Agenda Item Name:
Title
Resolution and Budget Amendment for the FY2022-23 State of Florida Public Emergency Medical Transportation (PEMT) Program
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Presenter:
Chief Harold Theus, 352-384-3101
Description:
Resolution and Budget Amendment for the FY2022-23 State of Florida Public Emergency Medical Transportation (PEMT) Program for Medicaid Managed Care Payment and Intergovernmental Transfer Program
Recommended Action:
Recommended Action
Adopt the resolution and approve the budget amendment
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Prior Board Motions:
N/A
Fiscal Consideration:
Fiscal Consideration
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 $1,068,419 (001.54.5450.526.49.00 #6195410-FY23), which will result in approximately $2,951,435 (001.54.5450.349.0000 #6195410-FY23) of additional Managed Care Option (MCO) patient transport revenue. The net unanticipated revenue for the MCO is $1,883,015 ($2,951,435-$1,068,420). The FY2022-23 Adopted budget includes approximately $204,205 of recurring expenses that were approved under prior year PEMT awards. This leaves approximately $1,678,810 ($1,883,015.00-$204,205.00) of the new revenue to allocate to additional needs. Staff recommends an allocation of $113,811.00 for vendor fees (001.54.5450.526.34.00 #6195410-FY23), $447,000 for stretcher upgrade/replacement and maintenance (001.54.5450.526.64.00 #6195410-FY23 $427,000.00 and 001.54.5450.526.46.00 #6195410-FY23 $20,000.00), $320,000.00 for equipment replacement (001.54.5450.526.52.00 #6195410-FY23 $150,000 and 001.54.5450.526.64.00 #6195410-FY23 $170,000), $160,000.00 for the Telehealth program equipment (001.54.5450.526.52.00 #6195410-FY23), $35,000 Consulting Services for the Medicare Ground Ambulance Data Collection Requirements (001.54.5450.526.34.00 #6195410-FY23), $73,000.00 for the Central Supply Warehouse position and warehouse equipment replacement (001.54.5450.526. various Personal Services #6195410-FY23 $58,000 and $15,000 related operating 001.54.5450.526.52.00 #6195410-FY23), $250,000 Fire Rescue training (001.54.5450.526.55.00 #6195410-FY23), $250,000.00 for the equipment and furniture for the Fire Rescue training facility (001.54.5450.526.52.00 #6195410-FY23 $125,000 and 001.54.5450.526.64.00 #6195410-FY23 $125,000) and $30,000 for anticipated increases to the agreement with ESO for electronic EMS and Fire reporting system (001.54.5450.526.52.31 #6195410-FY23); $204,205 returned to General Fund reserves as the recurring expenses were budgeted as part of the Adopted Budget (001.04.0440.590.99.30)
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Strategic Guide:
Strategic Guide
All Other Mandatory and Discretionary Services
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Background:
On December 10, 2019, the Board approved the 2019-20 State of Florida Medicaid Managed Care Payment and Intergovernmental Transfer Program (Item #19-0521
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.
The FY2022-23 estimated additional revenue for the Managed Care Option is $2,951,434.77 which will require a corresponding Intergovernmental Transfer to AHCA of $1,068,419.39 for a net additional revenue estimate of $1,883,015.38. The FY2022-23 Adopted budget includes approximately $204,205 of recurring expenses that were approved under prior year PEMT awards. This leaves approximately $1,678,810 ($1,883,015.00-$204,205.00) of the new revenue to allocate to additional needs.
The Department recommends the following allocation plan for the net $1,678,810.38 unanticipated revenue:
• $320,000.00 for equipment replacement. These funds will be used to replace stretchers, ventilation fans, extrication equipment, etc.
• $250,000.00 be allocated to cover expenses related to technical training such as firefighting school, EMT and Paramedic certifications, and Urban Search and Rescue classes. If necessary, this would allow the Department to continue the 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.
• $160,000 for equipment to facilitate the Telehealth program initiative.
• $250,000.00 for furniture and equipment for the renovated fire rescue training facility.
• $447,000.00 to continue the upgrade of stretcher systems to power load self-loading systems and provide installation and maintenance on existing units. The new equipment provides safety for patients and protects employees from injury.
• $73,000.00 to fund an additional position at the Fire Rescue Central Supply Warehouse and related operating. The position would be funded the first year with PEMT funds and then picked up by the General fund in future years. This position was included in the Fire Rescue 5-year plan for FY23. Despite tremendous growth in Fire Rescue operations, the warehouse has had the same number of staff since 1999. This position and equipment (i.e. forklift replacement, shelving replacement, security and RFID system enhancements) will assist in addressing the deficiencies, security, and accountability at the warehouse. Authorization for the FTE will be brought back for Board approval at a future date.
• $35,000.00 for consulting services related to the Medicare Ground Ambulance Data Collection requirements. Alachua County is required to begin additional data collection in FY2022-23 and report to the Centers for Medicare and Medicaid Services (CMS). Failure to sufficiently submit the required information will result in a 10 percent reduction to payments for one year. Precise and complete cost data collection is critical to maintaining future revenues from Medicaid and Medicare. Staff recommends an agreement with a consultant to assist will the first year to ensure requirements are met.
• $113,811.00 for Contract services for the assistance from consultant to complete the PEMT program requirements
• $30,000.00 to cover the anticipated increase in the Fire Rescue electronic reporting system due to increase in call volumes.
The resolution authorizes the participation in the supplemental payment program and amends the FY23 Adopted budget for the unanticipated revenue and expenditures. The program may require additional agreements with 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.