Senate Bill sb2148c1
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Florida Senate - 2003 CS for SB 2148
By the Committee on Health, Aging, and Long-Term Care; and
Senator Sebesta
317-2135-03
1 A bill to be entitled
2 An act relating to the indigent care and trauma
3 center discretionary sales surtax; amending s.
4 212.055, F.S.; reviving, reenacting, and
5 amending the indigent care and trauma center
6 discretionary sales surtax; requiring the clerk
7 of the circuit court to conduct a biennial
8 audit; providing for delivery of the audit to
9 specified governmental entities; deleting a
10 future expiration provision; providing an
11 effective date.
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13 Be It Enacted by the Legislature of the State of Florida:
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15 Section 1. Notwithstanding the provisions of section
16 11 of chapter 2000-312, Laws of Florida, subsection (4) of
17 section 212.055, Florida Statutes, shall not stand repealed on
18 October 1, 2005, as scheduled by such law, but that
19 subsection, as amended by section 13 of chapter 2000-312, Laws
20 of Florida, is revived, reenacted, and amended, to read:
21 212.055 Discretionary sales surtaxes; legislative
22 intent; authorization and use of proceeds.--It is the
23 legislative intent that any authorization for imposition of a
24 discretionary sales surtax shall be published in the Florida
25 Statutes as a subsection of this section, irrespective of the
26 duration of the levy. Each enactment shall specify the types
27 of counties authorized to levy; the rate or rates which may be
28 imposed; the maximum length of time the surtax may be imposed,
29 if any; the procedure which must be followed to secure voter
30 approval, if required; the purpose for which the proceeds may
31 be expended; and such other requirements as the Legislature
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Florida Senate - 2003 CS for SB 2148
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1 may provide. Taxable transactions and administrative
2 procedures shall be as provided in s. 212.054.
3 (4) INDIGENT CARE AND TRAUMA CENTER SURTAX.--
4 (a) The governing body in each county the government
5 of which is not consolidated with that of one or more
6 municipalities, which has a population of at least 800,000
7 residents and is not authorized to levy a surtax under
8 subsection (5), may levy, pursuant to an ordinance either
9 approved by an extraordinary vote of the governing body or
10 conditioned to take effect only upon approval by a majority
11 vote of the electors of the county voting in a referendum, a
12 discretionary sales surtax at a rate that may not exceed 0.5
13 percent.
14 (b) If the ordinance is conditioned on a referendum, a
15 statement that includes a brief and general description of the
16 purposes to be funded by the surtax and that conforms to the
17 requirements of s. 101.161 shall be placed on the ballot by
18 the governing body of the county. The following questions
19 shall be placed on the ballot:
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21 FOR THE. . . .CENTS TAX
22 AGAINST THE. . . .CENTS TAX
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24 (c) The ordinance adopted by the governing body
25 providing for the imposition of the surtax shall set forth a
26 plan for providing health care services to qualified
27 residents, as defined in paragraph (d). Such plan and
28 subsequent amendments to it shall fund a broad range of health
29 care services for both indigent persons and the medically
30 poor, including, but not limited to, primary care and
31 preventive care as well as hospital care. The plan must also
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Florida Senate - 2003 CS for SB 2148
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1 address the services to be provided by the Level I trauma
2 center. It shall emphasize a continuity of care in the most
3 cost-effective setting, taking into consideration both a high
4 quality of care and geographic access. Where consistent with
5 these objectives, it shall include, without limitation,
6 services rendered by physicians, clinics, community hospitals,
7 mental health centers, and alternative delivery sites, as well
8 as at least one regional referral hospital where appropriate.
