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Backup Documents 09/28/2021 Item #16D 6 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 0 b TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Board meeting. � �**NEW** ROUTING SLIP RG Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office. Route to Addressee(s) (List in routing order) Office Initials Date 1. 2. 3. County Attorney Office County Attorney Office DeJ3 I a7 \a, I 4. BCC Office Board of County t b Commissioners %1S ( *n- '?) 5. Minutes and Records Clerk of Court's Office PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above,may need to contact staff for additional or missing information. Name of Primary Staff Matthew Catoe/OVS Contact Information 239-252-4059 Contact/ Department Agenda Date Item was 9/28/2021 Agenda Item Number ID#20089 Approved by the BCC �p �p Type of Document (2)Agreements Number of Original 2 Attached Documents Attached PO number or account number if document is to be recorded INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable col , • ver is Yes N/A(Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signature A K N/A 2. Does the document need to be sent to another agency for additional signatures? If yes, MC provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be MC signed by the Chairman,with the exception of most letters,must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the MC document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's MC signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip MC should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on 9/28/2021 and all changes made during MC the meeting have been incorporated in the attached document. The County option for Attorney's Office has reviewed the changes,if applicable. this line. 9. Initials of attorney verifying that the attached document is the version approved by the M (�7 N/A is not BCC,all changes directed by the BCC have been made,and the document is ready for the gzotiv ki option for Chairman's signature. line. 16D 6 The Low Income Pool (LIP) Letter of Agreement requires immediate signature. We have to get the agreement back to the State by October 1, 2021. From: Pruett, Madison Sent: Wednesday, September 8, 2021 5:38 PM To: Maggie.Lopez@colliercountyfl.gov Cc: Ben Browning<ben@fachc.org> Subject: LIP LOA SFY 21-22 Good afternoon, Please see the attached LOA and Questionnaire for the SFY 2021-22 Low Income Pool program.The LOA is due back to the Agency no later than October 1, 2021. Thanks, Madison Pruett- MEDICAL/HEALTH CARE PROG ANALYST Bldg 3 Rm 1331 - BUREAU OF MEDICAID PROGRAM FINANCE 2727 MAHAN DR., TALLAHASSEE, FL. 32308 +1 850-412-4274 (Office) - (Fax) Madison.Pruett(a�ahca.myflorida.com Madison's last day with the agency was September 16, 2021. Jeffery Mistich (jeffery.mistich@ahca.myflorida.com) was given a POC going forward. Electronic routing is acceptable for LIP. 160 6 Low Income Pool Letter of Agreement THIS LETTER OF AGREEMENT(LOA) is made and entered into in duplicate on the day of . .Q.ADt2021, 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: i. 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 SPY 2021-22 0 16D 6 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 all reasonable times to inspection, review, or audit by state personnel and other personnel duly authorized by the Agency, as well as by federal personnel. iii. 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 i. 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. I'. Collier County Board of County Commissioners Healthcare Network of Southwest Florida_LOA SFY 2021-22 C,Q 16Q 6 i. 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 i. 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 i. 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 parties. 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_LOA SFY 2021-22 1 6 D 6 LIP Local Intergovernmental Transfers (IGTs) Program /Amount State Fiscal Year 2021-2022 Low Income Pool $443,611 Total Funding $443,611 WITNESSETH: IN WITNESS WHEREOF, the parties have caused this page Letter of Agreement to be executed by thei undersigned officials as duly authorized. Collier Coun of County STATE OF FLORIDA, AGENCY FOR Commission HEALTH CARE ADMINISTRATION SIGNED SIGNED BY: BY: NAME: 1£. ro `I T W`{ LO►P NAME: TITLE: CLA 1 12 TITLE: DATE: S \a a DATE: ATTEST CR ,STAL K. KINZEL,CLERK Approved as to form and legality BY; 1 A est as to Chairm n's A start County Attu- 32 . SirmatUf l Omit! Q\ Collier County Board of County Commissioners_Healthcare Network of Southwest Florida_LOA SFY 2021-22 CAC, -1 6 0 AGREEMENT �-h THIS AGREEMENT is made and entered on the 02 sis day of e""'1`.1 2021,by and between Collier County,Florida,a political subdivision of the State of Florida,hereinafter referred to as"the County" and Collier Health Services,Inc., d/b/a Healthcare Network of Southwest Florida,a Florida not for profit incorporated under the laws of the State of Florida, and a Federal Health Qualified Center hereinafter referred to as "Center". RECITALS: WHEREAS, Section 125.01(1)(e), Florida Statutes, authorizes the County to provide health welfare programs for the residents of Collier County to the extent not inconsistent with general or special law. WHEREAS,the establishment and maintenance of such programs are in the common interest of the people of Collier County. WHEREAS,The County desires the Center to become a community health partner to assist in providing payments for health prevention programs, and mental health services to residents of the County. WHEREAS, The Center desires to be a community health partner and is willing to voluntarily provide payments for such services, subject to the terms and conditions hereinafter set forth. NOW THEREFORE, in consideration of the covenants herein contained, the parties hereby agree as follows: ARTICLE I SERVICES TO BE PREFORMED 1. The Center shall provide documentation and monthly reports to the County related to payment for the delivery of hospital services, designated primary health care services, specialty health care services and other health care services. 