Agenda 09/28/2021 Item #16D 6 (Agreement w/Collier Health Services, Inc.)09/28/2021
EXECUTIVE SUMMARY
Recommendation to approve an agreement in the amount of $443,611 with the Agency for Health
Care Administration and an agreement with Collier Health Services, Inc., and authorize necessary
Budget Amendments to participate in the Medicaid Low Income Pool Program, generating
$572,728 in federal matching funds that will provide additional health services for the citizens of
Collier County.
OBJECTIVE: To provide additional health care services to the low-income citizens of Collier County.
CONSIDERATIONS: The Agency for Health Care Administration (AHCA), is a State entity that
provides Medicaid services in Florida and operates the Medicaid Low Income Pool (LIP) Program. The
LIP Program leverages local funds to obtain federal matching dollars . The County's participation in the
LIP Program is outlined in the contractual arrangement between Collier County and AHCA, which is
presented as part of this item.
Collier Health Services, Inc. (CHSI) desires and is qualified to administer the LIP Program with AHCA
using County ad valorem tax dollars. The allocation of County and matching funds is as follows:
Collier County LIP IGT Federal Matching Funds Provided
to CHSI as Program Administrator
Total Funds Benefiting Low-
Income Persons
$443,611 $572,728 $1,016,339
CHSI will utilize the total funds under the LIP Program to provide additional healthcare services for low -
income individuals in Collier County. An agreement that outlines the contractual arrangement between
Collier County and CHSI on behalf of Collier Health Services, Inc., is presented as part of this Item.
These funds may only be allocated to those Federally Qualified Health Centers (FQHC).
CHSI will make payments in an amount not to exceed $250,000 for eligible medical services authorized
by County staff.
FISCAL IMPACT: Funding in the amount of $443,611 is available within Community & Human
Services FY22 Community Mental Health & LIP Support Cost Center (001-156010) for the County’s
contribution payment to the State of Florida Agency for Healthcare Administration by October 31, 2021.
GROWTH MANAGEMENT IMPACT: There is no Growth Management impact associated with this
action.
LEGAL CONSIDERATIONS: This item is approved for form and legality and requires a majority vote
for Board action. - JAB
RECOMMENDATION: To approve and authorize the Chairman to sign an agreement in the amount of
$443,611 with the Agency for Health Care Administration and an agreement with Collier Health Services,
Inc., and authorize necessary Budget Amendments to participate in the Medicaid Low Income Pool
Program, generating $572,728 in federal matching funds that will provide additional health services for
the citizens of Collier County.
Prepared By: Matthew Catoe, Contract Administration Specialist, Operations and Veteran Services
Division
16.D.6
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09/28/2021
ATTACHMENT(S)
1. Agreement CAO Stamped (PDF)
2. SYF21-22_LIP_Model Summary (PDF)
3. (linked) LOA - Low Income Pool (PDF)
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09/28/2021
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.D.6
Doc ID: 20089
Item Summary: Recommendation to approve an agreement in the amount of $443,611 with the
Agency for Health Care Administration and an agreement with Collier Health Services, Inc., and
authorize necessary Budget Amendments to participate in the Medicaid Low Income Pool Program,
generating $572,728 in federal matching funds that will provide additional health services for the citizens
of Collier County.
Meeting Date: 09/28/2021
Prepared by:
Title: Operations Analyst – Public Services Department
Name: Matthew Catoe
09/16/2021 4:58 PM
Submitted by:
Title: Division Director - Ops Support – Operations & Veteran Services
Name: Kimberley Grant
09/16/2021 4:58 PM
Approved By:
Review:
Operations & Veteran Services Kimberley Grant Additional Reviewer Completed 09/17/2021 1:50 PM
Public Services Department Todd Henry Public Services Department Completed 09/20/2021 7:44 AM
Public Services Department Dan Rodriguez PSD Department Head Completed 09/20/2021 4:28 PM
County Attorney's Office Jennifer Belpedio Level 2 Attorney of Record Review Completed 09/21/2021 10:43 AM
Office of Management and Budget Debra Windsor Level 3 OMB Gatekeeper Review Completed 09/21/2021 11:16 AM
County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 09/21/2021 3:16 PM
Growth Management Operations Support Christopher Johnson Additional Reviewer Completed 09/21/2021 3:24 PM
County Manager's Office Sean Callahan Level 4 County Manager Review Completed 09/22/2021 8:30 AM
Board of County Commissioners Geoffrey Willig Meeting Pending 09/28/2021 9:00 AM
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16.D.6.aPacket Pg. 1168Attachment: Agreement CAO Stamped (20089 : LIP Agreement with AHCA & CHSI)
16.D.6.aPacket Pg. 1169Attachment: Agreement CAO Stamped (20089 : LIP Agreement with AHCA & CHSI)
16.D.6.aPacket Pg. 1170Attachment: Agreement CAO Stamped (20089 : LIP Agreement with AHCA & CHSI)
16.D.6.aPacket Pg. 1171Attachment: Agreement CAO Stamped (20089 : LIP Agreement with AHCA & CHSI)
16.D.6.aPacket Pg. 1172Attachment: Agreement CAO Stamped (20089 : LIP Agreement with AHCA & CHSI)
16.D.6.aPacket Pg. 1173Attachment: Agreement CAO Stamped (20089 : LIP Agreement with AHCA & CHSI)
