SUBJECT
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Board to authorize the County Manager to execute, on behalf of Polk County, the Low Income Pool Letter of Agreement with the State of Florida Agency for Health Care Administration, for Tri-County Human Services, Inc. behavioral health matching funds on or before the deadline of October 1, 2022. ($860,081) not-to-exceed one-time expense).
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DESCRIPTION
Since 2008, the County, through the Indigent Health Care program, has leveraged $63.4 million in match funding to draw in an additional $97.1 million in federal funding back to Polk non-profit health care organizations toward the provision of health care services to low-income Polk County residents, through the Low Income Pool program.
The Low income Pool provides government support for safety-net health care providers for the costs of uncompensated charity care for low-income individuals who are uninsured. Specifically, the program uses Intergovernmental Transfers to allow local county governments to provide matching funds on behalf of health care service providers such as non-profit hospitals and Federally Qualified Health Centers to the Agency for Health Care Administration. The Low Income Pool is authorized by the Centers for Medicare and Medicaid Services through waivers and state plan amendments.
In the State 2018/19 budget, only $20 million was allocated to the Low Income Pool for behavioral health. Polk County was not one of the ten entities eligible for the funding. AHCA has agreed to consider broadening eligibility, but it requires CMS approval and then legislative authority and funding.
In 2020, the Board lobbied the State Legislature to support modifying the Low Income Pool Special Terms and Conditions that would allow qualifying Polk County behavioral health providers to be eligible for Low Income Pool funding, therefore increasing behavioral health Low Income Pool funding as a result.
The Agency for Health Care Administration (AHCA) submitted a request to the Federal Centers for Medicare and Medicaid Services (CMS) seeking approval to amend the special terms and conditions for LIP to include behavioral health providers in counties that support indigent health care programs pursuant to Chapter 212 of the Florida Statutes, as a payment group.
The State of Florida incorporated the modified language in the state waiver to the Centers for Medicaid and Medicare Services at the federal level, and it was approved on May 25, 2022.
In June, the Centers for Medicaid and Medicare Services (CMS) approved Florida’s 1115 Medicaid Waiver Amendment. The amendment submitted from Florida included the language lobbied last year to allow Counties with indigent health care tax funded programs to be added to Low Income Pool for behavioral health Intergovernmental Transfers, this included Peace River and Tri County Human Services.
The County will transfer an amount not-to-exceed $860,081 allowing approximately $2,152,893 to flow back to Tri-County, including a net benefit of an additional $1,292,812 further supporting Tri-County in its ability to provide behavioral health care services to Polk County’s low-income residents.
$7.9 million is budgeted for behavioral health services.
RECOMMENDATION
Board to authorize the County Manager to execute, on behalf of Polk County, the Low Income Pool Letter of Agreement with the State of Florida Agency for Health Care Administration, for Tri-County Human Services, Inc. for behavioral health matching funds on or before the deadline of October 1, 2022.
FISCAL IMPACT
Funds are budgeted in the Indigent Health Care Fund.
CONTACT INFORMATION
Joy Johnson, Administrator, Health and Human Services at 863-534-5204.