HomeMy WebLinkAbout2021-054RESOLUTION NO. 2021- 054
AN ASSESSMENT RESOLUTION OF THE BOARD OF COUNTY
COMMISSIONERS OF INDIAN RIVER COUNTY, FLORIDA,
AUTHORIZING AND ADOPTING A NON -AD VALOREM
SPECIAL ASSESSMENT WITHIN THE COUNTY LIMITS FOR
THE PURPOSE OF BENEFITING ASSESSED PROPERTIES
THROUGH ENHANCED MEDICAID PAYMENTS FOR LOCAL
SERVICES; FINDING AND DETERMINING THAT CERTAIN
REAL PROPERTY IS SPECIALLY BENEFITED BY THE
ASSESSMENT; COLLECTING THE ASSESSMENT AGAINST
THE REAL PROPERTY; ESTABLISHING A PUBLIC HEARING
TO CONSIDER IMPOSITION OF THE PROPOSED
ASSESSMENT AND THE METHOD OF ITS COLLECTION;
AUTHORIZING AND DIRECTING THE PUBLICATION OF
NOTICES IN CONNECTION THEREWITH; PROVIDING FOR
CERTAIN OTHER AUTHORIZATIONS AND DELEGATIONS
OF AUTHORITY AS NECESSARY; AND PROVIDING AN
EFFECTIVE DATE.
WHEREAS, hospitals in Indian River County's jurisdiction (the "Hospitals") annually
provide millions of dollars of uncompensated care to uninsured persons and those who qualify for
Medicaid because Medicaid, on average, covers only 60% of the costs of the health care services
actually provided by Hospitals to Medicaid -eligible persons, leaving hospitals with significant
uncompensated costs; and
WHEREAS, the State of Florida (the "State") received federal authority to establish the
Statewide Medicaid Managed Care Hospital 'directed payment program (the "DPP") to offset
hospitals' uncompensated Medicaid costs and improve quality of care provided to Florida's
Medicaid population; and
WHEREAS, two of the three Hospitals have asked Indian River County (the "County") to
impose a non -ad valorem special assessment upon certain real property interests held by the
Hospitals to help finance the non-federal share of the State's Medicaid program, while the third
Hospital is unopposed to the assessment; and
WHEREAS, the only real properties interests that will be subject to the non -ad valorem
assessments authorized herein are those belonging to the Hospitals; and
WHEREAS, the funding raised by the County assessment will, through intergovernmental
transfers ("IGTs") provided consistent with federal guidelines, support additional funding for
Medicaid payments to some, but not necessarily all, Hospitals; and
WHEREAS, the County acknowledges that the Hospital properties assessed will benefit
directly and specially from the assessment as a result of the availability of above-described
additional funding provided to said Hospitals; and
US Active\118603232\V-1
WHEREAS, the County has an interest in promoting access to health care for its low-
income and uninsured residents; and
WHEREAS, leveraging additional federal support through the above-described IGTs to
fund Medicaid payments to the Hospitals for health care services directly and specifically benefits
the Hospitals' property interests and supports their continued ability to provide those services; and
WHEREAS, imposing an assessment limited to Hospital properties to help fund the
provision of these services and the achievement of certain quality standards by the Hospitals to
residents of the County is a valid public purpose that benefits the health, safety, and welfare of the
citizens of the County; and
WHEREAS, the assessment ensures the financial stability and viability of the Hospitals
providing such services; and
WHEREAS, the Hospitals are important contributors to the County's economy, and the
financial benefit to these Hospitals directly and specifically supports their mission, as well as their
ability to grow, expand, and maintain their facilities in concert with the population growth in the
jurisdiction of the County; and
WHEREAS, the Board finds the assessment will enhance the Hospitals' ability to grow,
expand, maintain, improve, and increase the value of their Indian River County properties and
facilities under all present circumstances and those of the foreseeable future; and
WHEREAS, the County is proposing a properly apportioned assessment by which all
Hospitals will be assessed at a uniform rate that is compliant with 42 C.F.R. § 433.68(d); and
WHEREAS, on September 14, 2021, the Board of County Commissioners adopted an
ordinance, enabling the County to levy a uniform non -ad valorem special assessment, which is
fairly and reasonably apportioned among the Hospitals' property interests within the County's
jurisdictional limits, to establish and maintain a system of funding for IGTs to support the non-
federal share of Medicaid payments, thus directly and specially benefitting Hospital properties.