SFY 2021-22 LIP Model Self-Funded Tiers Model $1,116,516,134Total0.6103 FMAP0.3897 SMAP$681,416,116 Federal$0 State GR$435,100,018 LocalTier 5 - Private Hospitals with a UC ratio less than 17%. Group 2 - Medical School Physician PracticesTier 1 - Medical SchoolsPer the Special Terms and Conditions (STCs), hospitals are required to have at least 1% Medicaid utilization to be eligible for LIP.Group 1 - HospitalsTier 1 - Private Hospitals with a Uncompensated Care (UC) ratio greater than or equal to 17% and less than 51.5%Tier 2 - All Public Hospitals, All Children's Hospitals, Statutory Teaching Hospitals with UC ratio greater than or equal to 19%, and Private Hospitals with UC ratio greater than or equal to 51.5%.Tier 3 - Statutory Teaching Hospitals with UC ratio less than 19%.Tier 4 - Regional Perinatal Intensive Care Centers (non-Public), and Statutory Teaching Regional Perinatal Intensive Care Centers with a UC ratio greater than or equal to 15% and less than 17.5%.SFY 2021-22 LIP Model SummaryModel includes the following assumptions:The 6.2% enhanced FMAP is per the Families First Corona Virus Act does not continue past 12/31/21.LIP Program pays providers based on their charity care cost. Hospitals are ranked from high to low based on their percentage of charity care costs to commercial costs as well as statutory designations and ownership status. Providers are divided into tiers based on the level of charity care cost to commercial costs and are paid a prescribed percentage of their charity care cost. Hospital charity care costs are calculated using 2019 Florida Hospital Uniform Reporting System (FHURS) data.1 of 6Agency for Health Care AdministrationBureau of Medicaid Program Finance9/10/202116.D.6.bPacket Pg. 1174Attachment: SYF21-22_LIP_Model Summary (20089 : LIP Agreement with AHCA & CHSI)
SFY 2021-22 LIP ModelTier 1 - FQHCs/RHCsTier 1 - Central Receiving SystemsTier Payments:Group 1 - Self-Funded ModelTier 1 - paid 8.54% of charity care costTier 2 - paid 100% of charity care costTier 3 - paid 58.43% of charity care costTier 4 - paid 100% of charity care costTier 5 - paid 1% of charity care costGroup 2Tier 1 - paid 100% of charity care costGroup 3Tier 1 - paid 24% of charity care costGroup 4Tier 1 - paid 100% of charity care costGroup 3 - Federally Qualified Health Centers (FQHCs)/Rural Health Clinics (RHCs)Group 4 - Behavioral Health Providers2 of 6Agency for Health Care AdministrationBureau of Medicaid Program Finance9/10/202116.D.6.bPacket Pg. 1175Attachment: SYF21-22_LIP_Model Summary (20089 : LIP Agreement with AHCA & CHSI)
11010187700 AdventHealth DeLand 5,937,515$ - 16.51% 22.73% 1 8.54% 507,169$ -$ -$ -$ 507,169$ 8.54%010182600 AdventHealth Fish Memorial 5,283,342$ 1,458,189 8.55% 17.65% 1 8.54% 451,291$ -$ -$ -$ 451,291$ 8.54%010102800 AdventHealth Tampa 25,733,931$ 1,515,019 15.84% 20.68% 1 8.54% 2,198,133$ 1,229,226$ -$ 1,229,226$ 968,907$ 3.77%010149400 AdventHealth Zephyrhills 5,523,658$ - 12.18% 23.04% 1 8.54% 471,818$ -$ -$ -$ 471,818$ 8.54%010123100 Baptist Medical Center - Nassau 3,188,500$ - 9.65% 17.53% 1 8.54% 272,354$ -$ -$ -$ 272,354$ 8.54%4012041300 Bartow Regional Medical Center 5,639,532$ 552,988 12.89% 35.29% 1 8.54% 481,716$ -$ -$ -$ 481,716$ 8.54%010959200 Bayfront Health Dade City 1,844,688$ - 16.26% 22.91% 1 8.54% 157,569$ -$ -$ -$ 157,569$ 8.54%##010009900 Cape Canaveral Hospital 6,798,190$ - 14.59% 20.76% 1 8.54% 580,686$ -$ -$ -$ 580,686$ 8.54%14010118400 Cleveland Clinic Martin North Hospital 22,095,436$ 1,612,854 9.18% 19.87% 1 8.54% 1,887,341$ -$ -$ -$ 1,887,341$ 8.54%000100024 Fishermen's Hospital 1,326,227$ - 4.65% 23.02% 1 8.54% 113,283$ -$ -$ -$ 113,283$ 8.54%15010041200 Hialeah Hospital 5,906,444$ - 27.76% 24.32% 1 8.54% 504,515$ -$ -$ -$ 504,515$ 8.54%16010008100 Holmes Regional Medical Center 28,319,433$ - 13.51% 24.02% 1 8.54% 2,418,981$ -$ -$ -$ 2,418,981$ 8.54%67010104400 Indian River Medical Center 11,134,014$ 2,845,182 9.86% 23.61% 1 8.54% 951,042$ -$ -$ -$ 951,042$ 8.54%68010173700 Jay Hospital 642,489$ - 7.95% 21.39% 1 8.54% 54,880$ -$ -$ -$ 54,880$ 8.54%21010166400 Lake Wales Medical Center 2,027,227$ 794,508 12.06% 20.98% 1 8.54% 173,161$ -$ -$ -$ 173,161$ 8.54%010107900 Leesburg Regional Medical Center 6,636,459$ 3,737,821 9.50% 23.79% 1 8.54% 566,871$ 317,002$ -$ 317,002$ 249,869$ 3.77%010116800 Manatee Memorial Hospital 16,494,529$ 6,067,187 15.64% 32.93% 1 8.54% 1,408,925$ 787,890$ -$ 787,890$ 621,035$ 3.77%010121400 Mariners Hospital 3,203,157$ - 3.33% 21.40% 1 8.54% 273,606$ -$ -$ -$ 273,606$ 8.54%##010154100 Mease Dunedin Hospital 6,109,221$ 37,853 19.65% 30.06% 1 8.54% 521,836$ -$ -$ -$ 521,836$ 8.54%76010158300 Morton Plant Hospital 30,262,001$ 3,231,878 13.51% 21.15% 1 8.54% 2,584,911$ -$ -$ -$ 2,584,911$ 8.54%77010031500 Naples Community Hospital 23,570,081$ 2,369,133 10.93% 19.19% 1 8.54% 2,013,302$ -$ -$ -$ 2,013,302$ 8.54%011519300 Northside Hospital 4,513,216$ - 10.48% 17.00% 1 8.54% 385,509$ -$ -$ -$ 385,509$ 8.54%003297500 Palm Bay Hospital 8,839,567$ - 11.45% 37.63% 1 8.54% 755,056$ -$ -$ -$ 755,056$ 8.54%010323300 Sacred Heart Hospital on the Emerald Coast 6,175,710$ - 16.98% 19.12% 1 8.54% 527,515$ -$ -$ -$ 527,515$ 8.54%78002012700 Sacred Heart Hospital on the Gulf 1,985,870$ - 10.11% 39.70% 1 8.54% 169,628$ -$ -$ -$ 169,628$ 8.54%79010098600 South Florida Baptist Hospital 11,872,226$ 841,406 15.09% 38.25% 1 8.54% 1,014,098$ -$ -$ -$ 1,014,098$ 8.54%80012022700 St. Anthony's Hospital 25,331,149$ 1,541,504 15.94% 30.39% 1 8.54% 2,163,729$ -$ -$ -$ 2,163,729$ 8.54%010097800 St. Joseph's Hospital 68,610,492$ 8,700,000 24.52% 18.73% 1 8.54% 5,860,551$ -$ -$ -$ 5,860,551$ 8.54%010169900 Winter Haven Hospital 19,521,139$ 2,356,922 14.99% 30.64% 1 8.54% 1,667,451$ -$ -$ -$ 1,667,451$ 8.54%Tier 1: High Utilization Private Hospitals 364,525,443$ 