Agenda 11/10/2009 Item #16D 7
Agenda Item No. 1607
November 10, 2009
Page 1 of 8
EXECUTIVE SUMMARY
Recommendation that the Board of County Commissioners approve and authorize the
Chairman to sign an Agreement with Physicians Regional Medical Center for participation
in the Low Income Pool (LIP) program for services provided on behalf of the Housing and
Human Services Department, Department of Health and David Lawrence Center Mental
Health Center to generate an additional $418,370 in Federal matching funds.
OBJECTIVE: That the Board of County Commissioners sign an agreement with the Physicians
Regional Medical Center (PRMC) to participate in the Lower Income Pool (UP) program.
CONSIDERATIONS: The Agency for Health Care Administration (AHCA), the State entity
that provides Medicaid Services in Florida, offers a program that leverages Federal Funds with
local matching funds to enhance services to low-income individuals through special Medicaid
payments. This Low Income Pool (LIP) program provides for communities to enter into an
agreement with AHCA to utilize local funds to gain an additional 15% from the Federal
Government to provide inpatient services through a local qualifying hospital.
Physicians Regional Medical Center (PRMC) has qualified to accept these funds and has agreed
to participate in the LIP program. PRMC will accept the funds from AHCA, which will include
the 15% match in the amount of $418,370 from AH CA, and in return provide payment for the
County's programs (Housing and Human Services, Department of Health and the David
Lawrence Center) and/or pay invoices approved by Collier County Housing and Human Services
at amounts already funded by the Board of County Commissioners in the FYIO budget. The
contract period is from October 1,2009 through September 30,2010.
GROWTH MANAGEMENT IMPACT: There is no growth management impact associated
with this executive summary.
FISCAL IMPACT: It is estimated the Low Income Pool program will provide an additional
$418,370 in revenue for healthcare and behavioral healthcare resources to Collier County. Local
matching funds are available within the FY I 0 budget within these program budgets.
Physicians Regional Medical Center will receive $60,000 from the match revenue received from
AHCA to administer the program. This fee was negotiated as an actual cost of the
administration based upon personnel time and overhead. No additional general funds are
required.
LEGAL CONSIDERATION: This item has been reviewed by the County Attorney's Office
and is legally sufficient for Board action. - CMG
RECOMMENDA TION: Staff recommends that the Board of County Commissioners approve
and authorize the Chai1111an to sign the agreement with the Physicians Regional Medical Center
to participate in the Low Income Pool program.
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Prepared by: Terri Daniels, Accounting Supervisor, Housing and Human Services Department
.1 at:;'- 1 V.l 1
Agenda Item No. 1607
November 10, 2009
Page 2 of 8
COLLIER COUNTY
BOARD OF COUNTY COMMISSIONERS
Item Number:
Item Summary:
16D7
Recommendation that the Board of County Commissioners approves and authorizes the
Chairman to sign an Agreement with Physicians Regional Medical Center for participation in the
Low Income Pool (LIP) program for services provided on behalf of the Housing and Human
Services Department, Department of Health and David Lawrence Center Mental Health Center
to generate an additional $418370 in Federal matching funds,
Meeting Date:
11/10/200990000 AM
Prepared By
Terri A. Daniels
Grants Coordinator
Date
Public Services
Housing & Human Services
10/24/200910:53:18 AM
Approved By
Marcy Krumbine
Director
Date
Public Services
Housing & Human Services
10/26/20098:51 AM
Approved By
Kathy Carpenter
Executive Secretary
Date
Public Services
Public Services Admin.
10/25/200910:45 AM
Approved By
Colleen Greene
Assistant County Attorner
Date
County Attorney
County Attorney Office
1 0/28/2009 11 : 23 AM
Approved By
Marla Ramsey
Public Services Administrator
Date
Public Services
Public Services Admin.
10/28/20092:36 PM
Approved By
OM8 Coordinator
OM8 Coordinator
Date
County Manager's Office
Office of Management & Budget
10/28/20094:22 PM
Approved By
Sherry Pryor
Management & Budget Analyst
Date
County Manager's Office
Office of Management & Budget
10/28/2009 4:49 PM
Approved By
Jeff Klatzkow
County Attorney
Date
County Attorney
County Attorney Office
10/30/20093:25 PM
Apprm'ed By
John A. Yonkosky
Director of the Office of Management
Date
County Manager's Office
Office of Management & Budget
10130/2009 4:43 PM
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,';genda item No. 1607
~Jovember 10, 2009
Page 3 of 8
AGREEMENT
THIS AGREEMENT is made and entered into this by and between Collier
County, Florida, a political subdivision of the State of Florida, hereinafter referred to as "the
Countylt and Naples HMA, Inc., a Florida corporation d/b/a Physicians Regional Medical Center,
hereinafter referred to as "the Hospital".
RECITALS:
WHEREAS, Section 125.01(1)(e), Florida Statutes, authorizes the County to
provide health welfare programs for the residents of Collier County to the extent not
inconsistent with general or special law; and
WHEREAS, the establishment and maintenance of such programs are in the best
interest of the people of Collier County; and
WHEREAS, the County desires to contract with the Hospital to provide payments
for health prevention programs, and mental health services to residents of the
County; and
WHEREAS, the Hospital is willing to provide payments for such services, subject
to the terms and conditions hereinafter set forth.
