11/21/2000
CLERK'S ORIGINAL
FINANCIAL AGREEMENT
AGREEMENT
BETWEEN
FLORIDA HEAL THY KIDS CORPORATION "FHKC"
AND
MONROE COUNTY GOVERNMENT
This Agreement is made and entered into this 2J,4l day of fI~ 2000 by and between Monroe
County Government, hereinafter called MCG and the Florida Healthy Kids Corporation hereinafter called
'FHKC', a Florida not-for-profit corporation under the provisions of Chapter 617, Florida Statutes.
WHEREAS, the Florida Legislature enacted Chapter 624.91, Laws of Florida, creating the Florida
Healthy Kids Corporation, a Florida not-for-profit corporation organized to facilitate a program to provide
comprehensive health insurance coverage and preventative health care services to Florida children;
WHEREAS, FHKC has been specifically empowered to receive federal funds available under Title XXI
of the Social Security Act and said Act requires matching dollars;
WHEREAS, FHKC implementing statute provides for the provision of local matching funds from the
participating county and that said local match must be secured prior to the enrollment of applicants above any
base enrollment allocation in the participating county by a Financial Agreement with local contributors to
provide the required local match on an agreed periodic basis;
WHEREAS, MCG has agreed to participate in the FHKC program for Monroe County by providing
funds eligible for federal matching dollars under Title XXI to be applied to the local match for Monroe County;
NOW THEREFORE, in consideration of the premises and as an inducement to FHKC to commence or
continue a FHKC program in Monroe County: 25 0 <::) ~
z)'.> ::=:
;u C'") z <- ~_
1. MCG agrees to provide matching funds for the provision of the FHKC program in ~Qe Ci!mtgs
follows: C'"). r-- · '1
'2~' \0 C)
~ ;:o::c: :;;::J
A. MCG agrees to provide local matching funds which comply with all applic~~~t~d ~eral
laws or regulations in the amount of$38,370 for the period of October 1, 2jJI50 ~o~ J~ 30,
2001. (;0 rT1 ~ Eg
B. MCG understands that FHKC will create an enrollment pool for counties who contribute local
matching funds. MCG agrees that the total number of enrollment slots allocated to each county
will be apportioned based on the number of slots available in the FHKC's local match enrollment
pool and the percentage oflocal match committed by MCG to the total amount collected by
FHKC on a statewide basis.
C. MCG agrees to be invoiced on a monthly basis for one-twelfth of the local match amount listed
in paragraph 1. A.
D. MCG agrees to remit payment within thirty (30) days of receipt of an invoice from FHKC.
Revised 5/00 Page 1 of 3
E, MCG agrees to provide documentation that all local matching funds covered under this
Agreement meet federal Title XXI guidelines and understands that FHKC may conduct an audit
of these funds to ensure compliance. Should FHKC determine that an audit is necessary, MCG
agrees to cooperate with the audit and to respond to all requests for information within thirty (30)
days of receipt of such request. Failure to cooperate by MCG is considered a breach of this
Agreement.
II. FHKC in consideration ofthe funds paid by MCG and to provide local matching funds for the
Momoe County FHKC program agrees as follows:
A. To provide comprehensive health insurance coverage to each participant who has paid the
required premium and has met the other eligibility standards for emollment established by
FHKC.
B. To invoice MCG on a scheduled basis in accordance with paragraphs.I.C. and I.B. Invoice shall
be sent to:
COUNTYOFMONROE-OMB
5100 COLLEGE ROAD
KEY WEST, FL 33040
Ill, The Parties understand that local matching funds must meet the eligibility criteria set by federal law or
regulation under Title XXI of the Social Security Act or by state law or regulation.
IV, The Parties agree that the non-payment oflocal matching funds may result in the termination of the
Momoe County Healthy Kids program at the sole discretion of the FHKC. Additionally, the Parties
agree that if County fails to maintain its local match commitment, FHKC must enforce the provisions of
Line 192A of the 2000-2001 General Appropriations Act which requires FHKC to freeze emollment and
to also reduce emollment through attrition to reach the equivalent value of lost state, federal and local
matching funds,
V. MCG understands that FHKC will commence the expenditure of state and federal funds to develop a
FHKC program in Momoe County based upon the assurances by MCG to provide local matching funds
that are eligible under state and federal law, to assume the responsibilities and duties set forth herein and
to provide the local matching funds in accordance with the terms hereof. In the event the local matching
funds provided herein are not forthcoming in the amounts and upon the dates scheduled, FHKC is
entitled to enforce the obligations of this agreement in accordance with the laws of the state of Florida
and in such event shall be entitled to additional reimbursement for its costs and attorneys fees necessarily
incurred in order to enforce the completion of the obligations herein. It is understood that the intent of
this provision is to protect the children who will receive health insurance benefits through the FHKC
program in Momoe County and who will thereafter rely upon the continuation of the program.
