08 HB1158/SCSFA/2
SENATE
SUBSTITUTE TO HB 1158
AS
PASSED SENATE
A
BILL TO BE ENTITLED
AN ACT
AN ACT
To
amend Titles 31 and 40 of the Official Code of Georgia Annotated, relating,
respectively, to health and motor vehicles, so as to revise certain provisions
relating to the duties and responsibilities of the Georgia Trauma Care Network
Commission; to fund the Georgia Trauma Trust Fund; to provide for certain
reports regarding the Georgia Trauma Trust Fund; to provide for intent of the
General Assembly with regard to certain funds for funding the Georgia Trauma
Trust Fund; to impose a charge on motor vehicle registrations in this state
which shall be transferred to the state treasury for the purpose of funding the
Georgia Trauma Trust Fund; to provide for the collection of such charge; to
provide for related matters; to provide for referendum approval and a contingent
effective date and applicability; to provide for automatic repeal under certain
circumstances; to repeal conflicting laws; and for other purposes.
BE
IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION
1.
Title
31 of the Official Code of Georgia Annotated, relating to health, is amended by
revising Code Section 31-11-102, relating to the duties and
responsibilities of the Georgia Trauma Care Network Commission, as
follows:
"31-11-102.
The
Georgia Trauma Care Network Commission shall have the following duties and
responsibilities:
(1)
To apply for, receive, and administer state funds appropriated to the commission
and federal funds and grants, private grants and donations, and other funds and
donations. The commission´s annual distributions shall be capped and
limited to funds received from the sources specified in this paragraph. The
commission shall ensure that its funds are not used as a supplement or secondary
payor to any other third-party payor;
(2)
For the
first two fiscal years in which funds are appropriated to the commission for
distribution, to
To
distribute
such
funds in
the following areas with the
primary
priority for distribution
for trauma
care readiness costs for Level I, II, III, and IV trauma centers and with
further priorities in the following areas
to be set by majority vote of the commission:
(A)
Physician
uncompensated trauma care services provided in designated trauma
centers
Extending air
or ground ambulance service to regions of the state which are unserved or
underserved;
(B)
Emergency
medical service uncompensated trauma care services provided to patients
transported to designated trauma centers
Training first
responders to provide trauma care and utilize the trauma care network;
and
(C)
Uncompensated
trauma care services of designated trauma
centers;
Creating and
enhancing command and communication networks to refer trauma patients to the
best available facility within the trauma care network.
(D)
Trauma care readiness costs for designated or certified trauma care service
providers; and
(E)
Trauma care service start-up costs for providers seeking a trauma care
designation or certification.
The
commission shall adopt a formula that prioritizes the distribution of state
appropriated funds that may be implemented
during the
third state fiscal year in which funds are appropriated to the
commission for distribution. Such formula
shall be evaluated and modified, if needed, every two years
thereafter;
(3)
To develop, implement, administer, and maintain a system to compensate
designated
Level I, II,
III, and IV trauma centers for a portion
of their cost of readiness through a semiannual distribution from the Georgia
Trauma Trust Fund in a standardized amount determined by the commission.
Readiness
costs shall include staffing and equipment costs of trauma centers which are
incurred solely in order to provide trauma readiness as a Level I, II, III, or
IV trauma center and shall not include any expenses which are incurred by a
hospital on an ordinary basis regardless of whether or not trauma services are
offered. The standardized amounts shall be
determined by
the commission by July 1, 2008, according
to designation level and shall be capped at that specific amount. Initially,
such standardized amount shall be based upon a three-year average of annual
trauma cases, annual amount of uncompensated trauma care services administered,
and a three-year annual average cost of readiness. Such criteria may be changed
by a majority vote of the commission.
The
standardized amounts established pursuant to this paragraph shall be published
by the commission. The commission shall be authorized to adjust the standardized
amounts for readiness cost reimbursements for a trauma center by a positive or
negative margin not to exceed 20 percent of the standardized amount for the
designation level based on the volume of patients who were provided trauma care
by the trauma center during the prior calendar year. No funds shall be
reimbursed to trauma centers by the commission in excess of the adjusted
readiness cost. Total annual distributions
for trauma center
and
emergency medical service readiness shall
be capped at an amount set by the commission. However, the standards developed
by the commission for readiness shall include, but are not limited to, the
following:
(A)
Criteria assuring the trauma fund is a payor of last resort;
(B)
Criteria assuring that all other resources must be exhausted before the trauma
funds are allocated; and
(C)
Criteria assuring that trauma funds must be used to meet a verified need that
assists the trauma center to maintain a trauma center designation;
(4)
To develop, implement, administer, and maintain a system to provide additional
designated trauma center compensation to cover trauma center costs not
associated with readiness based upon an application and review based process.
