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Agenda 10/09/2012 Item #16K210/9/2012 Item 16.K.2. EXECUTIVE SUMMARY Recommendation to adopt a Resolution formally electing the Medicaid Settlement Option set forth in Paragraph 3 of the Amended Stipulation Providing for Dismissal of Some Parties and Abatement of Case for Remaining Parties filed in Alachua County, Florida et al v. Elizabeth Dudek, et al; Case No.: 2012 -CA -1328, Second Judicial Circuit, Leon County, Florida, as it relates to litigation challenging the constitutionality of Chapter 2012 -33, Laws of Florida (HB 5301) and authorize the chairman to sign the Medicaid Payment Plan Agreement with the Agency for Health Care Administration (AHCA). OBJECTIVE: To formally end Collier County's involvement in the case Alachua County, Florida, et al v. Elizabeth Dudek, et al. (the Medicaid backlog litigation) by adopting the attached Resolution. CONSIDERATIONS: Since 1972, the State of Florida has utilized billing and payment mechanisms to charge its counties a percentage of the costs for certain services provided to county residents through Florida's Medicaid Program. Between state fiscal years 1994 -1995 and 2006 -2007, the counties contributed approximately 93 percent of the total Medicaid billings in any fiscal year. Subsequently, however, county contributions to Medicaid collections have steadily decreased with only 64.7 percent of billings in 2010 -2011 being paid that year. This backlog in billings, and resulting shortfall in the state's General Revenue Fund, is blamed on an electronic billing system implemented by the Agency for Health Care Administration around 2008. The purpose of HB 5301 (now Chapter 2012 -33, Laws of Florida) is to collect past disputed bills through an automatic withholding or garnishment of the county revenue sharing and half -cent sales tax distributions. At its April 24, 2012 regular meeting (Item 16K2) the Board authorized the County Attorney to take the steps necessary for Collier County to join the Florida Association of Counties as a plaintiff in litigation challenging the constitutionality of Chapter 2012 -33, Laws of Florida. Collier County was one of 50 or so counties to join in this litigation. On July 24, 2012 (Item 11.C.) the Board reviewed options related to this challenge and directed the County Manager to pursue Option #3 whereby the County would not dispute the billings owed, receive a 15% discount, and make an early payment toward the backlog amount in FY2012. The remaining balance would then be paid over the next five fiscal years. This option was formalized as "The Settlement Option" in the Amended Stipulation Providing for Dismissal of Some Parties and Abatement of Case for Remaining Parties, entered into by counsel for the Counties and the State on September 20, 2012. On September 14, 2012, due to a Court imposed deadline the County Attorney fled the attached "Tentative Notice of Acceptance" advising the State that subject to Board action, the County tentatively accepted the above - referenced settlement option. The proposed Resolution formalizes the Board's previous decision to accept the Settlement option, and withdraws Collier County from this action. Packet Page -1620- 10/9/2012 Item 16.K.2. FISCAL IMPACT: Funding in the amount of $137,280.85 is included for FY 2013 in the budget for the General Fund 001 within Housing, Human and Veteran Services Department. The remaining backlog balance will be budgeted accordingly in the General Fund (001) within the respective years at $137,280.85 annually until FY 2017. GROWTH MANAGEMENT PLAN IMPACT: None. LEGAL CONSIDERATIONS: The Resolution was drafted by the County Attorney, is legally sufficient, and requires majority support for approval. -JAK RECOMMENDATION: That the Board of County Commissioners adopts the attached Resolution memorializing its decision to elect the Medicaid Settlement Option set forth in Paragraph 3 of the Amended Stipulation Providing for Dismissal of Some Parties and Abatement of Case for Remaining Parties filed in Alachua County, Florida et al v. Elizabeth Dudek, et al; Case No.: 2012 -CA -1328, Second Judicial Circuit, Leon County, Florida, and conclude its involvement in a challenge to the constitutionality of Chapter 2012 -33, Laws of Florida (HB 5301); and authorize the Chairman to sign the Medicaid Payment Plan Agreement with the Agency for Healthcare Administration (AHCA). PREPARED BY: Jeffrey A. Klatzkow, County Attorney Packet Page -1621- COLLIER COUNTY Board of County Commissioners Item Number: 16.K.2. 10/9/2012 Item 16.K.2. Item Summary: Recommendation to adopt a Resolution formally electing the Medicaid Settlement Option set forth in Paragraph 3 of the Amended Stipulation Providing for Dismissal of Some Parties and Abatement of Case for Remaining Parties filed in Alachua County, Florida et al v. Elizabeth Dudek, et al; Case No.: 2012 -CA -1328, Second Judicial Circuit, Leon County, Florida, as it relates to litigation challenging the constitutionality of Chapter 2012 -33, Laws of Florida (HB 5301) and authorize the chairman to sign the Medicaid Payment Plan Agreement with the Agency for Health Care Administration (AHCA). Meeting Date: 10/9/2012 Prepared By Name: NeetVirginia Title: Legal Assistant/Paralegal,County Attorney 10/2/2012 2:37:37 PM Submitted by Title: County Attorney Name: KlatzkowJeff 10/2/2012 2:37:39 PM Approved By Name: KlatzkowJeff Title: County Attorney Date: 10/2/2012 3:19:04 PM Name: KlatzkowJeff Title: County Attorney Date: 10/2/2012 3:41:11 PM Name: PryorCheryl Title: Management/ Budget Analyst, Senior,Office of Management & Budget Date: 10/3/2012 9:00:24 AM Packet Page -1622- 10/9/2012 Item 16.K.2. Name: IsacksonMark Title: Director -Corp Financial and Mgmt Svs,CMO Date: 10/3/2012 1:32:30 PM Packet Page -1623- 10/9/2012 Item 16.K.2. 7/24/2012 Item 11.C. EXECUTIVE SUMMARY Recommendation to review and provide direction to the County Manager or his designee regarding the payment of Collier County's Medicaid backlog (retrospective bills). OBJECTIVE: To receive direction for payment of the Medicaid backlog amount due from Collier County. CONSIDERATIONS: In 1972, the Florida Legislature created a mechanism to charge counties for a portion of the state's Medicaid responsibility. During 2008, a new electronic billing system was implemented by the Agency for Health Care Administration (AHCA). Collection of Medicaid payments from the counties decreased due to increased disputes by the counties. Specifically, in Collier County, these disputes include billings for patients that were not deemed to be residents of Collier County; inadequate addresses that prohibited staff from verifying residency; and rebilling of claims determined to have been paid by Collier County. The Certified amount includes billings from November 1, 2001 through March 31, 2012. During the 2012 legislative session, the Legislature passed and the Governor signed HB 5301 (now Ch. 2012 -33, Laws of Florida) requiring the state to collect past disputed bills through an automatic withholding from the county revenue sharing. Rule development (59G- 1.025: Medicaid County Billing) for procedures to implement this unfunded mandate began in June of 2012 and is still being finalized. On August 1, 2012, AHCA will certify to the Department of Revenue (DOR) the final backlog amount remaining unpaid. AHCA provided a final adjusted backlog amount July 13, 2012 which included details on the disposition of each disputed claim. These disputed claims were adjusted according to direction provided by the Governor on July 12, 2012. The adjustments made included corrections for residency verifications, rebilling of claims and credit for payments received. Should this proposed final amount prove to be different from the actual certified amount issued on August 1, 2012, the Board will be notified. Several considerations for the payment of Collier County's backlog amount resulting from the retrospective bills are as follows: 1. Pay 100% of the certified backlog from AHCA; file a petition on or before September 1, 2012 to challenge the amount certified; and proceed with an appeal. 2. Accept the certified backlog amount provided by AHCA and receive a 15% reduction to the total certified amount. 3. Regardless of #1 or #2, the county has the option to pay all or part of the amount certified on August 1, 2012 by September 13, 2012 to avoid reductions to the Revenue Sharing. 4. Beginning with the October 2012 distribution, the DOR will reduce the County's distribution of Revenue Sharing for one -third of the outstanding certified amount. 5. With the October 2013 distribution, the DOR will reduce the County's Revenue Sharing distributions by one - quarter of the then remaining balance. This will continue until FY 2017. Packet Page -753- Packet Page -1624- 10/9/2012 Item 16.K.2. 