Agenda 09/22/2020 Item #16E 7 (Resolution - Ingergovernmental Transfers between Collier County EMS & Stat of FL ACHA)09/22/2020
16.E.7
EXECUTIVE SUMMARY
Recommendation to approve a resolution authorizing Intergovernmental Transfers (IGT) between
Collier County EMS and the State of Florida Agency for Health Care Administration (ACHA) for
FY21, to authorize Chairman to sign an Agreement with ACHA to accept direct payments from the
program named Statewide Medicaid Managed Care (SMMC) for FY21 and to approve the
necessary budget amendments.
OBJECTIVE: To participate in the Statewide Medicaid Managed Care (SMMC) program to receive
supplemental Medicaid reimbursement for services rendered.
CONSIDERATIONS: On July 14, 2020 the Board approved item 16.E.1 to allow Emergency Medical
Services to participate in the Statewide Medicaid Managed Care (SMMC) program and to accept direct
payments from the program for FY20. To participate in the SMMC program and accept direct payments
in FY21, The Agency for Health Care Administration (ACHA) requires an annual letter of agreement in
place with Collier County EMS. ACHA also requires Inter -Governmental Transfers (IGT), which will
require EMS to pay ACHA funds up front at the start of FY21 before receiving those funds and additional
funds back later during FY21.
It is estimated that for FY21 Collier County EMS's IGT total that will need to be paid upfront, will be
$306,352.16. This amount may increase or decrease depending on the number of providers that
participate in the program during FY21. Collier County's estimated allocation for FY21 that will be
received back is $805,342.17, adding an additional net new federal funding of an estimated $498,990.01.
FISCAL IMPACT: A Budget Amendment is needed in the amount of $306,352.16 to move funds from
490 reserves to fund 490 operating. A Budget Amendment is needed to appropriate $805,342.17 within
fund 490.
LEGAL CONSIDERATIONS: This item is approved for form and requires majority vote for approval.
-JAB
GROWTH MANAGEMENT IMPACT: There is no Growth Management Impact resulting from this
action.
RECOMMENDATION: Recommendation to approve a resolution authorizing Intergovernmental
Transfers (IGT) between Collier County EMS and the State of Florida Agency for Health Care
Administration (ACHA) for FY21, to authorize Chairman to sign an Agreement with ACHA to accept
direct payments from the program named Statewide Medicaid Managed Care (SMMC) for FY21 and to
approve the necessary budget amendments.
PREPARED BY: Erin Page, Accounting Supervisor, Emergency Medical Services Admin.
ATTACHMENT(S)
1. FL PEMT MCO Year 2 Projections (PDF)
2. Letter of Agreement (PDF)
3. Resolution MCO Program (PDF)
Packet Pg. 1711
16.E.7
09/22/2020
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.E.7
Doe ID: 13423
Item Summary: Recommendation to approve a resolution authorizing Intergovernmental
Transfers (IGT) between Collier County EMS and the State of Florida Agency for Health Care
Administration (ACHA) for FY21, to authorize Chairman to sign an Agreement with ACHA to accept
direct payments from the program named Statewide Medicaid Managed Care (SMMC) for FY21 and to
approve the necessary budget amendments.
