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Backup Documents 09/24/2013 Item #11BORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO I B THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATU 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. URGENT - - - - - -- DOCUMENTS MUST BE TO STATE BY OCT.1 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 # I through #2, complete the checklist, and forward to the County Attorney Office. Route to Addressee(s) (List in routing order) Office Initials Date 1. County, Attorney Office County Attorney Office JAB 9f2� Agenda Date Item was 9/24/13 V Agenda Item Number 11.13 2. BCC Office Board of County G�k JAB Type of Document Commissioners Number of Original 3. Minutes and Records Clerk of Court's Office Documents Attached Agreement (Collier County and NCH) oZ 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 Jennifer A. Belpedio, Assistant County Attorney Phone Number 252 -8400 Contact / Department anvrovriate. (Initial) Applicable) Agenda Date Item was 9/24/13 V Agenda Item Number 11.13 Approved by the BCC Does the document need to be sent to another agency for additional signatures? If yes, JAB Type of Document provide the Contact Information (Name; Agency; Address; Phone) on an attached sheet. Number of Original Attached 1. Documents Attached Agreement (Collier County and NCH) oZ PO number or account Ilia number if document is All handwritten strike - through and revisions have been initialed by the County Attorney's JAB to be recorded Office and all other parties except the BCC Chairman and the Clerk to the Board INSTRUCTIONS & CHECKLIST I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revise x:24"05; Revised 11/30/12 I Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is Yes N/A (Not anvrovriate. (Initial) Applicable) 1. Does the document require the chairman's original signature? JAB 2. Does the document need to be sent to another agency for additional signatures? If yes, JAB 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 JAB 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 JAB 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 JAB 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 JAB signature and initials are required. 7. In most cases (some contracts are an exception), the original document and this routing slip JAB 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 9/24/13 and all changes made during the JAB meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes, if applicable. 9. Initials of attorney verifying that the attached document is the version approved by th?411 JAB BCC, all changes directed by the BCC have been made, and the document is ready fo Chairman's signature. I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revise x:24"05; Revised 11/30/12 I 11B MEMORANDUM Date: October 3, 2013 To: Jennifer A. Belpedio, Assistant County Attorney Collier County Attorney's Office From: Ann Jennejohn, Deputy Clerk Minutes & Records Department Re: Agreement between Collier County and Community Health Partners for participation in the Intergovernmental Transfer Program (IGT) Attached are an original copy of the agreement referenced above, (Item #1111) approved by the Board of County Commissioners on Tuesday, September 24, 2013. The second original agreement will be held on file with the Minutes and Record's Department for the Board's Official Record. Thank you. If you have any questions, please contact me at 252 -8406. Thank you. Attachment 11B AGREEMENT THIS AGREEMENT is made and entered into on September 24, 2013 by and between Collier County, Florida, a political subdivision of the State of Florida, hereinafter referred to as "the County" and Naples Community Hospital, Inc., a Florida not for profit corporation, hereinafter referred to as"the Hospital". 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; and WHEREAS,The establishment and maintenance of such programs are in the common interest of the people of Collier County: and WHEREAS, The County desires the Hospital to become a Community Health partner to assist in providing payments for health prevention programs, and mental health services to residents of the County, where no existing state or federal resources are available; and WHEREAS, The Hospital 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 Hospital shall provide documentation and quarterly reports to the County that support Hospital's expenditures for the reimbursement to Collier partners as stated immediately below for the delivery of services, designated primary health care services, specialty health care services and other health care services such as, but not limited to,the following services: a. Immunization program provided by the Collier County Health Department b. AIDS Prevention Program provided by the Collier County Health Department c. Tuberculosis Program provided by the Collier County Health Department d. Communicable Disease Program provided by the Collier County Health Department e. Child Health Program provided by the Collier County Health Department f. Healthy Start Prenatal Program provided by the Foundation for Women's Health g. School Health Program provided by the Collier County Health Department h. Adult Health Program provided by the Collier County Health Department i. Dental Program provided by the Collier County Health Department j. Community Mental Health Services provided by the David Lawrence Center, Inc. k. Other health related programs and services. ARTICLE II PAYMENTS 1. The County shall make Intergovernmental Transfers, on behalf of the Hospital, in connection with the State's Medicaid Programs — specifically the self funding of inpatient DRG payments and buyback of the Medicaid outpatient trend adjustments - to the State of Florida in accordance with 1 2013 Agreement with Naples Community Hospital/IGT C.) 11 B :. 