Manatee County Government Administrative Center Commission Chambers, First Floor 9:00 a.m. - April 9, 2013
April 9, 2013 - Regular Meeting
Agenda Item #43

Health Care Surtax Referendum Ordinance 13-17


Contact and/or Presenter Information
Karen Windon, Deputy County Administrator

Action Requested
Adoption of Ordinance 13-17 providing for the levy of a discretionary indigent health care sales surtax of one-half percent (0.5%) to be placed on the August 6, 2013 Special Election ballot and rescinding Ordinance 13-07.

Enabling/Regulating Authority
Florida Statute 212.055(7)

Background Discussion

Ordinance 13-07, providing for the levy of a discretionary indigent health care sales surtax of one-half percent to be placed on the June 18, 2013 special election ballot, was adopted by the Board of County Commissioners on 3/12/2013.

During the 3/26/2013 Board of County Commissioners meeting, a motion passed to bring back an ordinance rescinding Ordinance 13-07 and providing for a special election in August, 2013.

The proposed Ordinance 13-17 substantially mirrors the previous ordinance with two exceptions: the date for the referendum (Section 8) now reflects an August 6, 2013 date, and Section 12 was added to repeal Ordinance 13-07.

Florida Statute 212.055(7) provides for the levying of a discretionary surtax not to exceed 0.5 percent and which must be enacted by adoption of a county ordinance. The Ordinance must set for a plan for providing health care services to qualified residents.

By Statute, a qualified resident is defined as those individuals:

  • Declared indigent by the County;
  • Meeting the definition of medically poor;
  • Having insufficient income, resources, or assets to provide needed medical care without using resources required to meet basic needs;
  • Not eligible for any other state or federal program;
  • Having medical needs that are not covered by any program;
  • Having insufficient third party insurance coverage; and
  • In all cases, the County shall be the payor of last resort.

The plan is required to fund a broad range of health care services including but not limited to: primary care, preventive care, and hospital care, and will include care rendered by physicians, clinics, community hospitals, mental health centers, alternative delivery sites, and hospitals. It will provide for agreements negotiated between the county and the providers including reimbursement methods which take into account the cost of services to eligible patients, recognize hospitals that render a disproportionate share of indigent care, provide other incentives to promote delivery of charity care, and require cost containment, including but not limited to case management. It also must include innovative health care programs that provide cost-effective alternatives to traditional methods of service delivery and funding.

The surtax would be collected on all transactions on any item of tangible personal property except for those above $5,000. Such a surtax will take effect only on January 1st of a given year and terminate on December 31st of a given year.

The plan has been developed in conjunction with system stakeholders and reflects a policy document for the expenditure of the funds. There will be implementation documents developed with subject matter experts who can ensure the maximum utilization of these dollars.  Additionally, an accountability structure will provide oversight for the plan, participants and providers.

The attached Health Care Plan reflects the previous plan with the addition of a preamble that is intended to clarify the short term approach until the impacts of the federal and state decisions on the Affordable Care Act are clear.  In the interim, we will 'stay the course' on funding, meaning we will continue to fund indigent health care as is current practice.

County Attorney Review
Formal Written Review (Opinion memo must be attached)

Explanation of Other

Reviewing Attorney

Instructions to Board Records
Original for Board Records, copy of executed Ordinance to Deputy County Administrator Karen Windon (karen.windon@mymanatee.org).

Cost and Funds Source Account Number and Name

Amount and Frequency of Recurring Costs

Attachment:  IndigentHealthTaxORD13.17.pdf
Attachment:  12-355 Indigent Health Care Sales Surtax Ord..pdf
Attachment:  History of Indigent Health Care Funding.pdf
Attachment:  MC Health Care Plan for 4.9.12.pdf
Attachment:  13-17 - Proof of Pub.pdf