VI. The parties agree that the provisions of this agreement are not subject to assignment without the express
written consent of the other party.
Revised 5/00
Page 2 of3
Vll. Any amendments to this Agreement shall be in writing and approved by both parties,
VllI. This Agreement shall be in effect from the date of its execution by both parties.... and shall remain in
effect until all obligations under this Agreement have been satisfied.
IN WITNESS WHEREOF, the Parties have caused this agreement to be executed by their undersigned officials
as duly authorized.
21 A-l.
day offl~2000.
Witness
MONROE COUNTY GOVERNMENT
I /}!/l IT-
~o (' ",,, j{!.."~ f-'-Cli~.....L(">~
L.. ,..A<:._ ,'...".. ( \
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NAME GeoV"jc..~. Ne-....j--.f-
TITLE tvr....yo.../ e.t.....i................
FLORIDA HEALTHY KIDS CORPORATION
~~J(~
ROSE M. NAFF, Ex / 'vector
Florida Healthy Kids Corporation
B
Revised 5/00
Page 3 of 3
NO:;, 1. 2000 3: 22PM
NO, 47:,4
T\
r. ...
THE FLORIDA LEGISLATURE
TONI JENNINGS
Pnlitiutl of the Serl(lte
June 14.2000
JOHN THRASHER
Sp.., oftlw Houn of
&pns."tDtiPa
Ms. Donna Arduin. Director
Office of Policy and Budget
Office of the Govemor
1602 The Capitol
Tallahassee, Florida 32399~OOOl
Dear Ms. Arduin:
This is in response to your inquiry dated June 6, regarding proviso language associated
with Specific Appropriations 192A and 193 of the 2000-2001 General Appropriatio~s
Act. Specifically, you asked for clarification regarding ,the definition and amount,of.locll1
',-. matching ~ds, and restrictions related to the non-Title XXI portion of the program. The
. . followmS"is'providcd fa c1ari1)1t:egislifiVEliUeiirregardiiig me issuesoutIfue(lUi-your
letter.
~ Local Match
The terms '.commitment" and Ucurrent local match 'levels'" refer to the FY 1999-00"!evels-'- --- ","- ,
of match pledged by local entities, which on a statewide basis are approximately SII.3 ,
million. This is the level of match required for FY 2000-01 for most counties.
Counties are not required to provide local match to participate in KidCare in excess of
this amount; however, counties may contribute additional local funds specifically for
non-Title XXI enrollees or Title XXI enrollees at their own discretion.
It is the intent of the Legislature that local match be capped at a maximum level ofS14.4
million. Counties whose local matching funds do not meet Title XXI eligibility
guidelines may continue to meet their "commitment" or "current local match"
requirements by allowing these funds to be used for non-Title XXI coverage even if these
enrollees arc not in their respective COWlty. The Florida Healthy Kids Corporation may
accept local matching funds that do not meet Title XXI eligibility guidelines; however.
such funds shall not be used as state matching funds for the purpose of drawing down
Title XXI federal funds. .
'---" Non-Title XXI Coverage
The legislative intent as stated in Section 409.813, Florida Statutes, is clear regarding the
non-entitlement nature of the KidCare program. The program is subject to fiscal limits as
ll~'" 1 'n~' ~ '''PI,!
. \IJV, ,~.IIjU j:~~',"
lW, 4754 p, 4.
(---
Ms. Donna Arduin
June 14,2000
Page Two
specified annually in the General Appropriations Act. It is the intent of the legislature
that only S13,500,OOO of state funds appropriated for FY 2000-01 shall be used for non-
Title XXI enrollees and that no additional state funded non-Title XXI children be
enrolled in the program after July 1, 2000.
,-.
It is tbe intent oCthe Legislature that non-Title XXI coverase be available for non-
citizens, state employee dependents and children over 19 years of ago to the extent state
funds arc specifically provided in Specific Appropriation 193 and to the extent local
matching funds, grant fimds, or other funds are legally av~lable.
It is not rIte intent of the Legislature to dis~oll non~ Title XXI eligible children Cor
reasons other than the failure to comply with the family payment provisions within the
allowable 30-day grace period or voluntary disemollment. However, state funded non-
Title XXI enrollees whose coverage is canceled for any reason shall not be reinstated and
the associated state funds shall be used to increase the availability of coverage to Title
XXI eligible CIiildieii and to maximiZe Cederal fimds.
