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Agenda 09/28/2021 Item #16D 3 (Resolution - hospital-owned properties LPPF)09/28/2021 EXECUTIVE SUMMARY Recommendation to adopt a Resolution authorizing non-ad valorem special assessment on hospital- owned properties or properties used as a hospital as authorized by the Local Provider Participation Fund for the Directed Payment Program established by Ordinance No 2021-23 and authorize the necessary budget amendment; and to authorize the County Manager or designee to sign the Letter of Agreement in an amount not to exceed the total of $6,687,755 with the Agency for Health Care Administration to participate in the Local Provider Participation Fund that will provide additional health services for the citizens of Collier County. OBJECTIVE: To adopt a Resolution authorizing a non-ad valorem special assessment on hospital- owned property or property used as a hospital with such assessment to be used to leverage federal funding in support of area hospitals that provide health services to the low-income citizens of Collier County. CONSIDERATIONS: On June 8, 2021, the Board of County Commissioners (Board) approved Agenda Item No. 16076 authorizing the advertisement of an ordinance establishing a Local Provider Participation Fund (LPPF) for the Directed Payment Program to be solely funded by assessments on hospital -owned property or property used as a hospital. On June 22, 2021, the Board adopted Ordinance No. 2021-23. At that time, Agency for Health Care Administration (AHCA) was in the process of finalizing its modeling of the amount for non-federal share (the assessment) needed for the program. The modeling has since been completed and a resolution containing the appropriate assessment rate has been developed and is now presented. Also, the County is required to enter into a Letter of Agreement with AHCA to provide for a mechanism for the collection of the funds in the LPPF and for their provision. AHCA is a State entity that provides Medicaid services in Florida and operates the LPPF. The County's participation in the LPPF Program is outlined in the contractual arrangement between Collier County and AHCA, which is presented as part of this Item. As background, Hospitals in Collier County annually provide millions of dollars of uncompensated care to persons who qualify for Medicaid because Medicaid, on average, covers only sixty percent (60%) of the costs of the health care services provided by Hospitals to Medicaid eligible persons, leaving hospitals with significant uncompensated costs. As a direct result of this revenue shortfall, during the FY21 Legislative session, the Governor with the full support of the House and Senate approved the establishment of the Directed Payment Program (DPP). This program is available to hospitals providing inpatient and outpatient services to Medicaid-managed care enrollees. It is the intent of the program to offset hospitals’ Medicaid shortfall and improve the quality of care provided to the Florida Medicaid population. At the time Ordinance 2021-23 was considered, this program had been adopted by three (3) Counties, Escambia, Brevard, and Walton. In April, the County was approached by the hospitals and requested the County participate in the Directed Payment Program. To participate in this program, the County was required to establish a Local Provider Participation Fund (LPPF) via an Ordinance. Ordinance No. 2021-23 establishes the parameters of the LPPF program. The County, at the request of the hospitals annually, will impose a non-ad valorem assessment upon real property owned by the Hospitals to help fund the non-federal share of the State’s Medicaid Program. This assessment will provide additional funding for Medicaid payments to Naples Community Hospital, Landmark Hospital, The Willough at Naples, and Physicians Regional Medical Center to address the Medicaid shortfall. The leveraging of additional federal suppo rt through the DPP program will directly benefit the health care services delivered to Medicaid-eligible persons and support their ability to provide critical services. 16.D.3 Packet Pg. 998 09/28/2021 Ordinance No. 2021-23 enables the County to levy a uniform non-ad valorem special assessment in compliance with 42 C.F.R. 433.68(d). The assessment shall be fairly and reasonably apportioned among each of the Hospital's properties within the County limits. The Board shall set the Assessment in amounts that in the aggregate will generate sufficient revenue to fund the non-federal share of Medicaid payments associated with Local Services to be funded by the Assessment. Approval will allow the County to establish and maintain a system of funding to support the non-federal share of Medicaid payments that will directly benefit the Hospital properties. The assessment shall constitute a lien upon the assessed properties. The proposed assessment shall be held in a separate account called the local provider participation fund (LPPF) and shall be available to be used only to (1) provide to the Florida Agency for Health Care Administration the non-federal share for Medicaid payments to be made directly or indirectly in support of hospitals serving Medicaid beneficiaries and (2) reimburse the County for administrative costs associated with the implementation of the assessment authorized by this Ordinance, as further specified in the forthcoming Assessment Resolution. Annually the Board shall set the Assessment in amounts that in the aggregate will generat e sufficient revenue to fund the non-federal share of Medicaid payments associated with Local Services to be funded by the Assessment. The amount of the Assessment required of each Assessed Property may not exceed an amount that, when added to the amount of other required assessments, equals an amount of revenue that exceeds the maximum percent of the aggregate net patient revenue of all Assessed Hospitals in the County permitted by 42 C.F.R. § 433.68(f)(3)(I)(A). Assessments for each Assessed Property will be derived from data contained in the Florida Hospital Uniform Reporting System, as available from the Florida Agency for Health Care Administration. If at the end of the Fiscal Year, additional amounts remain in the local provider participation fund, th e Board is hereby authorized either (a) to refund to Assessed Properties, in proportion to amounts paid in during the Fiscal Year, all or a portion of the unutilized local provider participation fund, or (b) if requested to do so by the Assessed Properties, to retain such amounts in the fund to transfer to the Agency in the next fiscal year for use as the non-federal share of Medicaid hospital payments. If, after the Assessment funds are transferred to the Agency, the Agency returns some or all of the transferred funding to the County (including, but not limited to, a return of the non-federal share after a disallowance of matching federal funds), the Board is hereby authorized to refund to Assessed Properties, in proportion to amounts paid in during the Fiscal Year, the amount of such returned funds. The Resolution was advertised, as required, in the Naples Daily News on September 8, 2021. The Resolution sets forth the assessment details and provides authority to make the assessment, invoice and collect the assessment, and then provide the appropriate share to the Agency for Health Care Administration. Accordingly, notices of invoice have been mailed to the affected four (4) properties (Landmark Hospital of Southwest Florida, NCH Baker Hospital, and Physicians Regional Medical Center) on August 23, 2021, and (The Willough at Naples) on August 27, 2021. The notice includes the proposed assessment amount for each hospital. All hospitals are required to participate and should any choose not to participate the assessment will not go forward. Per Senate Bill 2500, the General Appropriations Act of State Fiscal Year 2021-2022, passed by the 2021 Florida Legislature, the Collier County LPPF and the Agency for Health Care Administration agree that the Collier County LPPF will remit Intergovernmental Transfers (IGT) funds to the Agency in an amount not to exceed the total of $6,687,755 as per the referenced Letter of Agreement that is presented. The Collier County LPPF and the Agency have agreed that these IGT funds will only be used for the DPP 16.D.3 Packet Pg. 999 09/28/2021 program. DPP Local Intergovernmental Transfers Program / Amount State Fiscal Year 2021-2022 Year One DPP IGTs $6,687,755 Total Funding $6,687,755 FISCAL IMPACT: The Directed Payment Program is a funding mechanism that takes hospitals' funds collected through a non-ad valorem assessment and directs those dollars to the AHCA to fund the non- federal share of the State’s Medicaid program ultimately resulting in enhanced funding returned to the hospitals. AHCA is currently working on the implementation plan for the Directed Payment Program. Once AHCA finalizes its modeling the amount of non-federal share (the assessment) needed to fund the Directed Payment Program will become available. The Assessment shall equal 1.11% of net patient revenue for each Assessed Property. The amount of the Assessment required of each Assessed Property may not exceed an amount that, when added to the amount of other hospital assessments levied by the state or local government, exceeds the maximum percent of the aggregate net patient revenue of all Assessed Hospitals in the County permitted by 42 C.F.R. § 433.68(f)(3)(I)(A). No more than $150,000 will be retained for administrative expenses. The total non-ad valorem special assessment that will be collected for fiscal year 2021 from the Affected Properties is $9,327,890. Hospital Name Assessment Amount NCH Baker Hospital $5,780,701 Physicians Regional Medical Center $3,059,745 Landmark Hospital of Southwest Florida $288,404 The Willough at Naples $199,040 Total $9,327,890 Relative to budget administration, a Budget Amendment is necessary to establish a Local Provider Participation Fund (169). The budget will include a revenue account (363100 Special Assessment) for receipt of assessments paid by the hospitals in the amount of $9,327,890 and expense accounts (881400 Remit to Other Government) for the remittance of program funds to ACHA and (634980 Interdepartmental Payment for Service) for reimbursement of County administrative costs associated with the implementation of the assessment. Advertising fees are $763. Additionally, the Collier County LPPF will pay IGT funds to the Agency for Health Care Administration in an amount not to exceed the total of $6,687,755. Per Florida Statute 409.908, annual payments for the months of July 2021 through June 2022 are due to the Agency for Health Care Administration no later than October 31, 2021, unless an alternative plan is specifically approved by the agency. Funds will be available in Local Provider Participation Fund (169). GROWTH MANAGEMENT IMPACT: There is no Growth Management impact. LEGAL CONSIDERATIONS: This item is approved as to form and legality and requires a majority vote for Board action. -JAB RECOMMENDATION: To adopt a Resolution authorizing non-ad valorem special assessment on hospital-owned properties or properties used as a hospital as authorized by the Local Provider Participation Fund for the Directed Payment Program established by Ordinance No 2021-23 and authorize the necessary budget amendment, and to authorize the County Manager or designee to sign the Letter of 16.D.3 Packet Pg. 1000 09/28/2021 Agreement in an amount not to exceed the total of $6,687,755 with the Agency for Health Care Administration to participate in the Direct Payment Program that will provide additional health services for the citizens of Collier County. Prepared By: Irene Takla, Accountant, Operations and Veteran Services Division ATTACHMENT(S) 1. 1. Ordinance 2021-23 (PDF) 2. 2. Resolution Hospital Assessment CAO approved (PDF) 3. 3. Collier County Roll (PDF) 4. 4. Collier Description of Properties to be Assessed (PDF) 5. 5. Advertisement 9.8.21 (PDF) 6. 6. Landmark Invoice 09.29.2021 (PDF) 7. 7. NCH Baker Invoice 09.29.2021 (PDF) 8. 8. Physicians Regional Invoice 09.29.2021 (PDF) 9. 9. The Willough Invoice 09.29.2021 (PDF) 10. legal ad - agenda ID 19976 (PDF) 11. DPP LOA (PDF) 12. IGT questionnaire statewide DDP (XLSX) 16.D.3 Packet Pg. 1001 09/28/2021 COLLIER COUNTY Board of County Commissioners Item Number: 16.D.3 Doc ID: 19976 Item Summary: Recommendation to adopt a Resolution authorizing non-ad valorem special assessment on hospital-owned properties or properties used as a hospital as authorized by the Local Provider Participation Fund for the Directed Payment Program established by Ordinance No 2021-23 and authorize the necessary budget amendment; and to authorize the County Manager or designee to sign the Letter of Agreement in an amount not to exceed the total of $6,687,755 with the Agency for Health Care Administration to participate in the Local Provider Participation Fund that will provide additional h ealth services for the citizens of Collier County. Meeting Date: 09/28/2021 Prepared by: Title: – Public Services Department Name: Todd Henry 09/03/2021 1:17 PM Submitted by: Title: Department Head – Public Services Department Name: Dan Rodriguez 09/03/2021 1:17 PM Approved By: Review: Community & Human Services Kristi Sonntag Additional Reviewer Completed 09/03/2021 5:37 PM Operations & Veteran Services Kimberley Grant Additional Reviewer Completed 09/03/2021 5:59 PM Public Services Department Todd Henry Public Services Department Completed 09/07/2021 7:58 AM Public Services Department Dan Rodriguez PSD Department Head Completed 09/07/2021 9:52 AM County Attorney's Office Jennifer Belpedio Level 2 Attorney of Record Review Completed 09/08/2021 10:57 AM Office of Management and Budget Debra Windsor Level 3 OMB Gatekeeper Review Completed 09/08/2021 11:03 AM County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 09/08/2021 4:21 PM Office of Management and Budget Susan Usher Additional Reviewer Completed 09/08/2021 4:54 PM County Manager's Office Sean Callahan Level 4 County Manager Review Completed 09/20/2021 9:52 AM Board of County Commissioners Geoffrey Willig Meeting Pending 09/28/2021 9:00 AM 16.D.3 Packet Pg. 1002 ORDINANCE NO.2021- 9 3 AN ORDINANCE OF THE BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY,FLORIDA,TO BE CODIFIED IN CHAPTER 114 AS ARTICLE VI OF THE COLLIER COUNTY CODE OF LAWS AND ORDINANCES AUTHORIZING THE CREATION OF THE COLLIER COUNTY LOCAL PROVIDER PARTICIPATION FUND ("FUND") UNDER THE AUTHORITY OF SECTION 1(F), ARTICLE VIII OF THE CONSTITUTION OF THE STATE OF FLORIDA SPECIFYING THE METHOD OF SETTING AND COMPUTING ANNUAL NON-AD VALOREM SPECIAL ASSESSMENTS TO BE DEPOSITED INTO THE FUND AND SPECIFYING AUTHORIZED USES FOR THE FUND; PROVIDING FOR CONFLICT AND SEVERABILITY; PROVIDING FOR INCLUSION IN THE CODE OF LAWS AND ORDINANCES; AND PROVIDING FOR AN EFFECTIVE DATE OF