9 the Letter(s) of Agreement between the County and the Agency for Health Care Administration (AHCA). 2. There are no pre-arranged agreements (contractual or otherwise) between the County and the Hospital to re-direct any portion of Medicaid supplemental payments in order to satisfy non- Medicaid activities. 3. The following document is hereby incorporated by reference as an attachment to this Agreement: Letter of Agreement with AHCA-Attachment A ARTICLE III CLAIMS VALUATION AND CLAIMS PROCESSING As the claims processing entity, the Hospital will provide quarterly financial reports to the County in such detail as required by the County. ARTICLE IV TERMS OF AGREEMENT AND TERMINATION 1. The term of this Agreement shall be October 1, 2013 through September 30, 2014. 2. Either party may terminate this Agreement thirty (30) calendar days after receipt by the other party of written notice of intent to terminate. 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, facsimile, 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. ARTICLE V ASSIGNMENT The Hospital 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 Hospital shall be allowed to assign or transfer this Agreement or any of the Hospital's obligations hereunder to affiliates or wholly owned subsidiaries of the Hospital. This Agreement shall run to the County and its successors. ARTICLE VI SUBCONTRACTING The parties agree that the Hospital shall be permitted to execute subcontracts for the purchase by the Hospital 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 Hospital expressly 2 2013 Agreement with Naples Community Hospital/IGT 11B 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 Hospital 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 Hospital'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. Hospitals 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 Hospital 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 Hospital shall purchase all policies of insurance from a financially responsible insurer duly authorized to do business in the State of Florida. The Hospital 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 County shall provide the Hospital with invoices pursuant to this Agreement once the County has verified the validity of the invoices to be paid by the Hospital. The Hospital will not pay any invoices prior to the County's approval. The Hospital shall make payments on a voluntary basis in the amount of $1,913,660 to specific healthcare programs and services, such as the mental health programs of the David Lawrence Center, specified health programs of the Collier County Health Department, and other social service providers that are pre-approved by the County for payment. The Hospital shall use reasonable efforts to pay invoices approved by the County within thirty (30) days of County approval. Payments shall be made in accordance with this Agreement irrespective of whether Hospital has received funds from AHCA. If the amount invoiced to Hospital does not result in the amount of$1,913,660 the Hospital will credit County for the difference and voluntarily make those payments to providers elected by County upon invoice by the County in Year 2014-2015. 3 2013 Agreement with Naples Community Hospital/IGT S 11B ARTICLE IX RECORDS The Hospital 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 Hospital 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 Hospital 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 Hospital 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 Hospital 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 provision 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 Hospital 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 Hospital and/or its sub-contractor agrees to comply with all applicable requirements and guidelines prescribed by the County for recipients of funds. 5. The Hospital and/or its sub-contractor agree to safeguard the privacy of information pursuant to the Health Insurance Portability and Accountability Act of 1996(HIPAA). 