R20-099 1 RESOLUTION NO. R20-099
2
3
4 A RESOLUTION OF THE CITY OF BOYNTON BEACH,
5 FLORIDA, APPROVING AND AUTHORIZING THE CITY
6 MANAGER TO SIGN A LETTER OF AGREEMENT WITH THE
7 AGENCY FOR HEALTH CARE ADMINISTRATION FOR THE
8 STATE FISCAL YEAR 2020-21 FOR THE PUBLIC EMERGENCY
9 MEDICAL TRANSPORTATION (PEMT) MANAGED CARE
10 OPTION (MCO) PROGRAM; AND PROVIDING AN EFFECTIVE
11 DATE.
12
13
14 WHEREAS, the Boynton Beach Fire Rescue has participated in the PEMT program
15 for the past four(4) years; and
16 WHEREAS, the Managed Care Option portion of the program is new this year and
17 requires providers to fund a portion(38.53%)of the entire funding pool while the State funds
18 the remainder; and
19 WHEREAS, the City Commission of the City of Boynton Beach, Florida , upon the
20 recommendation of staff, deems it to be in the best interests of the City residents to approve
21 and authorize the City Manager to sign a Letter of Agreement with The Agency for Health
22 Care Administration (AHCA)to participate in the PEMT MCO Program for the State Fiscal
23 Year 2020-21.
24 NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF
25 THE CITY OF BOYNTON BEACH,FLORIDA,THAT:
26 Section 1. The foregoing "Whereas" clauses are hereby ratified and confirmed as
27 being true and correct and are hereby made a specific part of this Resolution upon adoption
28 hereof.
29 Section 2. The City Commission hereby approves and authorizes the City
30 Manager to sign a Letter of Agreement with The Agency for Health Care Administration
31 (AHCA)to participate in the PEMT MCO Program for the State Fiscal Year 2020-21, a copy
S:\CA\RESO\Agreements\LOA with AHCA FY 20-21-Reso.docx
32 of the Letter of Agreement is attached hereto as Exhibit"A."
33 Section 3. This Resolution shall become effective immediately upon passage.
34 PASSED AND ADOPTED this 15th day of September,2020
35 CITY OF BOYNTON BEACH, FLORIDA
36 YES NO
37
38 Mayor—Steven B. Grant
39
40 Vice-Mayor—Ty Penserga ✓
41
42 Commissioner—Justin Katz ✓
43
44 Commissioner—Woodrow L. Hay 1/
45
46 Commissioner—Christina L. Romelus I/
47
48 VOTE S-19
49 ATTEST:
50 �
51 C/
52 Cry al Gibson,MMC
53 City Clerk
54
55. r,
56 • (Corporate Seal)
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4 It
S:\CA\RESO\Agreements\LOA with MICA FY 20-21-Reso.docx
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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 Boynton Beach on behalf of Boynton Beach Fire
Rescue, 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, Boynton Beach and the Agency agree that
Boynton Beach will remit IGT funds to the Agency in an amount not to exceed the total
of $98,595.06. Boynton Beach and the Agency have agreed that these IGT funds will
only be used for the PEMT program.
2. Boynton Beach will return the signed LOA to the Agency.
3. Boynton Beach will pay IGT funds to the Agency in an amount not to exceed the total of
$98,595.06. Boynton Beach 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 Boynton Beach when payment is due.
4. Boynton Beach 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. Boynton Beach agrees to maintain books, records, and documents (including
electronic storage media) pertinent to performance under this LOA in accordance
Boynton Beach_Boynton Beach Fire Rescue_PEMT LOA_SFY 2020-21
with generally accepted accounting procedures and practices, which sufficiently
and properly reflect all revenues and expenditures of funds provided.
ii. Boynton Beach 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. Boynton Beach agrees to comply with public record laws as outlined in section
119.0701, Florida Statutes.
b. RETENTION OF RECORDS
i. Boynton Beach 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. Boynton Beach agrees to permit persons duly authorized by the Agency to inspect
any records, papers, and documents of the Boynton Beach which are relevant to
this LOA.
d. ASSIGNMENT AND SUBCONTRACTS
i. Boynton Beach 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.
Boynton Beach 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. Boynton Beach 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.