37,662,444 31,136,927$ 2,334,118$ -$ 2,334,118$ 28,802,809$ 8612,134,060$ 9,799,942$ 12,134,060$ 87012040500 Broward Health Coral Springs 2,256,308$ 17,085,447 25.47% 3.62% 2 100.00% 2,256,308$ 1,166,294$ 70,163$ 1,236,457$ 1,019,851$ 45.20%40010821900 Broward Health Imperial Point 1,849,970$ 31,557,004 18.38% 5.21% 2 100.00% 1,849,970$ 956,257$ 57,527$ 1,013,784$ 836,186$ 45.20%41010012900 Broward Health Medical Center 19,788,811$ 89,131,964 35.93% 13.76% 2 100.00% 19,788,811$ 10,228,908$ 615,360$ 10,844,268$ 8,944,543$ 45.20%10010021800 Broward Health North 5,600,974$ 22,996,228 17.12% 9.12% 2 100.00% 5,600,974$ 2,895,164$ 174,170$ 3,069,334$ 2,531,640$ 45.20%26011971700 Cape Coral Hospital 11,927,732$ 3,382,191 10.52% 22.14% 2 100.00% 11,927,732$ 6,165,488$ 370,909$ 6,536,397$ 5,391,335$ 45.20%9010192300Desoto Memorial Hospital2,301,490$ - 10.58%33.75%2100.00%2,301,490$ -$ -$ -$ 2,301,490$ 100.00%010103600 Doctors Memorial Hospital 319,239$ - 16.79% 14.04% 2 100.00% 319,239$ -$ -$ -$ 319,239$ 100.00%010004800 Ed Fraser Memorial Hospital 2,239,392$ - 4.45% 32.17% 2 100.00% 2,239,392$ -$ -$ -$ 2,239,392$ 100.00%2010080300 George E. Weems Memorial Hospital 440,169$ - 15.78% 20.52% 2 100.00% 440,169$ -$ -$ -$ 440,169$ 100.00%31011134100Gulf Coast Medical Center Lee Memorial Health Sy14,115,738$ 12,038,503 9.39% 16.67% 2 100.00% 14,115,738$ 7,296,476$ 438,948$ 7,735,424$ 6,380,314$ 45.20%20010184200 Halifax Health Medical Center 30,735,699$ 7,278,010 17.24% 17.61% 2 100.00% 30,735,699$ 15,887,395$ 955,768$ 16,843,163$ 13,892,536$ 45.20%22010086200 Hendry Regional Medical Center 1,813,578$ - 10.17% 17.76% 2 100.00% 1,813,578$ -$ -$ -$ 1,813,578$ 100.00%010226100 Homestead Hospital 26,628,699$ - 27.44% 54.89% 2 100.00% 26,628,699$ -$ -$ -$ 26,628,699$ 100.00%010106100 Jackson Hospital 2,331,818$ 2,475,213 12.30% 13.20% 2 100.00% 2,331,818$ -$ -$ -$ 2,331,818$ 100.00%28010042100 Jackson Memorial Hospital 102,478,827$ 365,867,555 36.01% 26.51% 2100.00% 102,478,827$ 52,971,680$ 3,186,717$ 56,158,397$ 46,320,430$ 45.20%010151600 Johns Hopkins All Children's Hospital 4,676,257$ 8,444,120 71.33% 2.97% 2 100.00% 4,676,257$ -$ -$ -$ 4,676,257$ 100.00%47010822700 Lake Butler Hospital 1,358,914$ - 13.73% 60.56% 2 100.00% 1,358,914$ -$ -$ -$ 1,358,914$ 100.00%010144300 Lakeside Medical Center 860,891$ 5,741,593 35.18% 10.62% 2 100.00% 860,891$ -$ -$ -$ 860,891$ 100.00%30012005700 Larkin Community Hospital 3,222,754$ - 23.86% 23.04% 2 100.00% 3,222,754$ -$ -$ -$ 3,222,754$ 100.00%010110900 Lee Memorial Hospital 42,364,951$ 29,376,068 25.37% 16.58% 2 100.00% 42,364,951$ 21,898,598$ 1,317,395$ 23,215,993$ 19,148,958$ 45.20%24010345400 Memorial Hospital Miramar 2,548,968$ 7,502,895 17.75% 3.03% 2 100.00% 2,548,968$ 1,317,570$ 79,264$ 1,396,834$ 1,152,134$ 45.20%44010222900 Memorial Hospital Pembroke 7,179,289$ 6,383,936 15.58% 15.02% 2 100.00% 7,179,289$ 3,711,000$ 223,250$ 3,934,250$ 3,245,039$ 45.20%23010252100 Memorial Hospital West 12,705,548$ 19,823,272 13.46% 6.75% 2 100.00% 12,705,548$ 6,567,544$ 395,096$ 6,962,640$ 5,742,908$ 45.20%42010020000 Memorial Regional Hospital 39,710,975$ 106,611,851 21.84% 12.36% 2100.00% 39,710,975$ 20,526,748$ 1,234,866$ 21,761,614$ 17,949,361$ 45.20%38010150800 Morton Plant North Bay Hospital 17,515,688$ 1,200,000 20.51% 67.60% 2 100.00% 17,515,688$ -$ -$ -$ 17,515,688$ 100.00%71004087600 Nemours Children's Hospital 2,203,162$ - 74.44% 3.29% 2100.00% 2,203,162$ -$ -$ -$ 2,203,162$ 100.00%50010060900 Nicklaus Children's Hospital 201,038$ - 63.07% 0.13% 2100.00% 201,038$ -$ -$ -$ 201,038$ 100.00%51010010200 Parrish Medical Center 3,310,421$ 6,172,558 12.91% 9.64% 2 100.00% 3,310,421$ 1,711,169$ 102,942$ 1,814,111$ 1,496,310$ 45.20%33010176100 Sarasota Memorial Hospital 15,639,805$ 26,460,414 15.06% 8.28% 2 100.00% 15,639,805$ 8,084,272$ 486,341$ 8,570,613$ 7,069,192$ 45.20%7010067600 UF Health Jacksonville 87,083,667$ 31,407,711 32.01% 50.45% 2 100.00% 87,083,667$ 20,668,091$ 1,243,369$ 21,911,460$ 65,172,207$ 74.84%023960157 Wolfson Children's Hospital 1,750,263$ - 57.16% 1.99% 2100.00% 1,750,263$ -$ -$ -$ 1,750,263$ 100.00%88467,161,035$ 800,936,533 467,161,035$ 182,052,654$ 10,952,085$ 193,004,739$ 274,156,296$ 52182,052,655$ 010129000 AdventHealth Orlando 188,569,597$ 7,638,732 14.96% 18.14% 3 58.43% 110,189,284$ 57,597,956$ -$ 57,597,956$ 52,591,328$ 27.89%012037500 Aventura Hospital and Medical Center 5,999,592$ - 16.07% 8.02% 3 58.43% 3,505,818$ -$ -$ -$ 3,505,818$ 58.43%011807900 Brandon Regional Hospital 10,632,269$ - 22.35% 11.95% 3 58.43% 6,212,890$ -$ -$ -$ 6,212,890$ 58.43%010220200 Cleveland Clinic Hospital 2,675,825$ - 2.42% 1.95% 3 58.43% 1,563,599$ -$ -$ -$ 1,563,599$ 58.43% Total LIP IGTs Provided Net (Total LIP Payment - LIP IGTs) % of Net Payment to Charity Care CostTier 2: All Publics, All Children's, and High Utilization Teaching HoRatio of Charity Care Costs to Commercial CostsTier% Gross Charity Payment Total LIP Payment LIP IGTs Provided to Fund Tier Additional LIP IGTs Provided for 1% Minimum and Tier 1 SFY 2021-22PROJECTED NET PAYMENTS FOR LIPSelf-Funded Tiers ModelMedicaid IDProvider Charity Care Cost Medicaid Days Medicaid Utilization 3 of 6Agency for Health Care AdministrationBureau of Medicaid Program Finance9/10/202116.D.6.bPacket Pg. 1176Attachment: SYF21-22_LIP_Model Summary (20089 : LIP Agreement with AHCA & CHSI)