7/24/2012 Item 11.C. AAW The following is a table depicting these financial impacts and options: FY 2014 Beginning with October 2013, Revenue Sharing Distribution will be reduced by one-quarter of the remaining balance and ammortized over four years. $ 292,418 $ 344,021 $ 159,084 FY 2015 Annual reduction to Revenue Sharing $ 292,418 $ 344,021 $ 159,084 FY 2016 Annual reduction to Revenue Sharing $ 292,418 $ 344,021 $ 159,084 FY 2017 Annual reduction to Revenue Sharing $ 292,418 $ 344,021 S 159,084 Total Fiscal Impact - FY 12 to FY 17 $ 1,754,507 5 2,064,126 $ 1,754,507 FISCAL IMPACT: The current budget for FY 12 has sufficient funds to make the $800,000 suggested, payment, drawing down part of the backlog balance. The remaining backlog amount will be budgeted accordingly in the General Fund (001) within the respective fiscal years. GROWTH MANAGEMENT IMPACT: There is no growth management impact associated with this Executive Summary. LEGAL CONSIDERATIONS: This item has been reviewed by the County Attorney, is legally sufficient, and requires majority vote for approval. This item has been coordinated with lead counsel on the Medicaid suit (in which Collier County joined with FAC and 54 other Counties). -JAK STAFF RECOMMENDATION: Based upon our current knowledge of the legislation and on -going rule making efforts, staff recommends the Board elect Option #3 which is depicted on the table above. This option entails not disputing the certified amount, taking the 15% discount, making an early payment toward the backlog amount in FY 12 and spreading the remaining balance over-the next five (5) fiscal years. The remaining backlog balance will be budgeted accordingly in the General Fund (001) within the respective fiscal years. PREPARED BY: Mark lsackson, Director, Corporate Financial Planning & Management Services, Office of County Manager Packet Page -754- Packet Page -1625- OPTION# 1 OPTION #2 OPTION 43 Do not Challenge, Make Do not Challenge Partial Pymt. in and Take 15% Challenge and FY12 and Take Year Impact Discount Pay 100% 15% Discount Certified Backlog amount at August 1, 2012 $ 2,064,126 $ 2,064,126 $ 2,064,126 Balance after 15% discount if taken 1,754,507 2,064,126 1,754,507 FY2012 Make partial payment 800,000 Balance Beginning October 1, 2012 $ 1,754,507 $ 2,064,1226 $ 954,507 FY 2013 Beginning with October 2012 Revenue Sharing Distribution will be reduced by 1/3 of total certified amount and deducted monthly $ 584,836 $ 688,042 $ 318,169 FY 2014 Beginning with October 2013, Revenue Sharing Distribution will be reduced by one-quarter of the remaining balance and ammortized over four years. $ 292,418 $ 344,021 $ 159,084 FY 2015 Annual reduction to Revenue Sharing $ 292,418 $ 344,021 $ 159,084 FY 2016 Annual reduction to Revenue Sharing $ 292,418 $ 344,021 $ 159,084 FY 2017 Annual reduction to Revenue Sharing $ 292,418 $ 344,021 S 159,084 Total Fiscal Impact - FY 12 to FY 17 $ 1,754,507 5 2,064,126 $ 1,754,507 FISCAL IMPACT: The current budget for FY 12 has sufficient funds to make the $800,000 suggested, payment, drawing down part of the backlog balance. The remaining backlog amount will be budgeted accordingly in the General Fund (001) within the respective fiscal years. GROWTH MANAGEMENT IMPACT: There is no growth management impact associated with this Executive Summary. LEGAL CONSIDERATIONS: This item has been reviewed by the County Attorney, is legally sufficient, and requires majority vote for approval. This item has been coordinated with lead counsel on the Medicaid suit (in which Collier County joined with FAC and 54 other Counties). -JAK STAFF RECOMMENDATION: Based upon our current knowledge of the legislation and on -going rule making efforts, staff recommends the Board elect Option #3 which is depicted on the table above. This option entails not disputing the certified amount, taking the 15% discount, making an early payment toward the backlog amount in FY 12 and spreading the remaining balance over-the next five (5) fiscal years. The remaining backlog balance will be budgeted accordingly in the General Fund (001) within the respective fiscal years. PREPARED BY: Mark lsackson, Director, Corporate Financial Planning & Management Services, Office of County Manager Packet Page -754- Packet Page -1625- 10/9/2012 Item 16.K.2. July 24, 2012 our final trim package. Before you is a resolution which establishes the maximum property tax rates to be levied across all family of Collier County funds, including the general fund and the unincorporated area general fund. Also in the resolution is a notification which verifies once again the public hearing dates in September as September 6th and September 20th, 2012, both being at 5:05 p.m. The notice that goes out from the Property Appraiser, the trim notice which goes out from the Property Appraiser will be the hearing notice for the first September hearing, which is "September 6th. Commissioners, I'll be happy to answer any questions that you might have. COMMISSIONER HENNING: Move to approve. COMMISSIONER FIALA:, Second. CHAIRMAN COYLE: Motion to approve by Commissioner Henning, seconded by Commissioner Fiala. All in favor please signify by saying aye. COMMISSIONER HLLLER: Aye. COMMISSIONER FIALA: Aye. CHAIRMAN COYLE: Aye. COMMISSIONER COLETTA: Aye. COMMISSIONER HENNING: Aye. CHAIRMAN COYLE: And it deserves repeating, that the property tax'rate will remain unchanged. MR..ISACKSON: Yes, sir. For the general fund and unincorporated area general fund. CHAIRMAN COYLE: Yes. Okay, thank you. Item #1 I C DIRECTION TO THE COUNTY MANAGER OR HIS DESIGNEE Page 26 Packet Page -1626- 10/9/2012 Item 16.x.2. July 24, 2012 REGARDING THE PAYMENT OF COLLIER COUNTY'S MEDICAID BACKLOG (RETROSPECTIVE BILLS) - MOTION TO ACCEPT OPTION #3 — APPROVED MR. OCHS: Item 10.0 (sic) is a recommendation to review and provide direction to the County Manager or his designee .regarding the payment of Collier County's Medicaid backlog. Mr. Isackson will present. COMMISSIONER HENNING: Don't pay.,'em. MR. ISACKSON: Thank you, County Manager Ochs. Again, for the record, Mark Isackson with the County Manager's Office. As the Board is well aware, the legislation that was passed this most recent session compels counties to make a backlog payment. And that backlog payment essentially is for a period of time from September of 2001 up until thtturrent March 31 st, 2012 period. In your executive summary there are a couple of dates that are integral and that the Board should be aware of. First is the Agency for Health Care Administration will require a certification of that backlog dollar amount on August l sit, which is why we're before you today, The backlog amount was originally over $3 million. And in conversations that we've had with the State Agency for Health Care Administration, Sherry Pryor in our office has been instrumental in conversations with AHCA. That amount has been reduced. There's been action by the Governor in an attempt to try and streamline some of this. I think also probably in recognition of a lawsuit that's pending with 53 other counties. That backlog amount has been reduced to a little over $2 million. That is the maximum amount of money, backlog amount that we could expect to owe under the legislation. Now, I will tell you that there are still conversations going on with my staff and with AHCA, and that amount may be -- Page 27 Packet Page -1627- 10/9/2012 Item 16.K.2. July 24, 2012 CHAIRMAN COYLE: Who is AHCA? MR. ISACKSON: AHCA is the Agency for Health Care Administration, sir. CHAIRMAN COYLE: Thank you. MR. ISACKSON: That amount may be further reduced. So this will be the maximum amount of dollars in terms of the backlog that we're looking to satisfy the legislation. We've laid out three options for the Board. County. Manager's trying to throw those up on the visualizer. Our suggested.option is option three. The first component of that option is the prepayment of $800,000 which we will do in fiscal year 2012. The second component of that will be taking the 15 percent discount off that $2 million, bringing the number down to -- after the prepayment down to about 954,000. And the third component of that is spreading the final backlog payment out over five years, through 2017. And in fact that would be budgeted annually within those respective fiscal years. The option three suggestion requires that the Board approve that option and then we would in turn convey that framework, as I might call it, to AHCA and we would proceed going forward then. Be happy to answer any questions the Board might have. CHAIRMAN COYLE: Commissioner Henning? COMMISSIONER HENNING: What Medicaid money do we receive from the state? We don't. MR. I§CKSON: That's probably why I was pausing, sir. COMMISSIONER HENNING: Yeah, that's true. So it's clearly a unfunded mandate by the legislators. And that's very disappointing. They're actually -- when you have unfunded mandates, you're actually raising the taxes on our existing citizens, because they're using those funds that were paid for with something else. And it just needs to stop. Where are we with that lawsuit with the Florida legislators and Representative Hudson's Bill 508? Page 28 Packet Page -1628- 10/9/2012 Item 16.K.2. July 24, 2012 AW MR. KLATZKOW: At this point in time the lawsuit continues... I'm getting the feeling that the Florida Association of Counties may decide to settle it, though, in light of some of the conversations with the Governor. COMMISSIONER HENNING: Well, if you do that, we're setting precedence so they can just do it over and over again. Do we have -- you don't have that slide showing their historical budgeting, do you? MR. OCHS: The state's budget? COMMISSIONER HENNING: Yeah. MR. OCHS : No, we don't. That's -- COMMISSIONER HENNING: I don't know if -- MR. ISACKSON: That's the one I -- is that the one I provided you, Commissioner Henning -- COMMISSIONER HENNING: Right. MR. ISACKSON: -- the full budget? COMMISSIONER HENNINQ I don't know if they provided it to my colleagues, but you can see the State of Florida's historical budgeting has pretty much been flatlined to where -- and if you compare to our county, our budgeting has been -- revenues have been going down. And, you know, I would imagine it would be fair to say that would be for all the 67 counties in the State of Florida, comparing it with ours. Our revenue has been going down, but the state has been staying the same. And they've been doing the cost shifting over and over again. You know, Medicaid is a federal program that was shifted down to the states, and now the state is shifting it down to the local government. We have no reason -- the only thing that we can do is, you know, shift it to our citizens. Anyways, it's frustrating. CHAIRMAN COYLE: Yes, it is. Commissioner Fiala? COMMISSIONER FIALA:. I'm so glad that you've made a point Page 29 Packet Page -1629- 10/9/2012 Item 16.K.2. July 24, 2012 of saying this publicly and so reporters can hear it and so forth. And. it even extends beyond just this item. We have seen a number of unfunded mandates handed down to us over the recent years. And it makes it more and more difficult all the time for us to deal with our budget when this is something we had not counted on until the state hands down further requirements. And I say that word meaningfully, that we pay other items that they're not going to pay. And we do our very best, and I think we do an outstanding job, considering the fact that we also have our own things to deal with and less dollars coming in. But it's important that you've brought this to everybody's attention and I thank you for that. CHAIRMAN COYLE: Let me make sure that I clearly understand the issue here. And you stop me or correct me if I'm wrong. If a Medicaid recipient who lists their residence as being Collier County goes for medical treatment