Broward County Commission Regular Meeting


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AI-27582 17.       
Meeting Date: 11/13/2018  
Director's Name: Kimm Campbell
Department: Human Services Division: Community Partnerships

Information
Requested Action
MOTION TO RETROACTIVELY APPROVE Letter of Agreement between the State of Florida Agency for Health Care Administration (AHCA) and Broward County in the amount of $170,931, from July 1, 2018 to June 30, 2019, to provide the Broward Community and Family Health Centers, Inc. local match for the State of Florida Medicaid Low Income Pool (LIP) Program; authorizing the Mayor and Clerk to execute same; authorizing the County Administrator to execute amendments to the agreement subject to approval of the same by the County Attorney; authorizing the County Administrator to take the necessary administrative and budgetary actions to execute the Letter of Agreement.

ACTION:  (T-10:28 AM)  Approved.

VOTE: 8-0. 
Why Action is Necessary
In accordance with the Broward County Administrative Code, Section 23.7, agreements with external agencies are subject to Board approval; and in accordance with Florida Statute 409.915, matching funds for the Low Income Pool (LIP) Program shall be provided by local governmental entities.
What Action Accomplishes
This action allows Broward County to meet the local match requirements for the Medicaid LIP that will result in funding to a Broward County Federally Qualified Health Center to deliver medical services to uninsured residents.
Is this Action Goal Related
Previous Action Taken
None.
Summary Explanation/Background
THE HUMAN SERVICES DEPARTMENT AND THE COMMUNITY PARTNERSHIPS DIVISION RECOMMEND APPROVAL OF THE ABOVE MOTION.

This action supports the Board’s Value of “[A]pproaching human services collaboratively and compassionately, with special emphasis on the most vulnerable,” and the Goal to “[E]ffectively advocate for and acquire municipal, state, and federal financial support to equitably address health and human services needs of the entire community, through a truly coordinated system of care.” This Federal/State and County collaboration will provide eligible Broward County residents with critically needed primary care services.

Retroactive approval is sought as the finalized Letter of Agreement (LOA) was received from the Agency for Health Care Administration (AHCA) on October 16, 2018, for state Fiscal Year 2018-2019 and is effective October 1, 2018. AHCA is aware that the Board approval date for the LOA and subsequent payment are inconsistent with Section 409.908, F.S. timelines.

The Low Income Pool (LIP) program requires a 39.13% non-federal match with a federal contribution of 60.87% for the State Fiscal Year 2018-2019. Eligible LIP match is tax-derived funding specifically earmarked for health purposes that must be transferred directly from the County to AHCA. Approximately $50 million in LIP funds have been designated for Federally Qualified Health Centers (FQHCs), contingent upon securing match commitments from eligible sources, including counties. Broward County’s match contribution of $170,931 will generate a total disbursement of $358,474 in additional Medicaid funding to the Broward Community and Family Health Centers, Inc. (BCFHC).

Funding will allow BCFHC to deliver primary care services to new patients in four clinical sites: Hollywood, Hallandale, Lauderhill and Pompano Beach. Last Fiscal Year, BCFHC served 11,156 unduplicated patients. In Fiscal Year 2018-2019, BCFHC projects to serve 15,673 patients and deliver 34,496 medical encounters. Funding generated from this agreement is anticipated to allow BCFHC to serve 515 new patients representing 1,545 new encounters.

While there are no clinical outcomes required by the LOA, specific clinical outcomes are established by the Health Resources Service Administration (HRSA) and reported annually to AHCA. Providers are subject to review and monitoring by the assigned HRSA Project Officers. Additionally, providers report the number of patients served quarterly and annually as well as complete a Cost Limit Report to the State to demonstrate that expenses are aligned with the State average. An annual breakdown of annual costs per patient, as well as costs per visit are also reported.

The LOA (Exhibit 2) is in the State of Florida’s required form and has been reviewed by the Office of the County Attorney with three disclosures noted. The LOA does not include a specific amount of LIP funds that will be paid to Broward Community and Family Centers, Inc. As a result of the County’s contribution, AHCA is also not required to return any portion of County’s contribution in the event that LIP payments are not made.
Source of Additional Information
Silvia Beebe, Acting Director, Community Partnerships Division, (954) 357-6396
William E. Green, Human Services Administrator, Health Care Services Section, (954) 357-5398

Fiscal Impact
Fiscal Impact/Cost Summary:
Matching funds of $170,931 for the LIP program are in the adopted Fiscal Year 2019 Broward County Budget.
Attachments
Exhibit 1 - LIP BCFHC Agreement Summary
Exhibit 2 - LIP Letter of Agreement
Exhibit 3 - 2018-19 LIP Model Summary


    

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