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF INDIAN RIVER COUNTY, FLORIDA:
Section 1. Definitions. As used in this Resolution, the following capitalized terms, not
otherwise defined herein or in the Ordinance, shall have the meanings below, unless the context
otherwise requires.
Assessed Property means the real property in the County to which an Institutional Health
Care Provider holds a right of possession and right of use through an ownership or leasehold
interest, thus making the property subject to the Assessment.
2
US Active\118603232\V-1
Assessment means a non -ad valorem special assessment imposed by the County on
Assessed Property to fund the non-federal share of Medicaid and Medicaid managed care
payments that will benefit hospitals providing Local Services in the County.
Assessment Coordinator means the person appointed to administer the Assessment
imposed pursuant to this Article, or such person's designee.
Board means the Board of County Commissioners of Indian River County, Florida.
County means Indian River County, Florida.
Fiscal Year means the period commencing on October 1 of each year and continuing
through the next succeeding September 30, or such other period as may be prescribed by law as
the fiscal year for the County.
Institutional Health Care Provider means a private for-profit or not-for-profit hospital that
provides inpatient hospital services.
Local Services means the provision of health care services to Medicaid, indigent, and
uninsured members of the Indian River County community.
Non Ad Valorem Assessment Roll means the special assessment roll prepared by the
County.
Ordinance means the Indian River County Local Provider Participation Fund Ordinance.
Section 2. Authority. Pursuant to Article VIII, Section 1(f) of the Constitution of the
State of Florida, Chapter 125 of the Florida Statutes, and the Indian River County Local Provider
Participation Fund Ordinance, the Board is hereby authorized to impose a special assessment
against private for-profit and not-for-profit hospitals located within the County to fund the non-
federal share of Medicaid payments associated with Local Services.
Section 3. Special Assessment. The non -ad valorem special assessment discussed
herein shall be imposed, levied, collected, and enforced against Assessed Properties located within
the County. Proceeds from the Assessment shall be used to benefit Assessed Properties through
availability of directed payment program that will benefit the Assessed Properties for Local
Services.
Section 4. Assessment Scope, Basis, and Use. Funds generated from the Assessment
shall be used only to:
1. Provide to the Florida Agency for Health Care Administration the non-federal share for
Medicaid managed care hospital directed payments to be made directly or indirectly in
support of hospitals serving Medicaid beneficiaries; and
US Active\118603232\V-1
2. Reimburse the County for administrative costs associated with the implementation of the
Assessment authorized by the Ordinance.
If, at the end of the Fiscal Year, additional amounts remain in the local provider participation fund,
the Board is hereby authorized either (a) to refund to Assessed Properties, in proportion to amounts
paid in during the Fiscal Year, all or a portion of the unutilized local provider participation fund,
or (b) if requested to do so by the Assessed Properties, to retain such amounts in the fund to transfer
to the Agency in the next fiscal year for use as the non-federal share of Medicaid hospital
payments.
If, after the Assessment funds are transferred to the Agency, the Agency returns some or all of the
transferred funding to the County (including, but not limited to, a return of the non-federal share
after a disallowance of matching federal funds), the Board is hereby. authorized to refund to
Assessed Properties, in proportion to amounts paid in during the Fiscal Year, the amount of such
returned funds.
Section 5. Computation of Assessment. The Assessment shall equal 2.1% of net
patient revenue for each Assessed Property specified in the attached Non -Ad Valorem Assessment
Roll. The amount of the Assessment required of each Assessed Property may not exceed an amount
that, when added to the amount of other hospital assessments levied by the state or local
government, exceeds the maximum percent of the aggregate net patient revenue of all Assessed
Hospitals in the County permitted by 42 C.F.R. § 433.68(0(3)(i)(A). Assessments for each
Assessed Property will be derived from data contained in cost reports and/or in the Florida Hospital
Uniform Reporting System, as available from the Florida Agency for Health Care Administration.