Meeting Date: 09/22/2020
Prepared by:
Title: Accounting Technician — Emergency Medical Services
Name: Erin Page
08/31/2020 8:15 AM
Submitted by:
Title: Division Director - EMS Operations — Emergency Medical Services
Name: Tabatha Butcher
08/31/2020 8:15 AM
Approved By:
Review:
Administrative Services Department
Emergency Medical Services
County Attorney's Office
Administrative Services Department
County Attorney's Office
Office of Management and Budget
Office of Management and Budget
County Manager's Office
Board of County Commissioners
Paula Brethauer
Level 1 Department Reviewer
Tabatha Butcher
Additional Reviewer
Jennifer Belpedio
Level 2 Attorney of Record Review
Len Price
Level 2 Department Head Review
Jeffrey A. Klatzkow Level 3 County Attorney's Office Review
Debra Windsor
Level 3 OMB Gatekeeper Review
Laura Wells
Additional Reviewer
Sean Callahan
Level 4 County Manager Review
MaryJo Brock
Meeting Pending
Completed
08/31/2020 10:46 AM
Completed
09/08/2020 11:39 PM
Completed
09/09/2020 2:31 PM
Completed
09/09/2020 3:30 PM
Completed
09/09/2020 4:13 PM
Completed
09/10/2020 8:28 AM
Completed
09/10/2020 2:53 PM
Completed
09/14/2020 2:41 PM
09/22/2020 9:00 AM
Packet Pg. 1712
FL PEMT MCO Year 2 Projection -Updated
Provider
Total Allotment
Total IGTs Needed
Net New Federal
Funding
Alachua County Fire Rescue
1,264,525.80
481,025.61
783,500.18
Baker County Fire Rescue
195,561.10
74,391.44
121,169.66
Bay County EMS
559,273.95
212,747.81
346,526.14
Boynton Beach Fire Rescue
150,597.45
57,287.27
93,310.18
Bradford County EMS
174,311.15
66,307.96
108,003.19
Brevard County Fire Rescue
1,492,731.74
567,835.15
924,896.59
Broward Sheriffs Fire Rescue
949,164.27
361,062.09
588,102.18
Charlotte County Fire & EMS
424,690.96
161,552.44
263,138.52
City of Apopka Fire Department
181,394.47
69,002.46
112,392.01
City of Fernandina Beach Fire Department
21,865.89
8,317.78
13,548.10
City of Greenacres
158,334.27
60,230.36
98,103.91
City of Hialeah Fire Department
249,763.86
95,010.17
154,753.69
City of Jacksonville - Fire Division Rescue Services
3,631,585.04
1,381,454.95
2,250,130.09
City of Key West Fire Department
60,054.20
22,844.62
37,209.58
City of Lauderhill Fire Rescue Department
710,795.31
270,386.54
440,408.77
City of Miami Fire -Rescue Department
2,140,393.15
814,205.56
1,326,187.60
City of Miramar Fire Rescue
150,597.45
57,287.27
93,310.18
City of Ocoee Fire Department
73,296.92
27,882.15
45,414.77
City of Pembroke Pines Fire Rescue Department
202,028.48
76,851.63
125,176.84
City of Plantation
174,927.10
66,542.27
108,384.83
City of Sanford
256,539.21
97,587.51
158,951.69
City of St. Cloud Fire Rescue
148,749.62
56,984.36
92,165.27
City of Stuart Fire Rescue
65,289.69
24,836.20
40,453.49
City of Sunrise Fire Rescue
269,165.99
102,390.74
166,775.25
City of Tamarac Fire Department
144,130.07
54,827.08
89,302.99
Clay CBOCC - Clay County Fire Rescue
385,270.77
146,557.00
238,713.77
Collier County EMS
1805,342.17
306,352.16
498,990.01
Coral Springs Fire Department
242,372.58
92,198.53
150,174.05
County of Desoto BCC - Desoto County Fire Rescue
104,709.88
39,831.64
64,878.24
County ofVolusia
2,028,907.93
771,796.58
1,257,111.35
Delray Beach Fire Rescue
184,782.14
70,291.13
114,491.02
Dixie County BOCC - Dixie County Emergency Services
114,256.96
43,463.35
70,793.61
Fla ler County Fire Rescue Department
137,970.67
52,484.04
85,486.62
Fort Lauderdale Fire Rescue
1,203,547.69
457,829.54
