Agenda Item Name:
Title
Resolution and Budget Amendment for the FY2021-22 State of Florida Public Emergency Medical Transportation (PEMT) Program for Medicaid Managed Care Payment, Intergovernmental Transfer Program, and Reallocation of the FY2020-21 PEMT funding
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Presenter:
Chief Harold Theus, 352-384-3101
Description:
Resolution and Budget Amendment for the FY2021-22 State of Florida Public Emergency Medical Transportation (PEMT) Program for Medicaid Managed Care Payment, Intergovernmental Transfer Program, and Reallocation of the FY2020-21 PEMT funding to provide for equipment replacement for Fire Rescue.
Recommended Action:
Recommended Action
Adopt the Resolution and approve the budget amendment and reallocation of the $304,309 of FY2020-2021 PEMT funding.
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Prior Board Motions:
N/A
Fiscal Consideration:
Fiscal Consideration
Staff was not successful in obtaining grant funds for the replacement of extrication equipment through the Assistance to Firefighters program. There is $304,309.00 available from the FY2020-21 funding to be reallocated from grant match to equipment replacement (001.54.5450.526.64.00 #6195410). The funding will be used to replace a portion of the Department’s extrication equipment.
The County will be providing the required State share through an intergovernmental transfer (IGT). The IGT will require the County to provide the State share, approximately $798,234.41 (001.54.5450.526.49.00 #6195410), which will result in approximately $2,048,330.56 (001.54.5450.334.20.00 #6195410) of additional Managed Care Option (MCO) patient transport revenue. The net unanticipated revenue for the MCO is $1,250,096.15 ($2,048,330.56-$798,234.41). The FY2021-22 Adopted budget included $204,205.00 estimated PEMT Revenue to cover recurring costs of prior year purchases. This leaves a revenue balance of $1,045,891.15 ($1,250,096.15-$204,205.00) to recognize and allocate. Staff recommends an allocation of $122,899.83 for vendor fees (001.54.5450.526.34.00 #6195410), $137,712.00 for EMS Equipment replacement (001.54.5450.526.64.00 #6195410), $200,000.00 for additional Fire Rescue training (001.54.5450.526.55.00 #6195410), $250,000.00 toward a partnership with the City of Newberry for a Northwest training center (001.54.5450.526.64.00 #6195410) $235,279.76 toward the renovation of the Tax Collector’s building, Air Vac Systems and other Sustainment projects for Fire Rescue Facilities (001.54.5450.526.46.00 #6195410, and $100,000.00 to update the Fire Rescue Master and Strategic Plan (001.54.5450.526.34.00 #6195410).
Staff recommends the reallocation of the remaining balance of FY2020-21 funds $304,309.00 for the replacement of extrication equipment.
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Strategic Guide:
All Other Mandatory and Discretionary Services
Background:
On December 10, 2019, the Board approved the 2019-20 State of Florida Medicaid Managed Care Payment and Intergovernmental Transfer Program
On February 9, 2021, the Board approved a resolution and budget amendment to allocate a portion of the Medicaid Managed Care Payment to provide for the required grant match
Since 2016, Alachua County has participated in the Florida Public Emergency Medical Transportation (PEMT) Managed Care Reimbursement Program. The supplemental funding was established to help close the gap between cost incurred to provide services and revenue received for each emergency medical transport provided to a Medicaid fee for service patient. This was the first step to address the challenge of current Medicaid reimbursement rates.
On February 9, 2021, the Board set aside $450,000.00 of the FY2020-21 PEMT revenue for grant match. The EMS Matching grant to purchase three (3) automatic chest compression devices was successful and $15,691.00 was allocated for the required match. Subsequently, the Board authorized the purchase of an electronic system to maintain the department’s policies, protocols and training platform for $130,000.00. The Department was unsuccessful in obtaining a grant award from the Assistance for Firefighters program to replace extrication equipment. Staff recommends the reallocation of the remaining balance of FY2020-21 funds $304,309.00 for the replacement of extrication equipment.
The FY2021-22 estimated additional revenue for the Managed Care Option is $2,048,330.56 which will require a corresponding Intergovernmental Transfer to the Agency of HealthCare Administration (AHCA) of $798,234.41 for a net additional revenue estimate of $1,250,096.15. The FY2021-22 Adopted budget included $204,205.00 anticipated revenue to cover recurring costs related to prior year PEMT purchases. The net additional unanticipated revenue increase is $1,045,891.15 ($1,250,096.15 - $204,205.00).
The Department recommends the following allocation plan for the net $1,254,717.52 unanticipated revenue:
• $137,712.00 for equipment replacement. These funds will be used to replace stretchers, ventilation fans, extrication equipment, etc.
• $200,000.00 be allocated to cover expenses related to technical training such as firefighting school, EMT and Paramedic certifications, and Urban Search and Rescue classes. This would allow the Department to focus on hiring candidates who exhibit positive character traits. It will also assist the Department in increasing paramedic qualified employees and expansion of the USAR program.
• $250,000 partnership with the City of Newberry for a joint training center in the northwest. The new training facility will be on 2 acres at the City of Newberry water treatment plant. The facility will include a drill tower, a burn facility and burn props (propane and car props).
• $235,279.76 for Sustainment and renovation projects. The funds would be combined with $350,000.00 of American Rescue funds to renovate the Tax Collector’s office to become an EMS Training facility. In addition, the funds would retrofit some stations with the air vac systems to further advance our cancer initiatives and other sustainment projects for rescue facilities (roof, flooring, painting, HVAC, etc.).
• $100,000.00 to update the Fire Rescue Master and Strategic plans. The most recent master plan is dated 2012 and the last strategic plan was developed in 2016.
• $122,899.83 for Contract services for the assistance from consultant to complete program requirements and collect the additional revenue. The program requires a 6% payment for the Managed Care component.
The resolution authorizes the participation in the supplemental payment program and amends the FY22 Adopted budget for the unanticipated revenue and expenditures. The program may require additional agreements with the Agency of Health Care Administration (AHCA) and Manager Care Providers. The resolution authorizes the Manager to execute those agreements. PCG Consulting Services (PCG) has provided support in compiling the data and submitting the funding requests to obtain additional PEMT revenues. The existing agreement with PCG would allow them to continue these efforts and provide assistance.