Of the SI1.3 million in local match cozmnitment, up to $1.6 million in local matching
funds may be used Cor non-Title XXI match. These local match funds must be in
addition to the $9.7 million local match commitment required for Title XXI match and
shall not impair federal Title XXI match earnings..
In the event an entity contributing local matcb funds agrees to provide loeal match for the
purpose of increasing the number of non-Title XXI children served, such funds must be
provided on an annualized basis. Any non-Title XXI child enrolled after July 1,2000
with local match funds may not be shifted to state funding.
Sincerely,
~~
k&l-
Ken Pruitt, Chair
Fiscal Responsibility Council
Locke Burt, Chair
Senate Budget Committee
KP;LB;sc
---
NOV,
1. 2000
3:22PM
CONFEREIfCE REPOR.T ON HOt7SE BILL ~US. GB!IERAI. Ai'PIlOPRlATICIIS N:r Py ~000.~001
SECTICl( 3 - HUMAN 5illVXas
requ.1re~ ~ ~e GovermaeJ:lt. Perfonance aad AGcOWl1:~111ty Act. of 1".:
_.__._..._.-____~.....__._..._....__.____._...._.._____...............c
I;;;:.;~:::_-------------_.........._-----------------_::-~;;;~~;;__I
QO'1'PUTS ,
101:&1 n~r of unin.ured childr.n enrolled in Xidcar........400.'12
~r ot children age. 1-20 anrall.d in Medicaid..,.,.,...1.179.1.,
.~r ot eld.r. enrolled in long term care waiver.,.... ..., .,13.61.
HUaber of eld.~. p~..eribed drug..........,...............10.04...25
...-----------------------------------........-----------------------
Addie10nal approved p.rfonl&J1Ca _a.ure. and ataudard~ are
le.Cabli'~d 1D ~e Py 2000-2001 Impl..-n1:1ag Bill aad A~e
iIlcozporaeed 1I.~e1n by refereDce. '
.._______....................................----....&:...===a===....
CHIL1)RP'S SPECIAL HUIoTK CUlE
U1 anNSES
noM TOBACCO 5!TrLEHENT TltVST 1"UND
nOM M!l)ICAl. 0Jl.E T1WST nJIID . , .
'" .'40
1.719, no
aVo LtlHP SlIM
n.ORIOA. JaDCARE PJIOORAM
F1tOl1 TOIlACCO SETTLEMDT TIlt7ST ~
FROM GlWlTS AND DOIIATI0N3 nOST FUlCD
PROM MEtlICAL ClUlE nun f't1N!) ,
40.tlll,"3
"', '67
54.956.656
Funds in Specific Appropriation lJZA are provi~ed to expand ~e
Plorida KidCa~e Program fo~ ch11dzen eligible under the S~ate Children'c
Healeh In$urance Progran (Title XXI), of ~he.e fund.. $18.400.000 from
the TobACCO S.ttl_nt Truee Fund i. trazwfernd fl"Olll the Lawton Chile.
Eodo~e Pund. The ottice of tha GoYemor may Autho~ixe movement of
~esc re~ource$ ~etween programe or .geD~ias bllOed on coneensu.
estimmte$ of the SOCial service. ~timating Conference and purSUAnt to
OIap'r.er 215. Plol:ida Seacutee. The agency. 1n coopel"atioa with the
nepartment of Health &Dd ~e Florida Healthy Kida Corporation. ahall
contraee for an avaluatioo of the Floriclll KidCare ProgrUl and ehall
provide ~ 6valuation queetione and 'r.~ daell requioite io~ the required
analy:e&. A441t1ooal local mat~h1ng fund. beyond $1....11,.50 are not
req1.lireci tor progrUl participation in the healeh ifttl11'&nce ponioo of
the Pn9~. Local _tch11l9 funds provided by the cO\lfttie. aDd.
~ittad to the Florida a.althy Kid. Corporaeion ~hll11 b. u.ed co match
the Title XXI federal fuad..
1Jl the event ~~reat local match level. ara not _t by ~o\&nei.a. die
a.althy Kid. P~ogram shall free.e adai..iene in c:ho.e ~ountiec which do
DOt: ...t eheir matCh comMic:ment. &Dd requirements acd begin reducing
enrollmoa1: thrO\&9A &ttr1t1oo co reach the equivulene value of the 10'C:
local. lJ~&t. and. ...0eLaced federal llI&'r.ching fund:;. Fundc ar. alao
p~ided to A~l~c & dental bane fit package for 1IA eeci_ced 1'0.000
childree enrolled 1n the Florida Healthy Kid. Program co coun~1.. thac
OQD~iftue th.1~ current level of lOCAl match. O~ will 1n the future.