JULY 1, 2021 UNLESS THE ENABLING LEGISLATION IS NOT APPROVED BY THE GOVERNOR OF THE STATE OF FLORIDA. RECITALS: WHEREAS, the hospitals in Collier County's jurisdiction (the "Hospitals") annually provide millions of dollars of uncompensated care to persons who qualify for Medicaid because Medicaid,on average, covers only 60%of the costs of the health care services actually provided by Hospitals to Medicaid eligible persons, leaving hospitals with significant uncompensated costs("Medicaid shortfall");and WHEREAS, the State of Florida(the"State")has received federal authority to establish the Statewide Medicaid Managed Care hospital directed payment program (the"DPP") to offset hospitals' Medicaid shortfall and improve quality of care provided to Florida's Medicaid population;and WHEREAS,impacted Hospitals have asked Collier County (the"County")to impose an assessment upon certain real property owned by the Hospitals to help finance the non-federal share of the State's Medicaid program; and WHEREAS, the only properties to be assessed in these localities are the real property sites of such Hospitals;and WHEREAS, the County recognizes that one or more Hospitals within the County's boundaries may be located upon real property leased from governmental entities and that such Hospitals may be assessed because courts do not make distinctions on the application of special assessments based on "property interests" but rather on the distinction of the classifications of real property being assessed;and Page l of 10 16.D.3.a Packet Pg. 1003 Attachment: 1. Ordinance 2021-23 (19976 : Non-Ad Valorem Special Assessment) WHEREAS, the funding raised by the County assessment will, through intergovernmental transfers ("IGTs") provided consistent with federal guidelines, support additional funding for Medicaid payments to Hospitals to address the Medicaid shortfall;and WHEREAS, the County acknowledges that the Hospital properties assessed will benefit directly and especially from the assessment as a result of the above-described additional funding provided to said Hospitals;and WHEREAS, the County has determined that a logical relationship exists between the Medicaid services provided by the Hospitals,which will be supported by the assessment,and the special and particular benefit to the real property of the Hospitals;and WHEREAS, the County has an interest in promoting access to health care for its low- income and under-insured residents;and WHEREAS, leveraging additional federal support through the above-described IGTs to fund payments to the Hospitals for health care services provided to Medicaid eligible persons directly and specifically benefits the Hospitals' properties and supports their continued ability to provide those services;and WHEREAS, imposing an assessment limited to Hospital properties to help fund the provision of Medicaid services and the achievement of certain quality standards by the Hospitals to residents of the County is a valid public purpose that benefits the health, safety,and welfare of the citizens of the County;and WHEREAS, the assessment ensures the financial stability and viability of the Hospitals providing Medicaid services;and WHEREAS, the Hospitals are important contributors to the overall County's economy, and the financial benefit to these Hospitals directly and specifically supports their mission, as well as their ability to grow, expand, and maintain their facilities in concert with the population growth in the jurisdiction of the County; and WHEREAS,the County finds the assessment will enhance the Hospitals' ability to grow, expand, maintain, improve and increase the value of their properties and facilities under all present circumstances and those of the foreseeable future;and WHEREAS, the County is proposing a properly apportioned assessment by which all Hospitals will be assessed a uniform amount that is compliant with 42 C.F.R. §433.68(d);and WHEREAS, the adoption of this Ordinance will enable the County to levy a uniform non-ad valorem special assessment, which is fairly and reasonably apportioned among the Hospitals' properties within the County's jurisdictional limits,to establish and maintain a system of funding for IGTs to support the non-federal share of Medicaid payments that will directly and specially benefit Hospital properties. Page 2 of 10 1 0 16.D.3.a Packet Pg. 1004 Attachment: 1. Ordinance 2021-23 (19976 : Non-Ad Valorem Special Assessment) WHEREAS, for the first year of the assessment the County finds that the alternative method, as specified in § 197.3631, Fla. Stat., for the assessment and collection of the non-ad valorem special assessment is appropriate but in future tax years may elect to use the uniform method if approved by the Board. NOW, THEREFORE, BE IT ORDAINED BY THE BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY,FLORIDA,that: SECTION 1. Chapter 126 of the Collier County Code of Laws and Ordinances, is hereby amended,by adding a new Article VI as follows: Sec. 126-211. -Title This Article VI shall be known and may be cited as the "Collier County Local Provider Participation Fund Ordinance." Sec. 126-212.-Authority. Pursuant to Article VIII, Section 1(0 of the Constitution of the State of Florida and Florida Statutes 125, the Board is hereby authorized to impose a special assessment against private for- profit and not-for-profit hospitals located within the County to fund the non-federal share of Medicaid payments associated with Local Services. Sec. 126-213.-Purpose. The non-ad valorem special assessment authorized by this Article shall be imposed, levied, collected,and enforced against Assessed Properties located within the County.Proceeds from the Assessment shall be used to benefit Assessed Properties through enhanced Medicaid payments for Local Services. When imposed, the Assessment shall constitute a lien upon the Assessed Properties equal in rank and dignity with the liens of all state,county,district,or municipal taxes and other non-ad valorem assessments. Failure to pay may cause foreclosure proceedings, which could result in loss of title, to commence. The Assessment shall be computed and assessed only in the manner provided in this Ordinance. Sec. 126-214. -Alternative Method. This Ordinance shall be deemed to provide an additional and alternative method, as specified in 197.3631, Fla. Stat., for the assessment and collection of the non-ad valorem special assessment described herein. The Ordinance shall be regarded as supplemental and additional to powers conferred by other laws and shall not be regarded as in derogation of any powers now existing or which may exist hereafter.This Ordinance,being necessary for the health,safety,and welfare of the inhabitants of the County, shall be liberally construed to effect the purposes hereof. Sec. 126-215. -Definitions. Page 3 of 10 16.D.3.a Packet Pg. 1005 Attachment: 1. Ordinance 2021-23 (19976 : Non-Ad Valorem Special Assessment) When used in this Ordinance, the following terms shall have the meanings below, unless the context clearly requires otherwise: Annual Final Assessment Resolution means the resolution described in Sections 126-224 and 126-225 hereof, which shall be the final proceeding for the imposition of an Assessment, establishing the rate for the non-ad valorem assessment for a specific Fiscal Year. Assessed Property means an Institutional Health Care Provider holding a right of possession and right of use of real property in the County through