Agenda 10/14/2008 Item #16D17Agenda Item No. 16017
October 14, 2008
Page 1 of 6
EXECUTIVE SUMMARY
Recommendation that the Board of County Commissioners approve and authorize the
Chairman to sign an agreement with the Agency for Health Care Administration in the
amount of $78,050 to be used as the local government match for State and Federal funding
to operate the Horizon's Primary Care Center.
OBJECTIVE: That the Board of County Commissioners approve and authorize the Chairman
to sign an agreement with the Agency for Health Care Administration (AHCA) to participate in
the Medicaid Low Income Pool (LIP) program, thus leveraging State and Federal dollars with
existing local funds.
CONSIDERATIONS: The Agency for Health Care Administration (AHCA) the State entity
that provides Medicaid services in Florida, offers a pro-rain that leverages local and State funds
with Federal matching dollars to enhance services to low- income individuals through special
Medicaid payments. Collier County Government has participated in this program for the last four
years by contributing matching funds to the Agency for Health Care Administration to operate
the Horizons Primary Care Center. The clinic currently provides adult, pediatric, and family
health care services.
Upon approval from the Board of County Commissioners, local government funds will be
,._ transferred to AHCA as an intergovernmental transfer (IGT) in the amount of $78,050. Those
funds will then be matched with $156,100 in State general revenue, which in turn will generate
an additional $193,900 in Federal matching funds.
FISCAL IMPACT: Local matching funds for the entire amount are available in the Housing
and Human Services FY09 budget for this program. Participation in the Low Income Payment
(LIP) Program will provide an additional $350,000 in State and Federal resources to operate the
Horizon's Primary Care Center.
LEGAL CONSIDERATIONS: This item has been reviewed by the County Attorney's Office
and is legally sufficient for Board action. - CMG
GROWTH MANAGEMENT IMPACT: There is no growth management impact associated
with this executive summary.
RECOMMENDATION: Staff recommends that the Board of County Commissioners approve
and authorize the Chairman to sign the agreement with the Agency for Health Care
Administration in the amount of $78,050.
Prepared by: Terri Daniels, Accounting Supervisor, Housing and Human Services Department
Agenda Item No. 16D17
October 14, 2006
Page 2 of 6
Letter of Agreement
THIS LETTER OF AGREEMENT made and entered into in duplicate on the 14th
day of October 2008, 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 2008 -2009,
passed by the 2008 Florida Legislature, County and the Agency, agree that County will remit
to the State an amount not to exceed a grand total of $78,050.
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 health 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 2008 -09
Collier Health Services
Agenda item No. 15517
October 14, 20CIS
F'aae .yc
2. The County will pay the State an amount not to exceed the grand total amount of $78,050.
The County will transfer payments to the State in the following manner:
a) The first quarterly payment of $19,514 for the months of July, August, and
September is due upon notification by the Agency.
b) Each successive payment of $19,512 is due no later than, December 31,
2008, March 31, 2009 and June 15, 2009.
c) The State will bill the County each quarter payments are due.
3. Attached are the DSH and LIP schedules reflecting the anticipated annual distributions for
State Fiscal Year 2008 -2009.
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, 2008 through June 30, 2009.
Letter of Agreement for SFY 2006 -09
Collier Health Services
Aaenda Item No. 16Di7
October 14, 2008
Page 4 of 6
WITNESSETH:
IN WITNESS WHEREOF the parties have duly executed this Letter of Agreement on the day
and year above first written.
COLLIER COUNTY HOUSING AND HUMAN SERVICES
BY:
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK, Clerk COLLIER COUNTY, FLORIDA
By: By:
Deputy Clerk Tom Henning, Chairman
Board of County Commissioners
Date: October 14 2008
Approved as to form and
legal sufficiency
��
Assistant County Attorney
Collier County
Letter of Agreement for SFY 2008 -09
Collier Health Services
STATE OF FLORIDA:
By:
Phil E. Williams
Assistant Deputy Secretary for Medicaid Finance
Agency for Health Care Administration
Date: October 14, 2008
Agenda Item No. 16D17
October 14, 2608
Rage 5 of 6
Local Government
Intergovernmental Transfers
Program / Amount
State Fiscal Year 2008 -2009
DSH
LIP
$78,050
Exem bons
Statewide Issues
Nursing Home SMP
Total Funding
$78,050
Letter of Agreement for SFY 2005 -09
Collier Health Services
Page I of 1
Agenda Item Igo, 16D17
October 14, 2008
Page 6 of 6
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COLLIER COUNTY
BOARD OF COUNTY COMMISSIONERS
Item Number:
16D17
Item Summary:
Recommendation that the Board of County Commissioners approve and authorize the
Chairman to sign an agreement with the Agency for Health Care Administration in the
amount of $78,050 to be used as the local government
match for State and Federal funding
to operate the Horizons Primary Care Center.
Meeting Date:
10/14/2008 9:00:00 AM
Prepared By
Terri A. Daniels
Grants Coordinator
Date
Public Services
Housing & Human Services
9123/2008 7 :02:17 PM
Approved By
Marcy Krumbine
Director
Date
Public Services
Housing & Human Services
8124/2008 1:29 PM
Approved By
Colleen Greene
Assistant County Attorner
Date
County Attorney
County Attorney Office
9/24/2008 2:42 PM
- Approved By
Maria Ramsey
Public Services Administrator
Date
Public Services
Public Services Admin.
9'2912008 4:34 Plitt
Approved By
OMB Coordinator
OMB Coordinator
Date
County Manager's Office
Office of Management & budget
5'3012005 3 :34 AM
Approved By
Sherry Pryor
Management & Budget Analyst
Date
County Manager's Office
Office of Management & Budget
9!3012005 11:36 AM
Approved By
James V. Mudd
County Manager
Date
Board of County
County Manager's Office
8:3012006 1:54 PFJI
Commissioners
file: / /C: \AgendaTest\ Export\ 114- October %2014, %202008\ 16. %2000N SENT %20AGEND... 10/8/2008