Boynton Beach_Boynton Beach Fire Rescue_PEMT LOA_SFY 2020-21
7. Boynton Beach agrees the following provision shall be included in any agreements
between Boynton Beach 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 2020-2021
Minimum Fee Schedule/MCO IGTs $98,595.06
Total Funding $98,595.06
IN WITNESS WHEREOF, the parties have caused this page Letter of Agreement to be
executed by their undersigned officials as duly authorized.
Boynton Beach STATE OF FLORIDA,AGENCY FOR
HEALTH CARE ADMINISTRATION
SIGNEDSIGNED
BY: A ,.moi 67iQ e BY:
NAME: Lori LaVerriere NAME:
TITLE: City Manager TITLE:
DATE: September 28 , 2020 DATE:
APPROVE AS TO •RM: /
b4f / /; iek_, ' 1( Jill'i 04,24
CITY ATTORNEY'Y' Y
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Boynton Beach_Boynton Beach Fire Rescue_PEMT LOA_SFY 2020-21
7. Boynton Beach agrees the following provision shall be included in any agreements
between Boynton Beach 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 I Amount State Fiscal Year 2020-2021
Minimum Fee Schedule/MCO IGTs $98,595.06
I Total Funding $98,696.06
IN WITNESS WHEREOF,the parties have caused this page Letter of Agreement to be
executed by their undersigned officials as duly authorized.
Boynton Beach STATE OF FLORIDA,AGENCY FOR
HEALTH CARE ADMINISTRATION
SIGNED ` /� SIGNED
NAME Lori LaVerriere NAME: • • a411 er
TITLE: City Manager TITLE: , / J.( 7 'o/ i_
DATE: September 26, 2020 DATE: fl/5/ 1
AppwaAS TO FORM: Y
714ZtiA) 3A, 04,4
CITY ATTORNEY";
Boynton Beech_Boynton Beach Fire Rescue_PEMT LOA_SFY 2020-21
SFY 2020-21 PEMT MCO Projections
MMA LTC
Total Budget 43,829,369.00 10,957,342.00
Statewide Add-On $ 215.54 $ 53.89
Pool% 80% 20%
Statewide Blended Rt $ 183.21
Provider Region Total Allotment Total IGTs Needed Net New Federal
Funding
1 Alachua County Fire Rescue 3 1,267,919.02 482,316.40 785,602.63
2 Baker County Fire Rescue 84,330.36 32,079.27 52,251.09
3 Bay County EMS 2 536,157.85 203,954.45 332,203.41
4 Boynton Beach Fire Rescue 9 259,187.87 98,595.06 160,592.80
5 Bradford County EMS 185,365.13 70,512.89 114,852.23
6 Brevard County Fire Rescue 7 1,473,221.68 560,413.53 912,808.15
7 Broward Sheriffs Fire Rescue 8 943,799.48 359,021.32 584,778.16
8 Charlotte County Fire&EMS 8 512,178.93 194,832.87 317,346.07
9 City of Apopka Fire Department 137,137.86 52,167.24 84,970.62
10 City of Femandina Beach Fire Department 26,942.61 10,248.97 16,693.64
11 City of Greenacres 109,656.41 41,713.30 67,943.11
12 City of Hialeah Fire Department 11 452,096.92 171,977.67 280,119.25
13 City of Jacksonville-Fire Division Rescue Services 4 3,770,348.24 1,434,240.47 2,336,107.77
14 City of Key West Fire Department 11 67,356.51 25,622.42 41,734.10
15 City of Lauderhill Fire Rescue Department 10 490,086.00 186,428.71 303,657.28
16 City of Miami Fire-Rescue Department 11 2,532,335.51 963,300.43 1,569,035.08
17 City of Miramar Fire Rescue 189,406.52 72,050.24 117,356.28
18 City of Ocoee Fire Department 35,294.81 13,426.15 21,868.67
19 City of Pembroke Pines Fire Rescue Department 11 350,792.73 133,441.55 217,351.17
20 City of Plantation 11 154,919.98 58,931.56 95,988.42
21 City of Sanford 7 225,240.18 85,681.37 139,558.82
22 City of St.Cloud Fire Rescue 7 119,625.17 45,505.41 74,119.75
23 City of Stuart Fire Rescue 9 72,475.61 27,569.72 44,905.89
24 City of Sunrise Fire Rescue 10 279,394.82 106,281.79 173,113.03
25 City of Tamarac Fire Department 10 142,526.38 54,217.04 88,309.35
26 Clay CBOCC-Clay County Fire Rescue 426,770.87 162,343.64 264,427.23
27 Collier County EMS 8 620,488.21 236,033.71 384,454.49
28 Coral Springs Fire Department 10 241,675.17 91,933.24 149,741.94
29 County of Desoto BCC-Desoto County Fire Rescue 120,433.45 45,812.88 74,620.56
30 County of Volusia 4 1,824,283.83 693,957.57 1,130,326.26
31 Delray Beach Fire Rescue 161,655.63 61,493.80 100,161.83