an ownership or leasehold interest,thus making the property subject to the Assessment. Assessment means a non-ad valorem special assessment imposed by the County on Institutional Health Care Providers located in the County limits to fund the non-federal share of Medicaid and Medicaid managed care payments directed to hospitals providing Local Services in the County. Assessment Coordinator means the person appointed by the County Manager or designee to administer the Assessment imposed pursuant to this Article,or such person's designee. Assessment Resolution means the resolution described in Section 126-219 hereof. Board means the Board of County Commissioners of Collier County,Florida. County means Collier County,Florida. Fiscal Year means the period commencing on October 1 of each year and continuing through the next succeeding September 30, or such other period as may be prescribed by law as the fiscal year for the County. Institutional Health Care Provider means a private for-profit or not-for-profit hospital that provides inpatient hospital services. Local Services means the provision of inpatient and outpatient hospital services to Medicaid,indigent,and uninsured members of the Collier County community. Non Ad Valorem Assessment Roll means the special assessment roll prepared by the County. Ordinance means the Collier County Local Provider Participation Fund Ordinance as it may be codified in Chapter 114 as Article VI in the Collier County Code of Laws and Ordinances. Tax Collector means the Collier County Tax Collector. Page 4 of 10 I 16.D.3.a Packet Pg. 1006 Attachment: 1. Ordinance 2021-23 (19976 : Non-Ad Valorem Special Assessment) Sec. 126-216.-Interpretation. Unless the context indicates otherwise, the terms "hereof," "hereby," "herein," "hereto," hereunder"and similar terms refer to this Article.The term"hereafter"means after and the term heretofore"means before the effective date of the Ordinance. Sec. 126-217. -Assessment. Pursuant to § 125.01, Fla. Stat., the Board is hereby authorized to create a non-ad valorem special assessment that shall be imposed, levied, collected, and enforced against Assessed Property to fund the non-federal share of Medicaid payments benefitting Assessed Properties providing Local Services in the County. Funds generated as a result of the Assessment shall be held in a separate account called the local provider participation fund and shall be available to be used only to: (1) provide to the Florida Agency for Health Care Administration the non-federal share for Medicaid payments to be made directly or indirectly in support of hospitals serving Medicaid beneficiaries and (2)reimburse the County for administrative costs associated with the implementation of the Assessment authorized by this Ordinance, as further specified in the Assessment Resolution. The Assessment will be broad based, and the amount of the Assessment must be uniformly imposed on each Assessed Property. The Assessment may not hold harmless any Institutional Health Care Provider, as required under 42 U.S.C. § 1396b(w). As set forth in Section 126-213, the Assessment shall constitute a lien upon the Assessed Properties equal in rank and dignity with the liens of all state, county, district, or municipal taxes and other non-ad valorem assessments. In addition to other remedies available at law or equity, the enforcement of the aforesaid Assessment shall be at the same time and in like manner as ad valorem taxes and subject to all ad valorem tax enforcement procedures afforded to the official annual real property tax notice. Creation and implementation of the Assessment will not result in any additional pecuniary obligation on the County, Board,or County residents. The Assessment shall be imposed, levied, collected, and enforced against only Assessed Properties, and the Assessment Resolution shall provide that the County's administrative costs shall be reimbursed from the collected amounts. The County's administrative costs shall not exceed$150,000. Any reasonable expenses the County incurs to collect delinquent assessments, including any attorney's fees incurred as a result of contracting with an attorney to represent the county in seeking and enforcing the collection of delinquent assessments, are not subject to the limitation on administrative costs. Sec. 126-218.-Computation of Assessment. The annual Assessment shall be specified for each Assessed Property. The Board shall set the Assessment in amounts that in the aggregate will generate sufficient revenue to fund the non- federal share of Medicaid payments associated with Local Services to be funded by the Assessment. Page 5 of 10 16.D.3.a Packet Pg. 1007 Attachment: 1. Ordinance 2021-23 (19976 : Non-Ad Valorem Special Assessment) The amount of the Assessment required of each Assessed Property may not exceed an amount that,when added to the amount of other required assessments, equals an amount of revenue that exceeds the maximum percent of the aggregate net patient revenue of all Assessed Hospitals in the County permitted by 42 C.F.R. §433.68(f)(3)(i)(A).Assessments for each Assessed Property will be derived from data contained in the Florida Hospital Uniform Reporting System, as available from the Florida Agency for Health Care Administration. Sec. 126-219. -Assessment Resolution. The Assessment Resolution shall describe: (a)the Medicaid payments proposed for funding from proceeds of the Assessment; (b) the benefits to the Assessment Properties associated with the Assessment; (c) the methodology for computing the assessed amounts; and (d) the method of collection,including how and when the Assessment must paid. Sec. 126-220.-Non-Ad Valorem Assessment Roll. The Assessment Coordinator shall prepare, or direct the preparation of, the Non-Ad Valorem Assessment Roll,which shall contain the following: a) The names of the Assessed Properties;and b) The Assessment rate and amount of the Assessment to be imposed against each Assessed Property based on the Assessment Resolution. The Non-Ad Valorem Assessment Roll shall be retained by the Assessment Coordinator and shall be open to public inspection. The foregoing shall not be construed to require that the Assessment Roll be in printed form if the amount of the Assessment for each Assessed Property can be determined by use of a computer terminal available to the public. Sec. 126-221. -Notice by Publication. Upon completion of the Non-Ad Valorem Assessment Roll, the Assessment Coordinator shall publish once in a newspaper of general circulation within the County a notice stating that theBoard, at a regular, adjourned, or special meeting on a certain day and hour, not earlier than 20 calendar days from such publication, will hear objections of all interested persons to approve the aforementioned Non-Ad Valorem Assessment Roll. Such notice shall include: a) The Assessment rate; b) The procedure for objecting to the Assessment rate; c) The method by which the Assessment will be collected;and d) A statement that the Non-Ad Valorem Special Assessment Roll is available for inspection at the Office of the Assessment Coordinator. Page 6 of 10 16.D.3.a Packet Pg. 1008 Attachment: 1. Ordinance 2021-23 (19976 : Non-Ad Valorem Special Assessment) Sec. 126-222.