Backup Documents 06/24/2025 Item #16D 6 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 D 6
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 2.25.24 BCC MTG
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
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 Attomey Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1. Carolyn Noble Community and Human CN 6.18.25
Services
2. County Attorney Office— County Attorney Office
5Atits4
3. BCC Office Board of County
Commissioners 'f 3S fl /5/
4. Minutes and Records Clerk of Court's Office /
1 LY
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 Carolyn Noble Phone Number 239-450-5186
Contact/ Department
Agenda Date Item was 6.24.25 BCC Meeting Agenda Item Number 16.D.6
Approved by the BCC
Type of Document RESOLUTION(3 COPIESi, 2 Number of Original 3 DOCUMENTS
Attached 'Z'o U — istJ 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 column,whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature STAMP OK CN
2. Does the document need to be sent to another agency for additional signatures? If yes, N/A
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 Yes
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 N/A
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 YES
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip N/A
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 above date and all changes made during N/A is not
the meeting have been incorporated in the attached document. The County .�( 44 an option for
Attorney's Office has reviewed the changes,if applicable. JJ this line.
9. Initials of attorney verifying that the attached document is the version approved by the i N/A is not
BCC,all changes directed by the BCC have been made,and the document is ready for the sit p j an option for
Chairman's signature. ( this line.
16D6
RESOLUTION NO. # 2025- 1 23
AN ASSESSMENT RESOLUTION OF THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA,
AUTHORIZING AND ADOPTING A NON-AD VALOREM
SPECIAL ASSESSMENT WITHIN THE COUNTY LIMITS FOR
THE PURPOSE OF BENEFITING ASSESSED PROPERTIES
THROUGH ENHANCED MEDICAID PAYMENTS FOR LOCAL
SERVICES; FINDING AND DETERMINING THAT CERTAIN
REAL PROPERTY IS SPECIALLY BENEFITED BY TILE
ASSESSMENT; COLLECTING THE ASSESSMENT AGAINST THE
REAL PROPERTY; ESTABLISHING A PUBLIC HEARING TO
CONSIDER IMPOSITION OF THE PROPOSED ASSESSMENT AND
THE METHOD OF ITS COLLECTION; AUTHORIZING AND
DIRECTING THE PUBLICATION OF NOTICES IN CONNECTION
THEREWITH; PROVIDING FOR CERTAIN OTHER
AUTHORIZATIONS AND 1)14:LEGATIONS OF AUTHORITY AS
NECESSARY; AND PROVIDING AN EFFECTIVE DATE.
WHEREAS, hospitals in Collier County's jurisdiction (the "Hospitals") annually provide
millions of dollars of uncompensated care to uninsured persons and those 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; and
WHEREAS, Hospitals in Collier County (the "County") support a non-ad valorem special
assessment upon certain real property interests held by the Hospitals to help finance the non-
federal share of the State's Medicaid program; and
WHEREAS, the only real properties interests that will be subject to the non-ad valorem
assessments authorized herein are those belonging to the hospitals; and
WHEREAS, the County recognizes that one or more of the Hospitals within the County's
boundaries may be located upon real property leased from governmental entities and that such
I{ospitals 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
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; and
WHEREAS, the County acknowledges that the Hospital properties assessed will have
increased income potential directly and especially from the assessment as a result of the above- 1 6 D 6
described additional funding provided to said Hospitals; and
WHEREAS, the County has determined that a logical relationship exists between the
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 uninsured residents; and
WHEREAS, imposing an assessment limited to Hospital properties to help fund the
provision of these 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 such services; and
WHEREAS, the Hospitals are important contributors to the 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 Board finds the assessment will enhance the Hospitals' ability to grow,
expand,maintain,improve,and increase the value of their Collier County 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 at a uniform rate that is compliant with 42 C.F.R. § 433.68(d); and
WHEREAS, on June 22, 2021, the Board of County Commissioners adopted Ordinance
2021-23, enabling the County to levy a uniform non-ad valorem special assessment, which is fairly
and reasonably apportioned among the Hospitals' property interests 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, thus directly and specially benefitting Hospital properties.
NOW, THEREFORE, BE IT RESOLVED. BY THE BOARD OF. COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA, that:
Section 1. Definitions. As used in this Resolution, the following capitalized terms,
not otherwise defined herein or in the Ordinance, shall have the meanings below, unless the 1 6 D 6i
context otherwise requires.