4 2013 Agreement with Naples Community Hospital/IGT CAO 118 fr,4 IN WITNESS WHEREOF,the parties have executed this Agreement on the dates first written above. ATTEST: BOARD OF CO ` CO MISSIONE S DWIGHT E.OROCK LERK OF COLLIER C UN ! , FL RI A ... pis By: 11° A. • . • . .0 . By: Attest . - : ;1 f CLERK GEORGIA. HILLER, ESQ. �signatt re 1 IY CHAIRWOMAN Approvjfor.form.an5l`legality: Jennifer A. Belpe Assistant County Attorney NAPLES COMMUNITY HOSPITAL, INC., A FLORIDA NOT FOR PR FIT CORPORATION � B '' IL By: Ke✓J.t Co.PCr Title: CL e..S 5 2013 Agreement with Naples Community Hospital/IGT cq ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATU Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the Con At rnffice at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attor a ater than Monday preceding the Board meeting. URGENT - - - - - -- DOCUMENTS MUST BE TO STATE BY OCT. I Complete routing lines #I through #2 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the cntinn nffl, rha;rmaWe cinnahire rlraw a line thrn,iah rontinv line- #I through 42- comnlete the checklist. and forward to the County Attorney Office. Route to Addressees (List in routing order) Office Initials Date 1. County Attorney Office County Attorney Office JAB 9/24/13 2. BCC Office Board of County Commissioners G�\ -` ,Z`( 3 3. Minutes and Records Clerk of Court's Office �l o t3 �"SI a/I 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 rnntart staff for additional or missing information. Name of Primary Staff Jennifer A. Belpedio, Assistant County Attorney Phone Number 252 -840 Contact / Department appropriate. (Initial) Agenda Date Item was 9/24/13 Agenda Item Number I LB Approved by the BCC 2. Does the document need to be sent to another agency for additional signatures? If yes, Type of Document Letter of Agreement ($3,644,150) Number of Original 2 Attached Letter of Agreement ($1,769,118) Documents Attached 2 ✓ / Agreement (Collier County and Naples HMA) signed by the Chairman, with the exception of most letters, must be reviewed and signed 3 ✓ (NOTE: Other Agreements approved as part of this item by the Office of the County Attorney. will be routed separately.) All handwritten strike - through and revisions have been initialed by the County Attorney's PO number or account n/a Office and all other parties except the BCC Chairman and the Clerk to the Board number if document is 5. The Chairman's signature line date has been entered as the date of BCC approval of the JAB to be recorded document or the final negotiated contract date whichever is applicable 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? JAB 2. Does the document need to be sent to another agency for additional signatures? If yes, JAB 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 JAB 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 JAB 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 JAB 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 JAB s4 mature and initials are required. 7. in most cases (some contracts are an exception), the original document and this routing slip JAB 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 9/24/13 and allals made during the JAB meeting have been incorporated in the attached document. The County Attorney's Office-has reviewed the changes, if applicable. l 9. Initials of attorney verifying that the attached document is the v ion approved by the JA BCC, all changes directed by the BCC have been made, and the document is ready for the Chairman's signature. I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05; Revised 11/30/12 118 MEMORANDUM Date: September 30, 2013 To: Jennifer A. Belpedio, Assistant County Attorney County Attorney's Office From: Ann Jennejohn, Deputy Clerk Minutes & Records Department Re: Letters of Agreement with the Agency for Health Care Administration to allow participation in the alternative intergovernmental transfer programs (IGT) Attached and requiring further execution are four (4) original copies of the two (2) Letters of Agreement (Item #1113) approved by the Board of County Commissioners on Tuesday, September 24, 2013. After the agreements have been signed by the State if you would please return one original copy of each agreement to the Minutes and Records Department we will have a complete original copy for the Board's Official Record. Thank you. If you have any questions, please contact me at 252 -8406. Thank you. Attachments (4) Letter of Agreement ,; V, THIS LETTER OF AGREEMENT made and entered into in duplicate on the Q LA- day of Sept -. 2013, by and between Collier County (the County), and the State of Florida, through its Agency for Health Care Administration (the Agency), 1. Per Senate Bill 1500, the General Appropriations Act of State Fiscal Year 2013 -2014, passed by the 2013 Florida Legislature, County and the Agency, agree that County will remit to the State an amount not to exceed a grand total of $3,644,150. 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. The Disproportionate Share Hospital (DSH) program. ii. The removal of outpatient reimbursement ceilings for teaching, specialty and community hospital education program hospitals. iii. The removal of outpatient reimbursement ceilings for hospitals whose charity care and Medicaid days as a percentage of total adjusted hospital days equals or exceeds 11 percent. iv. The removal of outpatient reimbursement ceilings for hospitals whose Medicaid days, as a percentage of total hospital days, exceed 7.3 percent, and are trauma centers. v. Inpatient DRG add -ons for teaching, specialty, children's, public and community hospital education program hospitals; hospitals whose charity care and Medicaid days as a percentage of total adjusted hospital days equals or exceeds 11 percent; or hospitals whose Medicaid days, as a percentage of total hospital days, exceed 7.3 percent, and are trauma centers. vi. The annual cap increase on outpatient services for adults from $500 to $1,500. vii. Medicaid Low Income Pool (LIP) payments to rural hospitals, trauma centers, specialty pediatric hospitals, primary care services and other Medicaid participating safety -net hospitals. viii. Medicaid LIP payments to hospitals in the approved appropriations categories. ix. Medicaid LIP payments to Federally Qualified Health Centers. x. Medicaid LIP payments to Provider Access Systems (PAS) for Medicaid and the uninsured in rural areas. 