These distributions shall be capped and limited to semiannual appropriations
received by the commission. Designated trauma centers shall submit an
application for trauma funds reimbursement semiannually. The application
process developed by the commission for such costs shall include, but is not
limited to, the following:
(A)
Criteria assuring that the trauma fund is a payor of last resort;
(B)
Criteria assuring that trauma funds shall be used for reimbursement for services
provided to designated trauma patients;
(C)
Criteria assuring that trauma funds shall be used for reimbursement for trauma
service codes;
(D)
Criteria assuring that trauma funds used for reimbursement for trauma care costs
shall be on a fee schedule or grant basis; provided, however, that no
reimbursement shall exceed the average rate reimbursed for similar services
under the State Health Benefit Plan; and
(E)
Criteria that require the trauma center to submit a semiannual report
documenting and verifying the use of such funds;
(5)
To develop, implement, administer, and maintain a system to compensate
physicians who provide uncompensated call and trauma care services. This
reimbursement shall be distributed on a semiannual basis and paid on a formula
to be set by the commission. The call hours must be documented and verified by
the trauma director at the appropriate trauma center in order to receive such
funds. The formula developed by the commission for reimbursement shall include,
but is not limited to, the following:
(A)
Criteria assuring that the trauma fund is a payor of last resort;
(B)
Criteria assuring that trauma funds shall be used for reimbursement for services
provided to designated trauma patients;
(C)
Criteria assuring that trauma funds used for reimbursement for physician costs
shall be on a fee schedule or grant basis; provided, however, that no
reimbursement shall exceed the average rate reimbursed for similar services
under the State Health Benefit Plan; and
(D)
Criteria assuring that trauma funds shall be used for reimbursement for trauma
service codes;
(6)
To reserve and disburse additional moneys to increase the number of participants
in the Georgia trauma system. These funds shall be disbursed through an
application process to cover partial start-up costs for nondesignated acute care
facilities to enter the system as Level II, III, or IV trauma centers. The
application process developed by the commission for start-up costs shall
include, but is not limited to, the following:
(A)
Criteria assuring that the trauma fund is a payor of last resort;
(B)
Criteria assuring that all other resources for start-up costs must be exhausted
before the trauma funds are allocated;
(C)
Criteria assuring that the distribution of trauma funds will result in the
applicant´s achieving a trauma designation as defined by the commission
within the time frame specified on the application;
(D)
Criteria assuring and verifying that the Department of Human Resources has
determined that there is a need for an additional trauma center with the
designation that the applicant is seeking; and
(E)
Criteria assuring that no more than 15 percent of the total annual distribution
from the trauma fund total shall be distributed for new trauma center
development;
(7)(A)
To develop, implement, administer, and maintain a system to compensate members
of the emergency medical service transportation community for readiness and
uncompensated trauma care.
(B)
The compensation for the cost of readiness shall be through an application
process adopted by the commission. The application process developed by the
commission for readiness costs shall include, but is not limited to, the
following:
(i)
Criteria assuring that the trauma fund is a payor of last resort;
(ii)
Criteria assuring that all other resources for readiness costs must be exhausted
before the trauma funds are allocated;
(iii)
Criteria assuring that the distribution of trauma funds will result in the
applicant´s achieving certification as defined by the commission within the
time frame specified on the application; and
(iv)
Criteria assuring and verifying that the Department of Human Resources has
determined that there is a need for additional emergency medical services with
the certification that the applicant is seeking.
(C)
The commission shall develop a formula for reimbursing emergency medical
services uncompensated trauma care services. The formula developed by the
commission for reimbursement shall include, but is not limited to, the
following:
(i)
Criteria assuring that the trauma fund is a payor of last resort;
(ii)
Criteria assuring that trauma funds shall be used for reimbursement for services
provided to designated trauma patients; and
(iii)
Criteria assuring that trauma funds used for reimbursement of emergency medical
service costs shall be on a fee schedule or grant basis; provided, however, that
no reimbursement shall exceed the average rate reimbursed for similar services
under the State Health Benefit Plan;
(8)
To appropriate, out of the Georgia Trauma Trust Fund, annual moneys for
investment in a system specifically for trauma transportation. The purpose of
this system is to provide transport to trauma victims where current options are
limited. The commission shall promulgate rules and regulations for such system
and shall pursue contracts with existing state transportation structures or
create a contractual arrangement with existing transportation organizations.