745,718.15
Fort Myers Beach Fire Department
27,717.32
10,543.67
17,173.65
Hamilton County EMS
123,496.07
46,977.90
76,518.16
Hardee County
69,601.27
26,476.32
43,124.95
Hernando County Fire Rescue
578,984.05
220,245.53
358,738.52
Highlands County EMS
310,434.00
118,089.09
192,344.91
Hillsborough County Fire Rescue
1,932,821.21
735,245.19
1,197,576.02
Hollywood Fire Rescue & Beach Safety Department
595,306.47
226,454.58
368,851.89
Indian River County ALS
310,741.97
118,206.25
192,535.72
Jefferson County Ambulance Service - Jefferson County Fire Rescue
90,543.25
34,442.65
56,100.60
Kissimmee Fire Department
466,574.91
177,485.10
289,089.81
Lake Emergency Medical Services
1,085,287.12
412,843.22
672,443.90
Lake Mary Fire Department
44,039.74
16,752.72
27,287.03
Lee County EMS
1,584,198.90
602,629.26
981,569.64
Lehigh Acres Fire Control and Rescue District
344,618.70
131,092.95
213,525.74
Leon County EMS
1,489,344.07
566,546.48
922,797.59
Maitland Fire Rescue Department
29,873.11
11,363.73
18,509.38
Manatee County EMS
682,770.02
259,725.71
423,044.30
Martin County Fire Rescue
397,281.61
151,125.92
246,155.68
Miami Beach Fire Department
122,880.12
46,743.60
76,136.53
Miami -Dade Fire Rescue
3,095,100.89
1,177,376.38
1,917,724.51
North Lauderdale Fire Rescue
171,231.45
65,136.44
106,095.01
North Port Fire Rescue
124,727.95
47,446.51
77,281.44
Oakland Park Fire Rescue
209,727.73
79,780.43
129,947.30
Okaloosa County EMS
595,614.44
226,571.73
369,042.71
Okeechobee County Fire Rescue
175,851.01
66,893.72
108,957.28
Orange County Fire Rescue
3,224,140.42
1,226,463.02
1,997,677.40
Orlando Fire Department
1,006,446.74
382,852.34
623,594.40
Osceola County Fire Department
535,868.21
203,844.27
332,023.95
Palm Beach County Fire Rescue
1,762,205.70
670,343.05
1,091,862.65
Palm Beach Gardens Fire Rescue
131,811.26
50,141.00
81,670.26
Pasco County Board of County Commissioners - Fire Rescue
1,568,492.42
596,654.52
971,837.90
Pinellas County EMS Authority DBA Sunstar
3,759,392.69
1,430,072.98
2,329,319.71
Plant City Fire Rescue
133,043.14
50,609.61
82,433.53
Polk County Fire Rescue
2,812,692.18
1,069,948.11
1,742,744.08
Pompano Beach Fire Rescue
754,527.08
287,022.10
467,504.98
Riviera Beach Fire Department
291,339.85
110,825.68
186,514.17
Sarasota County Fire Department
722,498.18
274,838.31
447,659.87
Seminole County Fire Department
583,911.57
222,119.96
361,791.61
South Walton Fire District
46,195.54
17,572.78
28,622.75
St. Lucie County Fire District
1,143,185.52
434,867.77
708,317.75
Tampa Fire Department
1,527,224.41
580,956.17
946,268.24
Temple Terrace Fire Department
80,996.17
30,810.94
50,185.23
Town of Davie Fire Rescue
220,814.66
83,997.90
136,816.76
Wakulla County Fire Rescue
89,619.34
34,091.20
55,528.14
Walton County Fire Rescue
97,010.62
36,902.84
60,107.78
West Palm Beach Fire Department
518,005.94
197,049.46
320,956.48
Winter Park Fire -Rescue
61,594.05
23,430.38
38,163.67
54,786,711.00
20,840,864.86
33,945,846.14
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1 of 1 Packet Pg. 1713
Public Emergency Medical Transportation Letter of Agreement
THIS LETTER OF AGREEMENT (LOA) is made and entered into in duplicate on the
day of 2020, by and between Collier County on behalf of Collier County EMS, and
the State of Florida, Agency for Health Care Administration (the "Agency"), for good and
valuable consideration, the receipt and sufficiency of which is acknowledged.