012032400H. Lee Moffitt Cancer Center & Research Institute 27,108,790$ 13,549,572 7.67% 6.86% 3 58.43% 15,840,826$ -$ -$ -$ 15,840,826$ 58.43%012013800 Kendall Regional Medical Center 4,697,583$ - 22.20% 4.17% 3 58.43% 2,744,999$ -$ -$ -$ 2,744,999$ 58.43%##011974100 Largo Medical Center 8,179,725$ - 11.61% 14.23% 3 58.43% 4,779,763$ -$ -$ -$ 4,779,763$ 58.43%010072200 Mayo Clinic 5,994,346$ - 1.66% 2.16% 3 58.43% 3,502,753$ -$ -$ -$ 3,502,753$ 58.43%57010046300 Mount Sinai Medical Center 20,215,091$ 3,388,382 11.79% 13.81% 3 58.43% 11,812,542$ -$ -$ -$ 11,812,542$ 58.43%010862600 North Florida Regional Medical Center 2,586,294$ - 15.76% 2.55% 3 58.43% 1,511,282$ -$ -$ -$ 1,511,282$ 58.43%55012007300 Oak Hill Hospital 3,726,614$ - 10.16% 10.35% 3 58.43% 2,177,620$ -$ -$ -$ 2,177,620$ 58.43%##010988600 Ocala Regional Medical Center 3,923,799$ 1,183,400 11.39% 5.42% 3 58.43% 2,292,844$ -$ -$ -$ 2,292,844$ 58.43%##010133800 Orlando Health 100,783,136$ 9,316,518 25.36% 12.26% 3 58.43% 58,891,899$ 30,783,873$ -$ 30,783,873$ 28,108,026$ 27.89%54010138900 Osceola Regional Medical Center 2,300,698$ - 19.19% 2.68% 3 58.43% 1,344,396$ -$ -$ -$ 1,344,396$ 58.43%011988100 Regional Medical Center Bayonet Point 4,092,689$ - 13.90% 10.07% 3 58.43% 2,391,533$ -$ -$ -$ 2,391,533$ 58.43%010047100 University of Miami Hospital and Clinics 9,864,369$ 4,599,751 15.79% 1.52% 3 58.43% 5,764,173$ 3,013,039$ -$ 3,013,039$ 2,751,134$ 27.89%61401,350,417$ 1,641,549,421 234,526,221$ 91,394,868$ -$ 91,394,868$ 143,131,353$ 91,394,868$ 91,394,868$ 91,394,868$ 97010156700 Bayfront Health - St Petersburg 17,100,258$ 2,890,877 18.91% 21.72% 4 100.00% 17,100,258$ -$ -$ -$ 17,100,258$ 100.00%25010076500 Sacred Heart Hospital 20,354,476$ 792,557 30.19% 15.81% 4 100.00% 20,354,476$ 9,061,391$ -$ 9,061,391$ 11,293,085$ 55.48%010148600 St. Mary's Medical Center 5,110,205$ 7,733,248 42.89% 5.11% 4 100.00% 5,110,205$ -$ -$ -$ 5,110,205$ 100.00%010099400 Tampa General Hospital 74,884,824$ 51,382,895 26.35% 17.37% 4 100.00% 74,884,824$ 33,337,171$ -$ 33,337,171$ 41,547,653$ 55.48%010003000 UF Health Shands Hospital 60,772,456$ 49,028,009 27.13% 14.64% 4 100.00% 60,772,456$ 27,054,637$ -$ 27,054,637$ 33,717,819$ 55.48%Tier 4: Regional Perinatal Intensive Care Centers (non-Public), and178,222,219$ 111,827,586 178,222,219$ 69,453,199$ -$ 69,453,199$ 108,769,020$ 62180,257,459$ 101.14% 69,453,199$ 0$ 69,453,199$ ##010094300 AdventHealth Carrollwood 5,437,512$ 14.41% 5 1.00% 54,375$ 41,658$ -$ 41,658$ 12,717$ 0.23%##000949600 Adventhealth Connerton 20,442$ - 2.49% 0.55% 5 1.00% 204$ -$ -$ -$ 204$ 1.00%010228800Adventhealth Heart Of Florida Regional Medical Ce3,331,210$ 1,176,087 13.52% 11.06% 5 1.00% 33,312$ -$ -$ -$ 33,312$ 1.00%010186900Adventhealth Memorial Medical Center//Advent He6,788,776$ - 12.25% 10.66% 5 1.00% 67,888$ -$ -$ -$ 67,888$ 1.00%010183400 Adventhealth New Smyrna 2,253,651$ 5,585,673 7.20% 11.27% 5 1.00% 22,537$ 17,266$ -$ 17,266$ 5,271$ 0.23%010161300 AdventHealth North Pinellas 2,895,594$ 12.34% 5 1.00% 28,956$ -$ -$ -$ 28,956$ 1.00%##010117600 Adventhealth Ocala 4,523,969$ 2,541,961 14.36% 7.60% 5 1.00% 45,240$ -$ -$ -$ 45,240$ 1.00%##010189300 Adventhealth Palm Coast 2,469,898$ - 7.98% 8.47% 5 1.00% 24,699$ -$ -$ -$ 24,699$ 1.00%5010090100 Adventhealth Sebring 2,369,471$ 665,693 15.58% 9.57% 5 1.00% 23,695$ -$ -$ -$ 23,695$ 1.00%##010109500 AdventHealth Waterman 7,343,372$ 15.15% 5 1.00% 73,434$ 56,259$ -$ 56,259$ 17,175$ 0.23%##005456800 Adventhealth Wesley Chapel 2,599,458$ - 8.04% 3.72% 5 1.00% 25,995$ -$ -$ -$ 25,995$ 1.00%##010073100 Ascension St Vincent'S Riverside 12,522,665$ - 12.52% 11.12% 5 1.00% 125,227$ -$ -$ -$ 125,227$ 1.00%82010373000 Ascension St Vincent'S Southside 4,626,530$ - 12.77% 8.16% 5 1.00% 46,265$ -$ -$ -$ 46,265$ 1.00%92009701300 Ascension St. Vincent'S Clay County 3,262,435$ - 10.75% 9.24% 5 1.00% 32,624$ -$ -$ -$ 32,624$ 1.00%93010074900 Baptist Hospital Inc 12,807,685$ - 18.87% 11.19% 5 1.00% 128,077$ -$ -$ -$ 128,077$ 1.00%95010035800 Baptist Hospital Of Miami 33,874,210$ - 13.61% 7.65% 5 1.00% 338,742$ -$ -$ -$ 338,742$ 1.00%96010232600 Baptist Medical Center - Beaches 6,065,209$ - 6.65% 15.78% 5 1.00% 60,652$ -$ -$ -$ 60,652$ 1.00%010064100 Baptist Medical Center Jacksonville 44,894,071$ - 10.84% 13.31% 5 1.00% 448,941$ -$ -$ -$ 448,941$ 1.00%98010006400 Bay Medical Center Sacred Heart Health System 473,080$ 3,176,496 8.78% 2.25% 5 1.00% 4,731$ -$ -$ -$ 4,731$ 1.00%##010372100 Baycare Alliant Hospital 1,276$ - 7.58% 0.04% 5 1.00% 13$ -$ -$ -$ 13$ 1.02%##010087100 Bayfront Health Brooksville 633,720$ 1,323,600 18.71% 2.52% 5 1.00% 6,337$ -$ -$ -$ 6,337$ 1.00%##010028500 Bayfront Health Port Charlotte 2,936,501$ - 12.18% 11.22% 5 1.00% 29,365$ -$ -$ -$ 29,365$ 1.00%010027700 Bayfront Health Punta Gorda 193,614$ - 8.84% 1.69% 5 1.00% 1,936$ -$ -$ -$ 1,936$ 1.00%##011998900 Bayfront Health Seven Rivers 508,501$ - 10.55% 4.20% 5 1.00% 5,085$ -$ -$ -$ 5,085$ 1.00%##010140100 Bethesda Hospital East 7,721,639$ 1,878,195 20.48% 10.23% 5 1.00% 77,216$ 59,157$ -$ 59,157$ 18,059$ 0.23%011021300 Blake Medical Center 5,485,989$ 697,540 9.89% 11.82% 5 1.00% 54,860$ -$ -$ -$ 54,860$ 1.00%##000100168 Boca Raton Regional Hospital 3,092,516$ 290,140 2.80% 1.78% 5 1.00% 30,925$ -$ -$ -$ 30,925$ 1.00%##010026900 Calhoun Liberty Hospital 79,063$ - 9.83% 2.23% 5 1.00% 791$ -$ -$ -$ 791$ 1.00%##011980600 Capital Regional Medical Center 460,866$ 407,350 20.15% 0.82% 5 1.00% 4,609$ -$ -$ -$ 4,609$ 1.00%##010178800 Central Florida Regional Hospital 3,280,337$ - 14.86% 7.36% 5 1.00% 32,803$ -$ -$ -$ 32,803$ 1.00%##010219900 Citrus Memorial Hospital 2,996,791$ 1,346,039 10.77% 13.05% 5 1.00% 29,968$ -$ -$ -$ 29,968$ 1.00%##010960600 Coral Gables Hospital 1,103,631$ - 10.67% 5.67% 5 1.00% 11,036$ -$ -$ -$ 11,036$ 1.00%##012009000 Delray Medical Center 2,511,457$ 1,406,644 8.03% 3.67% 