9 118 A. 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 $3,644,150. The County will transfer payments to the State in the following manner: a. The first quarterly payment in an amount not to exceed $911,039 for the months of July, August, and September is due upon notification by the Agency. b. Each successive payment in an amount not to exceed $911,037 is due as follows, November 30, 2013, March 31, 2014 and June 15, 2014. c. The State will bill the County each quarter payments are due. 3. Timelines: This agreement must be signed, submitted, and received to the Agency no later than October 1, 2013, for self- funded exemptions, buybacks and DRG add -ons, to be effective for SFY 2013 -2014. 4. Attached are the DSH and LIP schedules reflecting the anticipated annual distributions for State Fiscal Year 2013 -2014. 5. 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 Letter of Agreement. 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. 6. The County and the State agree that any modifications to this Letter of Agreement shall be in the same form, namely the exchange of signed copies of a revised Letter of Agreement. 7. 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. 8. 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. 9. The Agency will reconcile the difference between the amount of the IGTs used by or on behalf of individual hospitals' buybacks of their Medicaid inpatient and outpatient trend adjustments or exemptions from reimbursement limitations for SFY 2012 -13 and an estimate of the actual annualized benefit derived based on actual days and units of service provided. Reconciliation amount may be incorporated into current year (SFY 2013 -14) LOAs. 10. This Letter of Agreement covers the period of July 1, 2013 through June 30, 2014 and shall be terminated June 30, 2014. 2 11B WITNESSETH: IN WITNESS WHEREOF the parties have duly executed this Letter of Agreement on the day and year above first written. State of Florida Stacey Lampkin Acting Assistant Deputy Secretary for Medicaid Finance, Agency for Health Care Administration C,!&n?,C ►fl !-i 1 L LF fZiESQ . Name C- VA A R VJ O ,nn A "J Title Approved as to form and legality ATTM. � fE 4ork Assistant County ttorney By' �x v%' 3 bJ 118 Automatic DRG Add -On Self- Funded DRG Add -On $3,644,150 Total Funding$3,644,150, 4 11B Letter of Agreement THIS LETTER OF AGREEMENT made and entered into in duplicate on the ay 4- day of 5ePt-2013, by and between Collier County (the County), and the State of Florida, through its Agency for Health Care Administration (the Agency), 1. Per Senate Bill 1500, the General Appropriations Act of State Fiscal Year 2013 -2014, passed by the 2013 Florida Legislature, County and the Agency, agree that County will remit to the State an amount not to exceed a grand total of $1,769,118. 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. The Disproportionate Share Hospital (DSH) program. ii. The removal of outpatient reimbursement ceilings for teaching, specialty and community hospital education program hospitals. iii. The removal of outpatient reimbursement ceilings for hospitals whose charity care and Medicaid days as a percentage of total adjusted hospital days equals or exceeds 11 percent. iv. The removal of outpatient reimbursement ceilings for hospitals whose Medicaid days, as a percentage of total hospital days, exceed 7.3 percent, and are trauma centers. v. Inpatient DRG add -ons for teaching, specialty, children's, public and community hospital education program hospitals; hospitals whose charity care and Medicaid days as a percentage of total adjusted hospital days equals or exceeds 11 percent; or hospitals whose Medicaid days, as a percentage of total hospital days, exceed 7.3 percent, and are trauma centers. vi. The annual cap increase on outpatient services for adults from $500 to $1,500. vii. Medicaid Low Income Pool (LIP) payments to rural hospitals, trauma centers, specialty pediatric hospitals, primary care services and other Medicaid participating safety -net hospitals. viii. Medicaid LIP payments to hospitals in the approved appropriations categories. ix. Medicaid LIP payments to Federally Qualified Health Centers. x. Medicaid LIP payments to Provider Access Systems (PAS) for Medicaid and the uninsured in rural areas. 0 11B A. 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 $1,769,118. The County will transfer payments to the State in the following manner: a. The first quarterly payment in an amount not to exceed $442,281 for the months of July, August, and September is due upon notification by the Agency. b. Each successive payment in an amount not to exceed $442,279 is due as follows, November 30, 2013, March 31, 2014 and June 15, 2014. c. The State will bill the County each quarter payments are due. 3. Timelines: This agreement must be signed, submitted, and received to the Agency no later than October 1, 2013, for self- funded exemptions, buybacks and DRG add -ons, to be effective for SFY 2013 -2014. 