Backup Documents 12/01/2009 Item #16D1
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 0 1
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 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
exception of the Chairman's si2Jlature, draw a line throueh routine lines #1 throul!:h #4, comolete the checklist, and forward to Sue Filson line #5).
Route to Addressee(s) Office Initials Date
(List in routinp; order)
L Terri Daniels Housing and Human Services 12/04/09
2,
3.
4.
5. Ian Mitchell, Manager Board of County Commissioners .C'\- 11("6(09
6, Minutes and Records Clerk ofCourl's Office
PRIMARY CONTACT INFORMATION
(The primary contact is the holder of the original document pending Bee 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 statTfor additional or missing
information. All original documents needing the BCC Chairman's signature are to be delivered to the Bee office only after the Bee has acted to approve the
item.)
Name of Primary Staff Terri Daniels Phone Number 252-2689
Contact
Agenda Date Item was Agenda Item Number 16Dl
Approved bv the BCC December 1, 2009
Type of Document ARCA LIP Agreement 2009-10 (Major) Number of Original 3
Attached Documents Attached
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark "N/ A" in the Not Applicable column, whichever is
a r riate.
Original document has been signed/initialed for legal sufficiency, (All documents to be
signed by the Chainnan, with the exception of most letters, must be reviewed and signed 1#'
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
Chainnan and Clerk to the Board and ossibl State Officials.
All handwritten strike-through and revisions have been initialed by the County Attorney's
Office and all other arties exce t the BCC Chairman and the Clerk to the Board
The Cbainnan's signature line date has been entered as the date ofBCC approval of the
document or the final ne otiated contract date whichever is a licable.
"Sign here" tabs are placed on the appropriate pages indicating where the Chairman's
si nature and initials are re uired.
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 BCe's actions are nullified. B r our deadlines!
Tbe document was approved by the BCC on (enter date) and all changes
made during the meeting bave been incorporated n e ttached document. The
Coun Attorne 's Office has reviewed the chan es, if a Iicable.
1.
2.
3,
4,
5,
6,
N/A(Not
A licable)
11
I: Forms! County Forms! Bee Forms! Original Documents Routing Slip WWS Original 9.03.04, ReVised 1.26.05, Revised 2.24.05
16D I
MEMORANDUM
Date:
December 8, 2009
To:
Terri Daniels, Grants Supervisor
Human Services Department
From:
Martha Vergara, Deputy Clerk
Minutes & Records Department
Re:
AHCA LIP Agreement 2009-10 (Major)
Attached, please find two (2) original as referenced above (Agenda
Item #16D1), approved by the Board of County Commissioners on
Tuesday, December 1,2009.
Please return any fully executed original documents back to the
Minutes & Records Department for the Board's Official Record.
If you should have any questions, please call 252-7240.
Thank you.
160 1
Letter of Agreement
~ THIS LETTER OF AGREEMENT made and entered into in duplicate on the L day
of vet. 2009, 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 2600, the General Appropriations Act of State Fiscal Year 2009-2010,
passed by the 2009 Florida Legislature, County and the Agency, agree that County will remit
to the State an amount not to exceed a grand total of $2,221 ,077.
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 2009-10
160 1
2. The County will pay the State an amount not to exceed the grand total amount of
$2,221,077. The County will transfer payments to the State in the following manner:
a) The first quarterly payment of $555,270 for the months of July, August,
and September is due upon notification by the Agency.
b) Each successive payment of $555,269 is due no later than, December 31,
2009, March 31, 2010 and June 15, 2010.
c) The State will bill the County each quarter payments are due.
3. Attached are the DSH and LI P schedules reflecting the anticipated annual distributions for
State Fiscal Year 2009-2010.
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 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,
5. 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.
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,
8. This Letter of Agreement covers the period of July 1, 2009 through June 30, 2010.
Letter of Agreement for SFY 2009-10
160 1
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
BOARD OF COUNTY COMMISSIONERS
COLLIER CO YfjITY, FLORIDA
I{ !
I U. ,',
By: 11.7 h?-r". 'J.(<1..k:.r.,
Donna Fiala, Chairman
Board of County Commissioners
Attest aite'dII"-^,
s1\lf1.t...... 0111'
Date: December 1, 2009
STATE OF FLORIDA:
Approved as to form and
legal sufficiency
By:
~~
Assistant County Attorney
Collier County
Phil E. Williams
Assislant Deputy Secretary for Medicaid Finance
Agency for Health Care Administration
Date: December 1 2009
Item # lli.J) I
Agenda ~ ,{ JOt
Date ~
Date 1?.J '1 1&7
Rec'd -~
Letter of Agreement for SFY 2009.10
16D 1
Local Government Intergovernmental Transfers
Proaram I Amount State Fiscal Year 2009-2010
DSH
LIP 2,221,077
Exemptions
Statewide Issues
Nursing Home SMP
Total Fundina $2,221,077
Letter of Agreement for SFY 2009-10