in Miami and is treated under the Medicaid program, we are allocated the costs for that person because they say they are -- they reside in Collier County; is that correct? MR. ISACKSON: That's my understanding, sir. MR. OCHS: That's correct. CHAIRMAN COYLE: And so the state in many cases has not even verified whether .that person is a resident of Collier County or whether they're a resident of Miami or anyplace else, but yet they want to charge this money to us based upon the mere statement that the person is a resident of Collier.County, without any consideration being given to when that record was changed or the residency was changed. So the assessment of funds to us is in my opinion erroneous, and past experience has shown that, when we've tried to balance these things out, that the amount of money that the state says we owe turns out not to be the amount of money that we really owe because of incorrect state records pertaining to this -- the location of residency. Page 30 Packet Page -1630- 10/9/2012 Item 16.K.2. July 24, 2012 So my question at the present time is how much do you believe we really owe under this program, and do we have any way of proving that what the state has allocated to us is not the correct amount? MS. GRANT: Good morning, Commissioners, Kim Grant, Interim Director, Housing and Human Veteran Services. Hopefully what I'm about to say will help in this conversation. One of the premises of the new process that AHCA has set in place is a determination of one database and one database only that we'll be using for addresses and that is the database maintained by the Department of Children and Families. They recently came for their business, they went to all the counties around the state and they brought us a sample of approximately 100 clients, if you will, and they showed us the DCF database address and they showed us other records such as our property appraiser information here to validate that address. And their attempt was to have us review those records and see whether we thought in general the integrity of the DCF database was sufficient going forward. ' We have completed that review and we have a few questions that we've sent back up to AHCA. But I will tell you that we surprisingly felt that the database was more accurate than not accurate. So we're not completed with that review but that actually is the foundation of their entire new process that they have gone to greater lengths to validate the address that's being utilized for the process. CHAIRMAN COYLE: Okay. So out of the total amount of money that's being assessed to us, the total amount of charges that are being assessed to us, what percentage do you think we really owe? MS. GRANT: Well, if I use the sample of 100, we have approximately 10 questions. We don't know yet what the resolution of those questions will be. CHAIRMAN COYLE: You: mean 10 cases that you have a question on? Page 31 Packet Page -1631- 10/9/2012 Item 16.K.2. July 24, 2012 MS. GRANT: Correct, thank you very much. So if I just use that for a ballpark at this point in time, I would say that our sample showed that 90 percent was solid, 10 percent we have questions on. And I think before we move all the way forward with this, we will need to get those questions answered and be able to rely upon that. Because the other choice I have procedurally, which is not exactly what you're talking about, is on a going forward basis I have the procedural choice to have a staff member go .through our'own validation of all those addresses, which is what we have been doing for years and that's why we have disputed charges. So if we are really comfortable that there's a really high percentage of accuracy, like 99 percent, we will have to decide whether we also put staff time on it. But right now we're still trying to determine our confirmation of whether we feel that the process they're using in that database is valid. CHAIRMAN COYLE: Okay. So the option you're providing us today represents a recommendation to pay more or less than what the state wants to charge us? . MR. ISACKSON: The state right now has told us that our certified amount is $2,046,1 -- whatever that number is, $2,046,126. CHAIRMAN COYLE: Two million, 064. MR. ISACKSON: I'm sorry,, yes. I got a -- CHAIRMAN COYLE: And I can read that without glasses. MR. ISACKSON: What I'm telling you is what will be our maximum exposure. I believe it will be lower than that based on some conversations that we're still having. In other words, there's bills that have been paid that haven't been recognized in that amount of money, and I think that number will be significantly lower than that, as much as $400,000 lower than that number. MR. OCHS: Commissioners, and the significance of all this from a timing standpoint is you really have two choices today, and we Page 32 Packet Page -1632- 10/9/2012 Item 16.K.2. July 24, 2012 need direction on which choice you'd prefer. The first option is to pay that fully, 100 percent of that certified number when it's finalized,'and reserve your right to then appeal to AHCA for adjustments on or before September 1 st, which we won't meet again until after that. So this is why we're dealing with this today. The second option that's provided in the legislation, is that you can take a 15 percent discount off of that certified backlog payment amount. When you do that, you waive your right to appeal at that point. And that is the recommendation that the staff is making today, based in part of what Ms. Grant just said, if'histonically we're disputing about 10 percent of the bills, this second option discounts that backlog by 15 percent. CHAIRMAN COYLE: That's option three, not option two. MR. OCHS: Well, the only difference between option one and three is that we're recommending if we take three that we make an early partial payment to reduce our going forward liability sir. You're right, thank you. CHAIRMAN COYLE: Okay. So if we approve option three, based upon the research you've already done, we are likely not to be paying more than we should be paying; is that correct? MR. OCHS: Yes, sir. CHAIRMAN COYLE: Okay. But you waive your right to challenge. MR. ISACKSON: That's correct. MR. OCHS: That's correct. CHAIRMAN COYLE: For how long? MR. KLATZKOW: You're waived. MR. OCHS: You waived it. CHAIRMAN COYLE: Forever? MR. OCHS: Just for the backlog. MR. KLATZKOW: For the backlog. Page 33 Packet Page -1633- 10/9/2012 Item 16.K.2. July 24, 2012 MR. ISACKSON: For the backlog. CHAIRMAN COYLE: And this solves the backlog problem? MR. OCHS: Yes, sir. CHAIRMAN COYLE: So it's a one -time waiver. MR. OCHS: Correct. CHAIRMAN COYLE: Now, if they come back and charge us something next year, we can still oppose it, can't -- MR. ISACKSON: That's a -- MR. OCHS: Yes, sir. MR. ISACKSON: --different mechanism. CHAIRMAN COYLE: Is that right? MR. KLATZKOW: We're settling a disputed debt is what we're doing. What the County Manager is saying is that maybe the state is 10 percent off, but you're getting a 15, percent discount. CHAIRMAN COYLE: Yeah, okay. That's what I wanted to get to. MR. ISACKSON: Well, the other thing, keep in mind that part of the legislation on the retrospective piece also impacts a revenue sharing money. By doing this, we're dictating what source of money we're using to pay this backlog. The state's not telling us to do it. So there's another advantage to this approach. CHAIRMAN COYLE: All right. MR. OCHS: Commissioner, finally, on the going forward prospective billing, every month we have the opportunity to audit and challenge that invoice. CHAIRMAN COYLE: Good, good. Okay, who was first? COMMISSIONER COLETTA: I think I was. CHAIRMAN COYLE: Commissioner Coletta? COMMISSIONER COLETTA: How long has this backlog been occurring? What is -- how old is -- how far back does this go? MR. ISACKSON: It stretches from November of 2001 to March Page 34 Packet Page -1634- 10/9/2012 Item 16.K.2. July 24, 2012 of 2012. COMIVIISSIONER COLETTA: Okay. And if we did nothing, we'd be liable for the full amount and they'd, what, sue us for it or they'd take away what services? MR. ISACKSON: Well, what we would do is if there is a -- if we challenge, then what you have is, number one, you better have a basis for the challenge. We're telling you that while we're still in discussions that the basis for that challenge below this two million 064 number probably is not going to prove to be an economic win for the county. So that's why we're suggesting you don't challenge, you take the discount and you move out. COMMISSIONER COLETTA: I hate to take a blow like this and just have to roll with it. I don't know, there is no other choices. I mean, if we don't do it then we're going to be liable for the full amount. They would what, bring suit against us, take us into court? MR. ISACKSON: No, we would just avail ourselves of the challenge process, that's all. At some point in time we're going to be paying some backlog amount. MR. OCHS: We would file the appeal, if you chose to do that. You would have to then -- they would take that out of your revenue sharing. COMMISSIONER COLETTA: Okay. So in other words, there's no way you can win this. MR. OCHS: No, no, no, they -- COMMISSIONER COLETTA: They got us. We just can't move. I mean, they got us boxed into a corner here. We either pay now or we pay later. We'll pay more later if we don't pay now. That's what I'm hearing from you. And then if we challenge it, the chances are what, we got a 10 percent -- we got 10 percent of the items that are in question that we wanted to bring some questions up, but I guess the questions we bring up might be insufficient to be able to change the direction we're going; Page 35 Packet Page -1635- 10/9/2012 Item 16.K.2. July 24, 2012 is that what we're saying? MR. OCHS: Yes, sir. The historical error rate is around 10 percent, in our experience. This discount is 15 percent. And that's why we believe that even if you chose to pay the full certified amount and then appeal, you're not likely to do better than the 15 percent discount. COMMISSIONER COLETTA: The state still has some restrictions too as far as what we can do as far as raising the ad valorem; is that correct? I mean, we don't plan to raise it -- MR. OCHS: You just have a statutory millage cap of 10 mills. COMMISSIONER COLETTA: Well, no, is there any other ones where it