4. Attached are the DSH and LIP schedules reflecting the anticipated annual distributions for State Fiscal Year 2013 -2014. 5. 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 Letter of Agreement. 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. 6, The County and the State agree that any modifications to this Letter of Agreement shall be in the same form, namely the exchange of signed copies of a revised Letter of Agreement. 7. 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. B. 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. 9. The Agency will reconcile the difference between the amount of the IGTs used by or on behalf of individual hospitals' buybacks of their Medicaid inpatient and outpatient trend adjustments or exemptions from reimbursement limitations for SFY 2012 -13 and an estimate of the actual annualized benefit derived based on actual days and units of service provided. Reconciliation amount may be incorporated into current year (SFY 2013 -14) LOAs. 10. This Letter of Agreement covers the period of July 1, 2013 through June 30, 2014 and shall be terminated. June 30, 2014. 2 118 WITNESSETH: IN WITNESS WHEREOF the parties have duly executed this Letter of Agreement on the day and year above first written. State of Florida Stacey Lampkin Acting Assistant Deputy Secretary for Medicaid Finance, Agency for Health Care Administration � �c� (Z � ► A � . H t LL�2, � SQ Name C. A A � 2 ►n) o � � Title T 3' cX. �CSi A Approved as to form and lcplity c oU� Assistant County A om S� ,.� ry ► Ff ct -A . 6 3 �q 118 Loc'6[ Government Intergovernmental Transfers.; Pro rarii'i�L Amount ' State Fiscal .Year 2013;2014 S.0 ,_. Iemental Payments LIP DSH Nursing Home SMP Out atient Amounts_ Automatic Buyback Self- Funded Buyback Automatic Exemption Self- Funded Exemption SWI g' 9n atient Amounts' Automatic DRG Add -On Self- Funded DRG Add -On $1,769,118 Total' Fundin $1;769 ",118 Id �q 1113 1 MEMORANDUM Date: September 30, 2013 To: Jennifer A. Belpedio, Assistant County Attorney Collier County Attorney's Office From: Ann Jennejohn, Deputy Clerk Minutes & Records Department Re: Agreement between Collier County and Physician's Regional HealthCare System Attached are two (2) original copies of the agreement referenced above, (Item #1113) approved by the Board of County Commissioners on Tuesday, September 24, 2013. The third original will be held on file with the Minutes and Record's Department for the Board's Official Record. Thank you If you have any questions, please contact me at 252 -8406. Thank you. Attachments (2) 116 AGREEMENT THIS AGREEMENT is made and entered into on September 24, 2013 by and between Collier County, Florida, a political subdivision of the State of Florida, hereinafter referred to as "the County" and Naples HMA, L.L.C. d /b /a as Physicians Regional HealthCare System, a Florida Limited liability company, hereinafter referred to as "the Hospital ". 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; and WHEREAS, The establishment and maintenance of such programs are in the common interest of the people of Collier County: and WHEREAS, The County desires the Hospital to become a Community Health partner to assist in providing payments for health prevention programs, and mental health services to residents of the County, where no existing state or federal resources are available; and WHEREAS, The Hospital 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 Hospital shall provide documentation and quarterly reports to the County that support Hospital's expenditures for the reimbursement to Collier partners as stated immediately below for the delivery of services, designated primary health care services, specialty health care services and other health care services such as, but not limited to, the following services: a. Immunization program provided by the Collier County Health Department b. AIDS Prevention Program provided by the Collier County Health Department c. Tuberculosis Program provided by the Collier County Health Department d. Communicable Disease Program provided by the Collier County Health Department e. Child Health Program provided by the Collier County Health Department f. Healthy Start Prenatal Program provided by the Foundation for Women's Health g. School Health Program provided by the Collier County Health Department h. Adult Health Program provided by the Collier County Health Department i. Dental Program provided by the Collier County Health Department j. Community Mental Health Services provided by the David Lawrence Center, Inc. k. Other health related programs and services. ARTICLE II PAYMENTS 1. The County shall make Intergovernmental Transfers, on behalf of the Hospital, in connection with the State's Medicaid Programs — specifically the self funding of inpatient DRG payments and buyback of the Medicaid outpatient trend adjustments - to the State of Florida in accordance with 1 2013 Agreement with Naples HMA /IGT 0 11B the Letter(s) of Agreement between the County and the Agency for Health Care Administration (AHCA). 