agreements
386	negotiated between the county and providers, including hospitals
387	with a Level I trauma center, will include reimbursement
388	methodologies that take into account the cost of services
389	rendered to eligible patients, recognize hospitals that render a
390	disproportionate share of indigent care, provide other
391	incentives to promote the delivery of charity care, promote the
392	advancement of technology in medical services, recognize the
393	level of responsiveness to medical needs in trauma cases, and
394	require cost containment including, but not limited to, case
395	management. It must also provide that any hospitals that are
396	owned and operated by government entities on May 21, 1991, must,
397	as a condition of receiving funds under this subsection, afford
398	public access equal to that provided under s. 286.011 as to
399	meetings of the governing board, the subject of which is
400	budgeting resources for the rendition of charity care as that
401	term is defined in the Florida Hospital Uniform Reporting System
402	(FHURS) manual referenced in s. 408.07. The plan shall also
403	include innovative health care programs that provide cost-
404	effective alternatives to traditional methods of service
405	delivery and funding.
406	4.  For the purpose of this paragraph, the term "qualified
407	resident" means residents of the authorizing county who are:
408	a.  Qualified as indigent persons as certified by the
409	authorizing county;
410	b.  Certified by the authorizing county as meeting the
411	definition of the medically poor, defined as persons having
412	insufficient income, resources, and assets to provide the needed
413	medical care without using resources required to meet basic
414	needs for shelter, food, clothing, and personal expenses; or not
415	being eligible for any other state or federal program, or having
416	medical needs that are not covered by any such program; or
417	having insufficient third-party insurance coverage. In all
418	cases, the authorizing county is intended to serve as the payor
419	of last resort; or
420	c.  Participating in innovative, cost-effective programs
421	approved by the authorizing county.
422	5.  Moneys collected pursuant to this paragraph remain the
423	property of the state and shall be distributed by the Department
424	of Revenue on a regular and periodic basis to the clerk of the
425	circuit court as ex officio custodian of the funds of the
426	authorizing county. The clerk of the circuit court shall:
427	a.  Maintain the moneys in an indigent health care trust
428	fund;
429	b.  Invest any funds held on deposit in the trust fund
430	pursuant to general law;
431	c.  Disburse the funds, including any interest earned, to
432	any provider of health care services, as provided in
433	subparagraphs 3. and 4., upon directive from the authorizing
434	county. However, if a county has a population of at least
435	800,000 residents and has levied the surtax authorized in this
436	paragraph, notwithstanding any directive from the authorizing
437	county, on October 1 of each calendar year, the clerk of the
438	court shall issue a check in the amount of $6.5 million to a
439	hospital in its jurisdiction that has a Level I trauma center or
440	shall issue a check in the amount of $3.5 million to a hospital
441	in its jurisdiction that has a Level I trauma center if that
442	county enacts and implements a hospital lien law in accordance
443	with chapter 98-499, Laws of Florida. The issuance of the checks
444	on October 1 of each year is provided in recognition of the
445	Level I trauma center status and shall be in addition to the
446	base contract amount received during fiscal year 1999-2000 and
447	any additional amount negotiated to the base contract. If the
448	hospital receiving funds for its Level I trauma center status
449	requests such funds to be used to generate federal matching
450	funds under Medicaid, the clerk of the court shall instead issue
451	a check to the Agency for Health Care Administration to
452	accomplish that purpose to the extent that it is allowed through
453	the General Appropriations Act; and
454	d.  Prepare on a biennial basis an audit of the trust fund
455	specified in sub-subparagraph a. Commencing February 1, 2004,
456	such audit shall be delivered to the governing body and to the
457	chair of the legislative delegation of each authorizing county.
458	6.  Notwithstanding any other provision of this section, a
459	county shall not levy local option sales surtaxes authorized in
460	this paragraph and subsections (2) and (3) in excess of a
461	combined rate of 1 percent.
462	(b)  Notwithstanding any other provision of this section,
463	the governing body in each county the government of which is not
464	consolidated with that of one or more municipalities and which
465	has a population of less than 800,000 residents, may levy, by
466	ordinance subject to approval by a majority of the electors of
467	the county voting in a referendum, a discretionary sales surtax
468	at a rate that may not exceed 0.25 percent for the sole purpose
469	of funding trauma services provided by a trauma center licensed
470	pursuant to chapter 395.