NOW THEREFORE, in consideration of the covenants herein contained, the parties hereby
agree as follows:
ARTICLE I
SERVICES TO BE PERFORMED
1. The Hospital shall provide payment for the following services in the manner as described in
Attachment A, Scope of Services:
a. Collier County Health Department
1. Immunization program
B. AIDS Prevention Program
Ill. Tuberculosis Program
IV. Communicable Disease Program
v. Child Health Program
VI. Healthy Start Prenatal Program provided by the Foundation for Women's
Health
VB. School Health Program
VllI. Adult Health Program
IX. Dental Program
x. Physician Led Access Network (PLAN)
b. Community Mental Health Services provided by the David Lawrence Center, Inc.
c. Hospital agrees to fund other health related programs and services as directed by the
County.
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Agenda Item No. 1607
November 10, 2009
Page 4 of 8
2. The obligation of the Hospital to provide any services pursuant to this Agreement, or to
pay for services provided by other parties approved by the County pursuant to this
Agreement, shall be contingent upon designated funds being paid to Hospital by AReA or
County in advance of the obligation of the Hospital to provide any services or to pay for any
services. In the event that sufficient designated funds are available with the Hospital, the
Hospital shall have no obligations under this Agreement.
ARTICLE II
PAYMENTS
1. The County shall make quarterly payments to the State of Florida, Agency for Health Care
Administration (ARCA) under the Inter-Governmental Transfer Program (IGT).
2. Funding provided in this Agreement shall be prioritized so that designated funding shall
first be used to fund the Medicaid program (including Low Income Pool) and used
secondarily for other purposes.
ARTICLE III
TERMS OF AGREEMENT AND TERMINATION
1. The term of this Agreement shall be October 1, 2009 through September 30, 2010 with
two annual renewals.
2. Either party may terminate this Agreement thirty with (30) calendar days written notice to
the other party. In the event of termination, the County shall pay for services rendered,
prorated to the date of termination. The County shall continue to pay for any inpatient
receiving services on the date of termination until the discharge of such payment.
3. Upon breach of this Agreement, the aggrieved party may, by written notice of breach to
the breaching party, terminate the whole or any part of this Agreement. Termination shall be
upon no less than twenty-four (24) hours notice, in writing, delivered by certified mail,
telegram or in person. Waiver by either party of breach of any provisions of this Agreement
shall not be deemed to be a waiver of any other or subsequent breach and shall not be
construed to be a modification of the terms of this Agreement.
4. It is further agreed that in the event general funds to finance all or part of this Agreement
do not become available, the obligations of each party hereunder may be terminated upon no
less than twenty-four (24) hours notice in writing to the other party. Said notice shall be
delivered by certified mail, telegram or in person. The County shall be the final authority as
to the availability of funds and as to how any available funds will be allocated among its
various service providers.
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Aaenda Item ~Jo. 1607
~ November 10, 2009
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ARTICLE IV
ASSIGNMENT
1. The Hospital and/or its sub-contractor shall not assign or transfer this Agreement, or any
interest, right or duty herein, without the prior written consent of the County, which consent
shall not be unreasonably withheld by the County. The Hospital shall be allowed to assign or
transfer this Agreement or any of the Hospital's obligations hereunder to affiliates or wholly
owned subsidiaries of the Hospital without obtaining prior written consent. This Agreement
shall run to the County and its successors.
ARTICLE V
SUBCONTRACTING
1. The parties agree that the Hospital shall be permitted to execute subcontracts for the
purchase by the Hospital of such services, articles, supplies, and equipment, which is both
necessary and incidental to the performance of the work, required under this Agreement.
However, the Hospital expressly understands that it shall assume the primary responsibility
for performing the services outlined in Article I of this Agreement.
ARTICLE VI
INSURANCE, SAFETY AND INDEMNIFICATION
1. Indemnity. The Hospital and/or its sub-contractor shall indemnify the County against any
claims, damages, losses, and expenses, including reasonable attorneys' fees and costs, arising
out of, resulting from the Hospital's failure to pay for services as directed by the County.
The County shall indemnify the Hospital against any claims, damages, losses, and expenses,
including reasonable attorneys' fees and costs, arising out of, resulting from or in any way
connected with the performance of the County's responsibilities under this Agreement
including the County's review of all invoices to insure that no violations of state of federal
laws, rules or regulations occurs in payments made pursuant to this Agreement. The
County's liability is subject to the provision of section 768.28, F.S.