5 1.00% 25,115$ -$ -$ -$ 25,115$ 1.00%010354300 Doctors Hospital 3,718,362$ - 5.12% 4.76% 5 1.00% 37,184$ -$ -$ -$ 37,184$ 1.00%##011995400 Doctors Hospital Of Sarasota 1,182,587$ - 5.59% 3.90% 5 1.00% 11,826$ -$ -$ -$ 11,826$ 1.00%##010180000 Doctors' Memorial Hospital 266,307$ 1,300,000 16.42% 6.98% 5 1.00% 2,663$ -$ -$ -$ 2,663$ 1.00%010253900 Englewood Community Hospital 268,144$ - 4.21% 2.82% 5 1.00% 2,681$ -$ -$ -$ 2,681$ 1.00%011746300 Fawcett Memorial Hospital 1,251,514$ - 7.66% 4.71% 5 1.00% 12,515$ -$ -$ -$ 12,515$ 1.00%##010171100 Flagler Hospital 7,209,696$ 728,063 12.58% 11.95% 5 1.00% 72,097$ 55,235$ -$ 55,235$ 16,862$ 0.23%011132500 Fort Walton Beach Medical Center 674,986$ - 16.89% 1.31% 5 1.00% 6,750$ -$ -$ -$ 6,750$ 1.00%##010152400 Good Samaritan Medical Center 5,587,056$ 1,881,867 16.90% 9.65% 5 1.00% 55,871$ 42,804$ -$ 42,804$ 13,067$ 0.23%011761700 Gulf Coast Regional Medical Center 1,552,180$ - 24.32% 3.66% 5 1.00% 15,522$ -$ -$ -$ 15,522$ 1.00%010188500 Healthmark Regional Medical Center 256,333$ - 12.00% 14.35% 5 1.00% 2,563$ -$ -$ -$ 2,563$ 1.00%010089700 Highlands Regional Medical Center 663,100$ 1,172,309 8.32% 8.06% 5 1.00% 6,631$ -$ -$ -$ 6,631$ 1.00%010018800 Holy Cross Hospital 6,317,200$ - 7.92% 5.73% 5 1.00% 63,172$ -$ -$ -$ 63,172$ 1.00%##010146000 JFK Medical Center 5,493,250$ 3,628,520 21.18% 4.74% 5 1.00% 54,932$ 42,085$ -$ 42,085$ 12,847$ 0.23%##000100253 Jupiter Medical Center 2,496,022$ 517,096 6.91% 3.13% 5 1.00% 24,960$ -$ -$ -$ 24,960$ 1.00%023960090 Kindred Hospital Melbourne 6,328$ - 2.45% 0.10% 5 1.00% 63$ -$ -$ -$ 63$ 1.00%023960074 Kindred Hospital The Palm Beaches 39,015$ - 1.00% 0.78% 5 1.00% 390$ -$ -$ -$ 390$ 1.00%023960011 Kindred Hospital-Bay Area-St Petersburg 255,354$ - 10.58% 11.33% 5 1.00% 2,554$ -$ -$ -$ 2,554$ 1.00%000100115 Kindred Hospital-Bay Area-Tampa 195,827$ - 4.65% 3.02% 5 1.00% 1,958$ -$ -$ -$ 1,958$ 1.00%##000100143 Kindred Hospital-Central Tampa 56,320$ - 8.66% 1.68% 5 1.00% 563$ -$ -$ -$ 563$ 1.00%##000100016 Kindred Hospital-North Florida 252,288$ - 7.70% 3.71% 5 1.00% 2,523$ -$ -$ -$ 2,523$ 1.00%000100152 Kindred Hospital-South Florida-Coral Gables 472,218$ - 6.90% 11.91% 5 1.00% 4,722$ -$ -$ -$ 4,722$ 1.00%##000100042 Kindred Hospital-South Florida-Ft Lauderdale 96,116$ - 7.29% 2.03% 5 1.00% 961$ -$ -$ -$ 961$ 1.00%##000100120 Kindred Hospital-South Florida-Hollywood 226,593$ - 5.55% 5.95% 5 1.00% 2,266$ -$ -$ -$ 2,266$ 1.00%011976800 Lake City Medical Center 504,268$ - 8.42% 2.95% 5 1.00% 5,043$ -$ -$ -$ 5,043$ 1.00%##011976800 Lake City Medical Center Suwannee Campus 60,009$ 233,644 12.40% 1.86% 5 1.00% 600$ -$ -$ -$ 600$ 1.00%010164800 Lakeland Regional Medical Center 22,787,810$ - 16.21% 14.53% 5 1.00% 227,878$ -$ -$ -$ 227,878$ 1.00%Tier 3: Low Utilization Statutory Teaching4 of 6Agency for Health Care AdministrationBureau of Medicaid Program Finance9/10/202116.D.6.bPacket Pg. 1177Attachment: SYF21-22_LIP_Model Summary (20089 : LIP Agreement with AHCA & CHSI)
010342000 Lakewood Ranch Medical Center 1,751,717$ - 5.43% 6.17% 5 1.00% 17,517$ -$ -$ -$ 17,517$ 1.00%48010053600Larkin Community Hospital Palm Springs Campus237,907$ - 6.76% 3.70% 5 1.00% 2,379$ -$ -$ -$ 2,379$ 1.00%011969500Lawnwood Regional Medical Center & Heart Institu1,092,390$ - 22.94% 2.34% 5 1.00% 10,924$ -$ -$ -$ 10,924$ 1.00%010111700 Lehigh Regional Medical Center 333,640$ - 12.88% 4.68% 5 1.00% 3,336$ -$ -$ -$ 3,336$ 1.00%010119200 Lower Keys Medical Center 2,090,953$ - 16.84% 8.98% 5 1.00% 20,910$ -$ -$ -$ 20,910$ 1.00%010115000 Madison County Memorial Hospital 238,488$ - 3.45% 11.39% 5 1.00% 2,385$ -$ -$ -$ 2,385$ 1.00%012008100 Mease Countryside Hospital 10,270,772$ - 10.66% 11.52% 5 1.00% 102,708$ -$ -$ -$ 102,708$ 1.00%010552000 Medical Center Of Trinity 4,721,673$ - 17.45% 8.59% 5 1.00% 47,217$ -$ -$ -$ 47,217$ 1.00%010193100 Memorial Hospital Jacksonville 4,646,541$ - 20.59% 6.22% 5 1.00% 46,465$ -$ -$ -$ 46,465$ 1.00%011279800 Memorial Hospital Of Tampa 4,159,730$ - 16.46% 10.43% 5 1.00% 41,597$ -$ -$ -$ 41,597$ 1.00%010007200North Florida Regional Medical Center Starke Cam125,835$ 35,000 10.14% 2.67% 5 1.00% 1,258$ -$ -$ -$ 1,258$ 1.00%010126500 North Okaloosa Medical Center 805,322$ - 13.19% 5.54% 5 1.00% 8,053$ -$ -$ -$ 8,053$ 1.00%010049800 North Shore Medical Center 8,653,733$ - 30.10% 14.64% 5 1.00% 86,537$ -$ -$ -$ 86,537$ 1.00%023960114 North Tampa Behavioral Health 265,823$ - 17.07% 7.63% 5 1.00% 2,658$ -$ -$ -$ 2,658$ 1.00%010190700 Northwest Florida Community Hospital 286,618$ - 8.51% 2.73% 5 1.00% 2,866$ -$ -$ -$ 2,866$ 1.00%010459100 Northwest Medical Center 1,405,742$ - 20.27% 2.39% 5 1.00% 14,057$ -$ -$ -$ 14,057$ 1.00%011174100 Orange Park Medical Center 1,316,851$ - 19.83% 2.09% 5 1.00% 13,169$ -$ -$ -$ 13,169$ 1.00%010135400 Orlando Health - Health Central 4,105,571$ 2,831,525 14.11% 7.15% 5 1.00% 41,056$ -$ -$ -$ 41,056$ 1.00%021094100 Oviedo Medical Center 292,563$ - 10.75% 0.83% 5 1.00% 2,926$ -$ -$ -$ 2,926$ 1.00%010210500 Palm Beach Gardens Medical Center 4,273,192$ 903,738 8.01% 9.01% 5 1.00% 42,732$ 32,738$ -$ 32,738$ 9,994$ 0.23%010460400 Palmetto General Hospital 4,828,309$ - 22.92% 7.12% 5 1.00% 48,283$ -$ -$ -$ 48,283$ 1.00%012011100 Palms Of Pasadena Hospital 1,165,687$ - 6.44% 4.93% 5 1.00% 11,657$ -$ -$ -$ 11,657$ 1.00%012026000 Palms West Hospital 1,234,748$ 2,294,067 27.95% 2.31% 5 1.00% 12,347$ 9,459$ -$ 9,459$ 2,888$ 0.23%023960103 Park Royal Hospital 270,067$ - 12.06% 6.38% 5 1.00% 2,701$ -$ -$ -$ 2,701$ 1.00%010314400 Physicians Regional Medical Center - Pine Ridge 960,894$ 1,362,791 5.14% 1.89% 5 1.00% 9,609$ -$ -$ -$ 9,609$ 