Manatee County Government Administrative Center Honorable Patricia M. Glass Chambers, First Floor 9:00 a.m. - September 24, 2019
September 24, 2019 - Regular Meeting
Agenda Item #34

Low Income Pool - Letters of Agreement with the Florida Agency for Health Care Administration

Briefing Provided Upon Request

Contact and/or Presenter Information
Joshua T. Barnett, Health Care Services Manager
Ext 3978

Ava Ehde, Neighborhood Services Department Director
Ext. 3974

Action Requested
In matters pertaining to the State of Florida, Agency for Health Care Administration, Low Income Pool:
  • Approval of Low Income Pool (LIP) funds and the associated Letters of Agreement (LOA) 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 $596,182; Centerstone of Florida in the amount of $276,155; and MCR Health Services in the amount of $1,212,394, for a total IGT in the amount of $2,084,731.
  • Authorization for the Neighborhood Services Director, or designee, to sign the LOAs.
  • Authorization for the remaining approved balance of $3,344,713.00 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 - Social and Economic Assistance

H.B. 5201 - Medicaid

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 Medcaid 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 utilizing the Indigent Health Solutions 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.

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 Manatee County Rural Health Services.

Centerstone's participation in the LIP program will be continued for a second year by AHCA. The request of these funds is for emergency psychiatric evaluation services, using funds approved by the Board on August 6, 2019; no additional funding is needed.

The additional $3,344,713.00 shall be used for performance and results based agreements to be entered into by the organizations and the County, separately, to guarantee 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 $5,429,444 is the budgeted amount for these services in the FY20/21 budget, with the date of September 17, 2019, for the Board's vote.  

The deadline for AHCA to receive the Letters of Agreement is October 1, 2019, and staff is seeking approval of Neighborhood Services Interim Department 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
Please return the executed agreements to Joshua Barnett.  Fully executed copies will be forwarded to Board Records upon receipt from the State.

Cost and Funds Source Account Number and Name
$433,590 from approved Non-Profit Human Services; $4,995,854 General Fund

Amount and Frequency of Recurring Costs
TBD by State annually

Attachment:  MMH Health Services LOA.pdf
Attachment:  MCR Health Services LOA.pdf
Attachment:  Centerstone LIP Health Services LOA.pdf