2. The Center and/or its sub-contractor shall provide timely responses to contract requirements. Responses to inquiries from the Public Services Department or designee regarding any aspect of payment of services being provided shall be as indicated below. a. Emergency room, secondary andtertiary care for those patients determined eligible by the County Human Services Division. b. Secondary and tertiary services shall be provided upon the referring physician or designated physician's order. The referral order shall distinguish between a referral for specific therapeutic services and a diagnostic workup. 3. Nothing in this contract shall be construed to limit access for a patient to any service provided by a Health Services provider that is medically necessary and approved by the County. ARTICLE II PAYMENTS The County shall make intergovernmental transfers, on behalf of Collier Health Services in connection with the LIP program to the State of Florida, hereinafter referred to as "State", in accordance with the Letter of Agreement between the County and the Agency for Health Care 1 1 6 0 6 Administration. 1. The county will remit to the State an amount not to exceed a grand total of$443,611.00. The County will transfer payments to the State in the following manner: a. The payments for the months July 2021 - June 2022 are due by October 31, 2021, to the State. 2. The following document is hereby incorporated by reference as Attachment A to this Agreement. Low Income Pool Agreement(LIP)with State of Florida AHCA reflecting the anticipated annual distributions for State Fiscal Year 2021-2022(Attachment A). ARTICLE III CLAIM VALUATION AND CLAIMS PROCESSING 1. As the claims processing entity, the Center will provide quarterly financial reports to the County in such detail as required by the County. 2. Prompt payment of invoices as presented to the Center should be made within 30 business days of receipt from the County. 3. Copies of all checks issued are to be sent to the County for record keeping. ARTICLE IV TERMS OF AGREEMENT AND TERMINATION 1. The term of this Agreement shall be October 1, 2021 through September 30, 2022 with no renewal, or to the date upon which all funds under the agreement are disbursed by the Center, in accordance with Article VIII. 2. Either party may terminate this Agreement thirty (30) calendar days after receipt by the other party of written notice of intent to terminate. In the event of termination, the County shall pay for services rendered, prorated to the date of termination. 3. Upon breach of this Agreement, the aggrieved party may, by written notice of breach to the breaching party,terminate the whole or any part of this Agreement. Termination shall be upon no less than twenty-four (24) hours' notice, in writing, delivered by certified mail,telegram or in person. Waiver by either party of breach of any provisions of this Agreement shall not be deemed to be a waiver of any other or subsequent breach and shall not be construed to be a modification of the terms of this Agreement. iI 4. It is further agreed that in the event general funds to finance all or part of this Agreement do not become available,the obligations of each party hereunder may be terminated upon no less than twenty-four(24)hours' notice in writing to the other party. Said notice shall be delivered by certified mail, telegram or in person. The County shall be the final authority as to the availability of funds and as to how any available funds will be allocated among its various service providers. 2 0 163 6 ARTICLE V ASSIGNMENT The Center and/or its sub-contractor shall not assign or transfer this Agreement, or any interest, right or duty herein, without the prior written consent of the County, which consent shall not be unreasonably withheld by the County. Without obtaining prior consent by the County, the Center shall be allowed to assign or transfer this Agreement or any of the Center's obligations hereunder to affiliates or wholly owned subsidiaries of the Center. This Agreement shall run to the County and its successors. ARTICLE VI SUBCONTRACTING The parties agree that the Center shall be permitted to execute subcontracts for the purchase by the Center of such services, articles, supplies, and equipment, which is both necessary and incidental to the performance of the work, required under this Agreement. However, the Center expressly understands that it shall assume the primary responsibility for performing the services outlined in Article I of this Agreement. ARTICLE VII INSURANCE, SAFETY, AND INDEMNIFICATION 1. Indemnity. To the maximum extent permitted by Florida law, the Center and/or its sub- contractor shall indemnify and hold harmless the County against any claims,damages, losses, and expenses, including reasonable attorneys' fees and costs, arising out of or resulting from the Center's failure to pay for services or performance under this Agreement. This indemnification obligation shall not be construed to negate,abridge or reduce any other rights or remedies which otherwise may be available to an indemnified party or person described in this paragraph. Center shall jointly and severally indemnify and hold harmless Collier County for all claims, demands, actions, suits, losses, costs, charges, expenses, damages and liabilities whatsoever which the County may pay, sustain, suffer or incur by reason of or in connection with this agreement including payment of all legal costs, including but not limited to, attorney's fees paid by the County. 