takes -- I know for a while there the state legislative body put on some restrictions, if you wanted to raise your millage, not that we`re going to raise it. MR. ISACKSON: It's just a majority vote, two- thirds vote and -- COMMISSIONER COLETTA: So on one hand they place restrictions on what we can do for raising money, and then on the other hand they hand us the bills that they've been traditionally paying for us to have to take care so they can remain solvent. It's a little difficult to work with. CHAIRMAN COYLE: Well, you left out the third component. They also sponsor constitutional amendments that reduce your ability to tax and reduce tax revenue. So they put the squeeze on both ends, but yet their budget really doesn't change much. COMMISSIONER COLETTA:. Thank you. CHAIRMAN COYLE: Commissioner Hiller? COMMISSIONER HILLER: Jeff, can you comment? MR. KLATZKOW: To put it very, very simply, what we're doing here is settling debt, all right? And the 15 percent discount is substantially more than the amount you'd be able to prevail on if you administratively challenged it. That's what I'm getting from the County Manager. Page 36 Packet Page -1636- 10/9/2012 Item 16.K.2. July 24, 2012 MR. OCHS: And again, that's based on our historical review of the error rate for these billings that we've received. COMMISSIONER HILLER: And what is the source of funds? Where is the 800,000 coming from? MR. ISACKSON: Ma'am, we regularly true up from the June workshop to actual values. And the submission of the tentative budget on July 17th, which you received, we regularly true up our revenue sources. In the can on the property tax side I have an additional $900,000 that I didn't have in the June budget but I had in the July budget based on reviewing our reports and the receipts that came in. So that's where we're getting the $800,000. COMMISSIONER HILLER: So do you prefer option one or option three? MR. ISACKSON: Our recommendation is option three, ma'am. COMMISSIONER HILLER: Then I make a motion to approve option three. COMMISSIONER COLETTA: Second. CHAIRMAN COYLE: Motion. by Commissioner Hiller to approve option three, seconded by Commissioner Coletta. All in favor please signify by saying aye. COMMISSIONER HILLER: Aye. COMMISSIONER FIALA: Aye. CHAIRMAN COYLE: Aye. COMMISSIONER COLETTA: Aye. COMMISSIONER HENNING: Aye. CHAIRMAN COYLE: Any opposed by like sign. (No response.) CHAIRMAN COYLE: Okay, the motion passes unanimously. MR. ISACKSON: Thank you, Commissioners. COMMISSIONER FIALA: That's all we can do. CHAIRMAN COYLE: Yep. Page 37 Packet Page -1637- 10/9/2012 Item 16.K.2. RESOLUTION NO. 2012 - A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA, CONFIRMING ITS ACCEPTANCE OF THE SETTLEMENT OPTION SET FORTH IN PARAGRAPH 3 OF THE AMENDED STIPULATION PROVIDING FOR DISMISSAL OF SOME PARTIES AND ABATEMENT OF CASE FOR REMAINING PARTIES FILED IN ALACHUA COUNTY, FLORIDA, ET AL. Y. ELIZABETH DUDEK, ET AL.; CASE NO.: 2012 -CA -1328, SECOND JUDICIAL CIRCUIT, LEON COUNTY, FLORIDA. WHEREAS, since 1972, the State of Florida has utilized billing and payment mechanisms to charge its counties a percentage of the costs for certain services provided to county residents through Florida's Medicaid Program; and WHEREAS, inaccuracies attributed to an electronic billing system implemented by the Agency for Health Care Administration have caused a backlog in billings resulting in a shortfall in the State's General Revenue Fund; and WHEREAS, in 2012, the Florida Legislature passed and the Governor signed HB 5301 (now Chapter 2012 -33, Laws of Florida) to collect past disputed bills through an automatic garnishment of the county revenue sharing and half -cent sales tax distributions; and WHEREAS, Collier County, through its Board of County Commissioners (Board), joined numerous fellow counties and the Florida Association of Counties as a plaintiff in litigation challenging the constitutionality of Chapter 2012 -33, Laws of Florida; and WHEREAS, on July 24, 2012, during a public hearing, the Board accepted Staff's recommendation to elect not to dispute the State's certified amount of Collier County's unpaid Medicaid backlog; accept a 15% reduction of this certified amount; make an early payment toward the backlog amount in FY 2012; and spread the remaining balance over the next five (5) fiscal years; and WHEREAS, this election is formalized as "The Settlement Option" in an Amended Stipulation signed by Counsel for the Plaintiffs and the State dated September 20, 2012; and WHEREAS, the Amended Stipulation requires formal acceptance by the Board of County Commissioners; and WHEREAS, the Board has formally considered the Amended Stipulation Providing for Dismissal of Some Parties and Abatement of Case for Remaining Parties and desires to withdraw from this litigation pursuant to the Settlement Option set forth in Paragraph 3 therein. Packet Page -1638- 10/9/2012 Item 16.K.2. NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA, that it has elected to take the Settlement Option provided in Paragraph 3 of the Amended Stipulation Providing for Dismissal of Some Parties and Abatement of Case for Remaining Parties, filed in Alachua County, Florida et al v. Elizabeth Dudek, et al; Case No.: 2012 -CA -1328, Second Judicial Circuit, Leon County, Florida, a copy of which is attached hereto and made a part hereof. THIS RESOLUTION ADOPTED after motion, second and majority vote favoring same, this 9h day of October, 2012. ATTEST: BOARD OF COUNTY COMMISSIONERS DWIGHT E. BROCK, CLERK COLLIER COUNTY, FLORIDA By: By: Deputy Clerk FRED W. COYLE, CHAIRMAN 2 Packet Page -1639- 10/9/2012 Item 16.K.2. IN THE CIRCUIT COURT OF THE SECOND JUDICIAL CIRCUIT IN AND FOR LEON COUNTY, FLORIDA ALACHUA COUNTY, FLORIDA; ET AL, Plaintiffs, vs. ELIZABETH DUDEK, in her official capacity as SECRETARY of the STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION; and LISA VICKERS, in her official capacity as EXECUTIVE DIRECTOR of the STATE OF FLORIDA, DEPARTMENT OF REVENUE, Defendants. Case No.: 2012 -CA -1328 AMENDED STIPULATION PROVIDING FOR DISMISSAL OF SOME PARTIES AND ABATEMENT OF CASE FOR REMAINING PARTIES This Amended Stipulation Providing for Dismissal of some Parties and Abatement of Case for Remaining Parties is entered into between Plaintiffs ALACHUA COUNTY, FLORIDA; BAY COUNTY, FLORIDA; BREVARD COUNTY, FLORIDA; BRADFORD COUNTY, FLORIDA; CHARLOTTE COUNTY, FLORIDA; CITRUS COUNTY, FLORIDA; CLAY COUNTY, FLORIDA; COLLIER COUNTY, FLORIDA; DIXIE COUNTY, FLORIDA; DUVAL COUNTY, FLORIDA; ESCAMBIA COUNTY, FLORIDA; FLAGLER COUNTY, FLORIDA; FRANKLIN COUNTY, FLORIDA; GADSDEN COUNTY, FLORIDA; GILCHRIST COUNTY, FLORIDA; GULF COUNTY, FLORIDA; HAMILTON COUNTY, FLORIDA; HARDEE COUNTY, FLORIDA; HENDRY COUNTY, FLORIDA; HERNANDO COUNTY, FLORIDA; HIGHLANDS COUNTY, FLORIDA; HILLSBOROUGH COUNTY, FLORIDA; INDIAN RIVER Page 1 of 15 Packet Page -1640- 10/9/2012 Item 16.K.2. I COUNTY, FLORIDA; LEE COUNTY, FLORIDA; LEON COUNTY, FLORIDA; LEVY COUNTY, FLORIDA; LIBERTY COUNTY, FLORIDA; MADISON COUNTY, FLORIDA; MANATEE COUNTY, FLORIDA; MARION COUNTY, FLORIDA; MARTIN COUNTY, FLORIDA; MIAMI- DADE COUNTY, FLORIDA; MONROE COUNTY, FLORIDA; NASSAU COUNTY, FLORIDA; OKALOOSA COUNTY, FLORIDA; OKEECHOBEE COUNTY, FLORIDA; OSCEOLA COUNTY, FLORIDA; PASCO COUNTY, FLORIDA; PINELLAS COUNTY, FLORIDA; POLK COUNTY, FLORIDA; PUTNAM COUNTY, FLORIDA; SARASOTA COUNTY, FLORIDA; SEMINOLE COUNTY, FLORIDA; SUWANNEE COUNTY, FLORIDA; TAYLOR COUNTY, FLORIDA; VOLUSIA COUNTY, FLORIDA; and WAKULLA COUNTY, FLORIDA (hereafter the "Counties ") and the FLORIDA ASSOCIATION OF COUNTIES (hereafter the "Association ") and the Defendants, ELIZABETH DUDEK in her official capacity as Secretary of the State of Florida Agency for Health Care Administration (hereafter the "Agency ") and MARSHALL k> STRANBURG in his official capacity as Interim Executive Director (in place of former Executive Director, LISA VICKERS) of the State of Florida Department of Revenue (hereafter the "Department "), collectively Plaintiffs and Defendants are hereafter the "Parties." WITNESSETH: WHEREAS, Plaintiffs have filed a Complaint against Defendants challenging the constitutionality of certain legislation (i.e., HB 5301), which was adopted by the House and Senate in the 2012 Legislative Session and signed into law by the Governor on March 29, 2012. HB 5301 is now known as Chapter 2012 -33, Laws of Florida. Section 12 of Chapter 2012 -33 amends section 409.915, Florida Statutes, which relates to county contributions to Medicaid. Page 2 of 15 Packet Page -1641- 10/9/2012 Item 16.K.2. WHEREAS, Section 12 of Chapter 2012 -33 (hereafter, "Section 12 ") amends section 409.915, Florida Statutes, as it previously existed to include': a. Section 12 requires the Agency to certify to each county the amount of such county's unpaid billings from November 1, 2001, through April 30, 2012 (the "Prior Unpaid Amounts "). b. Section 12 provides that Counties may challenge the Prior Unpaid Amounts in an administrative process under chapter 120, Florida Statutes. Counties that do not challenge the Prior Unpaid Amounts shall pay only 85% of that county's Prior Unpaid Amounts. Counties that prove by a preponderance of the evidence that the Prior Unpaid Amounts were incorrect will be entitled to a credit on future payments. C. Section 12 implements a "collection enforcement mechanism" in order to require Counties to pay for the Prior Unpaid Amounts. Over a five year period beginning October, 201.2, the Department will deduct from each county's monthly distribution pursuant to section 218.26, Florida Statutes (the "County Revenue Sharing Funds "), that county's portion of the Prior Unpaid Amounts as certified by the Agency. The Department must leave sufficient County Revenue Sharing Funds to service outstanding debt secured by such funds. d. Section 12 provides that, beginning May 7, 2012 and continuing on the 7th day of each month thereafter, the Agency will certify the Counties' monthly share of Medicaid reimbursement ( "Future Billings ") and thereafter the Department will deduct ` The Parties stipulate and agree that the provisions of the Section 409.915, Florida Statutes, as amended by Section 12, speak for themselves, and that the following descriptions thereof are merely a summary of the pertinent provisions rather than a binding agreement as to the