| 1 | A bill to be entitled |
| 2 | An act relating to discretionary sales surtaxes; amending |
| 3 | s. 212.055, F.S.; deleting a limitation upon the |
| 4 | imposition of indigent care and trauma center |
| 5 | discretionary sales surtaxes by certain counties; |
| 6 | providing an effective date. |
| 7 |
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| 8 | Be It Enacted by the Legislature of the State of Florida: |
| 9 |
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| 10 | Section 1. Subsection (4) of section 212.055, Florida |
| 11 | Statutes, is amended to read: |
| 12 | 212.055 Discretionary sales surtaxes; legislative intent; |
| 13 | authorization and use of proceeds.--It is the legislative intent |
| 14 | that any authorization for imposition of a discretionary sales |
| 15 | surtax shall be published in the Florida Statutes as a |
| 16 | subsection of this section, irrespective of the duration of the |
| 17 | levy. Each enactment shall specify the types of counties |
| 18 | authorized to levy; the rate or rates which may be imposed; the |
| 19 | maximum length of time the surtax may be imposed, if any; the |
| 20 | procedure which must be followed to secure voter approval, if |
| 21 | required; the purpose for which the proceeds may be expended; |
| 22 | and such other requirements as the Legislature may provide. |
| 23 | Taxable transactions and administrative procedures shall be as |
| 24 | provided in s. 212.054. |
| 25 | (4) INDIGENT CARE AND TRAUMA CENTER SURTAX.-- |
| 26 | (a)1. The governing body in each county that the |
| 27 | government of which is not consolidated with that of one or more |
| 28 | municipalities, which has a population of at least 800,000 |
| 29 | residents and is not authorized to levy a surtax under |
| 30 | subsection (5), may levy, pursuant to an ordinance either |
| 31 | approved by an extraordinary vote of the governing body or |
| 32 | conditioned to take effect only upon approval by a majority vote |
| 33 | of the electors of the county voting in a referendum, a |
| 34 | discretionary sales surtax at a rate that may not exceed 0.5 |
| 35 | percent. |
| 36 | 2. If the ordinance is conditioned on a referendum, a |
| 37 | statement that includes a brief and general description of the |
| 38 | purposes to be funded by the surtax and that conforms to the |
| 39 | requirements of s. 101.161 shall be placed on the ballot by the |
| 40 | governing body of the county. The following questions shall be |
| 41 | placed on the ballot: |
| 42 | FOR THE. . . .CENTS TAX |
| 43 | AGAINST THE. . . .CENTS TAX |
| 44 | 3. The ordinance adopted by the governing body providing |
| 45 | for the imposition of the surtax shall set forth a plan for |
| 46 | providing health care services to qualified residents, as |
| 47 | defined in subparagraph 4. Such plan and subsequent amendments |
| 48 | to it shall fund a broad range of health care services for both |
| 49 | indigent persons and the medically poor, including, but not |
| 50 | limited to, primary care and preventive care as well as hospital |
| 51 | care. The plan must also address the services to be provided by |
| 52 | the Level I trauma center. It shall emphasize a continuity of |
| 53 | care in the most cost-effective setting, taking into |
| 54 | consideration both a high quality of care and geographic access. |
| 55 | Where consistent with these objectives, it shall include, |
| 56 | without limitation, services rendered by physicians, clinics, |
| 57 | community hospitals, mental health centers, and alternative |
| 58 | delivery sites, as well as at least one regional referral |
| 59 | hospital where appropriate. It shall provide that agreements |
| 60 | negotiated between the county and providers, including hospitals |
| 61 | with a Level I trauma center, will include reimbursement |
| 62 | methodologies that take into account the cost of services |
| 63 | rendered to eligible patients, recognize hospitals that render a |
| 64 | disproportionate share of indigent care, provide other |
| 65 | incentives to promote the delivery of charity care, promote the |
| 66 | advancement of technology in medical services, recognize the |
| 67 | level of responsiveness to medical needs in trauma cases, and |
| 68 | require cost containment including, but not limited to, case |
| 69 | management. It must also provide that any hospitals that are |
| 70 | owned and operated by government entities on May 21, 1991, must, |
| 71 | as a condition of receiving funds under this subsection, afford |
| 72 | public access equal to that provided under s. 286.011 as to |
| 73 | meetings of the governing board, the subject of which is |
| 74 | budgeting resources for the rendition of charity care as that |
| 75 | term is defined in the Florida Hospital Uniform Reporting System |
| 76 | (FHURS) manual referenced in s. 408.07. The plan shall also |
| 77 | include innovative health care programs that provide cost- |
| 78 | effective alternatives to traditional methods of service |
| 79 | delivery and funding. |
| 80 | 4. For the purpose of this paragraph, the term "qualified |
| 81 | resident" means residents of the authorizing county who are: |
| 82 | a. Qualified as indigent persons as certified by the |
| 83 | authorizing county; |
| 84 | b. Certified by the authorizing county as meeting the |
| 85 | definition of the medically poor, defined as persons having |
| 86 | insufficient income, resources, and assets to provide the needed |
| 87 | medical care without using resources required to meet basic |
| 88 | needs for shelter, food, clothing, and personal expenses; or not |
| 89 | being eligible for any other state or federal program, or having |
| 90 | medical needs that are not covered by any such program; or |
| 91 | having insufficient third-party insurance coverage. In all |
| 92 | cases, the authorizing county is intended to serve as the payor |
| 93 | of last resort; or |
| 94 | c. Participating in innovative, cost-effective programs |
