CS/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	requiring referendum approval for the surtax in certain
7	counties; providing an effective date.
8
9	Be It Enacted by the Legislature of the State of Florida:
10
11	Section 1.  Paragraph (a) of subsection (4) of section
12	212.055, Florida Statutes, is amended to read:
13	212.055  Discretionary sales surtaxes; legislative intent;
14	authorization and use of proceeds.-It is the legislative intent
15	that any authorization for imposition of a discretionary sales
16	surtax shall be published in the Florida Statutes as a
17	subsection of this section, irrespective of the duration of the
18	levy. Each enactment shall specify the types of counties
19	authorized to levy; the rate or rates which may be imposed; the
20	maximum length of time the surtax may be imposed, if any; the
21	procedure which must be followed to secure voter approval, if
22	required; the purpose for which the proceeds may be expended;
23	and such other requirements as the Legislature may provide.
24	Taxable transactions and administrative procedures shall be as
25	provided in s. 212.054.
26	(4)  INDIGENT CARE AND TRAUMA CENTER SURTAX.-
27	(a)1.  The governing body in each county that the
28	government of which is not consolidated with that of one or more
29	municipalities, which has a population of at least 800,000
30	residents and is not authorized to levy a surtax under
31	subsection (5), may levy, pursuant to an ordinance either
32	approved by an extraordinary vote of the governing body or
33	conditioned to take effect only upon approval by a majority vote
34	of the electors of the county voting in a referendum, a
35	discretionary sales surtax at a rate that may not exceed 0.5
36	percent. However, the governing body of a county that is
37	consolidated with one or more municipalities may levy the surtax
38	only if the ordinance is approved by referendum.
39	2.  If the ordinance is conditioned on a referendum, a
40	statement that includes a brief and general description of the
41	purposes to be funded by the surtax and that conforms to the
42	requirements of s. 101.161 shall be placed on the ballot by the
43	governing body of the county. The following questions shall be
44	placed on the ballot:
45
46	FOR THE. . . .CENTS TAX
47	AGAINST THE. . . .CENTS TAX
48
49	3.  The ordinance adopted by the governing body providing
50	for the imposition of the surtax shall set forth a plan for
51	providing health care services to qualified residents, as
52	defined in subparagraph 4. Such plan and subsequent amendments
53	to it shall fund a broad range of health care services for both
54	indigent persons and the medically poor, including, but not
55	limited to, primary care and preventive care as well as hospital
56	care. The plan must also address the services to be provided by
57	the Level I trauma center. It shall emphasize a continuity of
58	care in the most cost-effective setting, taking into
59	consideration both a high quality of care and geographic access.
60	Where consistent with these objectives, it shall include,
61	without limitation, services rendered by physicians, clinics,
62	community hospitals, mental health centers, and alternative
63	delivery sites, as well as at least one regional referral
64	hospital where appropriate. It shall provide that agreements
65	negotiated between the county and providers, including hospitals
66	with a Level I trauma center, will include reimbursement
67	methodologies that take into account the cost of services
68	rendered to eligible patients, recognize hospitals that render a
69	disproportionate share of indigent care, provide other
70	incentives to promote the delivery of charity care, promote the
71	advancement of technology in medical services, recognize the
72	level of responsiveness to medical needs in trauma cases, and
73	require cost containment including, but not limited to, case
74	management. It must also provide that any hospitals that are
75	owned and operated by government entities on May 21, 1991, must,
76	as a condition of receiving funds under this subsection, afford
77	public access equal to that provided under s. 286.011 as to
78	meetings of the governing board, the subject of which is
79	budgeting resources for the rendition of charity care as that
80	term is defined in the Florida Hospital Uniform Reporting System
81	(FHURS) manual referenced in s. 408.07. The plan shall also
82	include innovative health care programs that provide cost-
83	effective alternatives to traditional methods of service
84	delivery and funding.
85	4.  For the purpose of this paragraph, the term "qualified
86	resident" means residents of the authorizing county who are:
87	a.  Qualified as indigent persons as certified by the
88	authorizing county;
89	b.  Certified by the authorizing county as meeting the
90	definition of the medically poor, defined as persons having
91	insufficient income, resources, and assets to provide the needed
92	medical care without using resources required to meet basic
93	needs for shelter, food, clothing, and personal expenses; or not
94	being eligible for any other state or federal program, or having
95	medical needs that are not covered by any such program; or
96	having insufficient third-party insurance coverage. In all
97	cases, the authorizing county is intended to serve as the payor
98	of last resort; or
99	c.  Participating in innovative, cost-effective programs
100	approved by the authorizing county.
101	5.  Moneys collected pursuant to this paragraph remain the
102	property of the state and shall be distributed by the Department
103	of Revenue on a regular and periodic basis to the clerk of the
104	circuit court as ex officio custodian of the funds of the
105	authorizing county. The clerk of the circuit court shall:
106	a.  Maintain the moneys in an indigent health care trust
107	fund;
108	b.  Invest any funds held on deposit in the trust fund
109	pursuant to general law;
110	c.  Disburse the funds, including any interest earned, to
111	any provider of health care services, as provided in
112	subparagraphs 3. and 4., upon directive from the authorizing
113	county. However, if a county has a population of at least
114	800,000 residents and has levied the surtax authorized in this
115	paragraph, notwithstanding any directive from the authorizing
116	county, on October 1 of each calendar year, the clerk of the
117	court shall issue a check in the amount of $6.5 million to a
118	hospital in its jurisdiction that has a Level I trauma center or
119	shall issue a check in the amount of $3.5 million to a hospital
120	in its jurisdiction that has a Level I trauma center if that
121	county enacts and implements a hospital lien law in accordance
122	with chapter 98-499, Laws of Florida. The issuance of the checks
123	on October 1 of each year is provided in recognition of the
124	Level I trauma center status and shall be in addition to the
125	base contract amount received during fiscal year 1999-2000 and
126	any additional amount negotiated to the base contract. If the
127	hospital receiving funds for its Level I trauma center status
128	requests such funds to be used to generate federal matching
129	funds under Medicaid, the clerk of the court shall instead issue
130	a check to the Agency for Health Care Administration to
131	accomplish that purpose to the extent that it is allowed through
132	the General Appropriations Act; and
133	d.  Prepare on a biennial basis an audit of the trust fund
134	specified in sub-subparagraph a. Commencing February 1, 2004,
135	such audit shall be delivered to the governing body and to the
136	chair of the legislative delegation of each authorizing county.
137	6.  Notwithstanding any other provision of this section, a
138	county shall not levy local option sales surtaxes authorized in
139	this paragraph and subsections (2) and (3) in excess of a
140	combined rate of 1 percent.
141	Section 2.  This act shall take effect July 1, 2010.

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