Assessed Property means the real property in the County to which an Institutional Health Care
Provider holds a right of possession and right of use 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 Assessed
Property to fund the non-federal share of Medicaid and Medicaid managed care payments that
will benefit hospitals providing Local Services in the County.
Assessment Coordinator means the person appointed to administer the Assessment imposed
pursuant to this Article, or such person's designee.
Board means the Board of County Commissioners of Collier County, Florida.
Comptroller means the Collier County Comptroller, ex officio Clerk to the Board, or other such
person as may be duly authorized to act on such person's behalf.
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 health care 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.
6D6
Ordinance means the Collier County Local Provider Participation Fund Ordinance codified in
Chapter 126 of the Collier County Code of Ordinances.
Tax Collector means the Collier County Tax Collector.
Section 2. Authority. Pursuant to Article VIII,Section 1(f)of the Constitution of the State
of Florida, Chapter 125 of the Florida Statutes, and the Collier County Local Provider Participation
Fund Ordinance, 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.
Section 3. Special Assessment. The non-ad valorem special assessment discussed
herein 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 from programs, including the hospital directed payment program and
graduate medical education program, that will benefit the Assessed Properties for Local Services.
When imposed, the Assessment shall constitute a lien upon the Assessed Properties owned by
Hospitals and/or a lien upon improvements on the Property made by Hospital leaseholders equal in
rank and dignity with the liens of all state,county, district, or municipal taxes and other non-ad
valorem assessments. Payments made by Assessed Properties may not be passed along to patients
of the Assessed Property as a surcharge or as any other form of additional patient charge. Failure to
pay may cause foreclosure proceedings, which could result in loss of title, to commence.
Section 4. Assessment Scope, Basis, and Use. Funds generated from the Assessment
shall be used only to:
1. Provide to the Florida Agency for Health Care Administration the non-federal
share for Medicaid payments, including the hospital directed payment program
and graduate medical education program,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 the Ordinance.
If, at the end of the Fiscal Year, additional amounts remain in the local provider participation fund, 1 6 D 6
the 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) 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.
Section 5. Computation of Assessment, The Assessment shall equal 1.74% of net
patient revenue for each Assessed Property specified in the attached Non-Ad Valorem Assessment
Roll. 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). Assessments for each
Assessed Property will be derived from data contained in cost reports and/or in the Florida Hospital
Uniform Reporting System, as available from the Florida Agency for Health Care Administration.
Section 6. Timing and Method of Collection. The amount of the assessment is to be
collected pursuant to the Alternative Method outlined in §197.3631, Fla. Stat.
The County shall provide Assessment bills by first class mail to the owner of each affected Hospital.
The bill or accompanying explanatory material shall include: (1) a reference to this Resolution, (2)
the total amount of the hospital's Assessment for the appropriate period, (3) the location at which
payment will be accepted, (4) the date on which the Assessment is due, and (5) a statement that the
Assessment constitutes a lien against assessed property and/or improvements equal in rank and dignity with
the liens of all state,county,district or municipal taxes and other non-ad valorem assessments.
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 1 6 D 6
Ordinance and this resolution.
Section 7. Public Hearing. Per the notice provided on June 3, 2025, the Board has
heard and considered objections of all interested persons prior to rendering a decision on the
Assessment and attached Non-Ad Valorem Assessment Roll.
Section 8. 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.
Section 9. Severabilitys If any clause,section, or provision of this resolution is
declared unconstitutional or invalid for any reason or cause,the remaining portion hereof shall be in
full force and effect and shall be valid as if such invalid portion thereof had not been incorporated
herein.
Section 10. Effective Date.This Resolution shall become effective upon adoption by a majority
vote of the Board of County Commissioners.
This Resolution adopted bythe Board thisday tiN ----
This Zy of wie_. 2025, after motion,
second and majority vote favoring same.
ATTEST: AS TO COUNTY:
CRYSTAL`K. KINZEL, CLERK BOARD OF COUNTY
rha ;a• 1 COMMISSIONERSCOLLIER
r� ; "4 f ! w � COUNTY, FLORIDA
;,, k' . U'-
',yip , Deputy Clerk ��y
ira ,,,,i4 By I /fir
Dated: B `j2f 25 Burt L. Saunders, Chairperson
(SEAL) Attest as to Minna*
�'
i i signature only. Date: 4/25
_
Approval / . 1 and legality:
-444kiI►._
Jeffrey 41 a ow, ,ty Attorney