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Backup Documents 12/01/2009 Item #16D1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 0 1 TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. Original documents should be hand delivered to the Board Office. The completed routing slip and original documents are to be forwarded to the Board Office only after the Board has taken action on the item.) ROUTING SLIP Complete routing lines #1 through #4 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the exception of the Chairman's si2Jlature, draw a line throueh routine lines #1 throul!:h #4, comolete the checklist, and forward to Sue Filson line #5). Route to Addressee(s) Office Initials Date (List in routinp; order) L Terri Daniels Housing and Human Services 12/04/09 2, 3. 4. 5. Ian Mitchell, Manager Board of County Commissioners .C'\- 11("6(09 6, Minutes and Records Clerk ofCourl's Office PRIMARY CONTACT INFORMATION (The primary contact is the holder of the original document pending Bee approval. Normally the primary contact is the person who created/prepared the executive summary. Primary contact information is needed in the event one of the addressees above, including Sue Filson, need to contact statTfor additional or missing information. All original documents needing the BCC Chairman's signature are to be delivered to the Bee office only after the Bee has acted to approve the item.) Name of Primary Staff Terri Daniels Phone Number 252-2689 Contact Agenda Date Item was Agenda Item Number 16Dl Approved bv the BCC December 1, 2009 Type of Document ARCA LIP Agreement 2009-10 (Major) Number of Original 3 Attached Documents Attached INSTRUCTIONS & CHECKLIST Initial the Yes column or mark "N/ A" in the Not Applicable column, whichever is a r riate. Original document has been signed/initialed for legal sufficiency, (All documents to be signed by the Chainnan, with the exception of most letters, must be reviewed and signed 1#' by the Office of the County Attorney. This includes signature pages from ordinances, resolutions, etc. signed by the County Attorney's Office and signature pages from contracts, agreements, etc. that have been fully executed by all parties except the BCC Chainnan and Clerk to the Board and ossibl State Officials. All handwritten strike-through and revisions have been initialed by the County Attorney's Office and all other arties exce t the BCC Chairman and the Clerk to the Board The Cbainnan's signature line date has been entered as the date ofBCC approval of the document or the final ne otiated contract date whichever is a licable. "Sign here" tabs are placed on the appropriate pages indicating where the Chairman's si nature and initials are re uired. In most cases (some contracts are an exception), the original document and this routing slip should be provided to Sue Filson in the BCC office within 24 hours of BCC approval. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCe's actions are nullified. B r our deadlines! Tbe document was approved by the BCC on (enter date) and all changes made during the meeting bave been incorporated n e ttached document. The Coun Attorne 's Office has reviewed the chan es, if a Iicable. 1. 2. 3, 4, 5, 6, N/A(Not A licable) 11 I: Forms! County Forms! Bee Forms! Original Documents Routing Slip WWS Original 9.03.04, ReVised 1.26.05, Revised 2.24.05 16D I MEMORANDUM Date: December 8, 2009 To: Terri Daniels, Grants Supervisor Human Services Department From: Martha Vergara, Deputy Clerk Minutes & Records Department Re: AHCA LIP Agreement 2009-10 (Major) Attached, please find two (2) original as referenced above (Agenda Item #16D1), approved by the Board of County Commissioners on Tuesday, December 1,2009. Please return any fully executed original documents back to the Minutes & Records Department for the Board's Official Record. If you should have any questions, please call 252-7240. Thank you. 160 1 Letter of Agreement ~ THIS LETTER OF AGREEMENT made and entered into in duplicate on the L day of vet. 2009, by and between Collier County (the County), and the State of Florida, through its Agency for Health Care Administration (the Agency), 1. Per Senate Bill 2600, the General Appropriations Act of State Fiscal Year 2009-2010, passed by the 2009 Florida Legislature, County and the Agency, agree that County will remit to the State an amount not to exceed a grand total of $2,221 ,077. 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 rural 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 LIP 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 Agreement for SFY 2009-10 160 1 2. The County will pay the State an amount not to exceed the grand total amount of $2,221,077. The County will transfer payments to the State in the following manner: a) The first quarterly payment of $555,270 for the months of July, August, and September is due upon notification by the Agency. b) Each successive payment of $555,269 is due no later than, December 31, 2009, March 31, 2010 and June 15, 2010. c) The State will bill the County each quarter payments are due. 3. Attached are the DSH and LI P schedules reflecting the anticipated annual distributions for State Fiscal Year 2009-2010. 4. 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, 5. 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. 6. 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. 7. 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 shall first be used to fund the Medicaid program (including LIP) and used secondarily for other purposes, 8. This Letter of Agreement covers the period of July 1, 2009 through June 30, 2010. Letter of Agreement for SFY 2009-10 160 1 WITNESSETH: IN WITNESS WHEREOF the parties have duly executed this Letter of Agreement on the day and year above first written. ATTEST: DWIGHT E. BROCK',.Clerk BOARD OF COUNTY COMMISSIONERS COLLIER CO YfjITY, FLORIDA I{ ! I U. ,', By: 11.7 h?-r". 'J.(<1..k:.r., Donna Fiala, Chairman Board of County Commissioners Attest aite'dII"-^, s1\lf1.t...... 0111' Date: December 1, 2009 STATE OF FLORIDA: Approved as to form and legal sufficiency By: ~~ Assistant County Attorney Collier County Phil E. Williams Assislant Deputy Secretary for Medicaid Finance Agency for Health Care Administration Date: December 1 2009 Item # lli.J) I Agenda ~ ,{ JOt Date ~ Date 1?.J '1 1&7 Rec'd -~ Letter of Agreement for SFY 2009.10 16D 1 Local Government Intergovernmental Transfers Proaram I Amount State Fiscal Year 2009-2010 DSH LIP 2,221,077 Exemptions Statewide Issues Nursing Home SMP Total Fundina $2,221,077 Letter of Agreement for SFY 2009-10