Florida Senate - 2009 CS for SB 718
By the Committee on Health Regulation; and Senator King
588-02999-09 2009718c1
1 A bill to be entitled
2 An act relating to discretionary sales surtaxes;
3 amending s. 212.055, F.S.; deleting a limitation upon
4 the imposition of indigent care and trauma center
5 discretionary sales surtaxes by certain counties;
6 providing an effective date.
7
8 Be It Enacted by the Legislature of the State of Florida:
9
10 Section 1. Paragraph (a) of subsection (4) of section
11 212.055, Florida 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 government
27 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 Section 2. This act shall take effect July 1, 2009.