_e:cibuce local _cching fuadll eo the health 1AlIu~ence p:cogram, The
d.encal progrUl .hall be _de availUle co eouat1e. which provil1eor
eoea1c ~o provide local ma'r.ch )n exce.s of $6.0DO.
The Florida Healthy X1= Corpora,ton ahall ccmduct a revie" of l;urrene
local aaech requiremcntG and aevelop .. re~ndation for a mUlti-year
propoeal relaced to the :codu~~1oD of local ..~ch. Thie report ahall ~e
provided to ~e Governor. $~ax.r of the HOu8. of llepre.enelltive~. and
Pr..ident of tbe Seaa~e no lat.~ ~b&n NOvember 1, 2000,
193
SPECIlUo CA'l'EGOIlI!S
GRANTS AND AIDS - FLOIlIDA HV.I.1'HY ICIDS
COItPOJlATIOlf
noM GEN!1lAL REV'BNOE FURD
FJlOH 1'OaACCO SB1'TLEHENT' TllU$T FtJIII)
noM M!l)Ic:AL CMS TlWST FUND '
14.430.U'
'0.434..73
lC. 011, &52
Punds in Spoclflc Approp~i&cioo 193 are for 1:he operation Of the
Florida Jt14care Prograll, General ___aue Fund. lind Tobacco Set~l_t.
Trust PUD4e are eligible to _~ch ~e Seaee Children'S Heal~h Inaurance
Pt'Ogram (Ticla XXII. The Florida Beal~y JCidD COll'Po~aeion 1. authorized
to ~. up to 513.500.000 t~ tbe Geael:al Revenue rund for health
ift8uraoea coverage for .~te fundeG (naft-Tiele XXXI eligible children
it
NO, 47:,4
P.
~
:.
May 8, 2000
Mr, James Roberts
County Administrator
Stock Island Government Complex
College Road
Key West, FL 33040
Dear Jim:
Each year the state requires the Rural Health Network of Monroe County Florida as the lead
agency for the Florida KidCare Program, to provide local match funding for the Florida Healthy
Kids Program. The local match is required to maintain the current enrollment and add additional
children to the state's affordable health care initiative, Based on the current participation in the
program, the forecast for program year 2000-2001 is for 1,500 children to be enrolled,
The local match for the upcoming fiscal year is scheduled to remain at the current 15% rate,
and not increase to the 20% capped rate, as originally established by the legislature. Fortunately,
the legislature heard the pleas from rural counties concerning the challenge of securing local
match dollars plus being penalized with a local match rate increase to factor against an increased
number of enrolled children, due to the success of outreach efforts,
The Healthy Kids monthly premium cost currently is $72.00 (up from $59,00 in 1999), for
each child enrolled, with 48,5% of that total to be provided by the Monroe County and 51.5%
provided by the Lower Florida Keys Hospital District. The totals are based on enrollment
distribution, The County historically covers the portion of the current enrollment living from
Marathon to Key Largo, The formula used to determine the local match figures is calculated as
follows:
1. The total number of enrollment slots forecast is 1,500,
2, The state gives each KidCare region 500 free enrollment slots, reducing the number to 1,000,
3. The total cost of the program is $864,000 ($72/child/month x 12 months x 1,000 children),
4, The total local match requirement is $129,600 ($864,000 x 0,15),
5, The Monroe County portion is $62,856 ($129,600 x 0.485).
6, An additional $20,000 is needed for outreach to be divided equally between both local match
sources, or $10,000 from Monroe County.
7. Total request is $72,856 ($62,856 + $10,000),
EXECUTIVE DIRECTOR-VOICE 305-293-7570; FAX 305-293-7573; EMAIL RHNED@AOLCOM
COMMUNnY OUTREAot DIRECTOR-VOICE 305-293-7570; FAX 305-293-7573; EM~~~~~~~~COM
PRIMARY CARE DIRECTOR-VOICE 305-872-5522; FAX 305-872~2; =~~RE@Kel1"ticoNNEcnON.COM
HEAlTHY KIDS/KIDCARE DIRECTOR-VOICE 305-517-9002; FAX 305-517-9004, E
-2-
Hopefully, a portion of the savings realized by the effort to keep the local match at 15% can
be used to provide outreach to uninsured children and service the needs of currently enrolled
families. Thus the Rural Health Network of Monroe County Florida, Inc, asks the Monroe County
Commission to plan to allocate $77,856 to meet its portion of the local match required to provide
the Healthy Kids Program to 1,500 children, Thank you for your continued support of this
program vital to the health of our community.
J;;" ~7
1 er , / /.
~ '.or' ~:-;:.--
. . Keith DOUglasY
C KidCare Director