-Notice by Mail. In addition to the published notice required by Section 126-221, but only for the first fiscal year in which an Assessment is imposed by the Board against Assessed Properties, the Assessment Coordinator shall provide notice of the proposed Assessment by first class mail to the Assessed Properties. Such notice shall include: a) The purpose of the Assessment; b) The Assessment rate to be levied against each Assessed Property; c) The unit of measurement applied to determine the Assessment; d) The total revenue to be collected by the County from the Assessment; e) A statement that failure to pay the Assessment will cause a tax certificate to be issued against the property or foreclosure proceedings,either of which may result in a loss of title to the property; f) A statement that all affected and/or interested parties have a right to appear at the hearing and to file written objections with the Board within 20 days of the notice;and g) The date,time,and place of the hearing. Notice shall be mailed at least 20 calendar days prior to the hearing to each Assessed Property at such address as is shown on the Assessment Roll. Notice shall be deemed mailed upon delivery thereof to the possession of the United States Postal Service. The Assessment Coordinator may provide proof of such notice by affidavit. Failure of the Assessed Property to receive such notice, because of mistake or inadvertence, shall not affect the validity of the Assessment Roll or release or discharge any obligation for payment of the Assessment imposed by the Board pursuant to this Article. Sec. 126-223. -Adoption of Assessment Resolution and Non-Ad Valorem Assessment Roll. At the time named in the notice, the Board shall receive and consider any written objections of interested persons. All objections to the Assessment Resolution and Non-Ad Valorem Assessment Roll shall be made in writing and filed with the Assessment Coordinator at or before the time or adjourned time of such hearing. At the date and time named in the notice,the Board may adopt the Assessment Resolution and Non-Ad Valorem Assessment Roll which shall: a) Set the rate of the Assessment to be imposed; b) Approve the Non-Ad Valorem Assessment Roll,with such amendments as it deems just and right;and c) Affirm the method of collection. Page 7 of 10 rx J 16.D.3.a Packet Pg. 1009 Attachment: 1. Ordinance 2021-23 (19976 : Non-Ad Valorem Special Assessment) Sec. 126-224.-Annual Final Assessment Resolution. The Board may revise the Non-Ad Valorem Assessment Roll during the Fiscal Year to modify the Assessment rate. However, the Board must adopt an Annual Final Assessment Resolution during the Fiscal Year to memorialize the final rate applicable for the Fiscal Year. Sec. 126-225.-Effect of Annual Final Assessment Resolution. The adoption of the Annual Final Assessment Resolution shall be the final adjudication of the issues presented(including,but not limited to, the method of apportionment and Assessment, the Assessment rate, the initial rate of Assessment, the Non-Ad Valorem Assessment Roll, and the levy and lien of the Assessments), unless proper steps shall be initiated in a court of competent jurisdiction to secure relief within 20 days from the date of Board action on the Annual Final Assessment Resolution. The Non-Ad Valorem Assessment Roll shall be delivered to the Tax Collector or such other official as the Board by resolution shall designate. Sec. 126-226. -Method of Collection. The amount of the assessment is to be collected pursuant to the Alternative Method, as specified in the Assessment Resolution. Sec. 126-227.-Refunds. If, at the end of the Fiscal Year, additional amounts remain in the local provider participation fund, the Board is hereby authorized to make refund to Assessed Properties in proportion to amounts paid in during the Fiscal Year for all or a portion of the unutilized local provider participation fund. Sec. 126-228.-Responsibility for Enforcement, The County and its agent, if any, shall maintain the duty to enforce the prompt collection of the Assessment by the means provided herein. The duties related to collection of assessments may be enforced at the suit of any holder of obligations in a court of competent jurisdiction by mandamus or other appropriate proceedings or actions. Sec. 126-229, -Correction of Errors and Omissions. No act of error or omission on the part of the Comptroller, Property Appraiser, Tax Collector, Assessment Coordinator, Board, or their deputies or employees shall operate to release or discharge any obligation for payment of the Assessment imposed by the Board under the provision of this Chapter. Page 8oflO 0 16.D.3.a Packet Pg. 1010 Attachment: 1. Ordinance 2021-23 (19976 : Non-Ad Valorem Special Assessment) SECTION 2. APPLICABILITY. It is hereby intended that this Ordinance shall constitute a uniform Iaw applicable in all unincorporated areas of Collier County, Florida, and to all incorporated areas of Collier County where there is no existing conflict of law or municipal ordinance. SECTION 3. SEVERABILITY. In the event this Ordinance conflicts with any other Ordinance of Collier County or other applicable law, deemed a separate, distinct and independent provision and such holding shall not affect the validity of the remaining portion. SECTION 4. RESOLUTION OF CONFLICT OF LAWS. In all instances where Florida law, as evidenced by the Florida Administrative Code, Florida Statutes, applicable case law, or otherwise mandates standards or requirements that are stricter than the provisions of this Ordinance, or where a matter is addressed by Florida law that is not addressed by this Ordinance, then said law shall govern. In situations where this Ordinance addresses a matter in a manner that is stricter than that of Florida law, the provisions of this Ordinance shall control. SECTION 5. INCLUSION IN THE COLLIER COUNTY CODE. The provisions of this Ordinance shall be included and incorporated in the Collier County Code, as an addition or amendment thereto, and shall be appropriately renumbered to conform to the uniform numbering system of the Collier County Code, once established. The word "ordinance" may be changed to "section," "article," or other appropriate word or phrase necessary to accomplish such intentions. SECTION 6. FILING OF ORDINANCE. In accordance with the provisions of§ 125.66,Fla. Stat.,a certified copy of this Ordinance shall be filed with the Florida Department of State. SECTION 7. EFFECTIVE DATE. This Ordinance shall become effective July 1, 2021 unless the enabling legislation is not approved by the Governor of the State of Florida. PASSED AND 13ULY ADOPTED by the Board of County Commissioners of Collier County, Florida,this aorday of J u,ne, ,2021. Page 9 of 10 16.D.3.a Packet Pg. 1011 Attachment: 1. Ordinance 2021-23 (19976 : Non-Ad Valorem Special Assessment) ATTEST: BOARD OF COUNTY COMMISSIONERS CRYSTAL K KINZEL,CLERK COLLIER O Y, FLORIDA By—:)(By: DEPUT PENNY TAYL ,CHAIRP SON Attest as to Chaim an's •••. signature only. Approved as to form and legality: e i r A.Bel edio 1Jna p 5PAssistantCountyAtto I i This ordinance flied with t1'xs: Secr tort' of State's day of and acknowledgement of that filing received ihis day By Deouty C erk, Page 10 of 10 0G 16.D.3.a Packet Pg. 1012 Attachment: 1. Ordinance 2021-23 (19976 : Non-Ad Valorem Special Assessment) r . FLORIDA DEPARTMENT Of STATE RON DESANTIS LAUREL M. LEE Governor Secretary of State July 1, 2021 Ms. Martha Vergara, BMR & VAB Senior Deputy Clerk Office of the Clerk of the Circuit Court Comptroller of Collier County 3329 Tamiami Trail E, Suite#401 Naples, Florida 34112 Dear Ms. Vergara: Pursuant to the provisions of Section 