THE HUMAN SERVICES DEPARTMENT AND THE COMMUNITY PARTNERSHIPS DIVISION RECOMMEND APPROVAL OF THE ABOVE MOTIONS.
These actions support the Board’s Value of “Approaching human services collaboratively and compassionately, with special emphasis on the most vulnerable,” and the Goal to “Effectively 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.” Board approval allows for individuals who are ill or injured during the time of arrest to receive medical care compensated by the County.
Retroactive approval is requested due to protracted Contract Amendment negotiations relative to establishing new rates, which took an extended amount of time. This delay caused the original Agreement to expire, which resulted in a new Agreement being negotiated, that was finalized December 26, 2018. Although any hospital can provide medical care to arrestees, the two tax-assisted hospital districts provide medical services to the largest number of arrestees. Negotiated rates with the hospital districts result in significant cost savings to tax payers, versus paying reasonable and customary rates.
On July 1, 2013, Agency for Healthcare Administration ("AHCA") implemented a new prospective payment system for Medicaid, categorizing inpatient hospital services by Diagnosis Related Groups (DRGs) and assigning payment rates based on average resources used to treat patients within those DRGs. Recognizing the administrative burden that would result from adopting AHCA's highly complex rate plan, the Human Services Department (HSD) negotiated standardized, simpler reimbursement formulas with each hospital district inclusive of a fixed daily rate for inpatient services and outpatient services. This Agreement authorizes and sets reimbursement rates for medical services provided by Memorial to persons ill or injured at the time of arrest at a daily rate of $2,332 for Inpatient Services and $614 for Outpatient Services (Exhibit 2).
No performance outcomes have been assigned as this is a billing Agreement.
The Agreement has been reviewed and approved as to form by the Office of the County Attorney.
Section 112.313(7)(a), Florida Statutes, provides that "no public officer ... shall have or hold any employment or contractual relationship with any business entity ... which ... is ... doing business with an agency of which he or she is an officer or employee." In accordance with Section 112.313(7)(a), Florida Statutes, Board approval is required to waive any conflict of interest arising under Section 112.313(7)(a), Florida Statutes. An effective waiver requires two-thirds vote of the County Commission after disclosure of the conflicting relationship (Motion B) in accordance with Section 112.313(12), Florida Statutes. Forms 4A, Disclosure of Business Transaction, Relationship or Interest, are attached hereto as Exhibit 3 and constitute full disclosure of any existing conflicts.
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