2. There are no pre- arranged agreements (contractual or otherwise) between the County and the Hospital to re- direct any portion of Medicaid supplemental payments in order to satisfy non - Medicaid activities. 3. The following document is hereby incorporated by reference as an attachment to this Agreement: Letter of Agreement with AHCA - Attachment A ARTICLE III CLAIMS VALUATION AND CLAIMS PROCESSING As the claims processing entity, the Hospital will provide quarterly financial reports to the County in such detail as required by the County. ARTICLE IV TERMS OF AGREEMENT AND TERMINATION 1. The term of this Agreement shall be October 1, 2013 through September 30, 2014. 2. Either party may terminate this Agreement thirty (30) calendar days after receipt by the other party of written notice of intent to terminate. 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, facsimile, 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. ARTICLE V ASSIGNMENT The Hospital 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 Hospital shall be allowed to assign or transfer this Agreement or any of the Hospital's obligations hereunder to affiliates or wholly owned subsidiaries of the Hospital. This Agreement shall run to the County and its successors. ARTICLE VI SUBCONTRACTING The parties agree that the Hospital shall be permitted to execute subcontracts for the purchase by the Hospital 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 Hospital expressly 2 2013 Agreement with Naples HMA /IGT CAO kA 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 Hospital 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 Hospital'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. Hospitals 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 Hospital 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 Hospital shall purchase all policies of insurance from a financially responsible insurer duly authorized to do business in the State of Florida. The Hospital 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 County shall provide the Hospital with invoices pursuant to this Agreement once the County has verified the validity of the invoices to be paid by the Hospital. The Hospital will not pay any invoices prior to the County's approval. The Hospital shall make payments on a voluntary basis in the amount of $929,062 to specific healthcare programs and services, such as the mental health programs of the David Lawrence Center, specified health programs of the Collier County Health Department, and other social service providers that are pre- approved by the County for payment. The Hospital shall use reasonable efforts to pay invoices approved by the County within thirty (30) days of County approval. Payments shall be made in accordance with this Agreement irrespective of whether Hospital has received funds from AHCA. If the amount invoiced to Hospital does not result in the amount of $929,062 the Hospital will credit County for the difference and voluntarily make those payments to providers elected by County upon invoice by the County in Year 2014 -2015. 3 2013 Agreement with Naples HMA /IGT CA 0) ARTICLE IX 11B RECORDS The Hospital 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 Hospital 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 Hospital 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 Hospital 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 Hospital 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 provision 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 Hospital 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 Hospital and /or its sub - contractor agrees to comply with all applicable requirements and guidelines prescribed by the County for recipients of funds. 5. The Hospital and /or its sub - contractor agree to safeguard the privacy of information pursuant to the Health Insurance Portability and Accountability Act of 1996 (HIPAA). 4 2013 Agreement with Naples HMA /IGT lie IN WITNESS WHEREOF, the parties have executed this Agreement on the dates first written above. ATTEST: DWIGHT E. BROCK, CLERK Y:, UTY CLERK ]Aftt 6 0 A.- i a fo'r fot n and''legality: Jennifer A. Belpedio a,5��� Assistant County Attorney Ck 2013 Agreement with Naples HMA /IGT BOARD OF COUNTY COMMISSIONERS OF COLLIER O P By: GEOR A. HILLER, ESQ. CHAIRWOMAN 5 Naples HMA, LLC., d /b /a Physicians Regional Healthcare System, a Florida limited liability company Title: ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP .I TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO I B- 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. 