Parties' interpretation of the meaning of that statutory section. Page 3 of 15 Packet Page -1642- 10/9/2012 Item 16.K.2. Half Cent Sales Tax Funds from each County's distribution pursuant to section 218.61, Florida Statutes. Section 12 further provides, however, that the Department must leave sufficient Half Cent Sales Tax Funds to service outstanding debt secured by such funds. e. Section 12 provides that Counties may contest Future Billings by requesting a refund under a process to be determined by the Agency, the Department, and FAC - which process is currently Linder rule development by the Agency. If the Agency determines the refund request is appropriate, the Department may refund the amount to the county from the General Revenue Fund or issue the refund in the form of a credit against the Future Billings which process is currently under development by the Agency. WHEREAS, Plaintiffs have concern with the following circumstances, provisions or practices among others: �... a. Section 12 requires monthly payment of prior unpaid amounts from each County's monthly distribution pursuant to § 218.26, Florida Statutes, of the Counties' revenue sharing monies rather than from a revenue source of each County's choosing. b. Section 12 requires monthly future billings to be paid from the Counties' distribution pursuant to § 218.61, Florida Statutes of the shared Half Cent Sales Tax Funds rather than from a revenue source of each County's choosing. WHEREAS, the Complaint filed by Plaintiffs includes three (3) counts. The first and second counts assert challenges pursuant to Article VII, section 18(a) and (c), Florida Constitution, for violation of the unfunded mandate provisions. The third count asserts that Page 4 of 15 I Packet Page -1643- - 10/9/2012 Item 16.K.2. unpaid claims extending from 2001 - 2008 are time barred pursuant to §§ 95.11(3)(0 and (p) and 95.11(6), Florida Statutes (2011). errors. WHEREAS, the Parties have worked together to identify and correct billing system WHEREAS, the Counties have had unprecedented access to Agency staff for collaboration in seeking solutions. WHEREAS, the Parties, are creating a joint Work Group comprised of representatives from the Agency and the Association (on behalf of the Counties) to raise, address and solve ongoing concerns and problems, that will meet on a regularly scheduled basis. WHEREAS, to facilitate the orderly payment of these claims, the Agency has authorized the Counties to make a one time prepayment in whole or in part, to reduce or avoid the burden of revenue share withholding. WHEREAS, in order to administer these claims, the Agency has permitted counties to dispute Prior Unpaid Amounts (sometimes referred to as "Backlog" claims) based upon Agency policies in effect at the time each claim was originally disputed. WHEREAS, working in conjunction with the Counties, the Agency has created and implemented an Advanced Refund Request (ARR) process, allowing a prepayment dispute process on claims, and extending that process through April 2013. WHEREAS, working in conjunction with the Counties, the Agency has created and implemented a Back End Refund Request (BERR) process, including the allowance of filing BERRs on the denied ARRs, and thus allowing a prepayment dispute process on these claims as well, with finality and appeal rights. Page 5 of 15 Packet Page -1644- 10/9/2012 Item 16.x.2. WHEREAS, the Agency, working in conjunction with the Counties, has provided for direct monthly payments on prospective bills in order to allow Counties to choose to avoid revenue share withholdings. WHEREAS, the Florida Department of Children and Families ( "DCF "), working in conjunction with the Agency and the Counties has permitted the Counties unprecedented access to the DCF Medicaid eligible recipient address database. WHEREAS, the Agency working in conjunction with the Counties, has provided for a 60 day County review cycle, and a date certain for receipt of monthly statements on the second business day of the month, as well as a process of tracking payments, refunds, and credits on a monthly basis. WHEREAS, the Agency working in conjunction with the Counties, has created detailed time frames for responses and dispute resolution methods to avoid such backlogs from ever happening again. WHEREAS, the Agency working in conjunction with the Counties, has worked to enhance the fairness of the collection system by: 1) providing a $0 certification for the first month that HB 5301 was to be implemented, on May 7, 2012; 2) allowing for direct monthly payments on prospective bills to allow Counties to choose to avoid Half Cent Sales Tax withholding; 3) authorizing a one -time prepayment in whole or in part, by 11 :59 p.m., Eastern Standard Time, on September 13, 2012 to allow Counties to choose to reduce or avoid the burden of revenue share withholding; and 4) has provided preliminary backlog statements in advance of the August 1, 2012 statutory certification date in order to facilitate the review and resolution of these disputed claims. Page 6 of 15 Packet Page -1645- 10/9/2012 Item 16.K.2. WHEREAS, the Counties, working in conjunction with the Agency and in order to show their willingness to pay their fair share of the State's Medicaid payment, have paid those amounts which are accurate, and due and owing during the pendency of this litigation. WHEREAS, the Agency has begun the rule making process as required by Section 12 and has been working cooperatively with the Counties and the Association in an effort to address many of the Counties' concerns regarding how the collection process will be administered in the future and how the monthly payments for prior and future billings might be made directly to the Agency from revenue sources of the county's choice rather than providing for certification and automatic deduction by the Department from county revenue sources shared with the State. WHEREAS, the Parties recognize that the Chapter 120 process has been legislatively sanctioned as the forum for disputes relating to the backlog amounts under FIB 5301, and no abridgement of any rights to make such challenges is contemplated by this Stipulated Settlement and Dismissal. WHEREAS, the Parties recognize that the Department's role is primarily ministerial and the Department does not have a role in disputing Medicaid billings unless there is an issue of the protection of existing bond commitments required under HB 5301. WHEREAS, the Parties by entering into this stipulation recognize that the circumstances of the Counties on an individual basis may differ substantially; i.e., some Counties may be willing to accept the 15% discount available to Counties that do not challenge the Agency's certification, some Counties may want to bring an action under Chapter 120 challenging the prior unpaid amount that the Agency has certified including the right to assert a claim for what Page 7 of 15 Packet Page -1646- 10/9/2012 Item 16.K.2. AOW the Counties perceive to be stale or time barred. Some Counties will be willing to dismiss their claims and some, though not prepared to dismiss their claims at this time are willing to agree to an abatement to facilitate further resolution of this matter, for an undefined period, but no later than December 31, 2012, NOW THEREFORE, in consideration of the mutual promises set forth herein and other valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Parties agree as follows: herein. 1. The above recitals are true and correct and by this reference are incorporated 2. Those Counties and Association under this stipulation may choose between one of the two options (i.e., a SETTLEMENT OPTION or an ABATEMENT OPTION) set forth in paragraphs 3 and 4 below. 3. The SETTLEMENT OPTION is for Counties (or the Association) that intend to withdraw from this litigation. This includes both Counties that do not intend to challenge the Prior Unpaid Amounts and Counties that do intend to challenge the Prior Unpaid Amounts under Chapter 120 Florida Statutes. As to these Counties the Complaint will be deemed to be dismissed with prejudice as to Counts I and Il and without prejudice as to Count III. As to these Counties, the Agency, as provided in paragraph 7 below, will accept periodic direct payment of such County's Prior Unpaid Amount. The Agency acknowledges that a county which enters into this Agreement does not thereby waive the right to assert any valid affirmative defense it would otherwise have been able to assert in an administrative proceeding pursuant to Section 409.915(7)(x), Florida Statutes. Counties choosing the SETTLEMENT Page 8 of 15 Packet Page -1647- 10/9/2012 Item 16.K.2. OPTION must provide notification of this choice to the Agency by sending a scanned copy of a signed and verified stipulation form (the "Stipulation Form ") attached hereto as Exhibit 6 by email and U.S. Mail to the Agency's General Counsel (with a copy to the Association) which is emailed and post marked no later than September 1.2, 2012. An initial list of those Counties (or Association) choosing the SETTLEMENT OPTION is set forth in Exhibit 2- 4. The ABATEMENT OPT1ON is for Counties (or the Association) that intend to remain in this litigation. These Counties (including the Association) together with the Agency and the Department agree that this litigation will be held in abeyance by mutual agreement to facilitate further resolution of this matter for an undefined period but no later than December 31, 201.2. This abatement is to the litigation only, and all provisions and deadlines of HB 5301 . continue to take effect as set forth therein. The Parties acknowledge that the abatement applies only to the litigation and does not abate or otherwise affect the requirements imposed on the Parties by statute. Provided that nothing in this Stipulation shall prevent an abating county from individually dismissing the Complaint without prejudice and re- filing an action on its own behalf. An initial list of those parties choosing the ABATEMENT OPTION is set forth in Exhibit 3. 5. The Agency further agrees that any County (whether agreeing to settle or not) filing a Chapter 120 challenge of the Prior Unpaid Amount will be offered the opportunity to abate those proceedings to facilitate further resolution of the matter for a period not less than 90 days, which period may be extended upon the mutual agreement of the parties to such proceeding. Page 9 of 15 Packet Page -1648- 10/9/2012 Item 16.K.2. 