Agenda 01/13/2026 Item #16D 1 (MOU between Collier County and the David Lawrence Mental Health Center Inc)1/13/2026
Item # 16.D.1
ID# 2025-4823
Executive Summary
Recommendation to approve and authorize the Chair to sign a MOU between Collier County and the David Lawrence
Mental Health Center, Inc., to support the low-income pool for mental health and substance use services. (General Fund-
(Mental Health), 0001)
OBJECTIVE: To provide mental health and substance use services to the citizens of Collier County consistent with
Section 394.76(9) (a) and (b), Florida Statutes and to help meet the County’s strategic objective of promoting access to
health, wellness, and human services to benefit Collier County residents.
CONSIDERATIONS: Pursuant to Florida Statute, Section 394.76(9) (a) and (b), requiring a local match to state-
funded community alcohol and mental health services a commitment has been made to provide funding in the amount of
$2,371,401, including $594,235.91 from the Collier County Sheriff’s Office (CCSO). The statue further states that
governing bodies within a district or subdistrict shall be required to participate in the funding of alcohol and mental
health services under the jurisdiction of such governing bodies. The amount of participation shall be at least that amount
which, when added to other available local matching funds, is necessary to match state funds. For the current fiscal year
25-26, DLC requested that these funds not be provided to the David Lawrence Center directly, but rather through the
Intergovernmental Transfer Programs (IGT’s) with the State Agency on Health Care Administration (AHCA) program.
These funds are related to payments for charity care health services through the Low-Income Pool (LIP) Medicaid
program. The LIP Program leverages local funds to obtain federal matching dollars.
The David Lawrence Center is a not-for-profit mental health facility in Collier County. DLC is funded, in part, via state
contracts for the provision of mental health and substance abuse services. The proposed Memorandum of Understanding
(MOU) requires that DLC provide adult and children’s mental health and adult substance abuse services to citizens of
Collier County. Since the funds were provided directly to AHCA it is necessary for the County to ensure compliance,
thus necessitating an MOU to ensure that the dollars being provided are providing the necessary services to the required
population. The MOU period is from October 1, 2025, through September 30, 2026. The MOU requires DLC to report
on the number of residents served each quarter and their corresponding service units, also DLC is required to provide a
summary of match contributions received each quarter from other sources. Since there is no funding in the MOU, it does
specify that in the event the annual match requirement is reduced by more than 25% the County may reduce future years
local match contribution.
On September 23, 2025, Agenda #16.D.8., the BCC approved the LIP Agreement General Fund allocation to AHCA in
support of the LIP program and to provide support to DLC and meet the required statutory match obligation. The local
LIP contribution will provide the David Lawrence Center with $3,171,846.24 in federal matching dollars to be utilized
under the LIP program. The David Lawrence Center will receive a total of $5,543,247.24 in LIP funding to support
mental healthcare services for low-income individuals in Collier County through its central receiving facility and will
also provide services in the jail through the Behavioral Health Intervention Team program.
The allocation of County and LIP matching funds is as follows:
Collier County
General Fund LIP
IGT
Federal Matching Funds
Provided to DAVID
LAWRENCE CENTER as
Program Administrator
CCSO Funds
Total Funds
Benefiting
Low-Income
Persons
$1,777,165.09 $3,171,846.24 $594,235.91 $5,543,247.24 Approved
9/23/2025
Helps meet the County’s strategic objective of promoting access to health, wellness, and human services to benefit
Collier County residents
FISCAL IMPACT: There is no new fiscal impact. Funding for $2,371,401.00 is available within Community & Human
Services FY26 General Fund (0001, Cost Center (Mental Health) 156010 for the County’s contribution payment to the
State of Florida Agency for Healthcare Administration, which will be made via inter-governmental transfer (IGT) upon
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1/13/2026
Item # 16.D.1
ID# 2025-4823
receipt of an invoice.
GROWTH MANAGEMENT IMPACT: There is no Growth Management impact associated with this action.
LEGAL CONSIDERATIONS: This item has been reviewed by the County Attorney, is approved as to form and
legality, and requires a majority vote for Board approval. -JAK
RECOMMENDATION(S): To approve and authorize the Chair to sign a MOU between Collier County and the David
Lawrence Mental Health Center, Inc., to support the low-income pool for mental health and substance use services.
