Resolution 2021-197 RESOLUTION NO, 2 0 21 — 19 7
AN ASSESSMENT RESOLUTION OF THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA, AUTHORIZING
AND ADOPTING A NON-AD VALOREM SPECIAL ASSESSMENT WITHIN
THE COUNTY LIMITS FOR THE PURPOSE OF BENEFITING ASSESSED
PROPERTIES THROUGH ENHANCED MEDICAID PAYMENTS FOR
LOCAL SERVICES; FINDING AND DETERMINING THAT CERTAIN
REAL PROPERTY IS SPECIALLY BENEFITED BY THE ASSESSMENT;
COLLECTING THE ASSESSMENT AGAINST THE REAL PROPERTY;
ESTABLISHING A PUBLIC HEARING TO CONSIDER IMPOSITION OF
THE PROPOSED ASSESSMENT AND THE METHOD OF ITS
COLLECTION; AUTHORIZING AND DIRECTING THE PUBLICATION
OF NOTICES IN CONNECTION THEREWITH; PROVIDING FOR
CERTAIN OTHER AUTHORIZATIONS AND DELEGATIONS OF
AUTHORITY AS NECESSARY; AND PROVIDING AN EFFECTIVE DATE.
WHEREAS, hospitals in Collier County's jurisdiction (the "Hospitals") annually provide
millions of dollars of uncompensated care to uninsured persons and those who qualify for
Medicaid because Medicaid, on average, covers only 60% of the costs of the health care services
actually provided by Hospitals to Medicaid-eligible persons, leaving hospitals with significant
uncompensated costs; and
WHEREAS, the State of Florida (the "State") received federal authority to establish the
Statewide Medicaid Managed Care Hospital directed payment program (the "DPP") to offset
hospitals' uncompensated Medicaid costs and improve quality of care provided to Florida's
Medicaid population; and
WHEREAS, Hospitals have asked Collier County (the "County") to impose a non-ad
valorem special assessment upon certain real property interests held by the Hospitals to help
finance the non-federal share of the State's Medicaid program; and
WHEREAS, the only real properties interests that will be subject to the non-ad valorem
assessments authorized herein are those belonging to the Hospitals; and
WHEREAS,the County recognizes that one or more of the Hospitals within the County's
boundaries may be located upon real property leased from governmental entities and that such
Hospitals may be assessed because courts do not make distinctions on the application of special
assessments based on"property interests"but rather on the distinction of the classifications of real
property being assessed; and
WHEREAS,the funding raised by the County assessment will,through intergovernmental
transfers ("IGTs") provided consistent with federal guidelines, support additional funding for
Medicaid payments to Hospitals; and
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WHEREAS, the County acknowledges that the Hospital properties assessed will benefit
directly and especially from the assessment as a result of the above-described additional funding
provided to said Hospitals; and
WHEREAS, the County has determined that a logical relationship exists between the
services provided by the Hospitals, which will be supported by the assessment, and the special and
particular benefit to the real property of the Hospitals; and
WHEREAS, the County has an interest in promoting access to health care for its low-
income and uninsured residents; and
WHEREAS, leveraging additional federal support through the above-described IGTs to
fund Medicaid payments to the Hospitals for health care services directly and specifically benefits
the Hospitals' property interests and supports their continued ability to provide those services; and
WHEREAS, imposing an assessment limited to Hospital properties to help fund the
provision of these services and the achievement of certain quality standards by the Hospitals to
residents of the County is a valid public purpose that benefits the health, safety, and welfare of the
citizens of the County; and
WHEREAS, the assessment ensures the financial stability and viability of the Hospitals
providing such services; and
WHEREAS, the Hospitals are important contributors to the County's economy, and the
financial benefit to these Hospitals directly and specifically supports their mission, as well as their
ability to grow, expand, and maintain their facilities in concert with the population growth in the
jurisdiction of the County; and
WHEREAS, the Board finds the assessment will enhance the Hospitals' ability to grow,
expand, maintain, improve, and increase the value of their Collier County properties and facilities
under all present circumstances and those of the foreseeable future; and
WHEREAS, the County is proposing a properly apportioned assessment by which all
Hospitals will be assessed at a uniform rate that is compliant with 42 C.F.R. § 433.68(d); and
WHEREAS, on June 22, 2021, the Board of County Commissioners adopted Ordinance
2001-23,enabling the County to levy a uniform non-ad valorem special assessment,which is fairly
and reasonably apportioned among the Hospitals' property interests within the County's
jurisdictional limits, to establish and maintain a system of funding for IGTs to support the non-
federal share of Medicaid payments, thus directly and specially benefitting Hospital properties.
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA:
Section 1. Definitions. As used in this Resolution, the following capitalized terms, not
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otherwise defined herein or in the Ordinance, shall have the meanings below, unless the context
otherwise requires.
Assessed Property means the real property in the County to which an Institutional Health
Care Provider holds a right of possession and right of use through an ownership or leasehold
interest, thus making the property subject to the Assessment.
Assessment means a non-ad valorem special assessment imposed by the County on
Assessed Property to fund the non-federal share of Medicaid and Medicaid managed care
payments that will benefit hospitals providing Local Services in the County.
Assessment Coordinator means the person appointed to administer the Assessment
imposed pursuant to this Article, or such person's designee.
Board means the Board of County Commissioners of Collier County, Florida.
Comptroller means the Collier County Comptroller, ex officio Clerk to the Board, or other
such person as may be duly authorized to act on such person's behalf
County means Collier County, Florida.
Fiscal Year means the period commencing on October 1 of each year and continuing
through the next succeeding September 30, or such other period as may be prescribed by law as
the fiscal year for the County.
