Leon County adopts rule to join local provider participation fund; hospitals to seek federal match

The Leon County Commission on Monday adopted a resolution and related budget amendment enabling the county to participate in the Local Provider Participation Fund and authorized the county administrator to execute an agreement with the Agency for Healthcare Administration in a form approved by the county attorney.

The county attorney opened the public hearing by saying the item ‘‘is the first and only public hearing to consider adoption of a resolution approving and adopting the local provider participation fund non ad valorem assessment rule.’’ County staff told commissioners the measure would not require county operating funds but would allow private hospitals to advance local dollars and draw federal matching funds under federal Medicaid mechanisms.

The change could be sizable. County staff said that, if the resolution is adopted, it is estimated that ‘‘approximately $90,000,000 in gross federal and local provider participation funding will potentially be paid to local hospitals the next fiscal year.’’ The county will retain an annual administrative fee from assessments, staff said.

Hospital representatives and local hospital finance officers described how the program works. Priscilla Needham, chief financial officer at Tallahassee Memorial HealthCare, said the hospital’s ‘‘community benefit at cost that we provide every year is over $100,000,000’’ and described those dollars as including charity care and subsidized programs. She added that the county-level action would not reduce existing hospital community benefit but would constrain future assessment growth because of a new federal cap.

Suhail Chhabra, speaking for a coalition of hospitals, said the request was intended to let private hospitals ‘‘front their own private dollars to draw matching federal funds so that they can continue to provide care to those who need it the most.’’ He told commissioners, ‘‘No impact to the county. There will never be a dollar impact on any Leon County residents. Everything is there to be gained.’’

Commissioners asked county staff to explain the recent federal change. The county attorney said a federal law signed July 4 limited the maximum assessment rate hospitals can be charged, creating a nationwide ceiling; staff said final fiscal estimates were still being calculated in the days after enactment. Commissioners voted to adopt staff recommendations.

Votes and next steps The board voted to adopt the resolution approving the Local Provider Participation Fund non ad valorem assessment rule, and approved the associated budget amendment and authorization to execute an agreement with the Agency for Healthcare Administration. The motion to adopt staff recommendations (options 1, 2 and 3) was made by Commissioner Cummings, seconded by Commissioner O'Keefe, and passed unanimously with one commissioner out of chambers. Staff will execute the AHCA agreement in a form approved by the county attorney and implement the assessment rule if the county's supporting documents remain unchanged.

Why it matters The county’s action authorizes a mechanism by which private hospitals can finance part of their uncompensated-care costs through locally assessed payments that draw federal matching dollars. County staff emphasized the county itself will not contribute operating funds to the program; the county’s role is administrative, collecting and remitting assessed dollars and retaining a small administrative fee. Speakers at the hearing framed the measure as a tool to preserve care for uninsured and Medicaid populations while warning that the newly enacted federal cap will limit future growth of such assessments.

Public record and documentation The agenda packet filed with the county included revised attachments issued the same day to reflect the federal change signed July 4. The board’s action authorized the county administrator to finalize the agreement with the Agency for Healthcare Administration in consultation with the county attorney.