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11/17/2010 AgreementDANNY L. KOLHAGE CLERK OF THE CIRCUIT COURT DATE: November 23, 2010 TO: Suzanne A. Hutton County Attorney ATTN: Kathy M. Peters Executive Assistant FROM: Pamela G. Hanc 4ck,.. At the November 17, 2010, Board of County Commissioner's meeting, the Board granted approval and authorized execution of a Memorandum of Understanding with Mariners Hospital, Inc., in order to facilitate Mariners' enrollment in federal 340B discount drug program. Attached is a copy of the MOU executed by the County Administrator for your records. Should you have any questions, please feel free to contact this office. cc: County Administrator Finance File MEMORANDUM OF UNDERSTANDING l MONROE COUNTY, STATE OF FLORIDA 0 MARINERS HOSPITAL THIS MEMORANDUM OF UNDERSTANDING is made this /7 ' day of�+�mbe, . 2010 by and between the undersigned representatives of MONROE COUNTY, FLORIDA ("COUNTY"), located at 1100 Simonton Street Key West, FL 33040, and MARINERS HOSPITAL, INC. ("HOSPITAL71, a non-profit corporation organized and existing under the laws of the State of Florida, located at 91500 Overseas Highway, Tavernier, Florida, 33070. RECITALS: WHEREAS, HOSPITAL is a Florida not -for -profit hospital certified by the Centers for Medicare and Medicaid Services and the Florida Office of Rural Health as a "Critical Access Hospital," as defined by Section 1820(cx2) of the Social Security Act, and Hospital supports many programs that benefit the indigent, uninsured or underinsured population in the State of Florida; WHEREAS, HOSPITAL desires to participate in the drug discount program established under Section 340B of the Public Health Services Act, as amended (the "340B Program"); WHEREAS, in order to participate in the 340B Program, HOSPITAL must enter into an agreement with a unit of the state or local government pursuant to which HOSPITAL commits to provide health care services to low income individuals who are not entitled to Medicare or Medicaid benefits at no reimbursement or considerably less than full reimbursement from these patients; WHEREAS, HOSPITAL desires to make such a formal commitment to COUNTY; and WHEREAS, COUNTY agrees to accept such commitments on behalf of the citizens of COUNTY. NOW, THEREFORE, in consideration of the mutual agreements and covenants contained therein and for other good and valuable consideration, the receipt and sufficiency of which hereby are acknowledged, it is mutually agreed and covenanted, under seal, by and between the parties to this Agreement, as follows: Mariners Hospital- Monroe County- 340E MOU— Page 2 1. Commitment of HOSPITAL to Provide Indigent Care. During the term of this MOU, HOSPITAL agrees to continue its historic commitment to the provision of health care to indigent, uninsured and underinsured residents of COUNTY. During the fiscal year of 2010, this commitment totaled more than Fifteen Million Dollars ($15,000,000.00) in foregone charges. Pursuant to this commitment, it is the intention of HOSPITAL that indigent care provided during the term of this MOU will range generally between Fifteen Million Dollars ($15,000,000.00) and Fifteen Million Five Hundred Thousand Dollars ($15,500,000.00) annually. In any event, HOSPITAL will assume that all patients will receive necessary care, as required by law, regardless of ability to pay. 2. Acceptance and Acknowledgements of COUNTY. (a) COUNTY accepts the commitment of HOSPITAL set forth above; (b) COUNTY hereby acknowledges that the healthcare services provided by HOSPITAL hereunder are in the public interest and are being provided to individuals who are not entitled to benefits under Title XVIII or eligible for assistance under any State plan pursuant to Title XIX of the Social Security Act; and (c) COUNTY acknowledges that HOSPITAL is providing these services at no reimbursement or considerably less than full reimbursement from the patients. 3. Representations of HOSPITAL. HOSPITAL represents that as of the date hereof (a) HOSPITAL constitutes a corporation duly organized and validly existing in good standing under the laws of the State of Florida with the corporate power and authority to enter into and perform its obligations under this MOU; and (b) HOSPITAL is a tax-exempt corporation of under Section 501(cx3) of the Internal Revenue Code of the United States, as amended and under applicable laws of the State of Florida. 4. Term and Termination. The term of this MOU shall commence on the date first above written and shall continue until terminated by either party upon not less than sixty (60) days prior written notice to the other. 5. Notice. All notices required or permitted to be given under this MOU shall be deemed given when delivered by hand or sent by registered or certified mail, return receipt requested, addressed as follows: Mariners Hospital- Monroe County- 340B MOU—Page 3 MONROE COUNTY Attention: Roman Gastesi, County Manager Address: 1100 Simonton St. Key West, FL 33041-6193 MARINERS HOSPITAL: Attention: Maribeth Rouseff Assistant Vice President, Employee Health Services and Wellness Advantage 12420 SW 127th Avenue Miami, Florida 33186 With a copy to: David Friedman Corporate Vice President & General Counsel 6855 Red Road, Suite 600 Coral Gables, Florida 33134 6. Governing Law. This MOU shall be governed by and construed in accordance with the laws of the State of Florida (excepting any conflict of laws provisions which would serve to defeat application of Florida substantive law). IN WITNESS WHEREOF, HOSPITAL and COUNTY have executed this Memorandum of Understanding as of the day and year first written above by their duly authorized representatives. COUNTY: MO C B �// — Roman GastesL el - County Manager Approv)o as to form and legal sufficiency by: B �•��� Name: �%7?4A Title: h55;5T-**Vr HOSPITAL: MA RS OSPI TAL, INC. n.�". 7 ck F , Chief Executive cer rn cm - r"Q 1 p W 7:7 m = r t.-) o O