(General Fund- (Mental Health), 0001)
PREPARED BY: Carolyn Noble, Grant Coordinator, Community and Human Services
ATTACHMENTS:
1. DLC LIP ES 9.23.25 16D8
2. SFY 2025-26 LIP LOA David Lawrence Behavioral Health - executed
3. LIP MOU Agreement CAO SR signed 12.17.25
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9/23/2025
Item # 16.D.8
ID# 2025-2942
Executive Summary
Recommendation to approve and authorize the County Manager to sign the Low Income Pool Letter of Agreement with
the Agency for Health Care Administration, in the amount not to exceed $2,371,401, to participate in the Medicaid
Central Receiving Facility Low Income Pool Program, generating $3,171,846.24 in federal matching funds for the
benefit of David Lawrence Mental Health Center, to sign the Provider Questionnaire to assist in meeting the state
required match obligation, and authorize necessary Budget Amendments to the Fiscal Year 2026 budget in the amount
$594,235.91. (Fiscal Impact $2,371,401. General Fund 0001)
OBJECTIVE: To provide mental health and substance abuse services to the citizens of Collier County consistent with
Section 394.76(9)(a) and (b), Florida Statutes, while advancing the County’s strategic objective of promoting access to
health, wellness, and human services.
CONSIDERATIONS: The Agency for Health Care Administration (AHCA) is a State entity that provides Medicaid
funding 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 attached LIP Letter of
Agreement between Collier County and AHCA.
In recognition of the growing inpatient behavioral healthcare needs of Collier County residents, David Lawrence Center
(DLC) mobilized an expansion as an interim step towards the development of a Central Receiving Facility (CRF). The
development of the CRF allows DLC to participate in the LIP program through AHCA. DLC desires and is qualified to
administer the Central Receiving Facility LIP Program with AHCA using Collier County and Collier County Sheriff’s
Office (CCSO) ad valorem tax dollars.
The County’s General Fund and LIP allocations in the Fiscal Year 2026 (FY 26) budget are proposed and aim to assist in
meeting the state mandated required match obligation. The current DLC state required match obligation is
$2,313,044.78. The anticipated FY 26 budget has allocated $1,777,165.09, along with funding from the CCSO in the
amount of $594,235.91. CCSO has agreed to utilize these funds in support of the LIP program to augment the County
funds to yield a greater federal match. DLC will utilize the County and CCSO funds under the LIP Program to provide
additional mental healthcare services for low-income individuals in Collier County through its central receiving facility.
These funds are part of a tri-party agreement between DLC, CCSO, and the County to be brought to the Board of County
Commissioners (Board) in late October. CCSO will be invoiced by the County once an invoice is received from AHCA
to facilitate the payment to AHCA via an intergovernmental transfer (IGT).
The allocation of County and LIP matching funds is as follows:
Collier
County
General
Fund LIP
IGT
Federal
Matching Funds
Provided to
DAVID
LAWRENCE
CENTER as
Program
Administrator
CCSO
Funds
Total Funds
Benefiting
Low-Income
Persons
$1,719,499.44 $2,295,209 $0.00 $4,014,708.44 Prior FY25
$1,777,165.09 $3,171,846.24 $594,235.91 $5,543,247.24 Proposed Action
$1,777,165.09 $3,171,846.24 FY26 Tentative Budget
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9/23/2025
Item # 16.D.8
ID# 2025-2942
If approved, the County will provide all of its General Fund allocation and that of CCSO to AHCA in support of the LIP
program. By the Board allowing the entire general fund allocation and the CCSO funds to be submitted to AHCA this
will remove any authority the County and CCSO has with respect to these dollars. However, staff will prepare a
memorandum of understanding for both the County and CCSO to ensure the services supported through the LIP
agreement are to support those residents in Collier County. Through the remittance of these funds, the County will meet
all the required state match obligation. Should CCSO not provide payment to the County the LIP LOA contribution will
be reduced accordingly.
It is important to note that the County has historically supported the entire required match obligation without local
support from other agencies or municipalities. In prior years, the County has often overmatched in support of DLC.
As shown in the table below is a five-year summary of funding to support the David Lawrence Center
TABLE #2
Advances the County’s strategic objective of promoting access to health, wellness, and human services.
FISCAL IMPACT: Funding in the amount of $1,777,165.09 is available within the FY26 Community & Human
Services (CHS), Community Mental Health & LIP Support Fund 0001, Cost Center 156010 for the County’s
contribution to the State of Florida Agency for Healthcare Administration. A FY26 Budget Amendment of $594,235.91
is needed to accept the CCSO’s contribution towards this payment.