The commission shall also be responsible for creating, maintaining, and
overseeing a foundation to raise funds specifically for investment in this
system and overall trauma funding;
(9)(4)
To act as the accountability mechanism for the entire Georgia trauma system,
primarily overseeing the flow of funds from the Georgia Trauma Trust Fund into
the system. The State Office of EMS/Trauma shall receive an annual distribution
from the commission of not more than 3 percent of the total annual distribution
from the fund in the fiscal year. These funds shall be used for the
administration of an adequate system for monitoring state-wide trauma care,
recruitment of trauma care service providers into the network as needed, and for
research as needed to continue to operate and improve the system;
(10)(5)
To coordinate its activities with the Department of Human
Resources;
(11)(6)
To employ and manage staff and consultants in order to fulfill its duties and
responsibilities under this article;
(12)(7)
To establish, maintain, and administer a trauma center network to coordinate the
best use of existing trauma facilities in this state and to direct patients to
the best available facility for treatment of traumatic
injury. No
later than January 1, 2010, the commission shall establish a plan to divide the
state into trauma regions. Such plan shall be designed to bring new trauma care
providers to unserved trauma regions. Following establishment of the plan, the
commission shall be authorized to issue one or more requests for proposals to
provide trauma care services in unserved regions. In selecting proposals to
provide trauma care services in unserved regions, the commission shall consider
the quality of services and cost of services included in the proposals of the
trauma care providers;
(13)(8)
To coordinate, assist, establish, maintain, and administer programs designed to
educate the citizens of this state on trauma prevention;
(14)(9)
To coordinate and assist in the collection of data to evaluate the provision of
trauma care services in this state;
(15)(10)
To study the provision of trauma care services in this state to determine the
best practices and methods of providing such services, to determine what changes
are needed to improve the provision of trauma care services, and to report any
proposed legislative changes to the General Assembly each year; and
(16)(11)
To employ an executive director and other staff and to establish duties and
responsibilities of such persons."
SECTION
2.
Said
title is further amended by revising Code Section 31-11-103, relating to
the Georgia Trauma Trust Fund, as follows:
"31-11-103.
(a)
There is established the Georgia Trauma Trust Fund. The executive director of
the Georgia Trauma Care Network Commission shall serve as the trustee of the
Georgia Trauma Trust Fund. The moneys deposited into such fund pursuant to this
article may be expended by the executive director with the approval of the
Georgia Trauma Care Network Commission for those purposes specified in Code
Section 31-11-102.
(b)(1)
As soon as practicable after the end of each fiscal year, the Office of Treasury
and Fiscal Services shall report to the General Assembly, the Office of Planning
and Budget, and the Georgia Trauma Care Network Commission the amount of funds
received pursuant to Code Section 40-2-153 from the trauma charge on motor
vehicle registrations.
(2)
It is the intent of the General Assembly that, subject to appropriation, an
amount equal to such proceeds received in any fiscal year shall be made
available during the following fiscal year to the Georgia Trauma Trust Fund for
use of the Georgia Trauma Care Network Commission for the purposes set forth in
Code Section 31-11-102."
SECTION
3.
Title
40 of the Official Code of Georgia Annotated, relating to motor vehicles, is
amended by revising Code Section 40-2-23, relating to county tax collectors and
tax commissioners designated tag agents, as follows:
"40-2-23.
(a)
The tax collectors of the various counties of this state and the tax
commissioners of those counties in which the duties of the tax collector are
performed by a tax commissioner shall be designated as tag agents of the
commissioner for the purpose of accepting applications for the registration of
vehicles. The commissioner is authorized to promulgate rules and regulations
for the purpose of delegating to such tag agents the custodial responsibility
for properly receiving, processing, issuing, and storing motor vehicle titles or
registrations, or both.
(b)
The state revenue commissioner is authorized to further designate each such tag
agent as a sales tax agent for the purpose of collecting sales and use tax with
respect to the casual sale or casual use of a motor vehicle. For purposes of
this Code section, 'casual sale' or 'casual use' means the sale of a motor
vehicle by a person who is not regularly or systematically engaged in making
retail sales of motor vehicles and the first use, consumption, distribution, or
storage for use or consumption of such motor vehicle purchased through a casual
sale. As personal compensation for services rendered to the Department of
Revenue with respect to the collection of such sales and use tax, each such
designated tag agent shall be authorized to retain from such collection a fee of
$200.00 per month. In any month in which an insufficient amount of such tax is
collected to pay such fee, the amount of any such unpaid fee may be deferred
until such month as sufficient collections are made. Such compensation shall be
in addition to any other compensation to which such tax collector or tax
commissioner is entitled.