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 Addressees (List in routing order) Office Initials Date 1. County Attorney Office County Attorney Office JAB 10/21/13 2. BCC Office Board of County Commissioners Agenda Item Number 11.13 3. Minutes and Records Clerk of Court's Office JAB l 1.33gm 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 Jennifer A. Belpedio, Assistant County Attorney Phone Number 252 -840 Contact / Department a ro riate. Initial Applicable) Agenda Date Item was 9/24/13 V Agenda Item Number 11.13 Approved by the BCC Does the document need to be sent to another agency for additional signatures? If yes, JAB Type of Document Agreement(Collier County and David Lawrence) Number of Original 1 Attached Original document has been signed/initialed for legal sufficiency. (All documents to be Documents Attached PO number or account n/a number if document is by the Office of the County Attorney. to be recorded All handwritten strike - through and revisions have been initialed by the County Attorney's JAB t/ INSTRUCTIONS & CHECKLIST I: Forms/ County Forms/ BCC Forms / Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05; Revised 11/30/12 Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is Yes N/A (Not a ro riate. Initial Applicable) 1. Does the document require the chairman's original signature? JAB 2. Does the document need to be sent to another agency for additional signatures? If yes, JAB 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 JAB 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 JAB t/ 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 JAB 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 JAB signature and initials are required. 7. In most cases (some contracts are an exception), the original document and this routing slip JAB 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 9/24/13 and all changes made during the JAB meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes, if applicable. I 9. Initials of attorney verifying that the attached document is the version approved by the JAB BCC, all changes directed by the BCC have been made, and the document is ready for th 6 Chairman's signature. C - I: Forms/ County Forms/ BCC Forms / Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05; Revised 11/30/12 iiB " MEMORANDUM Date: October 29, 2013 To: Jennifer A. Belpedio, Assistant County Attorney County Attorney's Office From: Martha Vergara, Deputy Clerk Minutes & Records Department Re: Collier County & David Lawrence Agreement Attached for your records is a copy of document mentioned above, (Item #11B) approved by the Board of County Commissioners on Tuesday, September 24, 2013. The original document is being held in the Minutes and Records Department as part of the Board's Official Records. If you have any questions, please contact me at 252 -7240. Thank you. County of Collier CLERK OF THE`CIR'QUIT COURT Dwight E. Brock COLLIER COU1 TY COORTHOUSE Clerk of Courts 3315 TAMIAMI TRL E STE 102 , % P.O. BOX 413044 NAPLES, FLORIDA Yfi ; NAPLES, FLORIDA 34112 -5324 ;34101 -3044 t October 30, 2013 David Lawrence Mental Health Center, Inc. Attn: David C. Schimmel 6075 Bathey Lane Naples, Florida 34116 11 Clerk of Courts Accountant Auditor Custodian of County Funds Re: Agreement between Collier County & David Lawrence Mental Health Center, Inc. Transmitted herewith is a certified copy of the above referenced document for your records, as adopted by the Collier County Board of County Commissioners of Collier County, Florida on Tuesday, September 24, 2013, during Regular Session. Very truly yours, DWIGHT E. BROCK, CLERK Martha Vergara, Dej?uty C erk Enclosure Phone- (239) 252 -2646 Fax- (239) 252 -2755 Website-.www.CollierClerk.com Email- CollierClerk@collierclerk.com 11B 0 AGREEMENT THIS AGREEMENT is made and entered into this September 24, 2013 by and between Collier County, Florida, a political subdivision of the State of Florida, hereinafter referred to as "the County" and David Lawrence Mental Health Center, Inc. d /b /a David Lawrence Center, a Florida not - for - profit corporation, hereinafter referred to as "the Center". RECITALS: WHEREAS, Section 125.01(1)(e), Florida Statutes, authorizes the County to provide emergency medical services (EMS) for the residents of Collier County to the extent not inconsistent with general or special law; and WHEREAS, The establishment and maintenance of such programs are in the common interest of the people of Collier County; and WHEREAS, The County desires the Center to become a community health partner to assist with services to the uninsured and underinsured residents of the County, where no existing state or federal resources are available; and WHEREAS, The Center desires to be a community health partner and is willing to voluntarily provide financial assistance 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 CONTRIBUTION OF FUNDS The Center will provide a financial contribution or donation in the amount of $3,653,242 (three million six hundred fifty three thousand two hundred forty -two dollars) to the County to help offset the cost of EMS services to the uninsured and underinsured residents of the county. ARTICLE II PAYMENTS There are no pre- arranged agreements (contractual or otherwise) between the County and the Center to re- direct any portion of Medicaid supplemental payments in order to satisfy non - Medicaid services. ARTICLE III TERMS OF AGREEMENT AND TERMINATION 1. The term of this Agreement shall be October 1, 2013 through September 30, 2014. 2. Either party may terminate this Agreement thirty (30) calendar days after receipt by the other party of written notice of intent to terminate. 