Section 6. Timing and Method of Collection. The amount of the assessment is to be
collected pursuant to the Alternative Method outlined in §197.3631, Fla. Stat.
The County shall provide Assessment bills by first class mail to the owner of each affected
Hospital. The bill or accompanying explanatory material shall include: (1) a reference to this
Resolution, (2) the total amount of the hospital's Assessment for the appropriate period, (3) the
location at which payment will be accepted, and (4) the date on which the Assessment is due.
No act of error or omission on the part of the Assessment Coordinator, Board, or their
deputies or employees shall operate to release or discharge any obligation for payment of the
Assessment imposed by the Board under the Ordinance and this resolution.
Section 7. Public Hearing. Per the notice provided by first class mail sent on August
31, 2021 and notice published in the Indian River Press Journal on September 1, 2021, the Board
has heard and considered objections of all interested persons prior to rendering a decision on the
Assessment and attached Non -Ad Valorem Assessment Roll.
Section 8. Responsibility for Enforcement. The County and its agent, if any, shall
maintain the duty to enforce the prompt collection of the Assessment by the means provided herein.
The duties related to collection of assessments may be enforced at the suit of any holder of
4
US Active\118603232\V-1
obligations in a court of competent jurisdiction by mandamus or other appropriate proceedings or
actions.
Section 9. Severability. If any clause, section, or provision of this resolution is
declared unconstitutional or invalid for any reason or cause, the remaining portion hereof shall be in
full force and effect and shall be valid as if such invalid portion thereof had not been incorporated
herein.
Section 10. Effective Date. This Resolution to be effective immediately upon adoption.
This Resolution duly adopted this 21 st day of September, 2021.
The foregoing resolution was moved for adoption by Commissioner Moss
seconded by Commissioner Adams , and adopted by the following vote:
Chairman, Joseph E. Flescher
AYE
Vice -Chairman, Peter D. O'Bryan
NAY
Commissioner Susan Adams
AYE
Commissioner Joseph H. Earman
AYE
Commissioner Laura Moss
AYE
The Chairman thereupon declared the resolution duly passed and adopted this 211 day of
Sept , 2021.
B(
IN
LOM
ATTEST: Jeffrey R. Smith, Clerk
Of Court and Comptroller
12 moam�
By: alAA'
eputy Clerk
Approved as to form and legal sufficiency:
By:
an Reingold
County Attorney
US Active11186032321V-1
[Attachment- Assessment Roll]
US Active\1186032321V-1
n_-7 r
�OBenizaiio�x
y �`�• �.�. .=_, Invoice Address � -,.�
10104400 Cleveland Clinic Health System Indian River Medical Center / Cleveland Clinic Indian River Hospital 100036th St, Vero Beach, FL 32960 2.1% NPR $6,232,389 Warren Fuller 100036th Street Vero Beach, FL 32960
12034100 Encompass Health Encompass Health Rehabilitation Hospital of Treasure Coast 160037th St, Vero Beach, FL 32960 2.1% NPR $625,798 Andrew Wilburn 9001 Liberty Parkway, Birmingham, AL, 35242
12001400 Steward Health Care System Sebastian River Medical Center 13695 US -1, Sebastian, FL 32958 2.191 NPR $1,988,149 Bill Stokes 1900 N Pearl St, Ste 2400 Dallas, TX 75201
County Phone Number: (772) 226-1408
BCC Address: Indian River County Administration Building A located at 180127th St, Vero Beach, FL 32960
Ordinance Date: September 14, 2021
Resolution Date: September 21, 2021, 9:00 a.m.
