TO: Board of County Commissioners
THROUGH: John A. Titkanich, Jr., County Administrator
THROUGH: Jennifer W. Shuler, County Attorney
FROM: Susan J. Prado, Deputy County Attorney
DATE: June 3, 2025
SUBJECT: Local Provider Participation Fund Approval (Legislative)
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BACKGROUND
Hospitals that provide Medicaid services or other forms of indigent care often fail to receive full compensation for those services, which leaves hospitals with unreimbursed costs. In 2021, County staff was approached by the Sebastian River Medical Center and Cleveland Clinic Indian River Hospital about establishing a local provider participation fund (LPPF) to assist in covering such unreimbursed costs. Under the LPPF ordinance approved in September 2021, Indian River County imposes an assessment on real property on which hospitals are located in the County. The funding raised by the assessment then goes through intergovernmental transfers that are consistent with federal guidelines, to support additional funding for Medicaid payments to the hospitals to address the Medicaid shortfall. Since the LPPF ordinance was adopted, the Indian River County Board of County Commissioners ("Board") annually adopts an assessment resolution and assessment roll.
The LPPF ordinance requires each participating county to send a Letter of Agreement ("LOA") to the Florida Agency for Health Care Administration ("AHCA") by October 1st. Attached to this Board item, is a copy of the LOA that was approved by the Board for the State FY 24-25. If the Board approves the LPPF for the State FY 25-26, AHCA will issue a new agreement to the County in this same format. County staff has no objection to the approval of the attached assessment resolution and form of the LOA.
ANALYSIS
N/A
BUDGETARY IMPACT
There is no expenditure of County funds associated with this matter. The County collects these assessments and sends the funds to AHCA, which draws down additional Medicaid dollars from the Federal government. The local hospitals would then have the ability to bill for services provided to patients up to double the amount assessed.
PREVIOUS BOARD ACTIONS
The Board has approved the LPPF annually since its initiation in 2021.
POTENTIAL FUTURE BOARD ACTIONS
N/A
STRATEGIC PLAN ALIGNMENT
N/A
OTHER PLAN ALIGNMENT
N/A
STAFF RECOMMENDATION
Recommended Action
County staff recommends that the Board open the public hearing, take public comment and then vote whether to approve the Local Provider Participation Fund Resolution and the FY 25-26 Letter of Agreement.