Institutional Health Care Provider means a private for-profit or not-for-profit hospital that
provides inpatient hospital services.
Local Services means the provision of health care services to Medicaid, indigent, and
uninsured members of the Collier County community.
Non-Ad Valorem Assessment Roll means the special assessment roll prepared by the
County.
Ordinance means the Collier County Local Provider Participation Fund Ordinance No.
20021-23.
Tax Collector means the Collier County Tax Collector.
Section 2. Authority. Pursuant to the Constitution of the State of Florida, Chapter 125
of the Florida Statutes, and the Collier County Local Provider Participation Fund Ordinance, the
Board is hereby authorized to impose a special assessment against private for-profit and not-for-
profit hospitals located within the County to fund the non-federal share of Medicaid payments
associated with Local Services.
Section 3. Special Assessment. The non-ad valorem special assessment discussed
herein shall be imposed, levied, collected, and enforced against Assessed Properties located within
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the County. Proceeds from the Assessment shall be used to benefit Assessed Properties through a
directed payment program that will benefit the Assessed Properties for Local Services.
When imposed, the Assessment shall constitute a lien upon the Assessed Properties owned
by Hospitals and/or a lien upon improvements on the Property made by Hospital leaseholders equal
in rank and dignity with the liens of all state, county, district, or municipal taxes and other non-ad
valorem assessments. Payments made by Assessed Properties may not be passed along to patients
of the Assessed Property as a surcharge or as any other form of additional patient charge. Failure to
pay may cause foreclosure proceedings, which could result in loss of title, to commence.
Section 4. Assessment Scope, Basis, and Use. Funds generated from the Assessment
shall be used only to:
1. Provide to the Florida Agency for Health Care Administration the non-federal share for
Medicaid managed care hospital directed payments to be made directly or indirectly in
support of hospitals serving Medicaid beneficiaries; and
2. Reimburse the County for administrative costs associated with the implementation of the
Assessment authorized by the Ordinance.
If,at the end of the Fiscal Year, additional amounts remain in the local provider participation fund,
the Board is hereby authorized either(a)to refund to Assessed Properties, in proportion to amounts
paid in during the Fiscal Year, all or a portion of the unutilized local provider participation fund,
or(b)if requested to do so by the Assessed Properties,to retain such amounts in the fund to transfer
to the Agency in the next fiscal year for use as the non-federal share of Medicaid hospital
payments.
If, after the Assessment funds are transferred to the Agency, the Agency returns some or all of the
transferred funding to the County (including, but not limited to, a return of the non-federal share
after a disallowance of matching federal funds), the Board is hereby authorized to refund to
Assessed Properties, in proportion to amounts paid in during the Fiscal Year, the amount of such
returned funds.
Section 5. Computation of Assessment. The Assessment shall equal 1.11% of net
patient revenue for each Assessed Property specified in the attached Non-Ad Valorem Assessment
Roll. The amount of the Assessment required of each Assessed Property may not exceed an amount
that, when added to the amount of other hospital assessments levied by the state or local
government, exceeds the maximum percent of the aggregate net patient revenue of all Assessed
Hospitals in the County permitted by 42 C.F.R. § 433.68(f)(3)(i)(A). Assessments for each
Assessed Property will be derived from data contained in cost reports and/or in the Florida Hospital
Uniform Reporting System, as available from the Florida Agency for Health Care Administration.
Section 6. Timing and Method of Collection. The amount of the assessment is to be
collected pursuant to the Alternative Method outlined in §197.3631, Fla. Stat.
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The County shall provide Assessment bills by first class mail to the owner of each affected
Hospital. The bill or accompanying explanatory material shall include: (1) a reference to this
Resolution, (2) the total amount of the hospital's Assessment for the appropriate period, (3) the
location at which payment will be accepted, (4) the date on which the Assessment is due, and (5) a
statement that the Assessment constitutes a lien against assessed property and/or improvements equal
in rank and dignity with the liens of all state, county, district or municipal taxes and other non-ad
valorem assessments.
No act of error or omission on the part of the Comptroller, Property Appraiser, Tax
Collector, Assessment Coordinator, Board, or their deputies or employees shall operate to
release or discharge any obligation for payment of the Assessment imposed by the Board under
the Ordinance and this resolution.
Section 7. Public Hearing. As required by §197.3631, Fla. Stat. the Board has heard
and considered objections of all interested persons prior to rendering a decision on the Assessment
and attached Non-Ad Valorem Assessment Roll.
Section 8. Responsibility for Enforcement. The County and its agent, if any, shall
maintain the duty to enforce the prompt collection of the Assessment by the means provided herein.
The duties related to collection of assessments may be enforced at the suit of any holder of
obligations in a court of competent jurisdiction by mandamus or other appropriate proceedings or
actions.
Section 9. Severability. If any clause, section, or provision of this resolution is
declared unconstitutional or invalid for any reason or cause, the remaining portion hereof shall be in
full force and effect and shall be valid as if such invalid portion thereof had not been incorporated
herein.
Section 10. Effective Date. This Resolution to be effective immediately upon adoption. .
This Resolution duly adopted this 28th day of September, 2021.
ATTEST: BOARD OF COUNTY COMMISSIONERS
CRYSTAL K. KINZEL, CLERK COLLIE 0 TY, FLORID
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Attest as to Chain l$TrY CL PENNY TA OR, CHAIRPERSON
signat:si,3,only. -
Approved as to form and legality:
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Jenni er A. Belpedio O)?) �\
Assistant County Attorney , \\\
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