6. The Parties agree that Exhibits 2 and 3 of the Stipulation can be amended by the Association to add to Exhibit 2 the names of additional Counties choosing to settle and delete from Exhibit 3 the names of those Counties choosing to settle by filing such information in an addendum no later than September 3.6, 2012 at 5:00 p.m. (Eastern /Standard Time). 7. The Parties recognize that section 409.915(8), Florida Statutes, as amended by Section 12, provides for the payment of each county's Prior Unpaid Amount by the automatic deduction by the Department (over a sixty (60) month, or longer, time period) of each County's revenue sharing distribution. The Parties further recognize that the calculation and amount of each County's monthly deduction can be obtained from the Agency. As an accommodation to those Counties choosing THE SETTLEMENT OPTION that would like to avoid the automatic deduction of their revenue sharing distribution and that would like to make payments from a Aft revenue source of their choosing, the Agency and Department agree that such Counties shall *11 ' make periodic advance payments (in monthly, quarterly or greater increments or to be specified at the time the county enters into a payment plan with the Agency) to the Agency on or before October 5th by 11:59 p.m., (Eastern/Standard Time) and on or before the fifth day of each month thereafter by 1.1:59 p.m. (Eastern/Standard Time) from a revenue source of the County's choosing (unless an advance payment has already been submitted for that month). Once the Agency enters into a payment plan with a county, the Agency shall notify the Department of the details of the payment plan. If the incremental payment is not received by 11:59 p.m, of the date payment is required, the Agency shall notify the Department and the Department shall deduct that month's payment from that County's revenue sharing distribution. As set forth in paragraph 8 below, it is further agreed that a county's ability to continue to make the advance Page 10 of 15 Packet Page -1649- 10/9/2012 Item 16.x.2. payments provided in this paragraph shall be lost if the county fails to make a timely advance payment to the agency. 8. The Parties agree that if a County's incremental payment is not timely received by the Agency pursuant to paragraph 7, supra, that such County shall be in material and irreparable breach of this Agreement. As a consequence of that breach the Agency shall, within two (2) business days, amend its prior certification to the Department pursuant to section 409.915 (7), Florida Statutes, to include all amounts remaining unpaid by that County at the time of the breach. The Department shall act upon the Agency's amended certification in accordance with section 409.915 (8), Florida Statutes, by thereafter reducing the breaching County's distributions pursuant to that subsection, prospectively, from the time of the Agency's amended certification. The Counties hereby waive their right to administratively challenge the Agency's determination as to whether a payment has been timely received pursuant to this paragraph and paragraph 7, supra. 9. The Agency agrees to include the provisions of Composite Exhibit 4 in its proposed rules and further to move forward and work with the Counties and the Association in good faith with the proposed rules that are presently being considered for adoption. The Parties acknowledge that the Agency's draft rule attached hereto as Composite Exhibit 4 is presently in the administrative rulemaking process pursuant to Section 120.54, Florida Statutes, and that the draft rule will not become final until that process, including any administrative challenges that may be brought under Chapter 120, Florida Statutes, is successfully completed. The Parties agree that, should the rule or any other aspect of this settlement be successfully Page 11 of 15 Packet Page -1650- 10/9/2012 Item 16.K.2. challenged under Chapter 120, Florida Statutes, and be ruled invalid, it shall not constitute a breach by the Agency of this agreement or of any order entered that adopts this agreement. 10. The Parties agree that if any provision of this agreement is ruled by a judicial or administrative tribunal to be illegal, unenforceable, or void, then the Parties shall be relieved of their respective obligations arising under such provision, and the validity of the remainder of the agreement shall not be affected. 11. The Parties agree that in the interest of fairness the SETTLEMENT OPTION set forth in paragraph 3 above shall also be available to Counties that have not joined as Plaintiffs in this action, (the "Non- Plaintiff Counties") where any such County provides to the Agency by email and U.S. Mail to the Agency's General Counsel (with a copy to the Association), which is emailed and postmarked no later than September 12, 2012, a notice and waiver of such Counties' ability to pursue an action in Circuit Court challenging HB 5301 on the basis of an alleged violation of the unfunded mandate provisions of Art. VII, Sec. 18, Florida Constitution in substantially the form of the notice and waiver attached hereto as Exhibit 5. The Association shall provide a copy by email of this Stipulation to the County Attorney of all Non - Plaintiff Counties. 12. The Agency is willing to accept a tentative notice of acceptance of the settlement option (the "Tentative Notice of Acceptance ") from those counties (both Plaintiff. Counties and Non - Plaintiff Counties) that have not had an opportunity to make a formal determination of which option to accept. The Tentative Notice of Acceptance must be provided by the Chairman of the Board of County Commissioners or a member of such County's Senior Staff by September 12, 2012. The Tentative Notice of Acceptance must be accompanied by evidence that the Board Page 1.2 of 15 Packet Page -1651- 10/9/2012 Item 16.K.2. of County Commissioners will be formally considering the County's options no later than October 12, 2012, at 11:59 p.m. (Eastern/Standard Time) and shall be substantially the form attached hereto as Exhibit 1. Notice of the subsequent formal action of the Board of County Commissioners approving the settlement option ( "Notice of Approval ") must be provided by sendn-tg a scanned copy of a signed and verified Stipulation as provided in Exhibit 6 by email and U.S. Mail to the Agency's General Counsel (with a copy to the Association) and to the Department's Office of General Counsel no later than October 13, 2012 at 5:00 p.m. (Eastern /Standard Time). If a properly executed Notice of Approval which evidences that County's formal approval of the settlement option is not timely received by the Agency pursuant to this paragraph, that event shall constitute a material and irreparable breach of this Agreement. As a consequence of that breach the Agency shall, within two (2) business days, amend its prior certification to the Department pursuant to section 409.915 (7), Florida Statutes, to include all amounts remaining unpaid by that County at the time of the breach. The Department shall act upon the Agency's amended certification in accordance with section 409.915 (8), Florida Statutes, by thereafter reducing the breaching County's distributions pursuant to that subsection, prospectively, from the time of the Agency's amended certification. The Counties hereby waive their right to administratively challenge the Agency's determination as to whether a payment has been timely received pursuant to this paragraph 13. The Parties hereby agree that the signing of this Stipulation by any of them does not constitute an admission of any liability or wrongdoing whatsoever. Rather, the Parties have entered into this Stipulation in a desire to amicably compromise their differences and avoid protracted litigation, by dismissal and abatement. Page 13 of 15 Packet Page -1652- 10/9/2012 Item 16 . K.2. 14. This Stipulation shall not be construed against any one party, but shall be construed as if it were prepared jointly by all of them, and any uncertainty or ambiguity, or both, shall not be interpreted against any party. 15. The Parties agree that each shall pay their own attorney's fees and costs incurred in connection with this litigation. 16. The Parties recognize that St. Lucie County and St. Johns County are separately represented in this matter, and are not bound by the terms and conditions of this document or any prior stipulation. 17. The Parties acknowledge that Broward County is not a party to this Stipulation and is not bound by the terms and conditions of this document or any prior stipulation. DATED this day of September, 2012. i S H. Churuti Fla. ar No. 284076 Thomas B. Drage, Jr. Fla. Bar No. 173070 Bryant Miller OIive, P.A. One Tampa City Center, Suite 2700 Tampa, FL 33602 (813) 273 -6677 (813) 223 -2705 (fax) schuruti@bmolaw.com and 1x�6ph C. Mellichamp, I13' Timothy E. Dennis i Assistant Attorney General Office of the Attorney General Revenue Litigation Bureau PL -01, The Capitol Tallahassee, Florida 32399 -1050 Facsimile: 850 - 488 -5865 Page 14 of 15 Packet Page -1653- Virginia Saunders Delegal Fla. Bar No. 989932 General Counsel Florida Association of Counties 100 S. Monroe Street Tallahassee, FL 32301 (850) 922 -4300 (850) 488 -7192 (fax) gdelegal@fl- Counties.com 10/9/2012 Item 16.K.2. r Stuart WiIhams, General Counsel Bill Roberts, Deputy General Counsel State of Florida, Agency for Healthcare Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308 Facsimile: 850 - 921 -0158 CERTIFICATE OF SERVICE I HEREBY CERTIFY that on September 20, 2012, a copy of the foregoing was furnished via PDF email upon the following counsel of record: Stuart Williams, General Counsel Bill Roberts, Deputy General Counsel State of Florida, Agency for Healthcare Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308 Facsimile: 850 -921 -0158 Stuart .williams @acha.mvflorida.com Joseph C. Mellichamp, III Timothy E. Dennis Assistant Attorney General Office of the Attorney General Revenue Litigation Bureau PL -01 The Capitol Tallahassee, FL 32399 -1050 Joe.mellichamp@myfloridale ag l.com Page 15 of 15 Packet Page -1654- Gregory Stewart, Esq, Nabors Giblin & Nickerson PO Box 11008 Tallahassee, FL 32302 gstewart@nL,n-tallv.com I 10/9/2012 Item 16.K.2. 