(c)
The state revenue commissioner is authorized to further designate each such tag
agent as a tax agent for the purpose of collecting the trauma charge required by
Code Section 40-2-153.
(c)(d)
The duties and responsibilities of agents of the commissioner designated under
this Code section shall be a part of the official duties and responsibilities of
the county tax collectors and tax commissioners."
SECTION
4.
Said
title is further amended by revising Code Section 40-2-29, relating to license
fee to accompany application, as follows:
"40-2-29.
An
application for registration shall be accompanied by check; cash; certified or
cashier´s check; bank, postal, or express money order; or other similar
bankable
paper,
for the amount of the license fee
and other fees
or charges required by law. A money order
receipt or other evidence of the purchase and remittance of such bankable paper
for the proper amount, dated prior to any delinquency by the proper authority of
the issuer, and showing the office of the commissioner or the office of the
county tag agent as the payee and the owner of the vehicle sought to be licensed
and registered as the remitter shall serve as a temporary permit to operate such
vehicle for a period of 15 days from the date of such
remittance."
SECTION
5.
Said
title is further amended by revising Code Section 40-2-30, relating to purchase
by mail, as follows:
"40-2-30.
An
applicant may purchase a vehicle license plate or revalidation decal by mail, by
mailing a properly completed application form to the tag agent of the county of
his
the
applicant´s residence along with a
money order in the amount of the license
fee, all other
fees or charges required by law, and all
ad valorem taxes due thereon plus an additional fee of $1.00. The governing
authority of the county may by resolution authorize the tag agent of the county
to receive application and payment for the purchase of a license plate or
revalidation decal by mail without charging the additional $1.00
fee."
SECTION
6.
Said
title is further amended by revising paragraph (1) of subsection (a) of Code
Section 40-2-33, relating to issuance of license plates, as
follows:
"(a)(1)
Upon compliance with the provisions of this chapter and the payment of the
license fee
and other fees
or charges required by law, the tag agent
shall accept the application for registration and, except as otherwise provided
for in this chapter, if the license plate or revalidation decal applied for is
in such tag agent´s inventory, he
or
she shall issue the appropriate plate or
revalidation decal."
SECTION
7.
Said
title is further amended by revising Code Section 40-2-153, which is reserved,
as follows:
"40-2-153.
There
is imposed a trauma charge of $10.00 per year on each motor vehicle that is
required to be licensed and registered with the department. Such trauma charge
shall be collected in the same manner and at the same time as the license fee
required by this chapter is collected and prior to the issuance of a license
plate or revalidation decal for such motor vehicle. This Code section shall not
apply to vehicles owned by the state or its departments, agencies, or
authorities or by any political subdivision of the state. Such charge shall be
remitted to the state treasury for the purpose of funding the Georgia Trauma
Trust Fund."
SECTION
8.
(a)(1)
Except as otherwise provided in this section, Sections 2 through 7 of this Act
shall become effective on January 1, 2009; provided, however, that Sections 2
through 7 of this Act shall become effective on January 1, 2009, only if this
Act is approved by the voters as provided in subsection (b) of this section. If
this Act is not approved by the voters as provided in subsection (b) of this
section, then Sections 2 through 7 of this Act shall not become effective and
shall stand repealed in their entirety on January 1, 2009.
(2)
Sections 1, 8, and 9 of this Act shall become effective on July 1,
2008.
(b)
Unless prohibited by the federal Voting Rights Act of 1965, as amended, the
Secretary of State shall call and conduct an election as provided in this
section for the purpose of submitting this Act to the electors of the State of
Georgia for approval or rejection. The Secretary of State shall conduct that
election on the date of the November, 2008, state-wide general election. The
Secretary of State shall issue the call and conduct that election as provided by
general law. The Secretary of State shall cause the date and purpose of the
election to be published in the official organ of each county in the state once
a week for two weeks immediately preceding the date of the election. The ballot
shall have written or printed thereon the words:
|
"( ) YES
( ) NO
|
Shall
the Act be approved that provides for a $10.00 charge on motor vehicle
registrations in this state for the purpose of appropriation for funding the
Georgia Trauma Trust Fund?"
|
All
persons desiring to vote for approval of the Act shall vote "Yes," and those
persons desiring to vote for rejection of the Act shall vote "No." If more than
one-half of the votes cast on such question are for approval of the Act, then
Sections 2 through 7 of this Act may become effective as provided in subsection
(a) of this section; otherwise, Sections 2 through 7 of this Act shall not
become effective.
SECTION
9.
All
laws and parts of laws in conflict with this Act are repealed.