Interoffice Memorandum
DATE: September 4, 2026
TO: Mayor Jerry L. Demings and County Commissioners
THROUGH: Raul Pino, M.D. MPH, Director
FROM: John Goodrich, Deputy Director
CONTACT: Sandra Roe
PHONE: 407-836-7611
DIVISION: Health Services Fiscal and Operational Support Division
ACTION REQUESTED:
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Approval and execution of Directed Payment Program Letter of Agreement by and between Orange County and the State of Florida, Agency for Healthcare Administration in the amount of $1.00 and authorization for the Mayor or designee to sign any future amendments of this agreement. (Fiscal and Operational Support Division)
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PROJECT: N/A
PURPOSE: On August 24, 2021, the Board adopted Ordinance No. 2021-35, establishing the Local Provider Participation Fund (LPPF). The LPPF helps reduce the gap between Medicaid reimbursement and the actual cost of care provided by local hospitals. Through the program, the County imposes a non-ad valorem special assessment on properties owned by private for-profit and not-for-profit hospitals that provide inpatient services. The assessment generates a portion of Florida’s non-federal share of Medicaid funding, allowing the State to draw down additional federal Medicaid funds. The County collects the assessment proceeds and remits them to the Florida Agency for Health Care Administration (AHCA) as the non-federal share of the Directed Payment Program (DPP). These funds are matched with federal Medicaid dollars and returned to participating local hospitals through enhanced Medicaid reimbursement payments. The program helps offset unreimbursed Medicaid costs incurred by local hospitals. Due to delays in receiving federal approval of Florida’s DPP, the County has not yet approved the LPPF assessment for the upcoming program year. However, Florida law requires local jurisdictions to execute the DPP Letter of Agreement (LOA) by October 1 in order to participate in the program. To allow local governments to meet this deadline w...
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