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, facsimile, 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. ARTICLE IV ASSIGNMENT I le The Center 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 V SUBCONTRACTING There are no subcontracts applicable to this Agreement. ARTICLE VI INSURANCE, SAFETY AND INDEMNIFICATION 1. Indemnity. To the maximum extent permitted by Florida law, David Lawrence Center 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 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. 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 aggregate 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 VII BILLING PROCEDURES The Center will make payment as noted in Article I of this Agreement, to the County on behalf of the EMS department. Payments will be made as follows: $1,826,621 on October 15, 2013, $913,311 on January 15, 2014, and $913,310 on May 15, 2014. ARTICLE VIII RECORDS The Center 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 K 118 is Center 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 IX 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. David Lawrence Center shall comply with Title VI of the Civil Rights Act of 1964 (42 USC 2000d) in regard to persons served. 4. David Lawrence Center shall comply with Title VII of the Civil Rights Act of 1964 (42 USC 2000c) in regard to employees or applicants for employment. 5. David Lawrence Center shall comply with Section 504 of the Rehabilitation Act of 1973 in regard to employees or applicants for employment and clients served. ARTICLE X OTHER CONDITIONS 1. Any alterations, variations, modifications or waivers of provision 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 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 agrees to comply with all applicable requirements and guidelines prescribed by the County for recipients of funds. 5. The Center agrees to safeguard the privacy of information pursuant to the Health Insurance Portability and Accountability Act of 1996 (HIPAA). SIGNATURE PAGE TO FOLLOW REMAINDER OF PAGE LEFT INTENTIONALLY BLANK 3 118 IN WITNESS WHEREOF, the parties have executed this Agreement on the dates for mentioned above. ATTEST: DWIGHir LERK By.,, Attu# as to 001 0 S D p ' nat� to only.' ,_� slg #! ATTEST: By: BOAR OU TY COM ISSIONERS COLLI R C N By: e . H' ler, Esq., irwoman The David Lawrence Mental Health Center, Inc. d /b /a David Lawrence Center By. Title: Approved as to form and legality Assistant County rney 4 I I BI cK '' Hospitals 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. (PLEASE PRINT CLEARLY) MEETING DATE �c i1fff+4_' /^ _ � , �1�7 AGENDA ITEM TITLE _L--f , T A-,q q, Agenda Item # _Z1 1-3 (Circle Meeting Type) Regular Special Workshop Budget NAME &1k 5,e Cttf,51 � ADDRESS f _ Representing/ Petitioner: _ 4 LL�fl7�g�... Other: COLLIER COUNTY ORDINANCE NO. 2003 -53, AS AMENDED BY ORDINANCE 2004 -05 AND 2007 -24, REQUIRES THAT ALL LOBBYISTS SHALL, BEFORE ENGAGING IN ANY LOBBYING ACTIVITIES (INCLUDING, BUT NOT LIMITED TO, ADDRESSING THE BOARD OF COUNTY COMMISSIONERS), REGISTER WITH THE CLERK TO THE BOARD AT THE BOARD MINUTES AND RECORDS DEPARTMENT. YOU ARE LIMITED TO THREE (3) MINUTES FOR YOU COMMENTS AND ARE TO ADDRESS ONLY THE CHAIR PLACE COMPLETED FORM ON THE TABLE LEFT OF THE DIAS IN THE BOARD ROOM PRIOR TO THE SUBJECT BEING HEARD (PLEASE PRINT CLEARLY) MEETING DATE jr�� %�+1V! " , 2V1 Agenda Item # /% 13 (Circle Meeting Type) Regular Special Workshop Budget AGENDA ITEM TITLE C.' z -//,f- NAME 0A ADDRESS t Representing /Petitioner; C // _ Other: COLLIER COUNTY ORDINANCE NO. 2003 -53, AS AMENDED BY ORDINANCE 2004 -05 AND 2007 -24, REQUIRES THAT ALL LOBBYISTS SHALL, BEFORE ENGAGING IN ANY LOBBYING ACTIVITIES (INCLUDING, BUT NOT LIMITED TO, ADDRESSING THE BOARD OF COUNTY COMMISSIONERS), REGISTER WITH THE CLERK TO THE BOARD AT THE BOARD MINUTES AND RECORDS DEPARTMENT. YOU ARE LIMITED TO THREE (3) MINUTES FOR YOU COMMENTS AND ARE TO ADDRESS ONLY THE CHAIR PLACE COMPLETED FORM ON THE TABLE LEFT OF THE DIAS IN THE BOARD ROOM PRIOR TO THE SUBJECT BEING HEARD (PLEASE PRINT CLEARLY) MEETING DATE Agenda Item # /% 29 (Circle Meeting Type) Regular Special Workshop Budget AGENDA ITEM TITLE ^4 — NAME ADDRESS -- .._........_. !! Representing/ Petitioner: '7 'u, a i Other: COLLIER COUNTY ORDINANCE NO. 2003 -53, AS AMENDED BY ORDINANCE 2004 -05 AND 2007 -24, REQUIRES THAT ALL LOBBYISTS SHALL, BEFORE ENGAGING IN ANY LOBBYING ACTIVITIES (INCLUDING, BUT NOT LIMITED TO, ADDRESSING THE BOARD OF COUNTY COMMISSIONERS), REGISTER WITH THE CLERK TO THE BOARD AT THE BOARD MINUTES AND RECORDS DEPARTMENT. YOU ARE LIMITED TO THREE (3) MINUTES FOR YOU COMMENTS AND ARE TO ADDRESS ONLY THE CHAIR PLACE COMPLETED FORM ON THE TABLE LEFT OF THE DIAS IN THE BOARD ROOM PRIOR TO THE SUBJECT BEING HEARD (PLEASE PRINT CLEARLY) MEETING DATE AGENDA ITEM TITLE Agenda Item # (Circle Meeting Type) Regular Special Workshop Budget NAME ( I U/1 !j �fJ' oy ADDRESS Representing/ Petitioner: ! U C�/i Other: COLLIER COUNTY ORDINANCE NO, 2003 -53, AS AMENDED BY ORDINANCE 2004 -05 AND 2007 -24, REQUIRES THAT ALL LOBBYISTS SHALL, BEFORE ENGAGING IN ANY LOBBYING ACTIVITIES (INCLUDING, BUT NOT LIMITED TO, ADDRESSING THE BOARD OF COUNTY COMMISSIONERS), REGISTER WITH THE CLERK TO THE BOARD AT THE BOARD MINUTES AND RECORDS DEPARTMENT. YOU ARE LIMITED TO THREE (3) MINUTES FOR YOU COMMENTS AND ARE TO ADDRESS ONLY THE CHAIR PLACE COMPLETED FORM ON THE TABLE LEFT OF THE DIAS IN THE BOARD ROOM PRIOR TO THE SUBJECT BEING HEARD 11B