Backup Documents 09/26/2023 Item #16F 8 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 F 8
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. The completed routing slip and original documents arc to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the
exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1. County Attorney Office County Attorney Office Ak �/
2. BCC Office Board of County I/
Commissioners OWL /134 ci/21
Records Clerk of Court's Office
3. Minutes and #43 0?../A
4.
•
5.
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees
above,may need to contact staff for additional or missing information.
Name of Primary Staff Cherie DuBock Phone Number 239-252-3756
Contact/ Department
Agenda Date Item was 09/26/2023 Agenda Item Number 26701
Approved by the BCC 6'
Type of Document Letter of Agreement&Resolution Number of Original 3
Attached Documents Attached
PO number or account
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature? CD
2. Does the document need to be sent to another agency for additional signatures? If yes, CD
provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be CD
signed by the Chairman,with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's CD
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the CD
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's
si:nature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip CD
should be provided to the County Attorney Office at the time the item is input into SIRE.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8. The document was approved by the BCC on 09/26/23 (enter date)and all changes CD WA:is nab
made during the meeting have been incorporated in the attached document. The an option
County Attorney's Office has reviewed the changes,if applicable. this line.
9. Initials of attorney verifying that the attached document is the version approved by the N/A i$no
BCC,all changes directed by the BCC have been made,and the document is ready for the uAk an option fo4
Chairman's signature. this line.
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12
- - - - 16F
RESOLUTION NO. 2023 - 1 7 3
RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY,FLORIDA,TO AUTHORIZE COLLIER COUNTY
EMS 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 OR DOCUMENTS TO PARTICIPATE IN
INTERGOVERNMENTAL TRANSFERS AND THE SUPPLEMENTAL
PAYMENT PROGRAM FOR MEDICAID MANAGED CARE
PATIENTS SUBJECT TO BOARD RATIFICATION.
WHEREAS, Collier County provides emergency ambulance transportation services
throughout Collier County; and
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
medical transportation providers and has appropriated an additional $54 million for this
program; and
WHEREAS, Collier County EMS transports more than 1,500 Medicaid managed care
patients annually to hospitals and receives approximately $163 per patient for this service; and
WHEREAS, by participating in the supplemental payment program for Medicaid
managed care patients, Collier County EMS can substantially increase its Medicaid managed
care patient transport revenue and provide better services to the community.
NOW THEREFORE, IT IS RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA,that:
1. Authorizes Collier County EMS to participate in intergovernmental transfers
with the State of Florida Agency Health Care Administration and the supplemental payment
program for Medicaid managed care patients.
2. Authorizes the Collier County Chairman to execute any and all agreements or
documents necessary for Collier County EMS to participate in intergovernmental transfers or
the Medicaid managed care supplemental payment program subject to ratification by this Board.
[23-EMS-01179/1816066/1]
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This Resolution adopted on this 26th day of September, 2023, after motion, second and
majority vote favoring adoption.
ATTEST; `" • •. BOARD OF COUNTY COMMISSIONERS
Crystal I$``Kili . C .•of-Courts COLLIER COUNTY, FLORIDA
u
•
By: By: •
es )c` t Clerk Rick LoCastro, Chairman
sig at re oMyl P ' Y
Approved a o . and legality:
1iij !i .
Jeffrey A. latz iw, County Attorney
[23-EMS-01179/1816066/I]
16F8
Public Emergency Medical Transportation Letter of Agreement
THIS LETTER OF AGREEMENT (LOA) is made and entered into in duplicate on the 26th
day of September 2023, 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 2023-156 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 Senate Bill 2500, the General Appropriations Act of State Fiscal Year 2023-2024,
passed by the 2023 Florida Legislature, the Collier County and the Agency agree that
the Collier County will remit IGT funds to the Agency in an amount not to exceed the total
of $796,457.92. The Collier County and the Agency have agreed that these IGT funds
will only be used for the PEMT program.
2. The Collier County will return the signed LOA to the Agency.
3. The Collier County will pay IGT funds to the Agency in an amount not to exceed the
total of$796,457.92. The 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 2023
through June 2024 are due to the Agency no later than October 31, 2023, unless
an alternative plan is specifically approved by the agency.
b. The Agency will bill the Collier County when payment is due.
4. The 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 2023-24Ci:SN3
1 6 F 8
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
i. 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 2023-24
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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, 2023, through June 30, 2024, and shall be
terminated September 30, 2024, which includes the states certified forward period.
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 2023-2024
Estimated IGTs $796,457.92
Total Funding Not to Exceed $796,457.92
IN WITNESS WHEREOF,the parties have caused this page Letter of Agreement to be
executed by their undersigned officials as duly authorized.
Collier County STATE OF FLORIDA,AGENCY FOR
HEALTHSIGNED CARE ADMINISTRATION
SIGNED (..---/
BY: %' BY:
NAME: Rick LoCastro NAME: Thomas Wallace
TITLE: Chairman, Board of TITLE: Deputy Secretary, Division of
County Commissioners Medicaid
DATE: September 26, 2023 DATE:
ATTEST "`
CRY'S t: ,4 ' ,CLERK
i -
BY:
� I APProve �
n legality
ty� �Att Chairman's
ature only
_ -.4 Ilibilie.Jeffrey A. -Itzko ',County Attorney
1!
Collier County_Collier County EMS_PEMT LOA_SFY 2023-24 G AN