Bradenton Area Convention Center One Haben Boulevard, Palmetto - Longboat Key Room 9:00 a.m. - September 29, 2020
REVISED - September 29, 2020 - Regular Meeting
Agenda Item #28

Approval and Execution of Letters of Agreement for the Low Income Pool Program & Intergovernmental Transfer

Briefing Provided Upon Request

Contact and/or Presenter Information

Joshua T. Barnett, ext 3978
Health Care Services Manager

Ava Ehde, ext 3974
Department Director

Action Requested

In matters pertaining to the State of Florida, Agency for Health Care Administration, Low Income Pool and Intergovernmental Transfers:

  • Approval of the associated Letters of Agreement (LOAS) and the Low Income Pool (LIP) funds with the Florida Agency for Health Care Administration (AHCA) to submit Intergovernmental Transfer (IGT) funds on behalf of Manatee Memorial Hospital in the amount of $690,556; Centerstone of Florida in the amount of $250,424 and $488,257.85; and MCR Health Services in the amount of $1,332,760 for a total IGT in the amount of $2,761,997.85.
  • Authorization for the Neighborhood Services Director, or designee, to sign the LOAs.
  • Authorization for the remaining approved balance of $3,639,759.15 to develop agreements with each agency to be used for results based contracting; data exchange with providers; and, in some cases, financial audit.

Enabling/Regulating Authority

Florida Statute 125 - County Government

Florida Statute 409.908 & 409.909 - Social and Economic Assistance

H.B. 5201 - Medicaid

H.B. 5001 - General Appropriations Act of State Fiscal year 2020-2021

Background Discussion

Pending approval of the Board of County Commissioners (BCC) to provide Intergovernmental Transfer (IGT) dollars to the Florida Agency of Health Care Administration (AHCA) for Low Income Pool (LIP) dollars for Federal Medicaid Match (1115 Medicaid Demonstration Waiver-Florida), the BCC may approve funds and sign, or designee, associated Letters of Agreement (LOA) for one eligible hospital (Manatee Memorial Hospital), one behavioral health agency (Centerstone of Florida), and one federally qualified health center (MCR Health Services). Each of these facilities shall agree to use LIP funds for Eligible Manatee County Residents using the Indigent Health Solutions (IHS) software, actively participate in the utilization and exchange of information within the Health Information Exchange (HIE), and utilize IGT funds in compliance with LIP Rules, including funds not to be utilized for "bad debts" or Medicaid or CHIP "shortfalls" or reimbursement gaps. Graduate Medical Education Local Intergovernmental Transfers will abide by all requirements agreed to under this LOA.

Staff has received the recommended LIP funds for each of the following agencies from the State AHCA Office: Manatee Memorial Hospital, Centerstone of Florida, and MCR Health Services.

Centerstone's participation in the LIP program will be continued for a third year by AHCA. The request of these funds is for emergency psychiatric services, using funds approved by the Board on August 25, 2020; no additional funding is requested. Centerstone is also eligible this year for Graduate Medical Education; the requested funds for this IGT will be used from approved detoxification funds where no additional funding is requested.

The remaining $3,639,759.15 shall be used for performance and results-based agreements to be entered into by the organizations and the County, separately, to monitor the utilization and participation of Health Information Exchange (HIE) and health care results data and may also be used to conduct an audit of health services.

The total amount of $6,401,757 is the budgeted amount for these services in the FY21/22 budget, with the date of September 21, 2020, for the Board's vote.

The deadline for AHCA to receive the Letters of Agreement is October 1, 2020, and staff is seeking approval of the Neighborhood Services Director, or their designee, to sign and submit the Letters of Agreement once approved.

County Attorney Review
Not Reviewed (Utilizes exact document or procedure approved within the last 18 months)

Explanation of Other

Reviewing Attorney

Instructions to Board Records
Send Board approval to joshua.barnett@mymanatee.org. Fully executed copies will be forwarded to Board Records upon receipt from the State.

Cost and Funds Source Account Number and Name
$738,681.85 from approved Non-Profit Human Services; $2,023,316 from the General Fund

Amount and Frequency of Recurring Costs
$2,761,997.85 by State annually

Attachment:  Manatee County_Manatee Memorial Hospital LIP LOA 20-21 (002).pdf
Attachment:  Manatee County_Centerstone of Florida LIP LOA 20-21 updated (002).pdf
Attachment:  Manatee County Board of County Commissioners_Centerstone GME LOA 20-21 (004).pdf
Attachment:  Manatee County Board of County Commissioners_MCR Health_LIP LOA 20-21.pdf