| 95 | approved by the authorizing county. |
| 96 | 5. Moneys collected pursuant to this paragraph remain the |
| 97 | property of the state and shall be distributed by the Department |
| 98 | of Revenue on a regular and periodic basis to the clerk of the |
| 99 | circuit court as ex officio custodian of the funds of the |
| 100 | authorizing county. The clerk of the circuit court shall: |
| 101 | a. Maintain the moneys in an indigent health care trust |
| 102 | fund; |
| 103 | b. Invest any funds held on deposit in the trust fund |
| 104 | pursuant to general law; |
| 105 | c. Disburse the funds, including any interest earned, to |
| 106 | any provider of health care services, as provided in |
| 107 | subparagraphs 3. and 4., upon directive from the authorizing |
| 108 | county. However, if a county has a population of at least |
| 109 | 800,000 residents and has levied the surtax authorized in this |
| 110 | paragraph, notwithstanding any directive from the authorizing |
| 111 | county, on October 1 of each calendar year, the clerk of the |
| 112 | court shall issue a check in the amount of $6.5 million to a |
| 113 | hospital in its jurisdiction that has a Level I trauma center or |
| 114 | shall issue a check in the amount of $3.5 million to a hospital |
| 115 | in its jurisdiction that has a Level I trauma center if that |
| 116 | county enacts and implements a hospital lien law in accordance |
| 117 | with chapter 98-499, Laws of Florida. The issuance of the checks |
| 118 | on October 1 of each year is provided in recognition of the |
| 119 | Level I trauma center status and shall be in addition to the |
| 120 | base contract amount received during fiscal year 1999-2000 and |
| 121 | any additional amount negotiated to the base contract. If the |
| 122 | hospital receiving funds for its Level I trauma center status |
| 123 | requests such funds to be used to generate federal matching |
| 124 | funds under Medicaid, the clerk of the court shall instead issue |
| 125 | a check to the Agency for Health Care Administration to |
| 126 | accomplish that purpose to the extent that it is allowed through |
| 127 | the General Appropriations Act; and |
| 128 | d. Prepare on a biennial basis an audit of the trust fund |
| 129 | specified in sub-subparagraph a. Commencing February 1, 2004, |
| 130 | such audit shall be delivered to the governing body and to the |
| 131 | chair of the legislative delegation of each authorizing county. |
| 132 | 6. Notwithstanding any other provision of this section, a |
| 133 | county shall not levy local option sales surtaxes authorized in |
| 134 | this paragraph and subsections (2) and (3) in excess of a |
| 135 | combined rate of 1 percent. |
| 136 | (b) Notwithstanding any other provision of this section, |
| 137 | the governing body in each county that the government of which |
| 138 | is not consolidated with that of one or more municipalities and |
| 139 | which has a population of less than 800,000 residents, may levy, |
| 140 | by ordinance subject to approval by a majority of the electors |
| 141 | of the county voting in a referendum, a discretionary sales |
| 142 | surtax at a rate that may not exceed 0.25 percent for the sole |
| 143 | purpose of funding trauma services provided by a trauma center |
| 144 | licensed pursuant to chapter 395. |
| 145 | 1. A statement that includes a brief and general |
| 146 | description of the purposes to be funded by the surtax and that |
| 147 | conforms to the requirements of s. 101.161 shall be placed on |
| 148 | the ballot by the governing body of the county. The following |
| 149 | shall be placed on the ballot: |
| 150 | FOR THE. . . .CENTS TAX |
| 151 | AGAINST THE. . . .CENTS TAX |
| 152 | 2. The ordinance adopted by the governing body of the |
| 153 | county providing for the imposition of the surtax shall set |
| 154 | forth a plan for providing trauma services to trauma victims |
| 155 | presenting in the trauma service area in which such county is |
| 156 | located. |
| 157 | 3. Moneys collected pursuant to this paragraph remain the |
| 158 | property of the state and shall be distributed by the Department |
| 159 | of Revenue on a regular and periodic basis to the clerk of the |
| 160 | circuit court as ex officio custodian of the funds of the |
| 161 | authorizing county. The clerk of the circuit court shall: |
| 162 | a. Maintain the moneys in a trauma services trust fund. |
| 163 | b. Invest any funds held on deposit in the trust fund |
| 164 | pursuant to general law. |
| 165 | c. Disburse the funds, including any interest earned on |
| 166 | such funds, to the trauma center in its trauma service area, as |
| 167 | provided in the plan set forth pursuant to subparagraph 2., upon |
| 168 | directive from the authorizing county. If the trauma center |
| 169 | receiving funds requests such funds be used to generate federal |
| 170 | matching funds under Medicaid, the custodian of the funds shall |
| 171 | instead issue a check to the Agency for Health Care |
| 172 | Administration to accomplish that purpose to the extent that the |
| 173 | agency is allowed through the General Appropriations Act. |
| 174 | d. Prepare on a biennial basis an audit of the trauma |
| 175 | services trust fund specified in sub-subparagraph a., to be |
| 176 | delivered to the authorizing county. |
| 177 | 4. A discretionary sales surtax imposed pursuant to this |
| 178 | paragraph shall expire 4 years after the effective date of the |
| 179 | surtax, unless reenacted by ordinance subject to approval by a |
| 180 | majority of the electors of the county voting in a subsequent |
| 181 | referendum. |
| 182 | 5. Notwithstanding any other provision of this section, a |
| 183 | county shall not levy local option sales surtaxes authorized in |
| 184 | this paragraph and subsections (2) and (3) in excess of a |
| 185 | combined rate of 1 percent. |
| 186 | Section 2. This act shall take effect July 1, 2009. |