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6. 16.1 LOCAL Tax REFERENDA (SB 1100 & HB 791) Background.• Section 212.055, F.S., provides counties limited authority to levy discretionary sales sur- taxes for `specific purposes on transactions subject to state sales tax. Discretionary sales surtaxes are generally subject to approval by a majority of the qualified electors in a referendum. Legislation: The bill as originally filed would have required any referendum to levy a discretionary sales surtax to be held on the day of the general election and approved by 60 percent of electors voting before going into effect. The bill also would have prohibited any county or school district from spend- ing funds ito promote a surtax referendum, except where such funds were specifically appropriated for that purpose. Indian River County, as well as most local governments that levy a discretionary sales surtax, opposed this legislation. Amended. • The legislation was amended to require any referendum to levy a discretionary sales surtax held on the day of the general election to be approved by a majority of electors voting and any referen- dum to lel y a discretionary sales surtax held during a primary or presidential preference primary elec- tion to be approved by 60 percent of electors voting. The bill specifically prohibited any referendum to levy a disc, etionary sales surtax from being held during a special election Update: f.The legislation died in committee. The County anticipates that this issue will be back next 16.2 COVERAGE FOR EMERGENCY SERVICES (SB 1442 & HB 221) Backgrodnd: When an insured patient stays or is transported to a pre -approved hospital and under- goes treatment by a specialist and/or emergency ambulance personnel who may work with the hospital but who are not considered hospital employees, the services performed are not always covered by the patient's insurance. As such, an HMO, PPO, or EPO member may end up paying significant out of pocket expenses for care they received from non -hospital personnel while undergoing treatment at a mem bera cility. This is known as balance -billing. While Florida Law does address the reimbursements made by HiIN4Os, the same rules do not apply to PPOs and EPOS. Le slatil: The bill as originally fled would have required PPOs and EPOs to reimburse non - providers a "reasonable" amount for the care and services rendered, or an amount mutually agreed to between the insurer and the non -participating provider. This legislation would have impacted the Indi- an River County Emergency Services District's ability to be reimbursed for providing advance life ser- vices and basic life services to patients who have out -of -network providers. County staff estimated that the fiscal impact of this legislation could decrease billing revenues anywhere from 10%-15% ($500,000 - $800,000): Amended.• The legislation was amended to only apply to circumstances where care was provided in hospitals and like facilities. This amended language does not apply to ENIS services. Update: The legislation passed both chambers. It has not been presented to the Governor for signa- ture yet. 21