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Home My WebLink About2023-050RESOLUTION NO. 2023- 050 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, three of the Hospitals have asked Indian River County (the "County") to participate in the 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,; 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 WHEREAS, the County has an interest in promoting access to health care for its low- income and uninsured residents; and RESOLUTION NO. 2023- n S n 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. 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. RESOLUTION NO. 2023- 0 5 0 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 Scone, 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 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, RESOLUTION NO. 2023- 0 5 0 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(f)(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 16, 2023 and notice published in the Indian River Press Journal on August 23, 2023, 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 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. RESOLUTION NO. 2023- n 5 o Section 10. Effective Date. This Resolution to be effective immediately upon adoption. This Resolution duly adopted this 12th day of September, 2023. The foregoing resolution was moved for adoption by Commissioner T a u r a moss seconded by Commissioner Susan Adams , and adopted by the following vote: Chairman Joseph E. Earman Vice -Chairman Susan Adams AYE Commissioner Joseph E. Flescher AYE Commissioner Deryl Loar AYE Commissioner Laura Moss AYE The Chairman thereupon declared the resolution duly passed and adopted this 12th day of September, 2023. BOARD OF COUNTY COMMISSIONERS 0.... INDIAN RIVER—COUNTY ATTEST: Ryan L. Butler, Clerk Of Court and Comptroller '.. Dieputy Clerk Approved as to form and legal sufficiency: By: e4c_ �, 'Lie William K. De raal County Attorney Attachment — Assessment Roll RIDA n nN MCD ID # I Organization Facility Hospital Address Parcel # Rate Mandatory Invoice Contact Invoice Address Email Phone Number Payment Cleveland Clinic Cleveland Clinic Medical 1000 36th St, Vero _ 32393600000300000001.0 1000 36th St. Vero Beach, FL 10104400 Health System Center / Indian River Hospital Beach, FL 32960 0.37% NPR $1,229,363 Warren Fuller 32960 Fullerw3@ccf.org Encompass Health andrew.wilburn@encompasshealth. Rehabilitation Hospital of 1600 37th St, Vero Andrew Wilburn 9001 Liberty Parkway, com; 12034100 Encompass Health Treasure Coast Beach, FL 32960 32392600000700000001.4 0.37% NPR $110,306 and Katie Shuey Birmingham, AL, 35242 katie.shuey@encompasshealth.com Brian. Bodi@stewa rd.org; (205) 970-5761 Steward Health Sebastian River Medical 13695 US -1, Sebastian, Brian Bodi; Nigel 1900 N. Pearl St., Suite 2400, 12001400 30382500000002000006.1 0.37% NPR $408,704 Amanda.Davidson@steward.org; (407)443-7504 Care System Center FL32958 Bowman Dallas, Texas 75201 Nigel.Bowman@steward.org County Phone Number: (772) 226-1408 BCC Address: Indian River County Administration Building A, 180127th St., Vero Beach, Ordinance Date: September 14, 2021 Resolution Date: September 12, 2023 Disability Contact: accessibility@ircgov.com or (772) 226-1391 Mandatory Payments Due Date: Upon receipt of invoice Organization Title Name Hospital Address Phone Number Email Cleveland CFO Warren Clinic Fuller Senior VP, Steward Finance & Tax Bill Stokes Statutory & Andrew Encompass Regulatory Analyst Wilburn Cleveland Clinic 1000 36th Street Vero Beach, Medical Center/ Indian 772-563-4469 River Hospital FL 32960 Sebastian River Medical 1900 N Pearl St, Ste 2400 Center Dallas, TX 75201 615-406-7358 Encompass Health Rehabilitation Hospital 9001 Liberty Parkway, 205-970-5761 of Treasure Coast Birmingham, AL, 35242 Fullerw3@ccf.org william.stokes@steward.org andrew.wilburn@encompasshealth.com; katie.shuey@encompasshealth.com Numbe FACILITY FACILITY l PARCEL q LEGAL DESCRIPTION OWNER NAME r DESCRIPTION ADDRESS 1 Indian River County Hospital Cleveland Clinic 1000 36th St., 32393600000300000001.0 SEC 36 TWP 32 S RNG 39 E BEING MORE PART DESC AS FOLL: THE NE QUARTER OF District C/O Cleveland Clinic Medical Center/ Vero Beach, FL THE NW QUARTER LESS THE W 520 FT THEREOF AND ALSO LESS THE E 275 FT OF THE Indian River Hospital 32960 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 2 Ocean Health Associates Ltd Encompass Health 1600 37th St., 32392600000700000001.4 S 715 FT OF SE1/4 OF SE1/4 LESS E 690 FT& LESS W 27.50 FT AS IN OR BK 703 PP 24 43 Rehabilitation Vero Beach, FL & LESS S 55 FT FOR RD R/W Hospital of Treasure 32960 Coast A PARCEL OF LAND COMPRISING OF GOV GOTS 2 AND 4 SEC 25 TWN 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 10 MIN 46 SEC 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 13695 US 42 SEC E, 578.17 FT; TH CONT ON THE W ROW, 285.78 FT ON THE ARC OF A 11,459.20 Mpt of Sebastian-Steward LLC Sebastian River Highway 1, FT RAD CUR CONCAVE TO THE NE, THROUGH A CEN ANG OF 01 DEG 25 MIN 44 SEC 3 C/O Mpt Operating Partnership Medical Center Sebastian, FL 30382500000002000006.1 TO A POINT ON THE C/L OF A 70 FT ROW KNOWN AS BAY ST; TH CONT ON THE W LP 32958 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 01 DEG 09 MIN 26 SEC E,820.86 FT TO AN INTERSECTION WITH FLEMING GRANT LINE; TH RUN ON FLEMING GRANT LINE, N 44 DEG 04 MIN 20 SEC W 1921.27 FT TO A POINT ON THE S BNDRY OF GOVT LOT 1, SEC 25, TWN 30 RNG 38; TH RUN N 89 DEG 58 MIN 51 SEC E, 846.14 FT ALONG THE S BNDRY OF GOV LOT 1 A DIS OF 846.14 FT TO THE POB. LESS ROW OR BK 430 PG 732, THAT ROW RECORDED