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Home My WebLink About2022-180A TRUE COPY CERTIFICATION ON LAST PAGE DocuSign Envelope ID: 8B50F830-95924E2A-A70D-CF9CEEF344CD J.R. SMITH, CLERK Directed Payment Program Letter of Agreement THIS LETTER OF AGREEMENT (LOA) is made and entered into in duplicate on the 20th day of Sept 2022, by and between Indian River county LPPF (the "IGT Provider") on behalf of Region 9 , and the State of Florida, Agency for Health Care Administration (the "Agency"), for good and valuable consideration, the receipt and sufficiency of which is acknowledged. "Intergovernmental Transfers (IGTs)" means transfers of funds from a non -Medicaid governmental entity (e.g., counties, hospital taxing districts, providers operated by state or local government) to the Medicaid agency. IGTs must be compliant with 42 CFR Part 433 Subpart B. "Medicaid" means the medical assistance program authorized by Title XIX of the Social Security Act, 42 US.C. §§ 1396 et seq., and regulations thereunder, as administered in Florida by the Agency. "Directed Payment Program (DPP)," pursuant to the General Appropriation Act, Laws of Florida 2021-156, is the program that provides direct supplemental payments to eligible public and private entities that provide inpatient and outpatient services to Medicaid managed care recipients. A. GENERAL PROVISIONS 1. Per House Bill 5001, the General Appropriations Act of State Fiscal Year 2022- 2023,passed by the 2022 Florida Legislature, the IGT Provider and the Agency agree that the IGT Provider will remit IGT funds to the Agency in an amount not to exceed the total of $2,870,123.00 . The IGT Provider and the Agency have agreed that these IGT funds will only be used for the DPP program. 2. The IGT Provider will return the signed LOA to the Agency. 3. The IGT Provider will pay IGT funds to the Agency in an amount not to exceed the total of $2,870,123.00 The IGT Provider will transfer payments to the Agency in the following manner: a. Per Florida Statute 409.908, annual payments for the months of July 2022 through June 2023 are due to the Agency no later than October 31, 2022, unless an alternative plan is specifically approved by the agency. b. The Agency will bill the IGT Provider when payment is due. 4. The IGT Provider and the Agency agree that the Agency will maintain necessary records and supporting documentation applicable to health services covered by this LOA in accordance with public records laws and established retention schedules. a. AUDITS AND RECORDS i. IGT Provider agrees to maintain books, records, and documents (including Indian River County LPPF DPP LOA SFY 2022-23 Region 9 DocuSign Envelope ID: BB50F830-9592-4E2A-A700-CF9CEEF344CD A TRUE COPY CERTIFICATION ON LAST PAGE J.R. SkIlTH, CLERK electronic storage media) pertinent to performance under this LOA in accordance with generally accepted accounting procedures and practices, which sufficiently and properly reflect all revenues and expenditures of funds provided. ii. IGT Provider agrees to assure that these records shall be subject at all reasonable times to inspection, review, or audit by state personnel and other personnel duly authorized by the Agency, as well as by federal personnel. iii. IGT Provider agrees to comply with public record laws as outlined in section 119.0701, Florida Statutes. b. RETENTION OF RECORDS The IGT Provider agrees to retain all financial records, supporting documents, statistical records, and any other documents (including electronic storage media) pertinent to performance under this LOA for a period of six (6) years after termination of this LOA, or if an audit has been initiated and audit findings have not been resolved at the end of six (6) years, the records shall be retained until resolution of the audit findings. ii. Persons duly authorized by the Agency and federal auditors shall have full access to and the right to examine any of said records and documents. iii. The rights of access in this section must not be limited to the required retention period but shall last as long as the records are retained. c. MONITORING i. IGT Provider agrees to permit persons duly authorized by the Agency to inspect any records, papers, and documents of the IGT Provider which are relevant to this LOA. d. ASSIGNMENT AND SUBCONTRACTS The IGT Provider agrees to neither assign the responsibility of this LOA to another party nor subcontract for any of the work contemplated under this LOA without prior written approval of the Agency. No such approval by the Agency of any assignment or subcontract shall be deemed in any event or in any manner to provide for the incurrence of any obligation of the Agency in addition to the total dollar amount agreed upon in this LOA. All such assignments or subcontracts shall be subject to the conditions of this LOA and to any conditions of approval that the Agency shall deem necessary. 