Agenda 09/23/2025 Item #16F12 (Resolution - Authorizing Intergovernmental Transfers (IGT) between Collier County EMS and the State of Florida Agency for Health Care Administration (AHCA) for Fiscal Year 2026)9/23/2025
Item # 16.F.12
ID# 2025-3606
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 (AHCA) for Fiscal Year 2026, to authorize the Chair to
sign an Agreement with AHCA to accept direct payments from the program, “Statewide Medicaid Managed Care”
(SMMC) for Fiscal Year 2026, to approve an amendment to the Fiscal Year 2025 Letter of Agreement extending the
expiration date of the Agreement from September 30, 2025, to September 30, 2026, to authorize the County Manager to
sign the Intergovernmental Transfers Questionnaire, 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 September 22, 2020, the Board approved agenda item 16.E.7 to allow Emergency Medical
Services (EMS) to participate in the Statewide Medicaid Managed Care (SMMC) program and to accept direct payments
from the program in Fiscal Year 2021. In order to participate in the SMMC program and accept direct payments in
Fiscal Year 2026, the Agency for Health Care Administration (AHCA) requires an annual letter of agreement with
Collier County EMS. AHCA also requires Inter-Governmental Transfers (IGT), which will require EMS to pay AHCA
funds up front in Fiscal Year 2026 before receiving those funds and additional funds back. Additionally, due to delays
from the Centers for Medicare & Medicaid Services (CMS), an amendment to the Fiscal Year 2025 Letter of Agreement
is needed to extend the expiration date from September 30, 2025 to September 30, 2026.
It is estimated that for Fiscal Year 2026 Collier County EMS’s IGT total that will need to be paid upfront in the amount
of$708,054.21. This amount may increase or decrease depending on the number of providers that participate in the
program during Fiscal Year 2026. The County’s estimated allocation for Fiscal Year 2026 that will be received back is
$1,653,173.50, adding additional net federal funding in the estimated amount of $945,119.29.
This supports the Quality of Place objective of the Strategic Plan by supporting and enhancing our commitment to
robust public safety services.
FISCAL IMPACT: Funds are available and were budgeted in FY26, EMS Operating Fund (4050) for the upfront IGT.
A Budget Amendment is needed to appropriate received funds, estimated to be $1,653,173.50 within EMS Operating
Fund (4050).
GROWTH MANAGEMENT IMPACT: There is no Growth Management Impact resulting from this action.
LEGAL CONSIDERATIONS: This item is approved as to form and legality and requires a majority vote of the Board
for approval. – CLD
RECOMMENDATIONS: Recommendation to approve a resolution authorizing Intergovernmental Transfers (IGT)
between Collier County EMS and the State of Florida Agency for Health Care Administration (AHCA) for Fiscal Year
2026, to authorize the Chair to sign an Agreement with AHCA to accept direct payments from the program, “Statewide
Medicaid Managed Care” (SMMC) for Fiscal Year 2026, to approve an amendment to the Fiscal Year 2025 Letter of
Agreement extending the expiration date of the Agreement from September 30, 2025, to September 30, 2026, to
authorize the County Manager to sign the Intergovernmental Transfers Questionnaire, and to approve the necessary
Budget Amendments.
PREPARED BY: Jennifer Reynolds, Assistant Director, Corporate Finance & Management Services
ATTACHMENTS:
1. Resolution 2025-2026 MCO Supplemental Payment Program
2. SFY 2024-25 PEMT LOA Amendment Collier EMS
3. PEMT SFY 2025-26 LOA Collier EMS
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9/23/2025
Item # 16.F.12
ID# 2025-3606
4. PEMT - List of Providers for YR7 MCO PEMT Program
5. IGT Provider Questionnaire FY26
6. BA MCO AHCA
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Medicaid
Number Provider Region Total Allotment Total IGTs Needed Net New Federal
Funding
000683100 Marion County Fire Rescue B 8,755,918.21$ 3,745,781.81$ 5,010,136.40$
125443300 City of Fernandina Beach Fire Dept B 52,392.55$ 22,413.53$ 29,979.02$
003458200 Winter Park Fire-Rescue E 274,811.41$ 117,564.32$ 157,247.09$