471	1.  A statement that includes a brief and general
472	description of the purposes to be funded by the surtax and that
473	conforms to the requirements of s. 101.161 shall be placed on
474	the ballot by the governing body of the county. The following
475	shall be placed on the ballot:
476
477	FOR THE. . . .CENTS TAX
478	AGAINST THE. . . .CENTS TAX
479
480	2.  The ordinance adopted by the governing body of the
481	county providing for the imposition of the surtax shall set
482	forth a plan for providing trauma services to trauma victims
483	presenting in the trauma service area in which such county is
484	located.
485	3.  Moneys collected pursuant to this paragraph remain the
486	property of the state and shall be distributed by the Department
487	of Revenue on a regular and periodic basis to the clerk of the
488	circuit court as ex officio custodian of the funds of the
489	authorizing county. The clerk of the circuit court shall:
490	a.  Maintain the moneys in a trauma services trust fund.
491	b.  Invest any funds held on deposit in the trust fund
492	pursuant to general law.
493	c.  Disburse the funds, including any interest earned on
494	such funds, to the trauma center in its trauma service area, as
495	provided in the plan set forth pursuant to subparagraph 2., upon
496	directive from the authorizing county. If the trauma center
497	receiving funds requests such funds be used to generate federal
498	matching funds under Medicaid, the custodian of the funds shall
499	instead issue a check to the Agency for Health Care
500	Administration to accomplish that purpose to the extent that the
501	agency is allowed through the General Appropriations Act.
502	d.  Prepare on a biennial basis an audit of the trauma
503	services trust fund specified in sub-subparagraph a., to be
504	delivered to the authorizing county.
505	4.  A discretionary sales surtax imposed pursuant to this
506	paragraph shall expire 4 years after the effective date of the
507	surtax, unless reenacted by ordinance subject to approval by a
508	majority of the electors of the county voting in a subsequent
509	referendum.
510	5.  Notwithstanding any other provision of this section, a
511	county shall not levy local option sales surtaxes authorized in
512	this paragraph and subsections (2) and (3) in excess of a
513	combined rate of 1 percent.
514	(5)  COUNTY PUBLIC HOSPITAL SURTAX.--Any county as defined
515	in s. 125.011(1) may levy the surtax authorized in this
516	subsection pursuant to an ordinance either approved by
517	extraordinary vote of the county commission or conditioned to
518	take effect only upon approval by a majority vote of the
519	electors of the county voting in a referendum. In a county as
520	defined in s. 125.011(1), for the purposes of this subsection,
521	"county public general hospital" means a general hospital as
522	defined in s. 395.002 which is owned, operated, maintained, or
523	governed by the county or its agency, authority, or public
524	health trust.
525	(a)  The rate shall be 0.5 percent.
526	(b)  If the ordinance is conditioned on a referendum, the
527	proposal to adopt the county public hospital surtax shall be
528	placed on the ballot in accordance with law at a time to be set
529	at the discretion of the governing body. The referendum question
530	on the ballot shall include a brief general description of the
531	health care services to be funded by the surtax.
532	(c)  Proceeds from the surtax shall be:
533	1.  Deposited by the county in a special fund, set aside
534	from other county funds, to be used only for the operation,
535	maintenance, and administration of the county public general
536	hospital; and
537	2.  Remitted promptly by the county to the agency,
538	authority, or public health trust created by law which
539	administers or operates the county public general hospital.
540	(d)  Except as provided in subparagraphs 1. and 2., the
541	county must continue to contribute each year an amount equal to
542	at least 80 percent of that percentage of the total county
543	budget appropriated for the operation, administration, and
544	maintenance of the county public general hospital from the
545	county's general revenues in the fiscal year of the county
546	ending September 30, 1991:
547	1.  Twenty-five percent of such amount must be remitted to
548	a governing board, agency, or authority that is wholly
549	independent from the public health trust, agency, or authority
550	responsible for the county public general hospital, to be used
551	solely for the purpose of funding the plan for indigent health
552	care services provided for in paragraph (e);
553	2.  However, in the first year of the plan, a total of $10
554	million shall be remitted to such governing board, agency, or
555	authority, to be used solely for the purpose of funding the plan
556	for indigent health care services provided for in paragraph (e),
557	and in the second year of the plan, a total of $15 million shall
558	be so remitted and used.