125.66, Florida Statutes, this will acknowledge receipt of your electronic copy of Collier County Ordinance No. 2021-23, which was filed in this office on July 1, 2021. Sincerely, Anya Grosenbaugh Program Administrator AG/lb R. A. Gray Building • 500 South Bronough Street • Tallahassee, Florida 32399-0250 Telephone: (850) 245-6270 16.D.3.a Packet Pg. 1013 Attachment: 1. Ordinance 2021-23 (19976 : Non-Ad Valorem Special Assessment) 16.D.3.bPacket Pg. 1014Attachment: 2. Resolution Hospital Assessment CAO approved (19976 : Non-Ad Valorem Special Assessment) 16.D.3.bPacket Pg. 1015Attachment: 2. Resolution Hospital Assessment CAO approved (19976 : Non-Ad Valorem Special Assessment) 16.D.3.bPacket Pg. 1016Attachment: 2. Resolution Hospital Assessment CAO approved (19976 : Non-Ad Valorem Special Assessment) 16.D.3.bPacket Pg. 1017Attachment: 2. Resolution Hospital Assessment CAO approved (19976 : Non-Ad Valorem Special Assessment) 16.D.3.bPacket Pg. 1018Attachment: 2. Resolution Hospital Assessment CAO approved (19976 : Non-Ad Valorem Special Assessment) Collier County LPPF Rate SettingNet Patient RevenueLPPF Assessment RateLPPF Mandatory PaymentA B C = B * A10314400Physicians Regional Med Ctr - Pine Ridge CHS Naples$275,652,659 $3,059,74516431100Landmark Hospital of Southwest Florida Landmark Holdings of Missouri, LLC Naples25,982,331$288,40410031500Naples Community HospNCH Healthcare SystemNaples520,783,910$5,780,701104063The Willough at NaplesOglethorpe, LLCNaples17,931,511$199,040840,350,411$ 1.11%9,327,890$ Hospital ID #Provider NameHospital SystemCityTotal and %'s16.D.3.cPacket Pg. 1019Attachment: 3. Collier County Roll (19976 : Non-Ad Valorem Special Assessment) Facility  Type  Name Street Address Street  City Street  State  Street  Zip  Street  County Real Estate  Parcel Number Legal Description Hospital  PHYSICIANS REGIONAL  MEDICAL CENTER ‐ PINE  RIDGE  6101 Pine Ridge  Rd Naples FL 34119 Collier 80670080001 VINEYARDS UNIT ONE, THE TRACT "B" AND THAT PORTION OF SEC 8 TWP 49  RNG 26 AS DESC IN OR 2313 PG 3115 Hospital  LANDMARK HOSPITAL  OF SOUTHWEST  FLORIDA  1285 Creekside  Blvd Naples FL 34109 Collier 29331180612 CREEKSIDE COMMERCE PARK EAST, PART OF TR 5 DESC AS FOLL; COM AT NE  CNR 27‐48‐25 ALG E LI S01 09 43E 696.85FT, THENCE S88 50 17W 559.33FT  TO POB. THENCE S00W 245.17FT, THENCE 126.74FT ALG ARC TO NW,  THENCE S84 26 05W 428.11FT, THENCE 39.26FT ALG ARC, THENCE N05 35  40W 353.51FT, THENCE N90E 565.33FT TO POB. 4.36 AC Hospital NCH BAKER HOSPITAL 350 7th St N Naples FL 34102 Collier 14038880000 NAPLES T 7 BLKS 24 & 23, T 8 BLKS 23 & 24 & ALL VAC E/W & N/S ALLEYS &  THAT VACATED PORT OF 3RD AVE N LY BETWEEN 6TH ST & 8TH ST & THAT  VACATED PORT OF 7TH ST LY BETWEEN SECOND AVE N & FOURTH AVE N Hospital THE WILLOUGH AT  NAPLES  9001 Tamiami  Trail East Naples FL 33862 Collier 55100120000 LELY EST ST ANDREWS W A PORTION OF TR J DESC AS: COMM SE CNR SEC  19, N 39 DEG W 359.82FT TO POB, S 50 DEG W 473.35FT E RW US 41, N 39  DEG W 550FT, N 50 DEG E 604.72FT, S 58 DEG E 580.78FT, S 50 DEG W  324.20FT TO POB OR 996 PG 1813‐14 OR 1079 PG 1333 16.D.3.d Packet Pg. 1020 Attachment: 4. Collier Description of Properties to be Assessed (19976 : Non-Ad Valorem Special Assessment) NOTICE OF PUBLIC HEAzuNG TO CONSIDER THE IMPOSITION AND COLLECTION OF A NON-AD VALOREM SPECIAL ASSESSMENT Notice is hereby given that the Board of County Commissioners of Collier County, Florida, will conduct a public hearing to consider the approval of the imposition and collection of a non-ad valorem special assessment against each private for-profit and not-for-profit hospital that provides inpatient hospital services and that holds a right of possession and right of use to real property in Collier County, Florida (each, an "Assessed Property"). The list of affected hospitals is included at the conclusion of this notice. The assessment is intended to finance intergovernmental transfers provided consistent with federal guidelines to fund the non-federal share of certain Medicaid and./or Medicaid managed care payments. As a result, the assessment directly and specially benefits Assessed Properties and supports the provision of health care services to Medicaid, indigent, and uninsured members of the County's community. The public hearing will be held at Administration Building, located at 3299 Tamiami Trail East, Suite 303, Naples, FL 34112-5746, on September 28 at9 a.m., or as soon thereafter as the matter can be heard. At that time, the Board will receive public comment on the proposed special assessment. The County has prepared the Non-Ad Valorem Assessment Roll being considered for approval based on information provided by the hospitals. The roll contains the names of the hospitals; the tax parcel identification numbers of the parcels; the section, township, and range of the parcels assessed; the parcel owner's name; the address and the names and addresses of any leaseholders of the Assessed Properties; the assessment rate; and the amount of the special assessment to be imposed against each Assessed Property. The Non-Ad Valorem Assessment Roll will be available for inspection at the Collier County Operations & Veterans Services, located at3339 Tamiami Trail East Srite 212, Naples, FL 34112, during regular business hours from September 8, 2021 , until the hearing concludes on Tuesday, September 2l , 202I . The assessment rate set forth in the Non-Ad Valorem Assessment Roll to be levied against the net patient revenue of each Assessed Property is 1.1 1%. At the date and time set forth in this notice, the Board of County Commissioners may: (1) approve the Non-Ad Valorem Assessment Roll, with such amendments as it deems just and right and (2) adopt a resolution (the "Assessment Resolution") that describes (a) the Medicaid payments proposed for funding from proceeds of the assessment, (b) the benefits to the Assessed Properties, (c) the methodology for computing the assessed amounts, and (d) the method of collection, including how and when the assessment is to be paid. All interested persons have a right to appear at the public hearing and to file written objections with the Board prior to the resolution vote. All written objections to the Non-Ad Valorem Assessment being considered for approval shall be filed with the County by September 27 ,2021. Written objections should be sent to the attention of Collier County Operations & Veterans Services, located at3339 Tamiami Trail East Suite 212, Naples, FL34ll2. 