Disability Contact: Indian River County at Accessibility@ircgov.com or (772) 226-1391
Mandatory Payments Due Date: October 15, 2021
1-vorgdezati0h, A
"Hdspital dris' ''=Phone Number�
Enallg
Cleveland Clinic CFO Indian River Medical Center/ Warren Fuller 1000 36th Street Vero Beach, FL 32960 772-563-4469 Fullem3@ccf.arg
Cleveland Clinic Indian River Hospital
Steward Senior VP, Finance& Tax Sebastian River Medical Center Bill Stokes 1900 N Pearl St, Ste 2400 Dallas, TX 75201 615406-7358 william.stokes@steward.org
Encompass Statutory & Regulatory Encompass Health Rehabilitation Hospital Andrew Wilburn 9001 Liberty Parkway, Birmingham, AL, 35242 205-970-5761 andmw.wilburn@encompasshealth.com;
Analyst of Treasure Coast providertax@encompasshealth.com
Number OWNER NAME FACILITY DESCRIPTIONFACIIRY AOOR E55 PARCEL IEGILLOESCRIPTION
1 Indian River Comity Hosphal DistriR Ind'un RN., Medial Cerner/ 100036th St, Vero Beach, FL 32393600000300000000 SEC36TWP325RNG 39 E BEING MORE PART DESCAS FOLL: THE NEQUARTER OFTHE NWQUARTER LESSTHEW520FTTHEREOFANDAISO LEMTHE E275 HOF TNESe00FT
Uweland Clinic Indian RNer Hasp"nal 32960 THEREOF AND ALSO LESS THE 5 310 FT THEREOF AND ALSO LESS WE 5260 FT OF THE W 934 FT OF THE NW QUARTER OF THE NW QUARTER AND LESS THE N 75 FT FOR ROW ALSO
LESS ROW AS RECORDED IN OR 3358/1605
Ocean Heahh A—d— E—pass Heahh RehabR4aUon Hmpblot 160037th St,Vem BeacA,FL 31392600000700000000 5715 HOF SEI/40FSE3/4LESS E 690 R&LESSW27.50 HAS IN ORBK703 PP 2443& LMS55 FT FOR RD R/W
Treasure [Dart 32960
Sebastun River Med'val Center 13695 US -1. Sebastian, FL 30382500000002000000 A PARCEL OF LAND COMPRISING OF GOV GOTS 2 AND 4 SEC 257WN 30 RNG 38 MORE PART DESC AS: THAT PORTION OF PROPERTY LYING NWLY OF B3RD AVE(AKA BAYST) AND W OF
32958 US HM NO 1. BEG AT THE SW COR OF GOV LOT 2 SEC 25 T WN 30 RNG 38 SAID POINT BEING THE POB RUN S 00 DEG 00 MIN 30SEC W, 8954 FT; TH RUN N 35 DEG 10 MIN 46 SEC E,
742.74 H. TH RUN N 04 DEG 15 MIN 45 SEC E, 49A6 FT TO A POINT ON THE W ROW OF US HWY NO 1; TH RUN ON SAID W ROW 515 DEG 30 MIN 42 SEC E, 578.17 FT; TH CONT ON
THE W ROW, 285.78 FT ON THE ARC OF A 11,45920 FT RAD CUR CONCAVETO THE NE,THROUGH A CEN ANG OF 01 DEG 25 MIN 44 SECTO A POINT ON THE C/L OF A 70 FT ROW
Mpt OYSeba I—Steward LLC KNOWN AS BAY ST; TH COM ON THE W ROW, 9120 FT ON THE ABC OF AN 11.45920 FT RAD, CURVE CONCAVE TO THE NE.THROUGH A CENTRALANG OF 00 DEG 27 MIN 22 SEC; TH
RUN 546 DEG M MIN 35 SECVV 302AO FT; TH RUN 501 DEG D3 MIN 26 SEC E,82086"TO AN INTERSECTION WITH FLEMING GRAM UNE; TH RUN ON FLEMING GRAM UNE, N 44
DEG 04 MIN 20 SEC W 1921.27 HTO A POINT ON THE 5 BNDRY OF GOVT LOT 1, SEC 25, MN 30 RNG 30; TH RUN N 89 DEG 58 MIN 52 SEC E, 846.14 FT ALONGTHE S BNDRY OF GOV
LOT 1 A DIS OF 846.14 FT TO THE POB. LESS ROW OR SK 430 PG 732, THAT ROW RECORDED IN OR BK 813 PG 1438 AND SUB1ECr TO A CONSERVATION EASEMENT AS DFSC IN OR BK
2354 PG 630