GROWTH MANAGEMENT IMPACT: There is no Growth Management impact associated with this action.
LEGAL CONSIDERATIONS: This item has been approved as to form and legality and requires a majority vote for
Board approval. – CLD
RECOMMENDATION(S): To approve and authorize the County Manager to sign the Low Income Pool Letter of
Agreement with the Agency for Health Care Administration, in the amount not to exceed $2,371,401, to participate in the
Medicaid Central Receiving Facility Low Income Pool Program, generating $3,171,846.24 in federal matching funds for
the benefit of David Lawrence Mental Health Center, to sign the Provider Questionnaire to assist in meeting the state
required match obligation, and authorize necessary Budget Amendments to the Fiscal Year 2026 budget in the amount
$594,235.91. (Fiscal Impact $2,371,401. General Fund 0001)
PREPARED BY: Carolyn Noble, Grant Coordinator Community and Human Services
ATTACHMENTS:
Page 8748 of 14062
9/23/2025
Item # 16.D.8
ID# 2025-2942
1. LIP Letter of Agreement CAO Stamped
2. DLC CCSO LIP BA 9.2025c
3. LIP DLC IGT Provider Questionnaire 9.16.25 CAO Stamped
Page 8749 of 14062
Low Income Pool Letter of Agreement
THIS LETTER OF AGREEMENT (LOA) is made and entered into in duplicate on the 23,,E
day of 2025, by and between Collier County (the "IGT Provider") on behalf of
David Lawrence Behavioral Health 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 the 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 2025-
2026, passed by the 2025 Florida Legislature. the IGT Provider and the Agency agree
that the IGT Provider will remit IGT funds to the Agency in an amount not to exceed the
total of$2,371,401.
a. The IGT Provider 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 IGT
Provider 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_David Lawrence Behavioral Health_LIP LOA SFY 2025-26
C. Ate
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rural health centers pursuant to the approved Centers for Medicare &
Medicaid Services Special Terms and Conditions.
2. The IGT Provider will return the signed LOA to the Agency no later than October 1.
2025.
3. The IGT Provider will pay IGT funds to the Agency in an amount not to exceed the total
of$2,371,401.
a. Per Florida Statute 409 908, annual payments for the months of July 2025 through
June 2026 are due to the Agency no later than October 31, 2025, unless an
alternative plan is specifically approved by the agency.
b. The Agency will bill the IGT Provider when payment is due.
4. The IGT Provider 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 IGT Provider 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 IGT Provider agrees to ensure 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 IGT Provider agrees to comply with public record laws as outlined in
section 119.0701, Florida Statutes.
d. Retention of Records
i. The IGT Provider 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.
ii. 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_David Lawrence Behavioral Health_LIP LOA SFY 2025-26
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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 IGT Provider agrees to permit persons duly authorized by the
Agency to inspect any records, papers. and documents of the IGT
Provider which are relevant to this LOA.
f. Assignment and Subcontracts
i. The IGT Provider 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 IGT Provider 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 IGT Provider confirms that there are no pre-arranged agreements (contractual or
otherwise) between the respective counties, taxing districts. and/or the providers to
redirect any portion of these aforementioned charity care supplemental payments in
order to satisfy non-Medicaid, non-uninsured, and non-underinsured activities.
7. The IGT Provider agrees the following provision shall be included in any agreements
between the IGT Provider 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. 2025, through June 30, 2026, and shall
be terminated September 30. 2026. which includes the state's certified forward
period.
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_David Lawrence Behavioral Health_LIP LOA SFY 2025-26
CAU
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LIP Local Intergovernmental Transfers (IGTs)
Program /Amount State Fiscal Year 2025-2026
Estimated IGTs
2,371,401.00
Total FundingNot to Exceed 2,371,401.00
WITNESSETH:
IN WITNESS WHEREOF, the parties have caused this(4) page Letter of Agreement
to be executed by their undersigned officials as duly authorized.
COLLIER COUNTY STATE OF FLORIDA,AGENCY FOR
HEALTH CARE ADMINISTRATION
jet
SIGNED 9 SIGNED
BY: BY:
NAME: Atio Par NAME: Stephanie Scanlon
TITLE: 61.ottilAAmohal.er
TITLE: Chief of Medicaid Program
q /
Finance
DATE: 11_0 Z DATE:
Collier County_David Lawrence Behavioral Health_LIP LOA SFY 2025-26
10/10/2025
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