1.00%012000600 Plantation General Hospital 7,105,953$ - 27.03% 7.34% 5 1.00% 71,060$ -$ -$ -$ 71,060$ 1.00%009268300 Poinciana Medical Center 955,416$ - 12.58% 6.53% 5 1.00% 9,554$ -$ -$ -$ 9,554$ 1.00%011351400 Putnam Community Medical Center 889,967$ - 14.86% 9.17% 5 1.00% 8,900$ -$ -$ -$ 8,900$ 1.00%011975000 Raulerson Hospital 1,343,545$ 115,000 14.30% 13.97% 5 1.00% 13,435$ -$ -$ -$ 13,435$ 1.00%010011100 Rockledge Regional Medical Center 97,669$ - 8.50% 0.18% 5 1.00% 977$ -$ -$ -$ 977$ 1.00%010174500 Santa Rosa Medical Center 357,640$ 1,517,383 13.77% 2.08% 5 1.00% 3,576$ -$ -$ -$ 3,576$ 1.00%010033100 Shands Lake Shore Regional Medical Center 784,951$ 2,400,000 24.54% 9.32% 5 1.00% 7,850$ -$ -$ -$ 7,850$ 1.00%011994600 South Bay Hospital 1,142,847$ - 4.03% 13.12% 5 1.00% 11,428$ -$ -$ -$ 11,428$ 1.00%010108700 South Lake Hospital 9,313,332$ 2,038,010 9.37% 13.84% 5 1.00% 93,133$ -$ -$ -$ 93,133$ 1.00%010058700 South Miami Hospital 12,817,934$ - 22.25% 6.39% 5 1.00% 128,179$ -$ -$ -$ 128,179$ 1.00%010346200 St Cloud Regional Medical Center 230,434$ - 9.90% 1.47% 5 1.00% 2,304$ -$ -$ -$ 2,304$ 1.00%011997100 St Lucie Medical Center 307,121$ - 10.05% 0.80% 5 1.00% 3,071$ -$ -$ -$ 3,071$ 1.00%012010300 St Petersburg General Hospital 3,035,005$ - 14.87% 14.49% 5 1.00% 30,350$ -$ -$ -$ 30,350$ 1.00%010113300 Tallahassee Memorial Hospital 16,731,533$ 50,000 19.60% 7.48% 5 1.00% 167,315$ -$ -$ -$ 167,315$ 1.00%010125700 Twin Cities Hospital 445,808$ - 5.00% 4.15% 5 1.00% 4,458$ -$ -$ -$ 4,458$ 1.00%010317900 Uf Health The Villages 3,050,463$ - 3.96% 16.04% 5 1.00% 30,505$ -$ -$ -$ 30,505$ 1.00%011280100 University Hospital And Medical Center 3,008,626$ - 15.84% 12.50% 5 1.00% 30,086$ -$ -$ -$ 30,086$ 1.00%010007000 Venice Regional Bayfront Health 281,256$ - 3.91% 1.02% 5 1.00% 2,813$ -$ -$ -$ 2,813$ 1.00%003158800 Viera Hospital 2,529,082$ - 4.96% 7.25% 5 1.00% 25,291$ -$ -$ -$ 25,291$ 1.00%010213000 Wellington Regional Medical Center 2,798,606$ 1,388,548 18.51% 4.94% 5 1.00% 27,986$ 21,441$ -$ 21,441$ 6,545$ 0.23%012024300 West Boca Medical Center 955,360$ 1,726,823 18.82% 1.36% 5 1.00% 9,554$ 7,320$ -$ 7,320$ 2,234$ 0.23%011321200 West Florida Hospital 686,944$ - 13.85% 1.31% 5 1.00% 6,869$ -$ -$ -$ 6,869$ 1.00%003226500 West Kendall Baptist Hospital 11,327,781$ - 12.02% 13.98% 5 1.00% 113,278$ -$ -$ -$ 113,278$ 1.00%010062500 Westchester General Hospital 1,488,471$ - 13.92% 14.93% 5 1.00% 14,885$ -$ -$ -$ 14,885$ 1.00%011230500 Westside Regional Medical Center 1,876,134$ - 8.21% 3.49% 5 1.00% 18,761$ -$ -$ -$ 18,761$ 1.00%394,550,666$ 46,619,802 3,945,506$ 385,422$ -$ 385,422$ 3,560,084$ (385,422)$ -$ 1,805,809,780$ 2,638,595,786 914,991,908$ 345,620,261$ 10,952,085$ 356,572,346$ 558,419,562$ 9,414,520$ 005527800 Florida International University 3,000,000$ 1 100.00% 3,000,000$ 1,169,100$ -$ 1,169,100$ 1,830,900$ 61.03%276305209 Florida State University 145,000$ 1 100.00% 145,000$ 56,507$ -$ 56,507$ 88,493$ 61.03%053386600University of Florida Gainesville26,000,000$ 1100.00%26,000,000$ 10,132,200$ -$ 10,132,200$ 15,867,800$ 61.03%373978300 University of Florida Jacksonville 34,000,000$ 1 100.00% 34,000,000$ 13,249,800$ -$ 13,249,800$ 20,750,200$ 61.03%273179700 University of Miami 45,000,000$ 1 100.00% 45,000,000$ 17,536,500$ -$ 17,536,500$ 27,463,500$ 61.03%053079400 University of South Florida 10,000,000$ 1 100.00% 10,000,000$ 3,897,000$ -$ 3,897,000$ 6,103,000$ 61.03%118,145,000$ 118,145,000$ 46,041,107$ -$ 46,041,107$ 72,103,893$ 017234400 Agape Community Health Center 1,144,345$ 1 24.00% 274,627$ 119,869$ -$ 119,869$ 154,758$ 13.52%029543400 Aza Health 4,890,551$ 1 24.00% 1,173,666$ -$ -$ -$ 1,173,666$ 24.00%013881900 Banyan Community Health Care 4,180,603$ 1 24.00% 1,003,288$ 500,000$ -$ 500,000$ 503,288$ 12.04%060551400 Bond Community Health Center 1,192,843$ 1 24.00% 286,266$ 124,949$ -$ 124,949$ 161,317$ 13.52%029554000 Borinquen Health Care Center 8,727,030$ 1 24.00% 2,094,369$ 914,148$ -$ 914,148$ 1,180,221$ 13.52%688693100 Brevard Health Alliance 9,385,604$ 1 24.00% 2,252,418$ -$ -$ -$ 2,252,418$ 24.00%680027100 Broward Community & Family Health Centers 2,286,538$ 1 24.00% 548,738$ 375,095$ -$ 375,095$ 173,643$ 7.59%008037100 C.L. Brumback Primary Care Clinics 9,634,727$ 1 24.00% 2,312,204$ 1,009,228$ -$ 1,009,228$ 1,302,976$ 13.52%680002500 Camillus Health Concern 4,604,642$ 1 24.00% 1,105,052$ -$ -$ -$ 1,105,052$ 24.00%003407900 Care Resource Community Health Centers 10,045,830$ 1 24.00% 2,410,863$ -$ -$ -$ 2,410,863$ 24.00%010930500 Center for Family and Child Enrichment 2,484,824$ 1 24.00% 596,324$ -$ -$ -$ 596,324$ 24.00%025148200 CenterPlace Health 2,280,083$ 1 24.00% 547,189$ 238,837$ -$ 238,837$ 308,352$ 13.52%029549300 Central Florida Health Care, Inc 7,433,702$ 1 24.00% 1,783,988$ 778,673$ -$ 778,673$ 1,005,315$ 13.52%688571300 Citrus Health Network 6,381,011$ 1 24.00% 1,531,356$ 668,405$ -$ 668,405$ 862,951$ 13.52%029565500 Community Health Centers of Pinellas 10,142,333$ 1 24.00% 2,434,022$ 1,062,399$ -$ 1,062,399$ 1,371,623$ 13.52%029545100 Community Health Centers, Inc. 11,249,080$ 1 24.00% 2,699,627$ 1,178,330$ -$ 1,178,330$ 1,521,297$ 13.52%692990700 Community Health Northwest Florida 5,919,267$ 1 24.00% 1,420,544$ 414,750$ -$ 414,750$ 1,005,794$ 16.99%029572800 Community Health of South Florida 29,144,595$ 1 24.00% 6,994,308$ 6,489,010$ -$ 6,489,010$ 505,298$ 1.73%Totals Group 1 - HospitalsTotals Group 2 - Medical Schools Physician PracticesTier 5: Low Utilization Private Hospitals5 of 6Agency for Health Care AdministrationBureau of Medicaid Program Finance9/10/202116.D.6.bPacket Pg. 1178Attachment: SYF21-22_LIP_Model Summary (20089 : LIP Agreement with AHCA & CHSI)
