Agenda 11/09/2010 Item #16D 3
Agenda Item No. 18b3
Novemblt9.2010
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EXECUTIVE. SUMMARY
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the amoant of ~~1 to participate iD the MedieaJd Low IDeo.. Poel,......~"j...,.. ,
serviees pnMded:.,ltl~~efthe Ho....... BIIIIID and Veteran Servieef ~~Lr~llD"
order to ..erate~~r~.1 S340,637 in Fedenl matebiDg fundL,,: . ..... . . '!! .
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OBJECTIVE: 'I'hlttheBoard of County Commi~oners approve and authqrJze.1,r; ~
to sign an agreement.\1rith the Agency for Health Care Administration (AHCA) toJ*d~ in
the Medicaid Low InCome Pool (LIP) program. ,
CONSIDERA nONS: The Agency for Health Care Admini$8tion (AHCA) is the State entity
that provides Medicaid services in Florida and' operates the Hospital Low Income Pool (LIP)
program~-' This program takes local funds and through an agreement between local government
and AHCA uses these fimds to obtain Federal1D8tr.h1ng dollars.
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These dollars are returned to the community through an inpatient hospital in the form of special
medicaid payments in ~ to provi~ enhanced services to low-income individuals.
Physician's Regional Medical Center will acmtinue to participate in this program to receive these
special Medicaid payments ,__serve as ~.lhird Party Administrator for Collier County. The
original agreement with~. ..the amount of $2,488,228, with a State match of $449,227
was approved by the BOIn:1.~j~:' 14,2010, item 1604. Since that time, the State has
changed its funding bm...,>' _ amount with Collier County. The revised agreement
amount is $2,270,911!~ !" ~match of $340,637, fbra total allocation of $2,611 ,548. The
revised ~ ~. " matd1 revenue of$108,590.
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n.';~On of ~g funds is shown in the table below:
Couaty LIP
~-
$1,063,000
Collier County Health
D artment
David Lawrence Center
Social Services
Total
$899,300
$308,611
$2,270,911
ARCA Match
at 15%
$159,450
$ 134,895
$46,292
. S340,637
Total
Allocation
$1,222,450
fISCAL I)JPACf: Participat.ion in'the Low Income Payment Program will
$3~,637 in additional ~.,pJiea1thcare resources to Collier COunty.
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n ;' '. item has been reviewed. County Attorney's om,e
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Agend~' i ~ . .
November 9. 2010
Page2af6
;~TerriDaniels, Accounting Supervisor
. .' . Housing, Hmnan and Veteran Services
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Agenda Item No. 1603
November 9, 2010
Page 3 of 6
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COLLIER COUNTY
BOARD OF COUNTY COMMISSIONERS
Item Number:
Item Summary:
1603
Recommendation that the Board of County Commissioners approve and authorize the
Chairman to sign a revised agreement with the Agency for Health Care Administration in the
amount of $2,270,911 to participate in the Medicaid Low Income Pool Program for services
provided on behalf of the Housing, Human and Veteran Services Department in order to
generate an additional $340,637 in Federal matching funds.
11/9/20109:00:00 AM
Meeting Date:
Prepared By
Terri A. Daniels
Supervisor - Accounting
Date
Public Services Division
Human Services
10/21/20101:51:47 PM
Approved By
Marcy Krumbine
Director. Housing & Human Services
Date
Public Services Division
Human Services
10/21/20102:30 PM
Approved By
Kathy Carpenter
Executive Secretary
Date
Public Services
. Approved By
Jennifer White
Public Services Admin.
10/21/20103:56 PM
Assistant County Attorney
Date
County Attorney
County Attorney
10/21/20104:44 PM
Approved By
Marla Ramsey
Administrator - Public Services
Date
Public Services Division
Public Services Division
10/25/20101:01 PM
Approved By
OMB Coordinator
Date
County Manager's Office
Office of Management & Budget
10/25/20104:24 PM
Approved By
Sherry Pryor
Office of Management &
Budget
Management! Budget Analyst, Senior
Date
Office of Management & Budget
10/26/201012:12 PM
Approved By
Jeff Klatzkow
County Attorney
Date
10/28/20102:31 PM
.
Approved By
Leo E. Ochs, Jr.