003655700 Orlando Fire Department E 4,447,628.73$ 1,902,695.57$ 2,544,933.16$
003997800 County of Volusia B 7,138,485.27$ 3,053,844.00$ 4,084,641.27$
008855600 City of Ocoee Fire Department E 934,458.60$ 399,761.39$ 534,697.21$
124356900 Bay County EMS Division A 2,360,783.46$ 1,009,943.17$ 1,350,840.29$
014564900 City of Key West Fire Department I 238,261.37$ 101,928.21$ 136,333.16$
017422000 Okaloosa County EMS A 3,793,969.26$ 1,623,060.05$ 2,170,909.21$
018248400 Palm Beach Gardens Fire Rescue G 541,514.45$ 231,659.88$ 309,854.57$
020395700 Delray Beach Fire Rescue G 658,399.74$ 281,663.41$ 376,736.33$
022548000 City of Tampa Fire Department D 4,656,824.70$ 1,992,189.61$ 2,664,635.09$
023813300 Walton County Fire Rescue A 1,703,631.16$ 728,813.41$ 974,817.75$
083899301 Miami-Dade County Fire Rescue I 13,819,371.49$ 5,911,927.13$ 7,907,444.36$
083903500 Martin County Fire Rescue G 1,040,366.40$ 445,068.75$ 595,297.65$
084438100 Kissimmee Fire Department E 1,595,727.45$ 682,652.21$ 913,075.24$
084662700 Sarasota County Fire Department F 2,957,933.82$ 1,265,404.09$ 1,692,529.73$
084839500 Hendry County F 611,620.68$ 261,651.33$ 349,969.35$
085063200 Pembroke Pines Fire Rescue H 1,634,772.38$ 699,355.62$ 935,416.76$
087475200 City of Miami Fire Rescue Department I 8,047,995.03$ 3,442,932.27$ 4,605,062.76$
087678000 Pinellas County EMS Authority dba Su C 22,869,473.89$ 9,783,560.93$ 13,085,912.96$
087736100 Monroe County Fire Rescue (MCFR) I 205,827.88$ 88,053.17$ 117,774.71$
087867700 West Palm Beach Fire Rescue G 597,524.59$ 255,621.02$ 341,903.57$
088015900 Polk County Board of County Commissi D 11,664,079.10$ 4,989,893.04$ 6,674,186.06$
110095100 Baker County Fire Rescue B 234,519.04$ 100,327.25$ 134,191.79$
088022100 Lee County EMS F 6,350,601.08$ 2,716,787.14$ 3,633,813.94$
088024800 Jackson County Fire Rescue A 1,308,940.60$ 559,964.79$ 748,975.81$
088030200 Manatee County Department of Public D 3,320,689.87$ 1,420,591.13$ 1,900,098.74$
088031100 Hollywood Fire Rescue & Beach Safety H 1,062,820.35$ 454,674.55$ 608,145.80$
088042600 Madison County A 679,731.00$ 290,788.92$ 388,942.08$
088046900 Okeechobee County Fire Rescue G 725,387.36$ 310,320.71$ 415,066.65$
088048500 North Port Fire Rescue F 684,346.53$ 292,763.45$ 391,583.08$
088051500 Levy County Department of Public Saf B 1,137,417.36$ 486,587.15$ 650,830.21$
088053100 Hamilton County Ambulance Service B 397,559.68$ 170,076.03$ 227,483.65$
088061200 Jefferson County Ambulance Service A 389,326.56$ 166,553.90$ 222,772.66$
088065500 St. Lucie County Fire District G 6,396,631.68$ 2,736,479.03$ 3,660,152.65$
088070100 City of Miramar Fire Rescue H 434,109.72$ 185,712.14$ 248,397.58$
088084100 Hillsborough County Fire Rescue D 8,095,647.31$ 3,463,317.92$ 4,632,329.39$
088085000 Suwannee County Fire Rescue B 802,354.52$ 343,247.26$ 459,107.26$
088086800 Nassau County Fire Rescue B 1,281,746.37$ 548,331.10$ 733,415.27$
088087600 Flagler County Fire Rescue Departmen B 927,472.92$ 396,772.92$ 530,700.00$
088100700 County of Desoto BCC - Desoto County F 336,809.27$ 144,087.00$ 192,722.27$
088103100 Clay CBOCC - Clay County Fire Rescue B 1,721,344.84$ 736,391.32$ 984,953.52$
088104000 City of Jacksonville Fire and Rescue B 12,975,015.61$ 5,550,711.68$ 7,424,303.93$
088105800 Wakulla County Fire Rescue A 675,739.18$ 289,081.22$ 386,657.96$
088120100 Pasco County Board of County Commiss C 9,869,384.70$ 4,222,122.77$ 5,647,261.93$
111363700 Highlands County EMS D 1,587,120.11$ 678,969.98$ 908,150.13$
088137600 Brevard County Fire Rescue E 3,269,794.25$ 1,398,817.98$ 1,870,976.27$
088173200 Alachua County Fire Rescue B 5,924,973.96$ 2,534,703.86$ 3,390,270.10$
088175900 Dixie County BOCC - Dixie County ES B 459,058.55$ 196,385.25$ 262,673.30$
088224100 Indian River County Department of Em G 1,335,635.85$ 571,385.02$ 764,250.83$
088499500 St. Cloud Fire Rescue E 760,315.73$ 325,263.07$ 435,052.66$
088723400 Union County Fire Rescue B 472,530.93$ 202,148.73$ 270,382.20$
089085500 Osceola County Fire Dept E 3,426,597.67$ 1,465,898.49$ 1,960,699.18$
089269600 Temple Terrace Fire Department D 556,483.75$ 238,063.75$ 318,420.00$