DEFINITIONS
"Intergovernmental Transfers (IGTs)" means transfers of funds from a non -Medicaid
governmental entity (e.g., counties, hospital taxing districts, providers operated by state or local
government) to the Medicaid agency. IGTs must be compliant with 42 CFR Part 433 Subpart B.
"Medicaid" means the medical assistance program authorized by Title XIX of the Social Security
Act, 42 US.C. §§ 1396 et seq., and regulations thereunder, as administered in Florida by the
Agency.
"Public Emergency Medical Transportation (PEMT)," pursuant to the General Appropriation Act,
Laws of Florida 2020-111, is the program that provides supplemental payments for eligible Public
Emergency Medical Transportation (PEMT) entities that meet specified requirements and provide
emergency medical transportation services to Medicaid beneficiaries.
A. GENERAL PROVISIONS
1. Per House Bill 5001, the General Appropriations Act of State Fiscal Year 2020-2021,
passed by the 2020 Florida Legislature, Collier County and the Agency agree that Collier
County will remit IGT funds to the Agency in an amount not to exceed the total of
$306,352.16. Collier County and the Agency have agreed that these IGT funds will only
be used for the PEMT program.
2. Collier County will return the signed LOA to the Agency.
3. Collier County will pay IGT funds to the Agency in an amount not to exceed the total of
$306,352.16. Collier County will transfer payments to the Agency in the following
manner:
a. Per Florida Statute 409,908, annual payments for the months of July 2020 thru
June 2021 are due to the Agency no later than October 31, 2020 unless an
alternative plan is specifically approved by the agency.
b. The Agency will bill Collier County when payment is due.
4. Collier County and the Agency agree that the Agency will maintain necessary records
and supporting documentation applicable to health services covered by this LOA in
accordance with public records laws and established retention schedules.
a. AUDITS AND RECORDS
i. Collier County agrees to maintain books, records, and documents (including
Collier County_Collier County EMS_PEMT LOA_SFY 2020-21
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Packet Pg. 1714
16.E.7.d
electronic storage media) pertinent to performance under this LOA in accordance
with generally accepted accounting procedures and practices, which sufficiently
and properly reflect all revenues and expenditures of funds provided.
ii, Collier County agrees to assure that these records shall be subject at all
reasonable times to inspection, review, or audit by state personnel and other
personnel duly authorized by the Agency, as well as by federal personnel.
iii. Collier County agrees to comply with public record laws as outlined in section
119.0701, Florida Statutes,
b. RETENTION OF RECORDS
The Collier County agrees to retain all financial records, supporting documents,
statistical records, and any other documents (including electronic storage media)
pertinent to performance under this LOA for a period of six (6) years after
termination of this LOA, or if an audit has been initiated and audit findings have not
been resolved at the end of six (6) years, the records shall be retained until
resolution of the audit findings.
ii. Persons duly authorized by the Agency and federal auditors shall have full access
to and the right to examine any of said records and documents.
iii. The rights of access in this section must not be limited to the required retention
period but shall last as long as the records are retained.
c. MONITORING
i. Collier County agrees to permit persons duly authorized by the Agency to inspect
any records, papers, and documents of the Collier County which are relevant to
this LOA.
d. ASSIGNMENT AND SUBCONTRACTS
i. The Collier County agrees to neither assign the responsibility of this LOA to
another party nor subcontract for any of the work contemplated under this LOA
without prior written approval of the Agency. No such approval by the Agency of
any assignment or subcontract shall be deemed in any event or in any manner to
provide for the incurrence of any obligation of the Agency in addition to the total
dollar amount agreed upon in this LOA. All such assignments or subcontracts shall
be subject to the conditions of this LOA and to any conditions of approval that the
Agency shall deem necessary.
5. This LOA may only be amended upon written agreement signed by both parties.
The Collier County and the Agency agree that any modifications to this LOA shall be in
the same form, namely the exchange of signed copies of a revised LOA.
6. Collier County confirms that there are no pre -arranged agreements (contractual or
otherwise) between the respective counties, taxing districts, and/or the providers to re-
direct any portion of these aforementioned supplemental payments in order to satisfy non -
Medicaid, non -uninsured, and non-underinsured activities.