010739700 Empower-U 855,034$ 1 24.00% 205,197$ -$ -$ -$ 205,197$ 24.00%029570100 Family Health Centers of Southwest Florida 6,426,263$ 1 24.00% 1,542,216$ -$ -$ -$ 1,542,216$ 24.00%687955100 Family Health Source 696,974$ 1 24.00% 167,264$ -$ -$ -$ 167,264$ 24.00%684660200 Florida Community Health Centers, Inc. 7,959,550$ 1 24.00% 1,910,184$ 833,755$ -$ 833,755$ 1,076,429$ 13.52%001182600 FoundCare 7,717,008$ 1 24.00% 1,851,977$ 808,349$ -$ 808,349$ 1,043,628$ 13.52%006608600 Genesis Community Health 492,240$ 1 24.00% 118,131$ 51,562$ -$ 51,562$ 66,569$ 13.52%029152800 Healthcare Network of Southwest Florida 4,234,987$ 1 24.00% 1,016,339$ 443,611$ -$ 443,611$ 572,728$ 13.52%001718300 Heart of Florida Health Center 3,786,343$ 1 24.00% 908,671$ 396,616$ -$ 396,616$ 512,055$ 13.52%029540000 Jessie Trice Community Health System 7,063,630$ 1 24.00% 1,695,175$ 739,908$ -$ 739,908$ 955,267$ 13.52%029547700 Langley Health Services 2,660,283$ 1 24.00% 638,432$ 278,662$ -$ 278,662$ 359,770$ 13.52%014789100 Lee Community Healthcare 1,532,923$ 1 24.00% 367,881$ 160,572$ -$ 160,572$ 207,309$ 13.52%029561200 MCR Health 17,074,562$ 1 24.00% 4,097,663$ 1,788,544$ -$ 1,788,544$ 2,309,119$ 13.52%029544200 Miami Beach Community Health Center 10,783,285$ 1 24.00% 2,587,842$ -$ -$ -$ 2,587,842$ 24.00%262263700 Neighborhood Medical Center 1,878,716$ 1 24.00% 450,866$ 196,794$ -$ 196,794$ 254,072$ 13.52%027973100 New River Community Health Center 605,230$ 1 24.00% 145,247$ 63,397$ -$ 63,397$ 81,850$ 13.52%060075002 North Broward Hospital District 1,936,757$ 1 24.00% 464,795$ 202,873$ -$ 202,873$ 261,922$ 13.52%029568000 North Florida Medical Centers 2,242,999$ 1 24.00% 538,289$ -$ -$ -$ 538,289$ 24.00%687429100 Orange Blossom Family Health 4,550,323$ 1 24.00% 1,092,016$ 476,642$ -$ 476,642$ 615,374$ 13.52%020530900 Osceola Community Health Services 1,637,718$ 1 24.00% 393,030$ 171,549$ -$ 171,549$ 221,481$ 13.52%029506000 Palms Medical Group 6,584,626$ 1 24.00% 1,580,221$ 48,000$ -$ 48,000$ 1,532,221$ 23.27%689693600 PanCare Health 4,703,207$ 1 24.00% 1,128,706$ 492,656$ -$ 492,656$ 636,050$ 13.52%688412100 Pinellas Health and Human Services 2,002,043$ 1 24.00% 480,463$ 209,712$ -$ 209,712$ 270,751$ 13.52%029550700 Premier Community HealthCare Group 6,684,074$ 1 24.00% 1,604,087$ 300,000$ -$ 300,000$ 1,304,087$ 19.51%006558500 Rural Health Network of Monroe County 272,310$ 1 24.00% 65,351$ -$ -$ -$ 65,351$ 24.00%686032000 Sulzbacher Center 2,806,661$ 1 24.00% 673,560$ 293,995$ -$ 293,995$ 379,565$ 13.52%029557400 Suncoast Community Health Centers 12,333,972$ 1 24.00% 2,959,987$ 1,291,971$ -$ 1,291,971$ 1,668,016$ 13.52%029548500 Tampa Family Health Centers 13,527,057$ 1 24.00% 3,246,310$ 1,416,946$ -$ 1,416,946$ 1,829,364$ 13.52%680005000 Treasure Coast Community Health 3,967,793$ 1 24.00% 952,217$ 415,622$ -$ 415,622$ 536,595$ 13.52%029551500 True Health 8,787,134$ 1 24.00% 2,108,793$ 920,442$ -$ 920,442$ 1,188,351$ 13.52%027976500 Walton Community Health Center 1,405,931$ 1 24.00% 337,404$ 147,270$ -$ 147,270$ 190,134$ 13.52%022558502 Whole Family Health Center 686,848$ 1 24.00% 164,834$ 71,947$ -$ 71,947$ 92,887$ 13.52%279,024,088$ 66,961,997$ 26,095,088$ -$ 26,095,088$ 40,866,909$ 016911900 Apalachee Center 825,540$ 1 100.00% 825,540$ 321,713$ -$ 321,713$ 503,827$ 61.03%011030400 Aspire Health Partners 5,334,109$ 1 100.00% 5,334,109$ 2,078,702$ -$ 2,078,702$ 3,255,407$ 61.03%060291400 Circles of Care, Inc. 3,272,000$ 1 100.00% 3,272,000$ 1,275,098$ -$ 1,275,098$ 1,996,902$ 61.03%060280905 Centerstone of Florida 737,514$ 1 100.00% 737,514$ 287,409$ -$ 287,409$ 450,105$ 61.03%060272800 Gracepoint 727,014$ 1 100.00% 727,014$ 283,317$ -$ 283,317$ 443,697$ 61.03%060338400 Henderson Behavioral Health 275,502$ 1 100.00% 275,502$ 107,363$ -$ 107,363$ 168,139$ 61.03%016556800 Lifestream Behavioral Health 1,822,645$ 1 100.00% 1,822,645$ 710,285$ -$ 710,285$ 1,112,360$ 61.03%017645900 Park Place Behavioral 467,059$ 1 100.00% 467,059$ 182,013$ -$ 182,013$ 285,046$ 61.03%060293113 Mental Health Resource Center 2,169,816$ 1 100.00% 2,169,816$ 845,577$ -$ 845,577$ 1,324,239$ 61.03%017706400 SMA Behavioral 786,030$ 1 100.00% 786,030$ 300,000$ -$ 300,000$ 486,030$ 61.83%16,417,229$ 16,417,229$ 6,391,477$ -$ 6,391,477$ 10,025,752$ 6,397,794$ 2,219,396,097$ 1,116,516,134$ 424,147,933$ 10,952,085$ 435,100,018$ 681,416,116$ 435,106,337$ For Group 1 Hospitals, of the $10,952,084 in additional IGTs from Tier 2, $1,152,142 is used to fund a minimum of 1% base payment and the remaining $9,799,942 is used for additional funding for Tier 1.Estimated payments may vary based on providers meeting all LIP participation requirements and IGT availability. The proposed payments may be adjusted and disbursed to eligible providers up to 100% of charity care costs. Totals Group 3 - FQHCs/RHCsTotals Group 4 - Behavioral Health ProvidersGrand Totals LIP IGT projections are based on historical IGT amounts.6 of 6Agency for Health Care AdministrationBureau of Medicaid Program Finance9/10/202116.D.6.bPacket Pg. 1179Attachment: SYF21-22_LIP_Model Summary (20089 : LIP Agreement with AHCA & CHSI)
Low Income Pool Letter of Agreement
THIS LETTER OF AGREEMENT (LOA) is made and entered into in duplicate on the
day of 2021, by and between Collier County Board of County Commissioners on
behalf of Healthcare Network of Southwest Florida, and the State of Florida, Agency for
Health Care Administration (the "Agency"), for good and valuable consideration, the
receipt and sufficiency of which is acknowledged.