559	(e)  A governing board, agency, or authority shall be
560	chartered by the county commission upon this act becoming law.
561	The governing board, agency, or authority shall adopt and
562	implement a health care plan for indigent health care services.
563	The governing board, agency, or authority shall consist of no
564	more than seven and no fewer than five members appointed by the
565	county commission. The members of the governing board, agency,
566	or authority shall be at least 18 years of age and residents of
567	the county. No member may be employed by or affiliated with a
568	health care provider or the public health trust, agency, or
569	authority responsible for the county public general hospital.
570	The following community organizations shall each appoint a
571	representative to a nominating committee: the South Florida
572	Hospital and Healthcare Association, the Miami-Dade County
573	Public Health Trust, the Dade County Medical Association, the
574	Miami-Dade County Homeless Trust, and the Mayor of Miami-Dade
575	County. This committee shall nominate between 10 and 14 county
576	citizens for the governing board, agency, or authority. The
577	slate shall be presented to the county commission and the county
578	commission shall confirm the top five to seven nominees,
579	depending on the size of the governing board. Until such time as
580	the governing board, agency, or authority is created, the funds
581	provided for in subparagraph (d)2. shall be placed in a
582	restricted account set aside from other county funds and not
583	disbursed by the county for any other purpose.
584	1.  The plan shall divide the county into a minimum of four
585	and maximum of six service areas, with no more than one
586	participant hospital per service area. The county public general
587	hospital shall be designated as the provider for one of the
588	service areas. Services shall be provided through participants'
589	primary acute care facilities.
590	2.  The plan and subsequent amendments to it shall fund a
591	defined range of health care services for both indigent persons
592	and the medically poor, including primary care, preventive care,
593	hospital emergency room care, and hospital care necessary to
594	stabilize the patient. For the purposes of this section,
595	"stabilization" means stabilization as defined in s.
596	397.311(30). Where consistent with these objectives, the plan
597	may include services rendered by physicians, clinics, community
598	hospitals, and alternative delivery sites, as well as at least
599	one regional referral hospital per service area. The plan shall
600	provide that agreements negotiated between the governing board,
601	agency, or authority and providers shall recognize hospitals
602	that render a disproportionate share of indigent care, provide
603	other incentives to promote the delivery of charity care to draw
604	down federal funds where appropriate, and require cost
605	containment, including, but not limited to, case management.
606	From the funds specified in subparagraphs (d)1. and 2. for
607	indigent health care services, service providers shall receive
608	reimbursement at a Medicaid rate to be determined by the
609	governing board, agency, or authority created pursuant to this
610	paragraph for the initial emergency room visit, and a per-member
611	per-month fee or capitation for those members enrolled in their
612	service area, as compensation for the services rendered
613	following the initial emergency visit. Except for provisions of
614	emergency services, upon determination of eligibility,
615	enrollment shall be deemed to have occurred at the time services
616	were rendered. The provisions for specific reimbursement of
617	emergency services shall be repealed on July 1, 2001, unless
618	otherwise reenacted by the Legislature. The capitation amount or
619	rate shall be determined prior to program implementation by an
620	independent actuarial consultant. In no event shall such
621	reimbursement rates exceed the Medicaid rate. The plan must also
622	provide that any hospitals owned and operated by government
623	entities on or after the effective date of this act must, as a
624	condition of receiving funds under this subsection, afford
625	public access equal to that provided under s. 286.011 as to any
626	meeting of the governing board, agency, or authority the subject
627	of which is budgeting resources for the retention of charity
628	care, as that term is defined in the rules of the Agency for
629	Health Care Administration. The plan shall also include
630	innovative health care programs that provide cost-effective
631	alternatives to traditional methods of service and delivery
632	funding.
633	3.  The plan's benefits shall be made available to all
634	county residents currently eligible to receive health care
635	services as indigents or medically poor as defined in paragraph
636	(4)(d).
637	4.  Eligible residents who participate in the health care
638	plan shall receive coverage for a period of 12 months or the
639	period extending from the time of enrollment to the end of the
640	current fiscal year, per enrollment period, whichever is less.
641	5.  At the end of each fiscal year, the governing board,
642	agency, or authority shall prepare an audit that reviews the
643	budget of the plan, delivery of services, and quality of
644	services, and makes recommendations to increase the plan's
645	efficiency. The audit shall take into account participant
646	hospital satisfaction with the plan and assess the amount of
647	poststabilization patient transfers requested, and accepted or
648	denied, by the county public general hospital.