Collier County_Collier County EMS_PEMT LOA_SFY 2020-21
(01V__:))
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16.E.7.d
7. Collier County agrees the following provision shall be included in any agreements
between Collier County and local providers where IGT funding is provided pursuant to
this LOA. Funding provided in this agreement shall be prioritized so that designated IGT
funding shall first be used to fund the Medicaid program and used secondarily for other
purposes.
8. This LOA covers the period of July 1, 2020 through June 30, 2021 and shall be terminated
June 30, 2021.
9. This LOA may be executed in multiple counterparts, each of which shall constitute an
original, and each of which shall be fully binding on any party signing at least one
counterpart.
PEMT Local Intergovernmental Transfers
Program / Amount State Fiscal Year 2019-2020
Minimum Fee Schedule/MCO IGTs _ $306,352.16
Total Funding $306,352.16
IN WITNESS WHEREOF, the parties have caused this page Letter of Agreement to be
executed by their undersigned officials as duly authorized.
Collier County
SIGNED
BY:
NAME:
TITLE:
DATE:
A I" ITESI
CRYSTAL K. KINZEL, CLERK
Collier County_Collier County EMS_PEMT LOA_SFY 2020-21
STATE OF FLORIDA, AGENCY FOR
HEALTH CARE ADMINISTRATION
SIGNED
BY:
NAME:
TITLE:
DATE:
Approved as to form and k-gality
Assistant County Attoi nc
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16.E.7.e
RESOLUTION NO.2020-
RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA, TO AUTHORIZE COLLIER COUNTY
EMERGENCY MEDICAL SERVICES TO PARTICIPATE IN
INTERGOVERNMENTAL TRANSFERS WITH THE STATE OF
FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION AND
THE SUPPLEMENTAL PAYMENT PROGRAM FOR MEDICAID
MANAGED CARE PATIENTS; AUTHORIZING THE CHAIRMAN TO
EXECUTE ALL REQUIRED AGREEMENTS AND DOCUMENTS TO
PARTICIPATE IN INTERGOVERNMENTAL TRANSFERS AND THE
CO)
SUPPLEMNTAL PAYMENT PROGRAM FOR MEDICAID MANAGED
w
CARE PATIENTS SUBJECT TO BOARD RATIFICATION.
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WHEREAS, Collier County provides emergency ambulance transportation services
a
throughout Collier County; and
v
WHEREAS, the State of Florida has created a supplemental payment program for
Medicaid managed care patients who are transported to the hospital by public emergency
N
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medical transportation providers and has appropriated an additional $54 million for this
E
program; and
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WHEREAS, Collier County Emergency Medical Services (`EMS") transports more
a.
than 1,500 Medicaid managed care patients annually to hospitals and receives approximately
$163 per patient for this service; and
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WHEREAS, by participating in the supplemental payment program for Medicaid
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managed care patients, EMS can substantially increase its Medicaid managed care patient
d
transport revenue and provide better services to the community,
E
NOW THEREFORE, 1T IS RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA, that:
a
1. Authorizes EMS to participate in intergovernmental transfers with the State of
Florida Agency Health Care Administration and the supplemental payment program for
Medicaid managed care patients.
2. Authorizes the Collier County Chairnmi) to execute any and all agreements and
documents necessary for EMS to participate in intergovernmental transfers or the Medicaid
managed care supplemental payment program subject to ratification by this Board.
1
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16. E.7.e
THIS RESOLUTION ADOPTED on this of 2020 after
motion, second and majority vote favoring adoption.
ATTEST: BOARD OF COUNTY COMMISSIONERS
CRYSTAL K. KINZEL, CLERK COLLIER COUNTY, FLORIDA
, DEPUTY CLERK
Approved as to form and
legality:
Jennifer A. Belpedio
Assistant County Attorney
By:
BURT L. SAUNDERS CHAIRMAN
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