County Manager
Date
County Managers Office
County Managers Office
11/2/20103:50 PM
AgenOa Item No. 1603
November 9.2010
Page 4 of 6
Letter of Agreement
THIS LETTER OF AGREEMENT made and entered into in duplicate on the day
of 2010, by and between Collier County (the County), and the State of Rorida, through
its Agency for Health Care Administration (the Agency),
1. Per House Bill 5001, the General Appropriations At:A of State FisCal Year 2010-2011,
passed by the 2010 Florida Legislature, County and the Agency, agree that County will remit
to the State an amount not to exceed a grand total of $2,270,911. .
a) The County and the Agency have agreed that these funds will only be used to
increase the provision of health services for the Medicaid, uninsured, and
underinsured people of the County and the state of Florida at large.
b) The increased provision of Medicaid, uninsured, and underinsured funded
health services will be accomplished through the following Medicaid
programs:
i. The Disproportionate Share Hospital (DSH) program.
ii. The removal of inpatient and outpatient reimbursement ceilings for
teaching, specialty and community hospital education program
hospitals.
iii. The removal of inpatient and outpatient reimbursement ceilings for
hospitals whose charity care and Medicaid days as a percentage of
total adjusted hospital days equals or exceeds 11 percent.
iv. The removal of inpatient and outpatient reimbursement ceilings for
hospitals whose Medicaid days, as a percentage of total hospital
days, exceed 7.3 percent. and are trauma centers.
v. Increase the annual cap on outpatient services for adults from $500 to
$1,500.
vi. Medicaid Low Income Pool (LIP) payments to nual hospitals, trauma
centers, specialty pediatric hospitals, primary care services and other
Medicaid participating safety-net hospitals.
vii. Medicaid LIP payments to hospitals in the approved appropriations
categories.
viii. Medicaid UP payments to Federally Qualified Health Centers.
ix. Medicaid LIP payments to Provider Access Systems (PAS) for
Medicaid and the uninsured in rural areas.
x. Medicaid LIP payments for the expansion of primary care services to
low income, uninsured individuals.
Letter of Ap'cemCD1 for SFY 2010-11
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Agenda Item No. 1603
November 9. 2010
Page 5 of 6
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2. The County will pay the State an amount not to exceed the grand total amount of
$2,270,911. The County Will transfer payments to the State in the following manner:
a) The first quarterty payment of $567,730 for the months of July, August,
and September is due upon notification by the Agenr::f.
b) Each successive payment of $567,727 is due as follows. November 1,
2010, March 31,2011 and June 15, 2011.
c) The State will bill the County each quarter payments are due.
3. The enhanced FMAP is in effect for the first six months of SFY 2010-11. Any payments
made by the Agency on or after January 1, 2011, will not be eligible for the enhanced
FMAP. Therefore, the County will be responsible for funding the State share required as a
result of the reduced FMAP. If funding is not adequate due to the FMAP change, the State
will reduce the rate to the level of funded by the County.
4. Timelines: This agreement must be signed and submitted to the Agency no later than May
31, 2011, to be effective for SFY 2011.
5. Attached are the DSH and LIP schedules reflecting the anticipated annual distributions for
State Fiscal Year 2010-2011.
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6. The County and the State agree that the State will maintain necessary records and
supporting documentation applicable to Medicaid, uninsured, and underinsured health
services covered by this Letter of Agreement. Further, the County and State agree that the
County shall have access to these records and the supporting documentation by requesting
the same from the State.
7. The County and the State agree that any modifications to this Letter of Agreement shall be
in the same form, namely the exchange of signed copies of a revised Letter of Agreement.
8. The County confirms that there are no pre-arranged agreements (contractual or otherwise)
between the respective counties, taxing districts, and/or the providers to re-direct any
portion of these aforementioned Medicaid supplemental payments in order to satisfy non-
Medicaid, non-uninsured, and non-underinsured activities.
9. The County agrees the following provision shall be included in any agreements between the
County and local providers where funding is provided for the Medicaid program. Funding
provided in this agreement shall be prioritized so that designated funding shaD first be used
to fund the Medicaid program (including LIP) and used secondarily for other purposes.
10. This Letter of Agreement covers the period of July 1, 2010 through June 30, 2011.
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LeIla' of AarccmCllt for SFY 2010-11
WITNESSETH:
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IN WITNESS WHEREOF the parties have dUly executed this Letter of Agreement on the day
and year above first written.
ATIEST:
DWIGHT E. BROCK, ClerK
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
By:
By:
Fred W. Coyle, Chainnan
Board of County Commissioners
Deputy ClerK
Date: November 9. 2010
STATE OF FLORIDA:
Approved as to form and
legal sufficiency
By:
PhU E. Williams
Assistant Deputy Secretary for Medicaid Finance
Agency for Health Care Administration
~-f>JJ~
Assi m County Attorney
Collier County
Date: November 9. 2010
LcUcr of Agrccmcat for SFY 2016-11