PLACEMENT: Consent
TITLE:
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MARTIN COUNTY LOCAL BILL REQUEST - INDIGENT HEALTH CARE
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EXECUTIVE SUMMARY:
executive summary
The Board of County Commissioners is requested to provide staff direction regarding a potential local bill for the 2026 Legislative Session regarding indigent health care.
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DEPARTMENT: Administration
PREPARED BY: Name: Sarah Powers
Title: Legislative Coordinator
REQUESTED BY: Don G. Donaldson, P.E., County Administrator
PRESET:
PROCEDURES: None
BACKGROUND/RELATED STRATEGIC GOAL:
Presently, Martin County has two special acts of the legislature that address indigent health care within the County. These special acts are codified as 65-1906, Laws of Florida as amended by chapter 2011-247 and chapter 67-1702, Laws of Florida.
Chapter 65-1906, Laws of Florida, authorizes the Martin County Board of County Commissioners (BOCC) to levy a tax of not less than one-quarter (1/4) mill nor more than two (2) mills per annum on the assessed valuation of all taxable real and personal property in Martin County for the purpose of providing funds for the payment of health care services for indigent residents of Martin County. The money derived from this tax is paid into the County Health Care Fund which must be used by the BOCC to pay for the following:
1) Hospitalization, administrative costs, and costs of doctors' services incidental to and included in the cost of hospital care within Martin County for indigent residents; and
2) Health care programs required by Florida law to be funded by counties; and
3) Other health care programs based upon a level of service to be determined from time to time by the BOCC.
All unexpended monies in the County Health Care Fund at the end of each budget year must remain in the County Health Care Fund from year to year. Disbursements from the County Health Care Fund shall be approved by the BOCC. The current millage rate for fiscal year 2025 is 0.3310 mils, which generates $10.9 million per year for the County Health Care Fund. Approximately $6.5 million is allocated to inmate medical care, $1.6 million on indigent hospitalization and $1.4 million is allocated to Medicaid. For fiscal year 2026, the proposed millage rate is 0.3046, and it is estimated to generate $11.3 million for the County Health Care Fund.
Chapter 65-1906, Laws of Florida, created a five (5) member County Health Care Review Board which is comprised of the following:
a) Two (2) members of the BOCC, appointed by the Chair; and
b) Two (2) members of the Martin Memorial Health Systems Board appointed by the chairman of such boards; and
c) Once (1) member at large choses by a majority of the four (4) members so appointed.
The terms of the County Health Care Review Board expire January 15th of each year. The County Health Care Review Board is required to recommend to the BOCC those indigent individuals whose hospitalization and other costs as described above shall be paid from the County Health Care Fund.
Chapter 67-1702, Laws of Florida is a special act of the Legislature that authorizes Martin County to obtain repayment of welfare funds spent on the behalf of indigent residents. Martin County may obtain repayment of money expended for welfare purposes by obtaining a lien against real or personal property owned by indigent residents in the amounts directly spent for the care, hospitalization, sustenance, or maintenance of said individuals, provided that no undue hardship or unreasonable monetary loss will result to said persons. The lien against the recipient of such welfare funds shall be evidenced by a statement of expenditures, sworn by a county employee authorized by the BOCC and shall be recorded in the office of the Clerk of the Circuit Court of Martin County. The statement of expenditures and lien created thereby shall, when recorded, be prima facie evidence of the indebtedness to the County and of the security for said indebtedness. The recordation of the statement of expenditures and the lien created thereby shall have the same effect as a mortgage lien and shall be enforceable by the same procedure as a mortgage foreclosure in the State of Florida.
The statement of expenditures must be recorded in the Office of the Clerk of the Circuit Court in the official records. The lien is applicable to any real or personal property or interest therein presently held or after-acquired by the recipient of funds, whether recorded, or unrecorded, until a satisfaction thereof is filed with the Clerk of the Circuit Court. The liens are effective for a period of twenty (20) years from the date of execution of the sworn statement of expenditures and shall become void at the end of the twenty-year period. Finally, the BOCC may, in its discretion, if it determines that an undue hardship or unreasonable monetary loss will occur to the recipient, waive the payment thereof by resolution of the BOCC; and upon filing of a certified copy of said resolution with the Clerk of the Circuit Court, the lien shall be discharged.
Martin County staff is proposing a local bill which amends chapter 65-1906, Laws of Florida, to require the BOCC to create by ordinance a formula for the distribution of funds from the County Health Care Fund to be disbursed between all licensed hospitals in Martin County. Additionally, the proposed local bill abolishes the County Health Care Review Board and its requirement to make recommendations to the BOCC. Finally, the local bill repeals chapter 67-1702, Laws of Florida, removing the County's ability to lien real and personal property for the repayment of funds spent on behalf of indigents and recipients residing in Martin County.
Chapter 65-1906, Laws of Florida, as amended and chapter 67-1702, Laws of Florida, are attached for reference.
ISSUES:
Staff is requesting Board direction regarding the potential filing of a local bill to the County's state legislative program for 2026.
A local law is a form of special law "relating to or designed to operate only in, a specifically indicated part of the state [...] or one that purports to operate within classified territory when classification is not permissible or the classification adopted is illegal." Art. X., s. 12(g), Fla. Const. Local bills generally are proposed in the following circumstances:
* A local government is limited in its authority to accomplish a specific goal and must ask the Legislature for a special act;
* An area wished to be exempt from a general law; or
* The Legislature has retained authority to decide the local issue by special act (e.g., municipal incorporation and creation of independent special districts).
The local legislative delegation has discretion whether to hear the issue being proposed for a local bill. If the local delegation agrees, the proposed local bill is considered at a public hearing of the delegation. Although the public hearing is not required by law, Florida House policy requires all proposed local bills to be heard by the local legislative delegation at a public hearing in the area that would be subject to the legislative. Once an issue has been discussed and the intent of the bill is clear, the legislative delegation votes on whether or not to support the proposed bill.
A local legislative delegation's rules govern the requirements for approval of a local bill for introduction. Usually, a majority of the legislative delegation must approve the proposed local bill for introduction; however, a delegation's rules may require unanimous approval.
If the local legislative delegation agrees to support the issue and introduce the local bill, the legislative delegation or the local entity requesting the local bill, is responsible for placing a legal advertisement in a newspaper of general circulation and ensuring proper notice. A legal advertisement of the proposed bill must be placed in a newspaper of general circulation at least 30 days prior to introduction of the local bill in the House or Senate.
LEGAL SUFFICIENCY REVIEW:
To the extent this item contains legal issues, it has been reviewed for legal sufficiency, though it is primarily a matter of Board policy.
RECOMMENDED ACTION:
RECOMMENDATION
Move that the Board approve staff moving forward with the proposed local bill.
ALTERNATIVE RECOMMENDATIONS
Pull this item from the Consent Agenda and direct staff accordingly.
FISCAL IMPACT:
RECOMMENDATION
None
ALTERNATIVE RECOMMENDATIONS
None
DOCUMENT(S) REQUIRING ACTION:
?Budget Transfer / Amendment ? Chair Letter ?Contract / Agreement
?Grant / Application ?Notice ?Ordinance ?Resolution
?Other:
This document may be reproduced upon request in an alternative format by contacting the County ADA Coordinator (772) 320-3131, the County Administration Office (772) 288-5400, Florida Relay 711, or by completing our accessibility feedback form at www.martin.fl.us/accessibility-feedback.
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