089282300 City of Margate H 527,168.87$ 225,522.84$ 301,646.03$
089707800 Collier County EMS Department F 1,655,105.68$ 708,054.21$ 947,051.47$
089871600 Gilchrist County B 549,872.31$ 235,235.38$ 314,636.93$
089925900 Charlotte County Fire & EMS Departme F 1,863,428.45$ 797,174.69$ 1,066,253.76$
099404900 Bradford County EMS B 1,042,112.82$ 445,815.86$ 596,296.96$
103181100 Lake Emergency Medical Services B 4,057,304.21$ 1,735,714.74$ 2,321,589.47$
109865100 Gadsden County EMS A 1,916,694.21$ 819,961.78$ 1,096,732.43$
110344600 Miami Beach Fire Rescue Department I 533,780.31$ 228,351.22$ 305,429.09$
111179500 South Walton Fire District A 483,258.92$ 206,738.17$ 276,520.75$
111779200 Winter Garden Fire Rescue Department E 546,878.45$ 233,954.60$ 312,923.85$
112349200 Hernando County and Fire Rescue Dist B 5,383,085.28$ 2,302,883.88$ 3,080,201.40$
112679700 City of Coconut Creek - Fire Rescue H 216,056.91$ 92,429.14$ 123,627.77$
113723400 City of Sunrise Fire Rescue H 1,304,948.79$ 558,257.09$ 746,691.70$
113731200 Plant City Fire Rescue D 778,403.64$ 333,001.08$ 445,402.56$
113842700 Citrus County Fire Rescue B 3,131,328.22$ 1,339,582.21$ 1,791,746.01$
114515300 Holmes County A 628,710.63$ 268,962.41$ 359,748.22$
116069400 Sumter County Fire & EMS B 1,369,815.76$ 586,007.18$ 783,808.58$
117949700 Lighthouse Point H 72,351.62$ 30,952.02$ 41,399.60$
400001300 Boynton Beach Fire Rescue G 1,145,775.22$ 490,162.64$ 655,612.58$
400002100 Pompano Beach Fire Rescue H 2,113,790.00$ 904,279.36$ 1,209,510.64$
400006400 Oakland Park Fire Rescue H 266,453.55$ 113,988.83$ 152,464.72$
400007200 City of Hialeah Fire Department I 957,661.01$ 409,687.38$ 547,973.63$
400009900 City of Greenacres G 434,858.19$ 186,032.33$ 248,825.86$
400021800 Riviera Beach Fire Department G 1,084,650.58$ 464,013.52$ 620,637.06$
400024200 Lehigh Acres Fire Control and Rescue F 1,695,398.05$ 725,291.29$ 970,106.76$
400028500 Palm Beach County Fire Rescue G 9,086,116.04$ 3,887,040.44$ 5,199,075.60$
400032300 Oviedo Fire Department E 179,132.63$ 76,632.94$ 102,499.69$
400035800 Longwood Fire Department E 300,009.73$ 128,344.16$ 171,665.57$
400037400 City of Lauderhill Fire Rescue Depar H 1,817,896.83$ 777,696.26$ 1,040,200.57$
400038200 Orange County Fire Rescue EMS Bureau E 12,301,896.06$ 5,262,751.13$ 7,039,144.93$
400039100 City of Coral Springs Fire Departmen H 999,325.57$ 427,511.48$ 571,814.09$
400040400 City of Plantation H 668,005.04$ 285,772.56$ 382,232.48$
400041200 City of Tamarac Fire Department H 679,980.48$ 290,895.65$ 389,084.83$
400042100 Broward Sheriffs Fire Rescue H 4,443,013.19$ 1,900,721.04$ 2,542,292.15$
400045500 Fort Myers Beach Fire Department F 9,979.53$ 4,269.24$ 5,710.29$
400046300 Seminole County EMS/Fire Rescue Divi E 2,956,312.14$ 1,264,710.34$ 1,691,601.80$
400047100 Sanford Fire Department E 1,042,861.28$ 446,136.06$ 596,725.22$
400050100 North Lauderdale Fire Rescue H 609,624.77$ 260,797.48$ 348,827.29$
400051000 The Town of Davie Fire Rescue H 815,078.42$ 348,690.55$ 466,387.87$
400057900 City of Stuart Fire Rescue G 225,537.46$ 96,484.93$ 129,052.53$
400063300 Fort Lauderdale Fire Department Resc H 3,128,958.08$ 1,338,568.27$ 1,790,389.81$
400064100 Maitland Fire Rescue Department E 203,083.51$ 86,879.13$ 116,204.38$
400101000 Leon County EMS A 8,082,424.42$ 3,457,661.17$ 4,624,763.25$
400105200 Lake Mary Fire Department E 265,455.60$ 113,561.91$ 151,893.69$
400115000 Hardee County Board of County Commis D 224,539.51$ 96,058.00$ 128,481.51$
Totals 260,000,000.00$ 111,228,000.02$ 148,771,999.98$
SFY 2025-26 PEMT MCO Allotments
1 of 1
Agency for Health Care Administration
Bureau of Medicaid Program Finance
9/8/2025
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lntergovernmental Transfers Questionnaire
Collier County Emerqency Medical Services
$708,054.21
6t3012026
1. \Mat type of governmental entity is your organization considered? (county, city, hospital taxing
district, or other)
County
lf other in
2. Does your organization have a relationship with the provider for which you contribute lGTs as named
in the preamble of the enclosed Letter of Agreement (LOA)?
