Backup Documents 11/09/2010 Item #16D 3V1&11y11'gt1L LIVl.1LJ1vli11'1 I t,t1i'i1.111�10 1 " 1mV V 1 ju"ff C7Lkl L n 3
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO (.� u
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. Original documents should be hand delivered to the Board Office. The completed routing slip and original
documents are to be forwarded to the Board Office only after the Board has taken action on the item.
ROUTING SLIP
Complete routing lines #1 through #4 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the
c.,,e Are,,, A li— thrro,vh miltina line-,z #1 thmnvh #4_ mmnlete the checklist and forward to Sue Filson (line #5).
Route to Addressee(s)�
List in routing order
Office
Initials
Date
1. Marcy Krumbine
Housing ,Human and Veteran
Services
(Initial)
Applicable)
2. Fred Coyle
BCC
Agenda Item Number
16D3
3.Jennifer White
CAO
4.
agreements
Number of Original
2
5. Ian Mitchell, Executive Manager
Board of County Commissioners
I Documents Attached
t0 lb
6. Minutes and Records
Clerk of Court's Office
PRIMARY CONTACT INFORMATION
(The primary contact is the holder of the original document pending BCC approval. 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, including Sue Filson, need to contact staff for additional or missing
information. All original documents needing the BCC Chairman's signature are to be delivered to the BCC office only after the BCC has acted to approve the
item 1
Name of Primary Staff
Marcy Krumbine, Director
Phone Number
252 -8442
Contact
appropriate.
(Initial)
Applicable)
Agenda Date Item was
11/9/10
Agenda Item Number
16D3
Approved by the BCC
signed by the Chairman, with the exception of most letters, must be reviewed and signed
Type of Document
agreements
Number of Original
2
Attached
I
I Documents Attached
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
Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is
Yes
N/A (Not
appropriate.
(Initial)
Applicable)
1.
Original document has been signed/initialed for legal sufficiency. (All documents to be
yes
signed by the Chairman, with the exception of most letters, must be reviewed and signed
by the Office of the County Attorney. This includes signature pages from ordinances,
resolutions, etc. signed by the County Attorney's Office and signature pages from
contracts, agreements, etc. that have been fully executed by all parties except the BCC
Chairman and Clerk to the Board and possibly State Officials.
2.
All handwritten strike - through and revisions have been initialed by the County Attorney's
n/a
Office and all other parties except the BCC Chairman and the Clerk to the Board
3.
The Chairman's signature line date has been entered as the date of BCC approval of the
yes
document or the final negotiated contract date whichever is applicable.
4.
"Sign here" tabs are placed on the appropriate pages indicating where the Chairman's
yes
signature and initials are required.
5.
In most cases (some contracts are an exception), the original document and this routing slip
should be provided to Ian Mitchell in the BCC office within 24 hours of BCC approval.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified; Be aw a of your deadlines!
6.
The document was approved by the BCC on I ION U&d all changes made during the
meeting have been incorporated in the attacheA ddci ut. The County Attorney's
Office has reviewed the changes, if applicable.
I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05
16D3
MEMORANDUM
Date: December 13, 2010
To: Marcy Krumbine, Director
Housing, Human and Veteran Services
From: Ann Jennej ohn, Deputy Clerk
Minutes & Records Department
Re: Revised agreement with the State of Florida's
Agency for Health Care Administration to
participate in Medicaid's Low Income Pool
Program with services provided by Housing,
Human and Veteran Services
Attached are two original agreements, referenced above (Item #16D3)
approved by the Board of County Commissioners November 9, 2010.
After forwarding to for further processing please return an original
agreement to the Minutes and Records Department so a complete record
is on file for the Board of County Commissioners.
Thank you.
Attachment (2)
16D3
Letter of Agreement
, T � HIS LETTER OF AGREEMENT made and entered into in duplicate on the "day
of �q` - _ 2010, by and between Collier County (the County), 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 2010 -2011,
passed by the 2010 Florida Legislature, County and the Agency, agree that County will remit
to the State an amount not to exceed a grand total of $2,270,911.
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 inpatient and outpatient reimbursement ceilings for
teaching, specialty and community hospital education program
hospitals.
iii. The removal of inpatient and 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 inpatient and outpatient reimbursement ceilings for
hospitals whose Medicaid days, as a percentage of total hospital
days, exceed 7.3 percent, and are trauma centers.
v. Increase the annual cap on outpatient services for adults from $500 to
$1,500.
vi. Medicaid Low Income Pool (LIP) payments to rural hospitals, trauma
centers, specialty pediatric hospitals, primary care services and other
Medicaid participating safety -net hospitals.
vii. Medicaid LIP payments to hospitals in the approved appropriations
categories.
viii. Medicaid LIP payments to Federally Qualified Health Centers.
ix. Medicaid LIP payments to Provider Access Systems (PAS) for
Medicaid and the uninsured in rural areas.
x. Medicaid LIP payments for the expansion of primary care services to
low income, uninsured individuals.
Letter of Agreement for SFY 2010 -11
16D3
2. The County will pay the State an amount not to exceed the grand total amount of
$2,270,911. The County will transfer payments to the State in the following manner:
a) The first quarterly payment of $567,730 for the months of July, August,
and September is due upon notification by the Agency.
b) Each successive payment of $567,727 is due as follows, November 1,
2010, March 31, 2011 and June 15, 2011.
c) The State will bill the County each quarter payments are due.
3. The enhanced FMAP is in effect for the first six months of SFY 2010 -11. Any payments
made by the Agency on or after January 1, 2011, will not be eligible for the enhanced
FMAP. Therefore, the County will be responsible for funding the State share required as a
result of the reduced FMAP. If funding is not adequate due to the FMAP change, the State
will reduce the rate to the level of funded by the County.
4. Timelines: This agreement must be signed and submitted to the Agency no later than May
31, 2011, to be effective for SFY 2011.
5. Attached are the DSH and LIP schedules reflecting the anticipated annual distributions for
State Fiscal Year 2010 -2011.
6. 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.
7. 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.
8. 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.
9. 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.
10. This Letter of Agreement covers the period of July 1, 2010 through June 30, 2011.
Letter of Agreement for SFY 2010 -11
1603
WITNESSETH:
IN WITNESS WHEREOF the parties have duly executed this Letter of Agreement on the day
and year above first written.
ATTEST:
DWIGHT E.,BRQCK, Clerk
BY ea
•y 9
4
Approved as to form and
legal sufficiency:
Jennifer FWhite
Assistant County Attorney
Letter of Agreement for SFY 2010 -11
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
By:
FRED W. COYLE, CHAIRMAN
STATE OF FLORIDA:
Phil E. Williams
Assistant Deputy Secretary for Medicaid Finance
Agency for Health Care Administration