HB 767

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
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
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
43	FOR THE. . . .CENTS TAX
44	AGAINST THE. . . .CENTS TAX
45
46	3.  The ordinance adopted by the governing body providing
47	for the imposition of the surtax shall set forth a plan for
48	providing health care services to qualified residents, as
49	defined in subparagraph 4. Such plan and subsequent amendments
50	to it shall fund a broad range of health care services for both
51	indigent persons and the medically poor, including, but not
52	limited to, primary care and preventive care as well as hospital
53	care. The plan must also address the services to be provided by
54	the Level I trauma center. It shall emphasize a continuity of
55	care in the most cost-effective setting, taking into
56	consideration both a high quality of care and geographic access.
57	Where consistent with these objectives, it shall include,
58	without limitation, services rendered by physicians, clinics,
59	community hospitals, mental health centers, and alternative
60	delivery sites, as well as at least one regional referral
61	hospital where appropriate. It shall provide that agreements
62	negotiated between the county and providers, including hospitals
63	with a Level I trauma center, will include reimbursement
64	methodologies that take into account the cost of services
65	rendered to eligible patients, recognize hospitals that render a
66	disproportionate share of indigent care, provide other
67	incentives to promote the delivery of charity care, promote the
68	advancement of technology in medical services, recognize the
69	level of responsiveness to medical needs in trauma cases, and
70	require cost containment including, but not limited to, case
71	management. It must also provide that any hospitals that are
72	owned and operated by government entities on May 21, 1991, must,
73	as a condition of receiving funds under this subsection, afford
74	public access equal to that provided under s. 286.011 as to
75	meetings of the governing board, the subject of which is
76	budgeting resources for the rendition of charity care as that
77	term is defined in the Florida Hospital Uniform Reporting System
78	(FHURS) manual referenced in s. 408.07. The plan shall also
79	include innovative health care programs that provide cost-
80	effective alternatives to traditional methods of service
81	delivery and funding.
82	4.  For the purpose of this paragraph, the term "qualified
83	resident" means residents of the authorizing county who are:
84	a.  Qualified as indigent persons as certified by the
85	authorizing county;
86	b.  Certified by the authorizing county as meeting the
87	definition of the medically poor, defined as persons having
88	insufficient income, resources, and assets to provide the needed
89	medical care without using resources required to meet basic
90	needs for shelter, food, clothing, and personal expenses; or not
91	being eligible for any other state or federal program, or having
92	medical needs that are not covered by any such program; or
93	having insufficient third-party insurance coverage. In all
94	cases, the authorizing county is intended to serve as the payor
95	of last resort; or
96	c.  Participating in innovative, cost-effective programs
97	approved by the authorizing county.
98	5.  Moneys collected pursuant to this paragraph remain the
99	property of the state and shall be distributed by the Department
100	of Revenue on a regular and periodic basis to the clerk of the
101	circuit court as ex officio custodian of the funds of the
102	authorizing county. The clerk of the circuit court shall:
103	a.  Maintain the moneys in an indigent health care trust
104	fund;
105	b.  Invest any funds held on deposit in the trust fund
106	pursuant to general law;
107	c.  Disburse the funds, including any interest earned, to
108	any provider of health care services, as provided in
109	subparagraphs 3. and 4., upon directive from the authorizing
110	county. However, if a county has a population of at least
111	800,000 residents and has levied the surtax authorized in this
112	paragraph, notwithstanding any directive from the authorizing
113	county, on October 1 of each calendar year, the clerk of the
114	court shall issue a check in the amount of $6.5 million to a
115	hospital in its jurisdiction that has a Level I trauma center or
116	shall issue a check in the amount of $3.5 million to a hospital
117	in its jurisdiction that has a Level I trauma center if that
118	county enacts and implements a hospital lien law in accordance
119	with chapter 98-499, Laws of Florida. The issuance of the checks
120	on October 1 of each year is provided in recognition of the
121	Level I trauma center status and shall be in addition to the
122	base contract amount received during fiscal year 1999-2000 and
123	any additional amount negotiated to the base contract. If the
124	hospital receiving funds for its Level I trauma center status
125	requests such funds to be used to generate federal matching
126	funds under Medicaid, the clerk of the court shall instead issue
127	a check to the Agency for Health Care Administration to
128	accomplish that purpose to the extent that it is allowed through
129	the General Appropriations Act; and
130	d.  Prepare on a biennial basis an audit of the trust fund
131	specified in sub-subparagraph a. Commencing February 1, 2004,
132	such audit shall be delivered to the governing body and to the
133	chair of the legislative delegation of each authorizing county.
134	6.  Notwithstanding any other provision of this section, a
135	county shall not levy local option sales surtaxes authorized in
136	this paragraph and subsections (2) and (3) in excess of a
137	combined rate of 1 percent.
138	Section 2.  This act shall take effect July 1, 2010.

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