649	(f)  Notwithstanding any other provision of this section, a
650	county may not levy local option sales surtaxes authorized in
651	this subsection and subsections (2) and (3) in excess of a
652	combined rate of 1 percent.
653	(6)  SCHOOL CAPITAL OUTLAY SURTAX.--
654	(a)  The school board in each county may levy, pursuant to
655	resolution conditioned to take effect only upon approval by a
656	majority vote of the electors of the county voting in a
657	referendum, a discretionary sales surtax at a rate that may not
658	exceed 0.5 percent.
659	(b)  The resolution shall include a statement that provides
660	a brief and general description of the school capital outlay
661	projects to be funded by the surtax. The statement shall conform
662	to the requirements of s. 101.161 and shall be placed on the
663	ballot by the governing body of the county. The following
664	question shall be placed on the ballot:
665
	_____FOR THE _____CENTS TAX
666
	_____AGAINST THE _____CENTS TAX
667
668
669	(c)  The resolution providing for the imposition of the
670	surtax shall set forth a plan for use of the surtax proceeds for
671	fixed capital expenditures or fixed capital costs associated
672	with the construction, reconstruction, or improvement of school
673	facilities and campuses which have a useful life expectancy of 5
674	or more years, and any land acquisition, land improvement,
675	design, and engineering costs related thereto. Additionally, the
676	plan shall include the costs of retrofitting and providing for
677	technology implementation, including hardware and software, for
678	the various sites within the school district. Surtax revenues
679	may be used for the purpose of servicing bond indebtedness to
680	finance projects authorized by this subsection, and any interest
681	accrued thereto may be held in trust to finance such projects.
682	Neither the proceeds of the surtax nor any interest accrued
683	thereto shall be used for operational expenses.
684	(d)  Any school board imposing the surtax shall implement a
685	freeze on noncapital local school property taxes, at the millage
686	rate imposed in the year prior to the implementation of the
687	surtax, for a period of at least 3 years from the date of
688	imposition of the surtax. This provision shall not apply to
689	existing debt service or taxes authorized in the General
690	Appropriations Act.
691	(e)  Surtax revenues collected by the Department of Revenue
692	pursuant to this subsection shall be distributed to the school
693	board imposing the surtax in accordance with law.
694	(7)  VOTER-APPROVED INDIGENT CARE SURTAX.--
695	(a)1.  The governing body in each county that has a
696	population of fewer than 800,000 residents may levy an indigent
697	care surtax pursuant to an ordinance conditioned to take effect
698	only upon approval by a majority vote of the electors of the
699	county voting in a referendum. The surtax may be levied at a
700	rate not to exceed 0.5 percent, except that if a publicly
701	supported medical school is located in the county, the rate
702	shall not exceed 1 percent.
703	2.  Notwithstanding subparagraph 1., the governing body of
704	any county that has a population of fewer than 50,000 residents
705	may levy an indigent care surtax pursuant to an ordinance
706	conditioned to take effect only upon approval by a majority vote
707	of the electors of the county voting in a referendum. The surtax
708	may be levied at a rate not to exceed 1 percent.
709	(b)  A statement that includes a brief and general
710	description of the purposes to be funded by the surtax and that
711	conforms to the requirements of s. 101.161 shall be placed on
712	the ballot by the governing body of the county. The following
713	questions shall be placed on the ballot:
714
715	FOR THE. . . .CENTS TAX
716	AGAINST THE. . . .CENTS TAX
717	(c)1.  The ordinance adopted by the governing body
718	providing for the imposition of the surtax must set forth a plan
719	for providing health care services to qualified residents, as
720	defined in paragraph (d). The plan and subsequent amendments to
721	it shall fund a broad range of health care services for indigent
722	persons and the medically poor, including, but not limited to,
723	primary care and preventive care, as well as hospital care. It
724	shall emphasize a continuity of care in the most cost-effective
725	setting, taking into consideration a high quality of care and
726	geographic access. Where consistent with these objectives, it
727	shall include, without limitation, services rendered by
728	physicians, clinics, community hospitals, mental health centers,
729	and alternative delivery sites, as well as at least one regional
730	referral hospital where appropriate. It shall provide that
731	agreements negotiated between the county and providers shall
732	include reimbursement methodologies that take into account the
733	cost of services rendered to eligible patients, recognize
734	hospitals that render a disproportionate share of indigent care,
735	provide other incentives to promote the delivery of charity
736	care, and require cost containment, including, but not limited
737	to, case management. The plan must also include innovative
738	health care programs that provide cost-effective alternatives to
739	traditional methods of service delivery and funding.