44Z I N Tho B. Drage, Jr. -ro Page 16 of 15 Packet Page -1655- 10/9/2012 Item 16.K.2. EXHIBIT 1 Stuart Williams, Esquire General Counsel State of Florida Agency for Healthcare Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308 Email: stuart.williams@ahca.myflorida.com Re: Tentative Notice of Acceptance Dear Mr. Williams & Mr. Mellichamp .2012 Joseph C. Mellichamp, Ill, Esquire Chief Assistant Attorney General Florida Office of the Attorney General Revenue Litigation Bureau 400 S. Monroe Street, # PL -01 Tallahassee, Florida 32399 Email: joe .mellichamp@myfloridalegal.com The purpose of this letter is to advise the Agency for Healthcare Administration (the "Agency ") and the Florida Department of Revenue (the "Department ") that [ ] County (the "County ") intends to provide Tentative Notice of Acceptance that the County has elected to accept the Settlement Option as provided in paragraph 3 of Stipulation Providing for Dismissal of Some Parties and Abatement of Case for Remaining Parties (the "Stipulation ") entered into in the case of Alachua County; et al. vs. Elizabeth Dudek, et al., Case No. 2012 -CA -1328 in the Circuit Court for the Second Judicial Circuit in and for Leon County, Florida (the "Lawsuit "). Although, the County intends to settle the Lawsuit, the Board of County Commissioners has not had the opportunity to formally consider the matter. Please accept this as the County's Tentative Notice of Acceptance of the Settlement Option. Attached I have provided evidence indicating that the County will formally consider the Settlement Option no latter than October 12, 2012 at 11:59 p.m. (Eastern/Standard Time). [Senior Staff /County Administrator/ Manager/Deputy County Administrator/ County Attorney] cc: Ginger Delegal, General Counsel Florida Association of Counties EXHIBIT 1 Packet Page -1656- EXHIBIT 2 List of Counties Choosine the Settlement Option: Brevard County, Florida Charlotte County, Florida Collier County, Florida Duval County, Florida Gilchrist County, Florida Gulf County, Florida Hamilton County, Florida Hardee County, Florida Hendry County, Florida Highlands County, Florida Indian River County, Florida Manatee County, Florida Monroe County, Florida Osceola County, Florida Polk County, Florida Sarasota County, Florida Suwannee County, Florida Taylor County, Florida EXHIBIT 2 Packet Page -1657- 10/9/2012 Item 16.K.2. Alachua County, Florida Bay County, Florida Bradford County, Florida Citrus County, Florida Clay County, Florida Dixie County, Florida Escambia County, Florida Flagler County, Florida Franklin County, Florida Gadsden County, Florida Hernando County, Florida Hillsborough County, Florida Lee County, Florida Leon County, Florida Levy County, Florida Liberty County, Florida Madison County, Florida Marion County, Florida Martin County, Florida Miami -Dade County, Florida Nassau County, Florida OkaIoosa County, Florida Okeechobee County, Florida Pasco County, Florida Pinellas County, Florida Putnam County, Florida Seminole County, Florida Volusia County, Florida Wakulla County, Florida EXHIBIT 3 List of Counties Choosing to Abate: EXHIBIT 3 Packet Page -1658- 10/9/2012 Item 16.K.2. 10/9/2012 Item 16.K.2. COMPOSITE EXHIBIT 4 Notice of Change/Withdrawal AGENCY FOR HEALTH CARE ADMINISTRATION Medicaid RULE NO.: RULE TITLE: 59G- 1.025: Medicaid County Billing NOTICE OF CHANGE Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)l., F.S., published in Vol. 38 No. 26, June 29, 2012 issue of the Florida Administrative Weekly. The following changes have been made to the proposed rule. THE FULL TEXT OF THE PROPOSED RULE IS: 59G -1.025 Medicaid County Billing. id (1) Retrospective Bills. This paragraph applies to the certification of county billings from November 1, 2001, through April 30, 2012, that remain unpaid, as provided in section AMW VOW 409.915(7), F.S. (a) By August 1, 2012, the Agency will certify to each county the amount that is unpaid for retrospective bills. (b) By September 1, 2012, a county may contest the amount certified b filing iling a petition under the apxilicable 2mvisions of chapter 120 This procedure is the exclusive method to challenge the amount certified. (c) September 13, 2012,5:00 p.m. Eastern Stated Time, each county may make total or partial payment in the form of a check or wire transfer to the Agency of the amount certified by the Agency pursuant to subsection (1)(a). (d) By September 15, 2012, the Agency will certify to the Department of Revenue: COMPOSITE EXHIBIT 4 Page 1 of 7 Packet Page -1659- 10/9/2012 Item 16.K.2. 1. 100 percent of the amount provided in subsection (1)(a) minus amounts credited to the counties and /or amounts paid and received by the Agency pursuant to subsection (1)(c) for each county that challenges the certified amount by filing a petition pursuant to subsection (1)(b)13�y ME MIN �M 2. 85 percent of the amount provided in subsection (1)(a) minus amounts credited to the counties and /or paid and received b the he Agency pursuant to section (1)(c) for each county that does not challenge the certified amount by filing a petition pursuant to subsection (1)(b) by --Ptembe,r 1, - (2) Prospective Bills. This paragraph applies to the monthly amount of each county's contribution to Medicaid as required in section 409.915, F.S. The monthly bills will be rendered to the counties no later than the second business day of the month. (a) Certification 1. For all certifications prior to June 1, 2013, the Agency will certify to the Department of Revenue by the 711, day of each month the amount of the monthly bill rendered one month prior less any amounts as provided in subsections (2)(b) and (2)(c). 2. For the June, 2013 certification, the Agency will certify to the Department of Revenue the amount of the monthly bills rendered in May, 2013 and June, 2013 less any amounts credited to a county pursuant to subsection (2)(b). 3. Beginning July 1, 2013, the Agency will certify to the Department of Revenue by the 711, day of each month the amount of the monthly bill rendered that month less any amounts as provided in subsection (2)(b). COMPOSITE EXHIBIT 4 Page 2 of 7 Packet Page -1660- 10/9/2012 Item 16.K.2. 4. If the 711 day of the month falls on a weekend or holiday, certification will be completed on ' "` the first business day following the 71" day of the month. 5. If the Department of Revenue determines there are insufficient funds to pay a county's monthly certified amount, the Department will notify the Agency of the amount still owed, and the Agency will send an invoice to the affected county within two months of receiving; the Department's notice. The county shall pay the invoice within 60 days of receipt. The balance on any invoice that remains unpaid after 60 days will be re- certified to the Department of Revenue in subsequent months until paid in full. (b) Payments Each county may choose to submit payment in the form of a check or wire transfer to the Agency. Such payment must be received by 5:00 p.m. Eastern Standard Time two business days prior to the date of certification. (c) Refund Requests 1. Advanced- Refund Request a. No later than the last business day of each billing month, each county may request an advanced refund request through the county billing portal for those claims on the same monthly billing that the county disputes. If the request is less than or equal to the amount of the county's highest monthly dispute rate reasenable, the Agency will stay certification of the amount requested in the fer-tke advanced refund request. b. Refund requests resulting in certification amounts stayed will be researched within 60 days by the Agency. COMPOSITE EXHIBIT 4 Page 3 of 7 Packet Page -1661- 10/9/2012 Item 16.K.2. I. Denied refund requests will be certified to the county on a subsequent bill no later than 45 days from the conpletion of Agency research. II. Bills for which a refund request is granted on the basis that the bill should have been submitted to a different county will be transferred and certified to the appropriate county on a subsequent bill no later than 45 days from the completion of Agency research. c. A county does not waive any right to paragraph (c)2., Back End Refund Request, by making an advanced refund request. d. Except for sub- paragraph Lb,, subsecti on pai aph 1. sghall expire on April 30, 2013. 2. Back End Refund Request a. Each county may request a back end refund request noNe later than 60 days from the date of certification of the monthly bill for which the back end refund request is being requested the last business day ef the Fnenth following the b414 issuanee, eaeh eeanty FAay request a baeh ead b. Back end refund requests must be in writing and must include the reason and documentation for the request, and be r-eeeiN,ed by the ageney by the last business day ef the c. Within 960 days of r-eeeip of the certification request, the Agency will notify the county whether the request is granted, either in part or in whole. If any portion of the request is denied, the agency will provide information as to the reasons for the denial. If any portion of the refund request is granted, the refund will be in the form of a credit notification to the Department of Revenue, or a credit applied to a subsequent bill within 60 days of the Agency's decision. Approved refunds that should have been billed to a different county, will be COMPOSITE EXHIBIT 4 Page 4 of 7 Packet Page -1662- 10/9/2012 Item 16.K.2. transferred to the appropriate county on a subsequent bill within 60 days of the Agency's decision. (d) Receipts 1. The Agency will provide each county a monthly receipt of amounts billed, amounts paid and amounts certified to the Department of Revenue. 