Subject:
Title
Amendment to Ordinance 24-16 adjusting Section 110 Article III to allow exemption from assessment requirements for certain non-public hospital facilities that are granted waivers by the Centers for Medicare & Medicaid Services to participate in supplemental pay programs supported by the Local Provider Participation Fund.
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Recommended Action:
Recommended Action
Conduct a public hearing and adopt the proposed amendment to Ordinance 24-16 adjusting Section 110 Article III to allow exemption from assessment requirements for certain non-public hospital facilities that are granted waivers by the Centers for Medicare & Medicaid Services (CMS) to participate in supplemental pay programs supported by the Local Provider Participation Fund (LPPF).
• Pinellas County adopted Ordinance 24-16 on April 23, 2024, to establish procedures for Pinellas County Hospitals to participate in the Hospital Directed Payment program and other supplemental Medicaid reimbursement programs established within the State of Florida to help reduce local Medicaid reimbursement gaps.
• This amendment to the ordinance allows for an exemption from assessments for certain facilities when authorized by a waiver requested by the Florida Agency for Health Care Administration and granted by the CMS. The waiver process provides flexibility for pursuing annual assessments in alignment with federally defined program guidelines while accounting for service levels and utilization across facility types.
• The amendment will also position the LPPF to support new and evolving supplemental payment and enhanced funding programs as established by CMS and the State of Florida. Currently, the state is exploring a new Managed Care Organization Incentive Program to enhance hospital quality strategies under LPPF programs.
• Pinellas County has facilitated assessments and LPPF Intergovernmental Transfers for local hospital partners for three program years. A separate Legistar item is anticipated on a later Board agenda to bring forward a new assessment resolution for continued participation in year four.
• This amendment by itself has no fiscal impact on Pinellas County.
Body
Strategic Priorities:
Healthy and Safe Communities
2.1 Improve public health
2.2 Enhance community safety
Healthy and Safe Communities
2.1 Improve public health
2.2 Enhance community safety
Prosperity and Opportunity
3.3 Increase workforce opportunities
Smart Service Delivery
4.4 Pursue Continuous Improvement
Summary:
Summary
Local hospitals experience a significant gap in Medicaid reimbursements and losses from charity care when delivering critical services for low income, vulnerable residents.
To help close this reimbursement gap, the State of Florida and the Center for Medicare and Medicaid Services (CMS) authorized supplemental payment programs such as the Hospital Directed Payment Program and the Low Income Pool Program to help draw down enhanced funding for hospitals.
Pinellas County adopted Ordinance 24-16 on April 23, 2024 to establish procedures for Pinellas County Hospitals to participate in the Hospital Directed Payment program and other supplemental Medicaid reimbursement programs established within the State of Florida to help reduce local Medicaid reimbursement gaps.
This amendment to the ordinance allows for exemption from assessments for certain facilities, when authorized by a waiver granted by the Centers for Medicare & Medicaid Services (CMS), providing flexibility for pursuing annual assessments in alignment with federally defined program guidelines.
The amendment will also position the LPPF to support new and evolving supplemental pay and enhanced funding programs as established by CMS and the State of Florida. Currently, the state is exploring a new MCO Incentive Program to enhance hospital quality strategies under LPPF programs.
A public hearing was advertised for the August 11, 2026, Board meeting. A Business Impact Estimate was properly published on the County website.
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Background Information:
In April 2024, at the request of local hospital partners, the Board of County Commissioners (BCC) adopted Ordinance 24-16, establishing the LPPF and defining a structure for annual special assessments.
Pinellas County has facilitated participation for local hospitals for 3 program years:
• Fiscal Year 2023-2024 (FY2024) - Resolution for $108,534,798 assessment with estimated $200 million in enhanced revenues for hospitals.
• FY2025 - Resolution for $151,115,221 assessment with estimated $309.9 million in enhanced revenues for hospitals.
• FY2026 - Resolution for $355,646,140 assessment with estimated $700 million in enhanced revenues to hospitals.
Pinellas County local assessments cover Medicaid region five (5) which includes sixteen (16) Pinellas hospitals:
• AdventHealth North Pinellas
• Baycare Alliant Hospital
• Mease Countryside Hospital
• Mease Dunedin Hospital
• Morton Plant Hospital
• St. Anthony’s Hospital
• Encompass Rehabilitation Hospital of Largo
• Largo Medical Center
• Largo Medical Center - Indian Rocks
• Northside Hospital
• Palms of Pasadena Hospital
• St. Petersburg General Hospital
• All Children’s Hospital
• Kindred Hospital - Bay Area - St. Petersburg
• Bayfront Health - St. Petersburg
• Windmoor Healthcare of Clearwater
Pinellas County would continue to require adoption of a new resolution each year to allow for authorization and continuation of the Hospital DPP assessments.
Fiscal Impact:
This ordinance amendment by itself has no fiscal impact on Pinellas County.
Staff Member Responsible:
Karen Yatchum, Director, Human Services
Partners:
Non-Public Hospitals
Attachments:
Final Proposed Ordinance
Final Proposed Ordinance Redline Version
Program Update Hospital Special Assessment Program
Public Notice