5. This LOA may only be amended upon written agreement signed by both parties. The IGT Provider and the Agency agree that any modifications to this LOA shall be in the same form, namely the exchange of signed copies of a revised LOA. 6. IGT Provider confirms that there are no pre -arranged agreements (contractual or otherwise) between the respective counties, taxing districts, and/or the providers to re- direct any portion of these aforementioned supplemental payments in order to satisfy non - Medicaid, non -uninsured, and non -underinsured activities. Indian River County LPPF Region 9 DPP LOA SFY 2022-23 DocuSign Envelope ID: 8650F830-9592-4E2A-A70D-CF9CEEF344CD A TRUE COPY CERTIFICATION ON LAST PAGE J.R. SMITH, CLERK 7. IGT Provider agrees the following provision shall be included in any agreements between IGT Provider and local providers where IGT funding is provided pursuant to this LOA. Funding provided in this agreement shall be prioritized so that designated IGT funding shall first be used to fund the Medicaid program and used secondarily for other purposes. S. This LOA covers the period of July 1, 2022 through June 30, 2023 and shall be terminated September 30, 2023, which includes the states certified forward period. 9. This LOA may be executed in multiple counterparts, each of which shall constitute an original, and each of which shall be fully binding on any party signing at least one counterpart. DPP Local Inter overnmental Transfers Program / Amount State Fiscal Year 2022-2023 Estimated IGTs $2,870,123.00 Total Funding Not to Exceed $2,870,123.00 IN WITNESS WHEREOF, the parties have caused this page Letter of Agreement to be executed by their undersigned officials as duly authorized. IGT Provider SIGNED BY: NAME: TITLE: DATE: STATE OF FLORIDA, AGENCY FOR IEALTH CARE ADMINISTRATION Indian River County LPPF Region 9 SIGNED BY: NAME: TITLE: DATE: DPP LOA SFY 2022-23 [Attachment- Assessment Roll] US Active1118603232\V-1 A TRUE COPY " ERTIFICATION ON LAST PAGE P. SMITH, CLERK Copy of Indian River County Supplemental Packet Roll MCD ID # Organization Facility Hospital Address Parcel # Rate Payment Invoice Address 10104400 Cleveland Clinic Indian River Medical 1000 36th St. 0.78% NPR $2,281,523 1000 36th St. Health System Center/ Cleveland Clinic Vero Beach, FL 32960 32393600000300000000 Vero Beach, FL 32960 Indian River Hospital 12034100 Encompass Health Encompass Health 1600 37th St. 32392600000700000000 0.78% NPR $216,606 9001 Liberty Parkway Rehabilitation Rehabilitation Hospital of Vero Beach, FL 32960 Birmingham, AL, 35242 Hospital of Treasure Coast Treasure Coast 12001400 Sebastian River Sebastian River Medical 13695 US -1 30382500000002000000 0.78% NPR $667,846 1900 N. Pearl St., Ste 2400 Medical Center Center Sebastian, FL 32958 Dallas, Texas 75201 County Phone Number: (772) 226-1408 BCC Address: Indian River County Administration Building A located at 1801 27th St, Vero Beach, FL 32960 Ordinance Date: September 14, 2021 Resolution Date: September 20, 2022 Disability Contact: Indian River County at Accessibility@ircgov.eom or (772) 226-1391 Mandatory Payments Due Date: November 30, 2022 Copy of Indian River County Supplemental Packet Roll OWNER NAME FACILITY ADDRESS PARCEL # LEGAL DESCRIPTION Indian River County Indian River Medical 1000 36th St. 32393600000300000000 SEC 36 TWP 32 S RNG 39 E BEING MORE PART DESC AS FOLL: THE NE Hospital District Center/ Cleveland Clinic Vero Beach, FL 32960 QUARTER OF THE NW QUARTER LESS THE W 520 FT THEREOF AND Indian River Hospital ALSO LESS THE E 275 FT OF THE S 800 FT THEREOF AND ALSO LESS THE S 310 FT THEREOF AND ALSO LESS THE S 260 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 Health Encompass Health 1600 37th St. 32392600000700000000 S 715 FT OF SE1/4 OF SE1/4 LESS E 690 FT& LESS W 27.50 FT AS IN OR Associates Ltd Rehabilitation Hospital Vero Beach, FL 32960 BK 703 PP 24 43 & LESS S 55 FT FOR RD R/W of Treasure Coast Mpt Of Sebastian- Sebastian River 13695 US -1 30382500000002000000 A PARCEL OF LAND COMPRISING OF GOV GOTS 2 AND 4 SEC 25 TWN Steward LLC Sebastian, FL 32958 30 RNG 38 MORE PART DESC AS: THAT PORTION OF PROPERTY LYING NW -LY OF 83RD AVE (AKA BAY ST) AND W OF US HWY NO 1. BEG AT THE SW COR OF GOV LOT 2 SEC 25 TWN 30 RNG 38 SAID POINT BEING THE POB RUN S 00 DEG 00 MIN 30 SEC W, 89.54 FT; TH RUN N 35 DEG 1OMIN 46SEC E,742.74 FT; TH RUN N 04 DEG 15 MIN 45 SEC E, 49.46 FT TO A POINT ON THE W ROW OF US HWY NO 1; TH RUN ON SAID W ROW S 15 DEG 30 MIN 42 SEC E, 578.17 FT; TH CONT ON THE W ROW, 285.78 FT ON THE ARC OF A 11,459.20 FT RAD CUR CONCAVE TO THE NE, THROUGH A CEN ANG OF O1 DEG 25 MIN 44 SEC TO A POINT ON THE C/L OF A 70 FT ROW KNOWN AS BAY ST; TH CONT ON THE W ROW, 91.20 FT ON THE ARC OF AN 11,459.20 FT RAD, CURVE CONCAVE TO THE NE, THROUGH A CENTRAL ANG OF 00 DEG 27 MIN 22 SEC; TH RUN S 46 DEG 28 MIN 35 SEC W 302.40 FT; TH RUN S OJ2 ao nx —L,, DEG 09 MIN 26 SEC E,820.86 FT TO AN INTERSECTION WITH FLEMING '0D�' <_> GRANT LINE; TH RUN ON FLEMING GRANT LINE, N 44 DEG 04 MINPO Om Zm SEC W 1921.27 FT TOA POINT ON THE S BNDRY OF GOVT LOT 1, S C - = a� 25, TWN 30 RNG 38; TH RUN N 89 DEG 58 MIN 51 SEC E, 846.14 F �� on 0")06 ALONG THE S BNDRY OF GOV LOT 1 A DIS OF 846.14 FT TO THE P B. z= z a LESS ROW OR BK 430 PG 732, THAT ROW RECORDED IN OR BK 81 PG o z 1438 AND SUBJECT TO A CONSERVATION EASEMENT AS DESC IN R 'Ty BK 2354 PG 630rA — s O m 2 aJ � n .