Yes
lf yes, please describe your relatlonship, including services provided to/by the provider to/by the
organization and any other financial transactions between the provider and the organization.
Yes, we are the provider
3. Please describe the source of the IGT funding for your organization, including whether the source is
from a tax, a provider donation, or other funds. Provide the amount of funding from each source.
Source Amount
Ad Valorem $708,054
$
$
lf other
a. Verify whether the funds are public funds as defined by 42 CFR S 433.51, and exclude any federal
funds.
No
tf SC
Yes
4. Does your organization have taxing authority?
cA0
IGT Provider Name:
Health Care Provider Name.
IGT Amount:
State Fiscal Year Ending:
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5. lf the source of IGT funding is from taxes, please answer the following questions
a. ls the tax a or hospital district tax?
tf
b. Vlhat entities are taxed?
Property Owners in Collier County
c. What is the tax structure e.of revenue
d. What is the amount or of the tax?
e. Does at least 85% of the burden of the tax revenue fall on health care providers as deflned in 42
CFR 5433.55? (Provide the total tax revenue and the health care provider tax burden) lf so,
please answer the following questions:
Amount
Total Tax Burden $
Healthcare Provider Tax Burden $
0.00%
i) ls the tax broad based? A broad based tax can be defined as a tax that is imposed on at least
all health care items or services in the class or providers of such items or services furnished by
all non-Federal, non-public providers in the State, and is imposed uniformly, pursuant to 42
cFR S 433.68.
lf no
?
n
Ad Valorem/Property Tax
3.0107 per $1000 value
CAO
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ii) ls the tax uniform across all entities being taxed? Based on 42 CFR S 433.68, a health care-
related tax will be considered to be imposed uniformly even if it excludes Medicaid or Medicare
payments (in whole or in part), or both; or in the case of health care-related tax based on
revenue or receipts with respect to a class of items or services, if it excludes either Medicaid or
Medicare revenue with respect to a class of items or services, or both. The exclusion of
Medicaid revenue must be applied uniformly to all providers being taxed.
lf no
iii) ls the tax generally redistributive and a waiver of the broad-based or uniform tax requirement
was granted in accordance with 42 CFR ga33.6g(e)?
iv) Does the tax program comply with the hold harmless provisions included in 42 CFR g
433.68(f)?
tf ease lain
v) Does every tax paying entity receive a supplemental payment equal to or exceeding its tax cost?
6 Please answer the following regarding provider funds received from the healthcare entity and/or otherhealth care entities.
a Are provider voluntary payments or in-kind services received by the organization as defined in 42cFR S 433.52?
No
b How much of the organization's revenue is received from provider-related donations (provide thetotal revenue and the provider-related donation amounts)?
Amount
tf
No
Total Revenue
Provider Related Donations $
c. Do individual provider donations exceed $5,000 per year or $50,000 per year for a health careorganizational entity?
CAO
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lf yes, please list the provider and payment amount.
Provider Name Amount
d. Does any portion of the provider donation constitute as a "bona fide donation" pursuant to 42 CFR
S 433.54? 42 CFR S 433.54 requires donations will not be returned to the individual provider, the
provider class, or related entity under a hold harmless provision.
No
e. ls there an agreement between the IGT provider and the health care entity? lf so, please specify
whether the agreement is written and provide the details.
7. Were funds utilized for the IGT specifically appropriated by the organization's board?
Yes
lf yes, provide the board minutes and date of the appropriation.
certify that the statements and information contained
in this submittal are true, accurate, and complete.
Signature of Officer or Administrator
Title
Date
$
$
$
cao
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