Agenda 09/23/2014 Item #16D189/23/2014 16.D. 18.
EXECUTIVE SUMMARY
Recommendation to approve an agreement in the amount of $107,283 with the Agency for Health
Care Administration and an agreement with Collier Health Services to participate in the Medicaid
Low Income Pool Program,generating $158,007 in Federal matching funds that will provide
additional health services for the citizens of Collier County.
OBJECTIVE: To provide additional health services for 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.
Collier Health Services (CHS) desires and is qualified to administer the LIP program with AHCA using
County tax dollars. By participating in this program, CHS will receive $158,007 in additional Federal
funds that will be utilized to provide additional healthcare services for low- income individuals in Collier
County.
The allocation of County and matching funds is as follows:
Collier County Budgeted Funds
for Medical Assistance
Matching Funds Provided to CHS as
Program Administrator
Total Funds Benefitting
Low - Income Persons
$107,283
$158,007
$265,290
FISCAL IMPACT: In the FY15 budget, $107,283 is available and earmarked for medical assistance in
the Housing, Human and Veteran Services (HHVS) 155930 -001 cost center in the General Fund (001).
Under the proposed agreement, these funds will be transferred to AHCA then remitted by AHCA to CHS
for medical care for income - qualified HHVS clients. Additional Federal matching funds provided through
this arrangement will be used by CHS to provide healthcare services for low- income individuals in
Collier County.
LEGAL CONSIDERATIONS: This item is approved for form and legality and requires majority vote
for approval. - JAB
GROWTH MANAGEMENT IMPACT: None
RECOMMENDATION: The Board of County Commissioners approves and authorizes the Chairman to
sign the agreement with Collier Health Services and the agreement with Agency for Health Care
Administration.
Prepared Bv: Esther Mae, Senior Accountant, Housing, Human, and Veterans Services
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9/23/2014 16.D.18.
FQHCs $11 Million Alternative LIP Letter of Agreement
THiS LETTER OF AGREEMENT (LOA) made and entered into in duplicate on the day
of 2014, by and between Collier County (the County) on behalf of Collier Health
Services / Health Care Network of SW FL, and the State of Florida, through its Agency for
Health Care Administration (the Agency),
1. Per House Bill 5001, the General Appropriations Act of State Fiscal Year 2014 -2015,
passed by the 2014 Florida Legislature, County and the Agency, agree that County will
remit to the State an amount not to exceed a grand total of $107,283.
a. The County and the Agency have agreed that these funds will only be used to
increase the provision of health services for the Medicaid, uninsured, and
underinsured people of the County and the State of Florida at large.
b. The increased provision of Medicaid, uninsured, and underinsured funded health
services will be accomplished through the following Medicaid programs:
i. Medicaid LIP payments to hospitals in the approved appropriations
categories.
ii. Medicaid LIP payments to Federally Qualified Health Centers.
iii. Medicaid LIP payments to County Health Departments
iv. Medicaid LIP payments for the expansion of primary care services to low
income, uninsured individuals.
2. The County will pay the State an amount not to exceed the grand total amount of
$107,283. The County will transfer payments to the State in the following manner:
a. The first quarterly payment of $26,820 for the months of July, August, and
September is due upon notification by the Agency.
b. Each successive payment of $26,821 is due as follows, November 30, 2014,
March 31, 2015 and May 25, 2015.
c. The State will bill the County when each quarterly payment is due.
3. Attached is the LIP schedule reflecting the anticipated annual distributions for State
Fiscal Year 2014 -2015.
4. The County and the State agree that the State will maintain necessary records and
supporting documentation applicable to Medicaid, uninsured, and underinsured health
services covered by this LOA. Further, the County and State agree that the County shall
have access to these records and the supporting documentation by requesting the same
from the State.
Collier County_Collier Health Services / Health Care Network of SW FL_FQHCs $11 Million Alternative LIP LOA SFY 2014-
15
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9/23/2014 16.D.18.