740	2.  In addition to the uses specified or services required
741	to be provided under this subsection, the ordinance adopted by a
742	county that has a population of fewer than 50,000 residents may
743	pledge surtax proceeds to service new or existing bond
744	indebtedness incurred to finance, plan, construct, or
745	reconstruct a public or not-for-profit hospital in such county
746	and any land acquisition, land improvement, design, or
747	engineering costs related to such hospital, if the governing
748	body of the county determines that a public or not-for-profit
749	hospital existing at the time of issuance of the bonds
750	authorized under this subparagraph would, more likely than not,
751	otherwise cease to operate. The plan required under this
752	paragraph may, by an extraordinary vote of the governing body of
753	such county, provide that some or all of the surtax revenues and
754	any interest earned must be expended for the purpose of
755	servicing such bond indebtedness. Such county may also use the
756	services of the Division of Bond Finance of the State Board of
757	Administration pursuant to the State Bond Act to issue bonds
758	under this subparagraph. A jurisdiction may not issue bonds
759	under this subparagraph more frequently than once per year. Any
760	county that has a population of fewer than 50,000 residents at
761	the time any bonds authorized in this subparagraph are issued
762	retains the authority granted under this subparagraph throughout
763	the terms of such bonds, including the term of any refinancing
764	bonds, regardless of any subsequent increase in population which
765	would result in such county having 50,000 or more residents.
766	(d)  For the purpose of this subsection, the term
767	"qualified residents" means residents of the authorizing county
768	who are:
769	1.  Qualified as indigent persons as certified by the
770	authorizing county;
771	2.  Certified by the authorizing county as meeting the
772	definition of the medically poor, defined as persons having
773	insufficient income, resources, and assets to provide the needed
774	medical care without using resources required to meet basic
775	needs for shelter, food, clothing, and personal expenses; not
776	being eligible for any other state or federal program or having
777	medical needs that are not covered by any such program; or
778	having insufficient third-party insurance coverage. In all
779	cases, the authorizing county shall serve as the payor of last
780	resort; or
781	3.  Participating in innovative, cost-effective programs
782	approved by the authorizing county.
783	(e)  Moneys collected pursuant to this subsection remain
784	the property of the state and shall be distributed by the
785	Department of Revenue on a regular and periodic basis to the
786	clerk of the circuit court as ex officio custodian of the funds
787	of the authorizing county. The clerk of the circuit court shall:
788	1.  Maintain the moneys in an indigent health care trust
789	fund.
790	2.  Invest any funds held on deposit in the trust fund
791	pursuant to general law.
792	3.  Disburse the funds, including any interest earned, to
793	any provider of health care services, as provided in paragraphs
794	(c) and (d), upon directive from the authorizing county.
795	4.  Disburse the funds, including any interest earned, to
796	service any bond indebtedness authorized in this subsection upon
797	directive from the authorizing county, which directive may be
798	irrevocably given at the time the bond indebtedness is incurred.
799	(f)  Notwithstanding any other provision of this section, a
800	county may not levy local option sales surtaxes authorized in
801	this subsection and subsections (2) and (3) in excess of a
802	combined rate of 1 percent or, if a publicly supported medical
803	school is located in the county or the county has a population
804	of fewer than 50,000 residents, in excess of a combined rate of
805	1.5 percent.
806	Section 2.  This act shall take effect July 1, 2008.
807
808	-----------------------------------------------------
809	T I T L E  A M E N D M E N T
810	Remove the entire title and insert:
811	A bill to be entitled
812	An act relating to discretionary sales surtaxes; amending s.
813	212.055, F.S.; specifying a maximum aggregate rate for the total
814	of all discretionary sales surtaxes; changing the name of the
815	charter county transit system surtax to the charter county
816	transportation system surtax; expanding eligible counties
817	authorized to levy the charter county transportation system
818	surtax; requiring interlocal agreements in certain counties to
819	be updated no less than every 5 years to include certain
820	municipalities for purposes of the charter county transportation
821	system surtax; providing an effective date.

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