32 Dixie County BOCC-Dixie County Emergency Services 130,132.79 49,502.51 80,630.27
33 Flagler County Fire Rescue Department 4 149,800.89 56,984.26 92,816.63
34 Fort Lauderdale Fire Rescue 11 955,384.80 363,428.38 591,956.42
35 Fort Myers Beach Fire Department 8 33,678.26 12,811.21 20,867.05
37 Hamilton County EMS 3 117,739.19 44,787.99 72,951.20
38 Hardee County 80,288.97 30,541.92 49,747.04
39 Hernando County Fire Rescue 3 679,223.09 258,376.46 420,846.63
40 Highlands County EMS 6 341,362.81 129,854.41 211,508.40
41 Hillsborough County Fire Rescue 6 1,957,380.30 744,587.47 1,212,792.84
42 Hollywood Fire Rescue&Beach Safety Department 10 463,682.24 176,384.73 287,297.52
43 Indian River County ALS 9 256,493.61 97,570.17 158,923.44
44 Jefferson County Ambulance Service-Jefferson County Fire Rescue 99,418.22 37,818.69 61,599.53
45 Kissimmee Fire Department 7 438,625.62 166,853.19 271,772.43
46 Lake Emergency Medical Services 3 258,110.16 98,185.11 159,925.06
47 Lake Mary Fire Department 7 44,455.30 16,910.80 27,544.50
48 Lee County EMS 8 1,744,803.15 663,723.12 1,081,080.03
49 Lehigh Acres Fire Control and Rescue District 8 373,963.37 142,255.66 231,707.70
50 Leon County EMS 2 1,507,708.22 573,532.21 934,176.01
51 Maitland Fire Rescue Department 7 30,175.72 11,478.84 18,696.88
52 Manatee County EMS 6 900,421.88 342,520.48 557,901.40
53 Martin County Fire Rescue 9 300,948.91 114,480.96 186,467.94
54 Miami Beach Fire Department 11 108,848.13 41,405.83 67,442.30
55 Miami-Dade Fire Rescue 11 3,179,766.33 1,209,583.11 1,970,183.22
56 North Lauderdale Fire Rescue 10 158,961.37 60,468.91 98,492.47
57 North Port Fire Rescue 8 123,127.71 46,837.78 76,289.93
58 Oakland Park Fire Rescue 10 209,344.05 79,634.48 129,709.57
59 Okaloosa County EMS 1 521,069.99 198,215.03 322,854.97
60 Okeechobee County Fire Rescue 9 166,774.73 63,441.11 103,333.62
61 Orange County Fire Rescue 7 2,773,741.26 1,055,131.17 1,718,610.08
62 Orlando Fire Department 7 880,484.35 334,936.25 545,548.11
63 Osceola County Fire Department 9 502,210.17 191,040.75 311,169.42
64 Palm Beach County Fire Rescue 9 1,713,549.72 651,834.31 1,061,715.41
65 Palm Beach Gardens Fire Rescue 9 115,314.35 43,865.58 71,448.77
66 Pasco County Board of County Commissioners-Fire Rescue 5 1,696,037.03 645,172.49 1,050,864.54
67 Pinellas County EMS Authority DBA Sunstar 5 5,017,252.03 1,908,562.67 3,108,689.36
68 Plant City Fire Rescue 6 139,832.12 53,192.14 86,639.98
69 Polk County Fire Rescue 6 2,644,147.32 1,005,833.64 1,638,313.68
70 Pompano Beach Fire Rescue 10 648,508.52 246,692.64 401,815.88
71 Riviera Beach Fire Department 10 267,809.50 101,874.73 165,934.77
72 Sarasota County Fire Department 775,408.19 294,965.28 480,442.92
73 Seminole County Fire Department 7, 542,893.50 206,516.69 336,376.82
74 South Walton Fire District 54,424.06 20,702.91 33,721.15
75 St.Lucie County Fire District 9 1,354,943.64 515,420.56 839,523.08
76 Tampa Fire Department 6 1,492,081.50 567,587.80 924,493.70
77 Temple Terrace Fire Department 6 80,827.82 30,746.90 50,080.92
78 Town of Davie Fire Rescue 10 205,841.51 78,302.11 127,539.40
79 Wakulla County Fire Rescue 140,909.83 53,602.10 87,307.73
80 Walton County Fire Rescue 77,325.28 29,414.54 47,910.74
81 West Palm Beach Fire Department 9 439,703.33 167,263.14 272,440.18
82 Winter Park Fire-Rescue 7 78,672.41 29,926.98 48,745.42
54,786,711.00 20,840,864.86 33,945,846.14
AHCA-MPF
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Intergovernmental Transfers Questionnaire
1. What type of governmental entity is your organization considered? (county, city, hospital taxing
district, or other)
City
If other, please explain
2. Does your organization have a relationship with the provider for which you contribute IGTs as
named in the preamble of the enclosed Letter of Agreement (LOA)?