5. The County and the State 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 County 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 Medicaid supplemental payments in order to
satisfy non - Medicaid, non - uninsured, and non - underinsured activities.
7. The County agrees the following provision shall be included in any agreements between
the County and local providers where funding is provided for the Medicaid program.
Funding provided in this agreement shall be prioritized so that designated funding shall
first be used to fund the Medicaid program (including LIP) and used secondarily for other
purposes.
a. This LOA covers the period of July 1, 2014 through June 30, 2015 and shall be
terminated June 30, 2015.
FQHCs $11 Million Alternative LIP Local Intergovernmental Transfers
(IGTs)
State Fiscal Year 2014 -2015
Total Funding 1 $107,283
CD]her County_Coliier Health Services / Health Care Network of SW FL_FQHCs $11 Million Alternative LIP LOA SFY 2014-
15
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9/23/2014 16.D.18.
WITNESSETH:
IN WITNESS WHEREOF the parties have duly executed this LOA on the day and year above
first written.
Collier County State of Florida
Signature Stacey Lampkin
Assistant Deputy Secretary for Medicaid Finance,
Agency for Health Care Administration
Tom Henninq
Name
Chairman
Title
ATTE��.
DWj (jHIT E. BROCK, ClOrk
Approved as to form and legality
Assistant County AQMCY
Collier County_Collier Health Services/ Health Care Network of SW FL_FQHCs $11 Million Alternative LIP LOA SFY 2014-
15
Packet Page -2748-
9/23/2014 16.D.18.
AGREEMENT
THIS AGREEMENT is made and entered on the day of 2014,
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., 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 PERFORMED
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 Division or designee
regarding any aspect of payment of services being provided shall be as indicated below.
a. Emergency room, secondary and tertiary care for those patients determined eligible
by the County Human Services Department.
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
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9/23/2014 16.D.18. -
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
Administration,
1. The county will remit to the State an amount not to exceed a grand total of $107,283.
The County will transfer payments to the State in the following manner:
a. The first quarterly payment of $26,820 for the months of July, August, and
September is due upon notification by the State.
b. Each successive payment of $26,821 is due no later than, November 30, 2014,
March 31, 2015 and May 25, 2015.
c. The State will bill the County each quarter payments are due.
2. The following document is hereby incorporated by reference as Attachment A to this
Agreement.
a. Low Income Pool Agreement (LIP) with State of Florida AHCA reflecting the
anticipated annual distributions for State Fiscal Year 2014 -2015 (Attachment A).
ARTICLE Ill
CLAIMS 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, 2014 through September 30, 2015 with
no renewal.
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.
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9/23/2014 16.D.18.
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.
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 VIII
INSURANCE, SAFETY AND INDEMNIFICATION
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
Ub
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9/23/2014 16.D.18.
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.
ARTICLE VIII
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.
The Center shall make payments on a voluntary basis in the amount of $107,283 to specific
healthcare programs and services that are pre- approved by the County for payment. The
Center shall use reasonable efforts to pay invoices approved by the County within thirty (30)
days of receipt of County approved invoices. Payments shall be made in accordance with this
Agreement irrespective of whether the Center has received funds from AHCA.
If the amount invoiced to the Center does not result in the amount of $107,283, the Center
will hold the funds for the County for the difference and voluntarily make those payments to
providers elected by the County until all funds are exhausted.
ARTICLE IX
RECORDS
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
4
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9/23/2014 16.D.18.
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,
The Center and /or its sub - contractor shall comply with Title VI of the Civil Rights Act 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 for employment.
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.
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
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9/23/2014 16.D.18.
IN WITNESS WHEREOF, the parties have executed this Agreement on the dates indicated
below.
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK, Clerk COLLIER COUNTY, FLORIDA
in
, Deputy Clerk
Attest as to Chairman's signature only.
Approved as to form and legality:
Jennif A. Belpedio Ar
Assistant County Attorney
Collier County
M
Tom Henning, Chairman
COLLIE H ` LTH SE C S, INC.
By:
Title: C, �7C)
6� j .3 f
Date:
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