DEFINITIONS
"Charity care" or "uncompensated charity care" means that portion of hospital charges reported
to the Agency for which there is no compensation, other than restricted or unrestricted revenues
provided to a hospital by local governments or tax districts regardless of the method of payment.
Uncompensated care includes charity care for the uninsured but does not include
uncompensated care for insured individuals, bad debt, or Medicaid and Children's Health
Insurance Program (CHIP) shortfall. The state and providers that are participating in Low
Income Pool (LIP) will provide assurance that LIP claims include only costs associated with
uncompensated care that is furnished through a charity care program and that adheres to the
principles of the Healthcare Financial Management Association (HFMA) operated by the
provider.
"Intergovernmental Transfers (IGTs)" means transfers of funds from a non -Medicaid
governmental entity (e.g., counties, hospital taxing districts, providers operated by state or local
government) to the Medicaid agency. IGTs must be compliant with 42 CFR Part 433 Subpart B.
"Low Income Pool (LIP)" means providing government support for safety -net providers for the
costs of uncompensated charity care for low-income individuals who are uninsured.
Uncompensated care includes charity care for the uninsured but does not include
uncompensated care for insured individuals, "bad debt," or Medicaid and CHIP shortfall.
"Medicaid" means the medical assistance program authorized by Title XIX of the Social Security
Act, 42 U.S.C. §§ 1396 et seq., and regulations thereunder, as administered in Florida by the
Agency.
A. GENERAL PROVISIONS
1. Per Senate Bill 2500, the General Appropriations Act of State Fiscal Year 2021-22,
passed by the 2021 Florida Legislature, the Collier County Board of County
Commissioners and the Agency agree that the Collier County Board of County
Commissioners will remit IGT funds to the Agency in an amount not to exceed the total
of $443,611.
a. The Collier County Board of County Commissioners and the Agency have
agreed that these IGT funds will only be used to increase the provision of health
services for the charity care of the Collier County Board of County
Commissioners and the State of Florida at large.
b. The increased provision of charity care health services will be accomplished
through the following Medicaid programs:
LIP payments to hospitals, federally qualified health centers, Medical
School Physician Practices, community behavioral health providers, and
Collier County Board of County Commissioners_Healthcare Network of Southwest Florida LOA SFY 2021-22
rural health centers pursuant to the approved Centers for Medicare &
Medicaid Services Special Terms and Conditions.
2. The Collier County Board of County Commissioners will return the signed LOA
to the Agency no later than October 1, 2021.
3. The Collier County Board of County Commissioners will pay IGT funds to the
Agency in an amount not to exceed the total of $443,611.
a. Per Florida Statute 409.908, annual payments for the months of July 2021 through
June 2022 are due to the Agency no later than October 31, 2021 unless an
alternative plan is specifically approved by the agency.
b. The Agency will bill the Collier County Board of County Commissioners when payment is
due.
4. The Collier County Board of County Commissioners and the Agency agree that the
Agency will maintain necessary records and supporting documentation applicable to
health services covered by this LOA.
c. Audits and Records
i. The Collier County Board of County Commissioners agrees to
maintain books, records, and documents (including electronic storage
media) pertinent to performance under this LOA in accordance with
generally accepted accounting procedures and practices, which sufficiently
and properly reflect all revenues and expenditures of funds provided.
ii. The Collier County Board of County Commissioners agrees to assure
that these records shall be subject at ail reasonable times to inspection,
review, or audit by state personnel and other personnel duly authorized by
the Agency, as well as by federal personnel.
The
Collier County Board of County Commissioners
agrees
to comply
with
public record laws as outlined in section 119.0701,
Florida
Statutes.
d. Retention of Records
The Collier County Board of County Commissioners agrees to retain
all financial records, supporting documents, statistical records, and any
other documents (including electronic storage media) pertinent to
performance under this LOA for a period of six (6) years after termination
of this LOA, or if an audit has been initiated and audit findings have not
been resolved at the end of six (6) years, the records shall be retained
until resolution of the audit findings.
Persons duly authorized by the Agency and federal auditors shall have
full access to and the right to examine any of said records and documents.
Collier County Board of County Commissioners_Healihcare Network of Southwest Floritla_LOA SFY 2021-22
The rights of access in this section must not be limited to the
required retention period but shall last as long as the records are retained.
e. Monitoring
The Collier County Board of County Commissioners agrees to
permit persons duly authorized by the Agency to inspect any records,
papers, and documents of the Collier County Board of County
Commissioners which are relevant to this LOA,
f. Assignment and Subcontracts
The Collier County Board of County Commissioners agrees to
neither assign the responsibility of this LOA to another party nor
subcontract for any of the work contemplated under this LOA without
prior written approval of the Agency. No such approval by the Agency of
any assignment or subcontract shall be deemed in any event or in any
manner to provide for the incurrence of any obligation of the Agency in
addition to the total dollar amount agreed upon in this LOA, All such
assignments or subcontracts shall be subject to the conditions of this
LOA and to any conditions of approval that the Agency shall deem
necessary.
5. This LOA may only be amended upon written agreement signed by both part(es.
The Collier County Board of County Commissioners and the Agency agree that any
modifications to this LOA shall be in the same form, namely the exchange of signed
copies of a revised LOA.
6. The Collier County Board of County Commissioners 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
charity care supplemental payments in order to satisfy non -Medicaid, non -uninsured,
and non-underinsured activities.
7. The Collier County Board of County Commissioners agrees the following provision
shall be included in any agreements between the Collier County Board of County
Commissioners and local providers where IGT funding is provided pursuant to this
LOA: "Funding provided in this Agreement shall be prioritized so that designated IGT
funding shall first be used to fund the Medicaid program (including LIP or DSH) and
used secondarily for other purposes."
8. This LOA covers the period of July 1, 2021 through June 30, 2022 and shall be
terminated June 30, 2022,
9. This LOA may be executed in multiple counterparts, each of which shall constitute an
original, and each of which shall be fully binding on any party signing at least one
counterpart.
Collier County Board of County Commissioners_Healthcare Network of Southwest Florida LCA SFY 2021-22
LIP Local Intergovernmental Transfers (IGTs)
Program / Amount
State Fiscal Year 2021w2022
Low Income Pool
$4439611
Total Funding
$443,611
WITNESSETH:
IN WITNESS WHEREOF, the parties have caused this page Letter of Agreement to be
executed by their undersigned officials as duly authorized.
Collier County Board of County
Commissioners
SIGNED
BY:
NAME:
TITLE:
DATE:
ATTEST
CRYSTAL K. KINZEL, CLERK
STATE OF FLORIDA, AGENCY FOR
HEALTH CARE ADMINISTRATION
SIGNED
BY:
NAME:
TITLE:
DATE:
Approved as to form and legality
Assistant County Attorney �.�
Qua
Collier County Board of County Commissioners_Healthcare Network of Southwest Florida LOA SFY 2021-22
CAD