16.D.3.e Packet Pg. 1021 Attachment: 5. Advertisement 9.8.21 (19976 : Non-Ad Valorem Special Assessment) The amount of the assessment is to be collected pursuant an additional and alternative method, as specified in $ 197.363 1, Fla. Stat., for the assessment and collection of a non-ad valorem special assessment. Details will be included in the Assessment Resolution. If you are a person with disability who needs any accommodation to participate in this proceeding, you are entitled, at no cost to you, to the provision of certain assistance. Please contact Collier County Facilities Management Division at (239) 252-8380 at least three days prior to the public hearing if you need special accommodations. Collier County, FLOzuDA List of Affected Properties: The special assessment is to be levied against each private for-profit and not-for-profit hospital operating under a Florida hospital license affiliated with the following providers of inpatient hospital services that holds a right of possession and right of use to real property in Collier County, Florida: Physicians Regional Medical Center 6101 Pine Ridge Rd Naples, FL 34119 Parcel #: 80670080001 Landmark Hospital of Southwest Florida 1285 Creekside Blvd Naples FL 34109 Parcel #:29331180612 NCH Baker Hospital 350 7th St N Naples FL 34102 Parcel #: 14038880000 The Willough at Naples 9001 TamiamiTrail East Naples, FL 33862 Parcel #: 55100120000 16.D.3.e Packet Pg. 1022 Attachment: 5. Advertisement 9.8.21 (19976 : Non-Ad Valorem Special Assessment) Re C-OtttlW Pu blic Services Department Community & Human Services Division September 29,2021 Daniel Dunmyer Landmark Hospital of Southwest Florida 1285 Creekside Blvd Naples FL 34109 Parcel Number 2933 I I 80 6 12 Collier County Local Provider Participation Fund Assessment Dear Hospital Administrator: Attached is your invoice for the annual mandatory payment for the Collier County Local Provider Participation Fund ("LPPF"). The mandatory payment rate for Fiscal Year 2027 has been set at 1 .17Yo of your net patient revenue. Net patient revenue is based on the Hospital's most recently filed Medicare Cost report, which is filed with the Centers of Medicare and Medicaid services. The mandatory payments will be deposited into the LPPF. These funds will be used for the non-federal share of a Medicaid supplemental payment program. The LPPF is broad based; it applies to all non-public hospitals located in Collier County that provide inpatient hospital services. The formula for calculating the mandatory payments is the same for each hospital. No hospitals are held harmless or exempt from paying the mandatory payments. The mandatory payments are assessed annually but paid in installments due in accordance with the schedule below: Questions regarding your assessment and the process for collection may be directed to the Operations & Veterans Services Division of Collier County at County at (239) 252- 8387. Community & Human Services Division . 3339 Tamiami Trail East, Suite 211 . Naples, Florida 341 12-5361 239-252{ARE (2273), 23L252-CAFE (2233) . 23y252-4230 (RSVP) . www.colliergov.netihumanservlces L-4 Landmark Hospital of Southwest Florida $288,404 October t5,2021 Mandatory Payment Quarter Provider Name Due Date 16.D.3.f Packet Pg. 1023 Attachment: 6. Landmark Invoice 09.29.2021 (19976 : Non-Ad Valorem Special Assessment) Jr '< '< 'r THIS IS AN INVOICE * * * * COLLIER COUNTY LOCAL PROVIDER PARTICIPATION FT]ND Landmark Hospital of Southwest Florida Parcel Number 29331 1 80612 Amount of assessment attributed to hospital: $288,404 Number of annual payments: I Total amount of annual payments: $288,404 Amount Due: $288,404 Due by Date: October 15,2021 Make check payable to: Collier County Board of County Commissioners C/O Operations & Veterans Services 3339 Tamiami Trail East Suite 212 Naples, FL 34112 ,s * * * THIS IS AN INVOICE 's * '< * 16.D.3.f Packet Pg. 1024 Attachment: 6. Landmark Invoice 09.29.2021 (19976 : Non-Ad Valorem Special Assessment) Re: C-ountW Pu blic SeMces Department Community & Human Services Division September 29,2021 Rick Wyles 350 7th Street North Naples, PL 34102 Parcel Number 1 403 8880000 Collier County Local Provider Participation Fund Assessment Dear Hospital Administrator: Attached is your invoice for the annual mandatory payment for the Collier County Local Provider Participation Fund ("LPPF"). The mandatory payment rate for Fiscal Year 2021has been set at 1 .l1o/o of your net patient revenue. Net patient revenue is based on the Hospital's most recently filed Medicare Cost report, which is filed with the Centers of Medicare and Medicaid services. The mandatory payments will be deposited into the LPPF. These funds will be used for the non-federal share of a Medicaid supplemental payment program. The LPPF is broad based; it applies to all non-public hospitals located in Collier County that provide inpatient hospital services. The formula for calculating the mandatory payments is the same for each hospital. No hospitals are held harmless or exempt from paying the mandatory payments. The mandatory payments are assessed annually but paid in installments due in accordance with the schedule below: Questions regarding your assessment and the process for collection may be directed to the Operations & Veterans Services Division of Collier County at County at (239) 252- 83 87. Community & Human Services Division . 3339 Tamiami Trail East, Suite 211 . Naples, Florida 341'12-5361 1.-4 NCH Baker Hospital 5 s,7Bo,7o1-October L5,202t Quarter Mandatory Payment Due Date : -/ Provider Name 16.D.3.g Packet Pg. 1025 Attachment: 7. NCH Baker Invoice 09.29.2021 (19976 : Non-Ad Valorem Special Assessment) * * ,r ,( THIS IS AN INVOICE * '( 'r 'f COLLIER COUNTY LOCAL PROVIDER PARTICIPATION FUND NCH Baker Hospital Parcel Number 1 4038880000 Amount of assessment attributed to hospital: $ 5,780,701 Number of annual payments: 1 Total amount of annual payments: $ 5,780,701 Amount Due: $ 517801701 Due try Date: October 15,2021 Make check payable to:Collier County Board of County Commissioners C/O Operations & Veterans Services 3339 Tamiami Trail East Suite 212 Naples, FL 34112 * ,T * J< THIS IS AN INVOICE '< * * ?K 16.D.3.g Packet Pg. 1026 Attachment: 7. NCH Baker Invoice 09.29.2021 (19976 : Non-Ad Valorem Special Assessment) Re C-Ottltty Pu blic SeMces Department Communrty & Human Services Division September 29,2027 Lyme Mitchell 8300 Collier Boulevard Naples, Florida 34114 Parcel Number 80670080001 Collier County Local Provider Participation Fund Assessment Dear Hospital Administrator: Attached is your invoice for the arurual mandatory payment for the Collier County Local Provider Participation Fund ("LPPF"). The mandatory payment rate for Fiscal Year 2021has been set at 1 .ll%o of your net patient revenue. Net patient revenue is based on the Hospital's most recently filed Medicare Cost report, which is filed with the Centers of Medicare and Medicaid services. The mandatory payments will be deposited into the LPPF. These funds will be used for the non-federal share of a Medicaid supplemental payment program. The LPPF is broad based; it applies to all non-public hospitals located in Collier County that provide inpatient hospital services. The formula for calculating the mandatory payments is the same for each hospital. No hospitals are held harmless or exempt from paying the mandatory payments. The mandatory payments are assessed annually but paid in installments due in accordance with the schedule below: Questions regarding your assessment and the process for collection may be directed to the Operations & Veterans Services Division of Collier County at County at (239) 252- 8387. Community & Human Services Division . 3339 TamiamiTrail East, Suite 21'l . Naples, Flonda 34112-5361 239-252CARE (2273).23L252-CAFE (2233). 