2. Insurance Required. During the term of this agreement the Hospital shall procure and
maintain liability insurance coverage. The liability insurance coverage shall be in amounts
not less than $1,000,000 per person and $2,000,000 per incident or occurrence for personal
injury, death, and property damage or any other claims for damages caused by or resulting
from the activities under this Agreement. Such policies of insurance shall name the County
as an additional insured. The Hospital shall submit written evidence of having procured all
insurance policies required herein no later than 10 days after the effective date of this
Agreement and shall submit written evidence of such insurance policies to the County
Housing and Human Services Director and to the County's Risk Management office. The
Hospital shall purchase all policies of insurance from a financially responsible insurer duly
authorized to do business in the State of Florida. The Hospital shall be financially
responsible for any loss due to failure to obtain adequate insurance coverage and the failure
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Agenda Item No. 1607
November 10, 2009
Page 6 of 8
to maintain such policies or certificate in the amounts set forth herein shall constitute a
breach of this agreement.
ARTICLE VII
BILLING PROCEDURES
The Hospital has standard, acceptable billing procedures that the Hospital will utilize in the
performance of its obligations under this Agreement.
The County shall direct the Hospital to make payments pursuant to this Agreement once the
County has verified the validity of the invoices to be paid by the Hospital. The Hospital will
not pay any invoices prior to the County's approval.
The Hospital shall make payments to specific healthcare programs and services, such as the
mental health programs of the David Lawrence Mental Health Center and the Collier County
Health Department that are pre-approved by the County for payment. The Hospital shall use
reasonable efforts to pay invoices approved by the County within thirty (30) days of County
approval.
For the healthcare services provided by the Hospital, the Hospital shall be reimbursed at the
federally approved Medicare rates. The County shall be responsible for verifying invoices for
such services prior to reimbursement to the Hospital. The Hospital has the right to bill the
balance to the patient for any difference between the Medicare rate and the amount the
hospital is paid pursuant to the County's authorization.
For providing Third Party Administrator (TP A) services, the Hospital shall be compensated
monthly and in advance at the rate of $5,000.00 (five thousand dollars) per month not to
exceed $60,000 annually. The Hospital will deduct its compensation from the match revenue
it receives from ARCA.
ARTICLE VIII
RECORDS
1. The Hospital shall provide quarterly financial reports to the County in such detail as
required by the County.
2. The Hospital and/or its sub-contractor shall keep orderly and complete records of its
accounts and operations related to the services provided under this Agreement for the entire
term of the Agreement plus three (3) years. The Hospital and/or its sub-contractor shall keep
open these records to inspection by County personnel at reasonable hours during the entire
term of this Agreement. If any litigation, claim or audit is commenced prior to the expiration
of the three (3) year period and extends beyond this period the records must remain available
until any litigation, claim or audits have been resolved. Any person duly authorized by the
County shall have full access to and the right to examine any of said records during said
period. Access to PHI shall be in compliance with federal laws and HIP AA.
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Agenda Item No. 1607
i'Jovernber 10, 2009
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ARTICLE IX
CIVIL RIGHTS
I. There will be no discrimination against any employee or person served on account of race,
color, sex, age, religion, ancestry, national origin, handicap or marital status in the
performance of the Agreement.
2. It is expressly understood that, upon receipt of evidence of such discrimination, the County
shall have the right to terminate this Agreement for breach of agreement.
3. The Hospital and/or its sub-contractor shall comply with Title VI of the Civil Rights Act
of 1964 (42 USC 2000d) in regard to persons served.
4. The Hospital and/or its sub-contractor shall comply with Title VII of the Civil Rights Act
of 1964 (42 use 2000c) in regard to employees or applicants for employment. The Hospital
and/or its sub-contractor shall comply with Section 504 of the Rehabilitation Act of 1973 in
regard to employees or applicants for employment and clients served.
ARTICLE X
OTHER CONDITIONS
1. Any alterations, variations, modifications or waivers of provisions of this Agreement shall
only be valid when they have been reduced to writing, duly signed and attached to the
original of this Agreement. The parties agree to renegotiate the Agreement if revision of any
applicable laws or regulations makes changes in the Agreement necessary.
2. This Agreement contains all the terms and conditions agreed upon by the parties. All items
incorporated by reference are as though physically attached. No other agreements, oral or
othenvise, regarding the subject matter of this Agreement, shall be deemed to exist or to bind
any of the parties hereto.
3. The Hospital and/or its sub-contractor shall obtain and possess throughout the term of this
Agreement all licenses and permits applicable to its operations under federal, state, and local
laws, and shall comply with all fire, health and other applicable regulatory codes.
4. The Hospital and/or its sub-contractor agrees to comply with all applicable requirements
and guidelines prescribed by the County for recipients of funds.
5. The Hospital and/or its sub-contractor agree to safeguard the privacy of information
pursuant to the Health Insurance Portability and Accountability Act of 1996 (HIP AA).
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Agenda Item No. 16 7
November 10, 2009
Page 8 of 8
IN WITHNESS WHEREOF, the parties have executed this Agreement on the dates indicated
below.
A TIEST:
DWIGHT E. BROCK., Clerk
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
By:
By:
Deputy Clerk
Donna Fiala, Chairman
Board of County Commissioners
Date: November 10. 2009
NAPLES HMA, INC., d/b/a A FLORIDA
CORPORATION AND PHYSICIANS REGIONAL
MEDICAL CENTER:
Approved as to form and
legal sufficiency
By:
Geoffrey Mobius, Chief Executive Officer
Physicians Regional Medical Center
Date: November 10. 2009
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