HomeMy WebLinkAboutAgenda Item Summary FormAGENDA ITEM SUMMARY FORM
File ID: #6444
Date: 11/26/2019
Commission Meeting Date: 12/12/2019
Requesting Department: Office of
Management and Budget
Sponsored By:
District Impacted: All
Type: Resolution
Subject: MOU - Intergovernmental Transfer of Funds
Purpose of Item:
A resolution of the Miami City Commission, with attachment(s), authorizing the City of
Miami ("City") to participate in and receive reimbursements under the new Medicaid
Public Emergency Medical Transportation ("PEMT") and Managed Care Emergency
Medical System ("EMS") Supplement Payment Program ("Partial Reimbursement
Program") for Medicaid Managed Care ("MMC") patients transported by the City's
Department of Fire -Rescue ("Department"), with administration of federal funds by the
State of Florida ("State") through its Agency for Health Care Administration ("AHCA") for
the first program year ending June 30, 2020 ("First Program Year"); authorizing the City
Manager to negotiate and execute any and all necessary agreements, in a form
acceptable to the City Attorney.
Background of Item:
The Department of Fire -Rescue (Department) transports two types of patients covered
by Medicaid. Those that are enrolled in a Fee for Service (FFS) plans and those in
enrolled in Medicaid Managed Care plans (MMC). Currently, the Department receives
$190 for Advanced Life Support and $136 for Basic Life Support transports for both FFS
and MMC patients. These payments are comprised of both a State of Florida share of
38.53 percent and a federal government share of 61.47 percent.
Currently, the Department receives supplemental reimbursement for FFS transports
from the Federal government through the Public Emergency Medical Transport (PEMT)
Medicaid FFS program. In FY 2018-19 this program reimbursed an additional $2.343
million in revenues to the City of Miami. Therefore, paying a supplement in addition to
the State share payment for the transport of FFS patients.
In 2019, the Governor of the State of Florida (State) signed State Bill 2500 that
established the PEMT MMC program to provide a reimbursement supplement to public
transport providers for MMC patients. For MMC patients, federal rules 42 CFR 438.6
requires Florida to send its share of 38.53 percent of transport cost to the federal
government by mean of an intergovernmental transfer (IGT). The IGT certifies the that
public expenditures have been incurred. IGTs have been used from the beginning of
the Medicaid program.
The State established a funding pool of $54.000 million and requires that public
emergency medical transportation provider send their state share portion of 38.53
percent as an intergovernmental transfer to State of Florida Agency for Health Care
Administration (AHCA). AHCA will then leverage the State share portion in order to
receive the 61.47 percent federal portion from the Centers for Medicaid and Medicaid
Services (CMS) . CMS will then transfer back both the State and Federal share
portions to AHCA. ACHA will then disburse funds to the various Managed Care
Organizations (MCO) that currently reimburse the Department for transports. The
MCOs will then reimburse the City based on the number of transports formula. This
new program will pay a supplement above the fees that the City already is receiving.
For the City to participate in the PEMT MMC program, ACHA requires each transport
provider to sign a Letter of Agreement (LOA). This item is requesting the City Manager
to be given the authority to sign a Letter of Agreement with AHCA and to allocate
approximately $899,407 to be transferred to AHCA via and IGT.
Budget Impact Analysis
Item is Related to Revenue
Item is an Expenditure
Item is NOT funded by Bonds
Total Fiscal Impact:
The City expects to net $1.435 million in Federal share funds due to this new program. This
includes $899,407 from Fire -Rescue's General Fund budget that will be sent to Agency for
Health Care Administration and approximately $2.334 million of gross revenues received from
both the Federal and State of Florida governments.
General Account No: 00001.181000.881000.0000.00000
Office of Management and Budget
City Manager's Office
Legislative Division
City Manager's Office
Office of the City Attorney
Office of the City Attorney
City Commission
Office of the Mayor
Office of the City Clerk
Office of the City Clerk
Reviewed B
Christopher M Rose
Sandra Bridgeman
Valentin J Alvarez
Nikolas Pascual
Barnaby L. Min
Victoria Mendez
Maricarmen Lopez
Mayor's Office
City Clerk's Office
City Clerk's Office
Department Head Review
Assistant City Manager Review
Legislative Division Review
City Manager Review
Deputy City Attorney Review
Approved Form and Correctness
Meeting
Completed
Completed
Completed
Completed
Completed
Completed
Completed
Unsigned by the Mayor Completed
Signed and Attested by the City Clerk Completed