23*252-4230 (RSVP) . *ww.colliergov.net/humanservices 1,-4 Physicians Regional Medical Center s3,059,745 October 1.5,2021- Mandatory Payment Quarter Provider Name Due Date _l 16.D.3.h Packet Pg. 1027 Attachment: 8. Physicians Regional Invoice 09.29.2021 (19976 : Non-Ad Valorem Special Assessment) ,s :k ,r ,r THIS IS AN INVOICE 'r 'r :r '( COLLIER COUNTY LOCAL PROVIDER PARTICIPATION FT]ND Physicians Regional Medical Center Parcel Number 8067008000 1 Amount of assessment attributed to hospital: $3,059,745 Number of annual payments: I Total amount of annual payments: $3,059,745 Amount Due: $3,0591745 Due by Date: October 15,2021 Make check payable to:Collier County Board of County Commissioners C/O Operations & Veterans Services 3339 Tamiami Trail East Suite 212 Naples, FL 34112 'r '( 'r * THIS IS AN II\TVOICE * * * ,( 16.D.3.h Packet Pg. 1028 Attachment: 8. Physicians Regional Invoice 09.29.2021 (19976 : Non-Ad Valorem Special Assessment) Re Chtn*y Public SeMces Department Community & Human Services Division September 29,2021 Rick Bennett The Willough at Naples 9001 Tamiami Trail East Naples, FL 33862 Parcel Number: 55 100120000 Collier County Local Provider Participation Fund Assessment Dear Hospital Administrator: Attached is your invoice for the annual mandatory payment for the Collier County Local Provider Participation Fund ("LPPF"). The mandatory payment rate for Fiscal Year 2027 has been set at I .llYo of your net patient revenue. Net patient revenue is based on the Hospital's most recently filed Medicare Cost report, which is filed with the Centers of Medicare and Medicaid services. The mandatory payments will be deposited into the LPPF. These funds will be used for the non-federal share of a Medicaid supplemental payment program. The LPPF is broad based; it applies to all non-public hospitals located in Collier County that provide inpatient hospital services. The formula for calculating the mandatory payments is the same for each hospital. No hospitals are held harmless or exempt from paying the mandatory payments. The mandatory payments are assessed annually but paid in installments due in accordance with the schedule below: Questions regarding your assessment and the process for collection may be directed to the Operations & Veterans Services Division of Collier County at County at (239) 252- 8387. Community & Human Services Division . 3339 Tamiami Trail East, Suite 211 . Naples, Florida 34112-5361 239-2524ARE (2273),23*252-CAFE (2233). 23V252-4230 (RSVP) . urwrl.colliergov.net/humanservices 1.-4 The Willough at Naples S199,040 October L5,202L Mandatory Payment Quarter Provider Name Due Date 16.D.3.i Packet Pg. 1029 Attachment: 9. The Willough Invoice 09.29.2021 (19976 : Non-Ad Valorem Special Assessment) * ,r ,f ,( THIS IS AN INVOICE * * * * COLLIER COUNTY LOCAL PROVIDER PARTICIPATION FUND The Willough at Naples Parcel Number: 55 1 00 1 20000 Amount of assessment attributed to hospital: $199,040 Number of annual payments: 1 Total amount of annual payments: $199,040 Amount Due: $199,040 Due by Date: October 15,2021 Make check payable to: Collier County Board of County Commissioners C/O Operations & Veterans Services 3339 Tamiami Trail East Suite 212 Naples, FL 34112 >I ,r * ,( THIS IS AN INVOICE ,( ,r ,( * 16.D.3.i Packet Pg. 1030 Attachment: 9. The Willough Invoice 09.29.2021 (19976 : Non-Ad Valorem Special Assessment) 16.D.3.k Packet Pg. 1031 Attachment: legal ad - agenda ID 19976 (19976 : Non-Ad Valorem Special Assessment) 16.D.3.lPacket Pg. 1032Attachment: DPP LOA (19976 : Non-Ad Valorem Special Assessment) 16.D.3.lPacket Pg. 1033Attachment: DPP LOA (19976 : Non-Ad Valorem Special Assessment) 16.D.3.lPacket Pg. 1034Attachment: DPP LOA (19976 : Non-Ad Valorem Special Assessment) IGT Provider Name: Health Care Provider Name: IGT Amount: State Fiscal Year Ending: 1. County If other, please explain 2. No 3. Amount 6,687,755$ -$ -$ If other, please explain a. Yes If no, please explain 4.Does your organization have taxing authority? Yes 5.If the source of IGT funding is from taxes, please answer the following questions: a.Is the tax a state, county, city, or hospital district tax? 16.D.3.m Packet Pg. 1035 Attachment: IGT questionnaire statewide DDP (19976 : Non-Ad Valorem Special Assessment) County If other, please explain b.What entities are taxed? c.What is the tax structure (i.e. property tax, percentage of revenue, assessment, etc.)? d.What is the amount or percent of the tax? e. Amount 9,327,890$ 9,327,890$ 100.00% i) Yes If no, please explain Total Tax Burden Healthcare Provider Tax Burden Is the tax broad based? A broad based tax can be defined as a tax that is imposed on at least all health care items or services in the class or providers of such items or services furnished by all non- Federal, non-public providers in the State, and is imposed uniformly, pursuant to 42 CFR § 433.68. Does at least 85% of the burden of the tax revenue fall on health care providers as defined in 42 CFR §433.55? (Provide the total tax revenue and the health care provider tax burden) If so, please answer the following questions: Special assessment 1.11% of Net Patient Revenue Licensed non-public hospitals in Collier County 16.D.3.m Packet Pg. 1036 Attachment: IGT questionnaire statewide DDP (19976 : Non-Ad Valorem Special Assessment) ii) Yes If no, please explain iii) No If no, please explain iv) Yes If no, please explain v)Does every tax paying entity receive a supplemental payment equal to or exceeding its tax cost? If yes, please explain 6. a. No b. Amount c. No Are provider voluntary payments or in-kind services received by the organization as defined in 42 CFR § 433.52? No waiver was requested Is the tax uniform across all entities being taxed? Based on 42 CFR § 433.68, a health care-related tax will be considered to be imposed uniformly even if it excludes Medicaid or Medicare payments (in whole or in part), or both; or in the case of health care-related tax based on revenue or receipts with respect to a class of items or services, if it excludes either Medicaid or Medicare revenue with respect to a class of items or services, or both. The exclusion of Medicaid revenue must be applied uniformly to all providers being taxed. Is the tax generally redistributive and a waiver of the broad-based or uniform tax requirement was granted in accordance with 42 CFR §433.68(e)? Does the tax program comply with the hold harmless provisions included in 42 CFR § 433.68(f)? The county is not involved in the distribution of funds following federal match. The county is not in position to speak to the ultimate distribution to hospitals from the managed care organizations. Please answer the following regarding provider funds received from the healthcare entity and/or other health care entities. How much of the organization’s revenue is received from provider-related donations (Provide the total revenue and the provider-related donation amounts)? Do individual provider donations exceed $5,000 per year or $50,000 per year for a health care organizational entity? Total Revenue Provider Related Donations 16.D.3.m Packet Pg. 1037 Attachment: IGT questionnaire statewide DDP (19976 : Non-Ad Valorem Special Assessment) If yes, please list the provider and payment amount. Funding Source Amount -$ -$ -$ d. e. 7. No If yes, provide the board minutes and date of the appropriation. I certify that the statements and information contained in this submittal are true, accurate, and complete. Signature of Officer or Administrator Title Date No Were funds utilized for the IGT specifically appropriated by the organization's board? Does any portion of the provider donation constitute as a “bona fide donation” pursuant to 42 CFR § 433.54? 42 CFR § 433.54 requires donations will not be returned to the individual provider, the provider class, or related entity under a hold harmless provision. Is there an agreement between the IGT provider and the health care entity? If so, please specify whether the agreement is written and provide the details. Provider Name 16.D.3.m Packet Pg. 1038 Attachment: IGT questionnaire statewide DDP (19976 : Non-Ad Valorem Special Assessment)