Yes
If yes, please describe your relationship, including services provided to/by the provider to/by the
organization and any other financial transactions between the provider and the organization.
We are the provider(Boynton Beach Fire Rescue Department).
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
Revenue Account for EMS Services $ 98,595
$ -
$ -
If other, please explain
Funded through reimbursement of medical claims by Health Insurance payers and
treated/transported patients.
a. Verify whether the funds are public funds as defined by 42 CFR § 433.51, and exclude any
federal funds.
No
If no, please explain
The source of these funds is revenue generated through insurance reimbursements and
patients paying for services provided.
4. Does your organization have taxing authority?
Yes
5. If the source of IGT funding is from taxes, please answer the following questions:
a. Is the tax a state, county, city, or hospital district tax?
If other, please explain
N/A
b. What entities are taxed?
N/A
c. What is the tax structure (i.e. property tax, percentage of revenue, assessment, etc.)?
N/A
d. What is the amount or percent of the tax?
N/A
e. Does at least 85% of the burden of the tax revenue fall on health care providers as defined in
42 CFR §433.55? (Provide the total tax revenue and the health care provider tax burden) If so,
please answer the following questions:
Amount
Total Tax Burden $ -
Healthcare Provider Tax Burden $ -
0.00%
i) Is 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 § 433.68.
If no, please explain
N/A
ii) Is the tax uniform across all entities being taxed? Based on 42 CFR § 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.
If no, please explain
N/A
iii) Is the tax generally redistributive and a waiver of the broad-based or uniform tax
requirement was granted in accordance with 42 CFR §433.68(e)?
If no, please explain
N/A
iv) Does the tax program comply with the hold harmless provisions included in 42 CFR §
433.68(f)?
If no, please explain
N/A
6. If the source of IGT funding is from provider payments, please answer the following:
a. Are provider voluntary payments or in-kind services received by the organization as defined in
42 CFR §433.52?
No
b. How much of the organization's revenue is received from provider-related donations (Provide
the total revenue and the provider-related donation amounts)?
Amount
Total Revenue $ -
Provider Related Donations $ -
c. Do individual provider donations exceed $5,000 per year or $50,000 per year for a health care
organizational entity?
If yes, please list the provider and payment amount.
Provider Name Amount
N/A $ _
$
$
d. Does any portion of the provider donation constitute as a "bona fide donation" pursuant to 42
CFR §433.54?42 CFR §433.54 requires donations will not be returned to the individual
provider, the provider class, or related entity under a hold harmless provision.
e. Please provide the details of the agreement including the amount between the IGT provider
and the health care system.
N/A
7. Were funds utilized for the IGT specifically appropriated by the organization's board?
Yes
If yes, provide the board minutes and date of the appropriation.
8. Did the organization receive provider funds from the health care entity the IGT was made on behalf
of, or from any other health care entity?
No
If yes, please provide a listing of providers, funding source, and amounts received.
Provider Name Funding Source Amount
N/A $ _
$$
Kevin R. Carter certify that the statements and information contained
in this submittal are true, accurate, and complete.
h
Signature of Officer or Administrator
Fire Chief, Director of Fire and EMS
Title
9/10/2020
Date