2. The Agency will provide each county a monthly receipt of action taken on Advance Refund Requests. Actions taken include: a. ARR Denied — Advance Refund Request Denied and the claim will appear on a subsequent bill with a status of ARR Denied; b. ARR Transferred Out — Advance Refund Request Transferred Out and the claim will be AW transferred to a different county than the county requesting Advanced Refund; " Rulemaking Authority 409.919 FS. Law Implemented 409.915 FS. History —New Page 5 of 7 COMPOSITE EXHIBIT 4 Packet Page -1663- i i 10/9/2012 Item 16.K.2. Notice of Chan gelWithdrawal AGENCY FOR HEALTH CARE ADMINISTRATION Medicaid RULE NO.: RULE TITLE: 59G- 1.020: Definition of County of Residence NOTICE OF CHANGE Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d) 1., F.S., published in Vol. 38 No. 26, June 29, 2012 issue of the Florida Administrative Weekly. The following changes have been made to the proposed rule. THE FULL TEXT OF THE PROPOSED RULE IS: 59G -1.020 Definition of County of Residence. For the purpose of county financial participation in the Medicaid Program, the county of residence for inpatient hospital care and nursing home care is determined by the recipient's address information contained in the federally approved Medicaid eligibility system. (1) For hospital claims, whether through fee - for - service or managed care, the address is based on the current living or residential address, with the exception of when the resident lives in a nursing home. When an recipient individual lives in a nursing home, the address is based on the prior address. (2) For nursing home claims, whether through fee - for- service or managed care, the address is based on the prior address, except when an- recipient individual is admitted to a nursing home directly from a place of residence outside of the State of Florida. If the recilient individ Rl is admitted to a nursing home from another state, the nursing home address will be used for county billing purposes. COMPOSITE EXHIBIT 4 Page 6 of 7 Packet Page -1664- 10/9/2012 Item 16.K.2. (3) Since address information for children in custody of the Department of Children and Families is unavailable, counties are not responsible for these payments. living affangement� eutside faeility, physieal ef a medical whieh they er semeene responsible for- theme, eensider- te be home. A to does 'lent visit anether- eetmq, net malee a. e , :e deu it differ-enee situations related an e*te= visit, Makes h , the �c- �..:�..:_.,.,.o.:..�,:. -_.� _ - _ - _ - .o - - _ - - '•iiiiiiiiiiTiiii7 Rulemaking Authority 409.919 FS. Law Implemented 409.915 FS. History —New 1 -1 -77, Formerly 10C -7.31, 10C - 7.031, Amended COMPOSITE EXHIBIT 4 Page 7 of 7 Packet Page -1665- EXHIBIT 5 2012 Stuart Williams, Esquire General Counsel State of Florida Agency for Healthcare Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308 Email: stuart .williams@ahca.myflorida.com 10/9/2012 Item 16.K.2. Joseph C. Mellichamp, III, Esquire Chief Assistant Attorney General Florida Office of the Attorney General Revenue Litigation Bureau 400 S. Monroe Street, ti PL -01 Tallahassee, Florida 32399 Email: joe .mellichamp@myfloridalegal.com Re: Notification and Waiver by Non - Plaintiff County Dear Mr. Williams & Mr. Mellichamp: The purpose of this letter is to provide notification to the Agency for Healthcare Administration (the "Agency ") and the Florida Department of Revenue (the "Department ") that [-I County (the "County ") intends to take advantage of those provisions available to a "non- plaintiff county" as set forth in paragraphs 3, 7 and 10 of that Stipulation Providing for Dismissal of Some Parties and Abatement of Case for Remaining Parties (the "Stipulation ") entered into in the case of Alachua County; et al. vs. Elizabeth Dudek, et al., Case No. 2012 -CA -1328 in the Circuit Court for the Second judicial Circuit in and for Leon County, Florida (the "Lawsuit "). As you may know the County did not join in the Lawsuit and has not otherwise filed a challenge to that certain legislation (i.e., HB 5301) which was passed in the 2012 Legislative Session and signed into law by the Governor on March 29, 2012. The County's Board of County Commissioners has authorized me [as Chairman of the Board of County Commissioners or County Administrator /Manager or County Attorney] to provide this notification and to provide a limited waiver of the right of the County individually or in concert with others to make a Circuit Court challenge of HB 5301 on the basis of an alleged violation of the Unfunded Mandate Provision of Art. VII, Sec. 18, Florida Constitution. This notification and waiver is not in any way deemed to affect the ability of the Colulty to challenge the amount of prior unpaid Medicaid billings in a Chapter 120 proceeding (as provided by existing law). Further, the County is not waiving the ability to assert in such 120 challenge or a subsequent Circuit Court Challenge any defenses which it might have, including defenses related to the statute of limitations, laches and equitable estoppel. cc: Ginger Delegal, General Counsel Florida Association of Counties EXHIBIT 5 Packet Page -1666- 10/9/2012 Item 16.K.2. EXHIBIT b Stuart Williams, Esquire General Counsel State of Florida Agency for Healthcare Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308 Email: stuart.williams@ahca.myflorida.com Re: Verified Stipulation Dear Mr. Williams & Mr. Mellichamp: .2012 Joseph C. Mellichamp, III, Esquire Chief Assistant Attorney General Florida Office of the Attorney General Revenue Litigation Bureau 400 S. Monroe Street, # PL -01 Tallahassee, Florida 32399 Email: joe .mellichamp @myfloridalegal.com The purpose of this letter is to verify that [_ ] County (the "County ") has elected to take the Settlement Option provided in paragraph 3 of the Stipulation Providing for Dismissal of Same Parties and Abatement of Case for Remaining Parties filed in Alachua County, Florida et al v. EIizabeth Dudek et al; Case No.: 2012 -CA -1328 in the Circuit Court of the Second Judicial Circuit in and for Leon County, Florida. The County's election to take this option was made by [Resolution, Motion or Delegation to the County Attorney]. [If by Resolution or Motion, attach verified copies to letter, if possible.] [If by Delegation to County Attorney, indicate that the Board of County Commissioners has provided parameters for settlement of this case and has authorized the undersigned to settle on behalf of the County.] M. Ginger Delegal, General Counsel Florida Association of Counties EXHIBIT 6 Packet Page -1667- Collier County 10/9/2012 Item 16.K.2. STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION Respondent, STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, J PAYMENT PLAN AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION ( "AHCA" or "the Agency "), and Collier County, ( "the COUNTY "), by and through the undersigned, hereby stipulate and agree as follows: 1. This Agreement is entered into for the purpose of memorializing the payment arrangement for the amount certified to the COUNTY on August 1, 2012 minus any payments or adjustments. 2. The COUNTY has accepted the terms outlined in the Stipulation Providing For Dismissal of Some Parties and Abatement of Case for Remaining Parties, as amended September 20, 2012 in Alachua County, Florida; et al. v. Dudek; et al., Case No. 2012 -CA -1328 in the Circuit Court for the Second Judicial Circuit in and for Leon County, Florida ( "Stipulation "). The above - referenced Stipulation is attached as Exhibit 1 and incorporated by reference. 3. The Agency and the COUNTY agree to the following: (A) AHCA agrees to accept the payment arrangements set forth in the payment plan agreement. Packet Page -1668- 10/9/2012 Item 16.K.2. (B) The amount owed by the COUNTY is $686,404.26. (C) The payment agreement is for sixty (60) monthly payments beginning October 5, 2012 as provided in Attachment A. 4. Payment shall be made in the form of check, automated clearing house (ACH) or wire transfer. ACH and wire transfer payments must be coordinated through the Agency's Revenue Management Unit. If making payment by check, payment shall be sent to: AGENCY FOR HEALTHCARE ADMINISTRATION ATTN: Medicaid County Billing Retrospective Finance and Accounting MS #14 2727 Mahan Drive Tallahassee, Florida 32308 5. AHCA reserves the right to enforce this Agreement under the laws of the State of Florida and all other applicable rules and regulations. 6. The signatories to this Agreement, acting in a representative capacity, represent that they are duly authorized to enter into this Agreement on behalf of the respective parties. 7. This Agreement shall be in full force and effect upon execution by the respective parties in counterpart. Dated: , 2012 Name, Title Collier County Dated: , 2012 Tonya Kidd Deputy Secretary for Operations Agency for Health Care Administration 2 Packet Page -1669- Q z WC C S v Q Y C v E Q1 N L O Q b Y � C � al t0 E C v o e v r v N Y O1 OD 00 0p 00 N Y C G C O O eT' m N N N N N N N GO a a N N OJ O) 0! � v- 'o'0000 � E o Z cc E E E E E v a O a a a a > C O N m a n a N � � U o w d w w a�i O y U m r r > >> r a p Y 'Z'>i'9 � WGII Z �OZ /6/0 � - 0L91- aSedlal:)ed 01 O Z N N O O a E v a 0 `o 0°10 m a 10/9/2012 Item 16.K.2. •.11i 1/19 2012 Stuart Williams, Esquire Joseph C. Mellichamp, III, Esquire General Counsel Chief Assistant Attorney General State of Florida Agency for Florida Office of the Attorney General Healthcare Administration Revenue Litigation Bureau 2727 Mahan Drive, Mail Stop 93 400 S. Monroe Street, : FL -01 Tallahassee, Florida 32308 Tallahassee, Florida 32399 Email: stuart.williams0ahca.myflorida.com Email: joe.mellichampomyfloridalegaLcom Re: Tentative Notice of Acceptance Dear Mr. Williams & Mr. Mellichamp: The purpose of this letter is to advise the Agency for Healthcare Administration (the "Agency ") and the Florida Department of Revenue (the "Department") that [fLller 1 County (the "County") intends to provide Tentative Notice of Acceptance that the County has elected to accept the Settlement Option as provided in paragraph 3 of Stipulation Providing for Dismissal of Some Parties and Abatement of Case for Remaining Parties (the "Stipulation ") entered into in the case of Alachua County; et al. vs. Elizabeth Dudek, et al., Case No. 2012 -CA -1328 in the Circuit Court for the Second judicial Circuit in and for Leon County, Florida (the "Lawsuit "). Although, the County intends to settle the Lawsuit, the Board of County Commissioners has not had the opportunity to formally consider the matter. Please accept this as the County's Tentative Notice of Acceptance of the Settlement Option. Die County will forma y der the slettl `�t.Optioni�tt rdt October 4. 42;2012 ,"mil • A �1 y Attorney] CC. Ginger Delegal, General Counsel Florida Association of Counties Lty Administrator/ County Administrator/ (25909/002/00693710.DOCv2 )EXHIBIT 1 Packet Page -1671-