2. Insurance Required: During the term of this agreement the Center shall procure and maintain liability insurance coverage. The liability insurance coverage shall be in amounts not less than { $1,000,000 per person and $2,000,000 per incident of occurrence for personal injury, death, and property damage or any other claims for damages caused by or resulting from the activities under this Agreement. Such policies of insurance shall name the County as an additional insured. The Center shall purchase all policies of insurance from a financially responsible insurer duly authorized to do business in the State of Florida. The Center shall be financially responsible for any loss due to failure to obtain adequate insurance coverage and the failure to maintain such policies or certificate in the amounts set forth herein shall constitute a breach of this agreement. c. 3 160 6 ARTICLE VII BILLING PROCEDURES The Center has standard, acceptable billing procedures that the Center will utilize in the performance of its obligations under this Agreement. The County shall direct the Center to make payments pursuant to this Agreement once the County has verified the validity of the invoices to be paid by the Center. The Center will not pay any invoices prior to the County's approval. The Center will provide copies of checks for payments as they are remitted.The Center shall also provide quarterly reports showing invoices paid and pending payments. ARTICLE IX RECORDS 1. The Center and/or its sub-contractor shall keep orderly and complete records of its accounts and operations related to the services provided under this Agreement for the entire term of the Agreement plus three (3) years. The Center and/or its sub-contractor shall keep open these records to inspection by County personnel at reasonable hours during the entire term of this agreement. If any litigation, claim, or audit is commenced prior to the expiration of the three (3) year period and extends beyond this period the records must remain available until any litigation, claim or audits have been resolved. Any person duly authorized by the County shall have full access to and the right to examine any of said records during said period. Access to PHI shall be in compliance with federal laws and HIPAA. ARTICLE X CIVIL RIGHTS 1. There will be no discrimination against any employee or person served on account of race, color, sex, age, religion, ancestry, national origin, handicap, or marital status in the performance of the Agreement. 2. It is expressly understood that,upon receipt of evidence of such discrimination,the County shall have the right to terminate this Agreement for breach of agreement. 3. The Center and/or its sub-contractor shall comply with Title VI of the Civil RightsAct of 1964 (42 USC 2000d) in regard to persons served. 4. The Center and/or its sub-contractor shall comply with Title VII of the Civil Rights Act of 1964 (42 USC 2000c) in regard to employees or applicants foremployment. 5. The Center and/or its sub-contractor shall comply with Section 504 of the Rehabilitation Act of 1973 in regard to employees or applicants for employment and clients served. 0 4 160 6 ARTICLE XI OTHER CONDITIONS 1. Any alterations, variations, modifications, or waivers of provisions of this Agreement shall only be valid when they have been reduced to writing,duly signed, and attached to the original of this Agreement. The parties agree to renegotiate the Agreement if revision of any applicable laws or regulations makes changes in the Agreement necessary. 2. This Agreement contains all the terms and conditions agreed upon by the parties. All items incorporated by reference are as though physically attached. No other agreements, oral or otherwise, regarding the subject matter of this Agreement, shall be deemed to exist or to bind any of the parties hereto. 3. The Center and/or its sub-contractor shall obtain and possess throughout the term of this Agreement all licenses and permits applicable to its operations under federal, state, and local laws, and shall comply with all fire, health, and other applicable regulatory codes. 4. The Center and/or its sub-contractor agrees to comply with all applicable requirements and guidelines prescribed by the County for recipients of funds. The Center and/or its sub-contractor agree to safeguard the privacy of information pursuant to the Health Insurance Portability and Accountability Act of 1996(HIPAA), 5 �� { 160 b { 1N WITNESS WHEREOF,the parties have executed this Agreement on the dates indicated below. ATTEST: BOARD OF COUNTY COMMISSIONERS Crystal K.Kinzel, COLLIER C UNTY,FLORIDA Clerk c` 04‘448 L3114 c By: By: PENNY TAYLOR,CHAIR Attest as to Chairman' elpu erk signature only. 1 Attest as to Chairman's signature only. COLLIER HEALTH SERVICES, INC. d/b/a HEALTHCARE NETWORK OF SOUTHWEST FLORIDA By: ailA, Approved as to form and legality: Title: CFO Jennifer A. Belpedio 1> Date: g'/d—dias / Assistant County Attorney Collier County { 1(` 6 141