9 It shall provide that agreements negotiated between the county
10 and providers, including hospitals with a Level I trauma
11 center, will include reimbursement methodologies that take
12 into account the cost of services rendered to eligible
13 patients, recognize hospitals that render a disproportionate
14 share of indigent care, provide other incentives to promote
15 the delivery of charity care, promote the advancement of
16 technology in medical services, recognize the level of
17 responsiveness to medical needs in trauma cases, and require
18 cost containment including, but not limited to, case
19 management. It must also provide that any hospitals that are
20 owned and operated by government entities on May 21, 1991,
21 must, as a condition of receiving funds under this subsection,
22 afford public access equal to that provided under s. 286.011
23 as to meetings of the governing board, the subject of which is
24 budgeting resources for the rendition of charity care as that
25 term is defined in the Florida Hospital Uniform Reporting
26 System (FHURS) manual referenced in s. 408.07. The plan shall
27 also include innovative health care programs that provide
28 cost-effective alternatives to traditional methods of service
29 delivery and funding.
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Florida Senate - 2003 CS for SB 2148
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1 (d) For the purpose of this subsection, the term
2 "qualified resident" means residents of the authorizing county
3 who are:
4 1. Qualified as indigent persons as certified by the
5 authorizing county;
6 2. Certified by the authorizing county as meeting the
7 definition of the medically poor, defined as persons having
8 insufficient income, resources, and assets to provide the
9 needed medical care without using resources required to meet
10 basic needs for shelter, food, clothing, and personal
11 expenses; or not being eligible for any other state or federal
12 program, or having medical needs that are not covered by any
13 such program; or having insufficient third-party insurance
14 coverage. In all cases, the authorizing county is intended to
15 serve as the payor of last resort; or
16 3. Participating in innovative, cost-effective
17 programs approved by the authorizing county.
18 (e) Moneys collected pursuant to this subsection
19 remain the property of the state and shall be distributed by
20 the Department of Revenue on a regular and periodic basis to
21 the clerk of the circuit court as ex officio custodian of the
22 funds of the authorizing county. The clerk of the circuit
23 court shall:
24 1. Maintain the moneys in an indigent health care
25 trust fund;
26 2. Invest any funds held on deposit in the trust fund
27 pursuant to general law; and
28 3. Disburse the funds, including any interest earned,
29 to any provider of health care services, as provided in
30 paragraphs (c) and (d), upon directive from the authorizing
31 county. However, if a county has a population of at least
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1 800,000 residents and has levied the surtax authorized in this
2 subsection, notwithstanding any directive from the authorizing
3 county, on October 1 of each calendar year, the clerk of the
4 court shall issue a check in the amount of $6.5 million to a
5 hospital in its jurisdiction that has a Level I trauma center
6 or shall issue a check in the amount of $3.5 million to a
7 hospital in its jurisdiction that has a Level I trauma center
8 if that county enacts and implements a hospital lien law in
9 accordance with chapter 98-499, Laws of Florida. The issuance
10 of the checks on October 1 of each year is provided in
11 recognition of the Level I trauma center status and shall be
12 in addition to the base contract amount received during fiscal
13 year 1999-2000 and any additional amount negotiated to the
14 base contract. If the hospital receiving funds for its Level I
15 trauma center status requests such funds to be used to
16 generate federal matching funds under Medicaid, the clerk of
17 the court shall instead issue a check to the Agency for Health
18 Care Administration to accomplish that purpose to the extent
19 that it is allowed through the General Appropriations Act;
20 and.
21 4. Prepare on a biennial basis an audit of the
22 indigent care trust fund. Commencing February 1, 2004, such
23 audit shall be delivered to the governing body and to the
24 chair of the legislative delegation of each authorizing
25 county.
26 (f) Notwithstanding any other provision of this
27 section, a county shall not levy local option sales surtaxes
28 authorized in this subsection and subsections (2) and (3) in
29 excess of a combined rate of 1 percent.
30 (g) This subsection expires October 1, 2005.
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1 Section 2. This act shall take effect upon becoming a
2 law.
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4 STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
COMMITTEE SUBSTITUTE FOR
5 Senate Bill 2148
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7 The committee substitute requires the clerk of the circuit
court, as an ex officio custodian of the funds of the
8 authorizing county, to prepare an audit of the indigent care
trust fund on a biennial basis. Commencing February 1, 2004,
9 the audit must be delivered to the governing body and to the
chair of the legislative delegation of each authorizing
10 county.
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