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Backup Documents 09/14/2010 Item #16D 4ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 b 0 TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 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,Oftice only fa ter the Board has taken action on the item J 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 exception of the Chairman's signature, draw a line through routing lines #1 through #4, complete the checklist, and forward to Sue Filson (line #5). Route to Addressee(s) List in routing order Office Initials Date 1. Terri Daniels Housing, Human and Veteran Services (Initial ) 9/17/10 2. September 14, 2010 Agenda Item Number 16D4 3. signed by the Chairman, with the exception of most letters, must be reviewed and signed 4. Ian Mitchell, Manager Board of County Commissioners Number of Original 3 5. Minutes and Records Clerk of Court's Office Documents Attached PRIMARY CONTACT INFORMATION (The primary contact is the holder of the original document pending 13CC 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.) Name of Primary Staff Terri Daniels Phone Number 252 -2689 Contact appropriate. (Initial ) Applica ble) Agenda Date Item was September 14, 2010 Agenda Item Number 16D4 Approved by the BCC signed by the Chairman, with the exception of most letters, must be reviewed and signed Type of Document Agreement- Agency for Health Care Number of Original 3 Attached Administration Documents Attached INSTRUCTIONS & CHECKLIST I: Forms/ County Forms/ BCC Forms / Original Documents Routing Slip W WS 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 ) Applica ble) 1. Original document has been signed/initialed for legal sufficiency. (All documents to be 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, v+ 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 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 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 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 Sue Filson 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 awar of our deadlines! 6. The document was approved by the BCC on (enter date) and all changes made during the meeting have been incorpora e i t e attached document. The County Attorney's Office has reviewed the changes, if applicable. I: Forms/ County Forms/ BCC Forms / Original Documents Routing Slip W WS Original 9.03.04, Revised 1.26.05, Revised 2.24.05 16D MEMORANDUM Date: September 23, 2010 To: Terri Daniels, Grants Supervisor Human Services Department From: Martha Vergara, Deputy Clerk Minutes & Records Department Re: Agreement — Agency for Health Care Administration Attached, please find one (3) original as referenced above (Agenda Item #16D4), approved by the Board of County Commissioners on Tuesday, September 14, 2010. Please return a fully executed copy once all signatures have been obtained for the Board's permanent records. If you should have any questions, please call 252 -7240. Thank you 16D Letter of Agreement THIS LETTER OF AGREEMENT made and entered into in duplicate on the 14th day of September 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 $2,488,228. 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. 16D The County will pay the State an amount not to exceed the grand total amount of $2,488,228. The County will transfer payments to the State in the following manner: a) The first quarterly payment of $622,057 for the months of July, August, and September is due upon notification by the Agency. b) Each successive payment of $622,057 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. 160 WITNESSETH: IN WITNESS WHEREOF the parties have duly executed this Letter of Agreement on the day and year above first written. ATTEST: DWIGHT E. BROCK, Clerk Bfs y Clerk Ato Ow I i t 'watwo M'1 Approved as to form and legal sufficiency Assis nt County Attorney��� Collier County BOARD OF COUNTY COMMISSIONERS COLLIER COUNTY. FLORIDA By' yT Fred W. Coyle, Chairman,J Board of County Commissioners Date: September 14, 2010 STATE OF FLORIDA: M Phil E. Williams Assistant Deputy Secretary for Medicaid Finance Agency for Health Care Administration Date: September 14, 2010 Local Government Inter overnmental Transfers Program / Amount State Fiscal Year 2010 -2011 DSH LIP, Exemptions & SWI $2,488,228 Nursing Home SMP Total Funding $2,488,228 160 4 4