Rendered Completed
12/02/2019 1:13 PM
12/02/2019 1:16 PM
12/02/2019 1:28 PM
12/02/2019 2:43 PM
12/02/2019 7:32 PM
12/02/2019 10:38 PM
12/12/2019 9:00 AM
12/23/2019 5:33 PM
12/23/2019 5:44 PM
12/23/2019 5:44 PM
City of Miami
Legislation
Resolution
Enactment Number: R-19-0512
City Hall
3500 Pan American Drive
Miami, FL 33133
www.miamigov.com
File Number: 6444 Final Action Date:12/12/2019
A RESOLUTION OF THE MIAMI CITY COMMISSION, WITH ATTACHMENT(S),
AUTHORIZING THE CITY OF MIAMI ("CITY") TO PARTICIPATE IN AND
RECEIVE REIMBURSEMENTS UNDER THE NEW MEDICAID PUBLIC
EMERGENCY MEDICAL TRANSPORTATION AND MANAGED CARE
EMERGENCY MEDICAL SYSTEM SUPPLEMENT PAYMENT PROGRAM
("PARTIAL REIMBURSEMENT PROGRAM") FOR MEDICAID MANAGED CARE
PATIENTS TRANSPORTED BY THE CITY'S DEPARTMENT OF FIRE -RESCUE
("DEPARTMENT") WITH ADMINISTRATION OF FEDERAL FUNDS BY THE
STATE OF FLORIDA ("STATE") THROUGH ITS AGENCY FOR HEALTH CARE
ADMINISTRATION ("AHCA") FOR THE FIRST PROGRAM YEAR ENDING
JUNE 30, 2020 ("FIRST PROGRAM YEAR"); AUTHORIZING THE CITY
MANAGER TO NEGOTIATE AND EXECUTE ANY AND ALL NECESSARY
AGREEMENTS, ALL IN A FORM ACCEPTABLE TO THE CITY ATTORNEY, IN
ORDER TO PARTICIPATE IN THE PARTIAL REIMBURSEMENT PROGRAM
FOR THE FIRST PROGRAM YEAR, TO PROVIDE THE REQUIRED FIRST
PROGRAM YEAR CITY MATCH BY INTERGOVERNMENTAL TRANSFER(S)
OF FUNDS TO ACHA, AND TO RECEIVE APPROXIMATELY 61.47 PERCENT
BACK FROM THE FEDERAL SHARE OF THE PARTIAL REIMBURSEMENT
PROGRAM AND 38.53 PERCENT BACK FROM ACHA UNDER THE STATE
SHARE OF THE PARTIAL REIMBURSEMENT PROGRAM; AUTHORIZING
AND APPROPRIATING FROM ACCOUNT NO. 00001.181000.881000 TO BE
TRANSFERRED TO ACHA IN AN AMOUNT NOT TO EXCEED EIGHT
HUNDRED NINETY-NINE THOUSAND FOUR HUNDRED SEVEN DOLLARS
AND FORTY EIGHT CENTS ($899,407.48) WHICH IS APPROXIMATELY 38.53
PERCENT OF THE FUNDING REQUIRED TO BE PAID AS THE CITY MATCH
BY JANUARY 2020, OR SUCH OTHER TIME AS DESIGNATED IN WRITING
BY AHCA, IN ORDER FOR THE CITY TO PARTICIPATE IN THE PARTIAL
REIMBURSEMENT PROGRAM FOR THE FIRST PROGRAM YEAR AND WILL
REQUIRE THAT THE DEPARTMENT'S OPERATING BUDGET BE
INCREASED IN THE FISCAL YEAR 2019-20 MID -YEAR BUDGET
AMENDMENT; REQUIRING THE CITY MANAGER AND THE DEPARTMENT,
BEGINNING OCTOBER 1, 2020, TO PROVIDE TO THE CITY COMMISSION
AN ANNUAL REPORT ON THE FIRST PROGRAM YEAR'S PARTICIPATION
AND PARTIAL REIMBURSEMENTS TO THE CITY; FURTHER AUTHORIZING
THE CITY MANAGER TO NEGOTIATE AND EXECUTE, IN A FORM
ACCEPTABLE TO THE CITY ATTORNEY, ALL AMENDMENTS, EXTENSIONS,
RENEWALS, AND MODIFICATIONS TO ANY AND ALL FIRST PROGRAM
YEAR AGREEMENTS FOR THE PARTIAL REIMBURSEMENT PROGRAM;
PROVIDING FOR AN EFFECTIVE DATE.
WHEREAS, pursuant to the General Appropriation Act — Laws of the State of Florida
2019-15 and Section 409.908, Florida Statutes, the State of Florida ("State"), through its Agency
for Health Care Administration ("ACHA"), has created a new Medicaid Public Emergency
Medical Transportation ("PEMT") and Managed Care Emergency Medical System ("EMS")
supplement payment program ("Partial Reimbursement Program") to administer Federal funds
for reimbursements to local service providers for Medicaid Managed Care patients who ("MMC")
are transported to the hospital by PEMT providers and has appropriated $54.787 million for this
Partial Reimbursement Program; and
WHEREAS, the City of Miami's ("City") Department of Fire -Rescue ("Department")
transported 9,330 MMC patients in Fiscal Year 2017-18 and received approximately $1.512
million for this service; and
WHEREAS, by participating in the new Partial Reimbursement Program for MMC
patients, the City and the Department can substantially increase revenues for MMC patient
transports; and
WHEREAS, under the new Partial Reimbursement Program, the City and the
Department as a provider of MMC patient transports must enter into certain Reimbursement
Program Agreement(s) by December 31, 2019 and must send the local matching portion for the
state share ("State Share") portion of Partial Reimbursement Program by January 2020, or such
other time as designated in writing by AHCA, for the first program year ("First Program Year")
ending June 30, 2020 by means of an intergovernmental transfer to AHCA in order to allow the
State to certify the public expenditure incurred by the Department and to become eligible to
receive the Federal share ("Federal Share") for partial reimbursement to the City and the
Department;
NOW, THEREFORE, BE IT RESOLVED BY THE COMMISSION OF THE CITY OF
MIAMI, FLORIDA:
Section 1. The recitals and findings contained in the Preamble to this Resolution are
adopted by reference and incorporated as if fully set forth in this Section.
Section 2. The City is authorized' to participate in and to receive reimbursements under
the Partial Reimbursement Program for MMC patients transported by the Department with
administration of Federal funds by the State through ACHA for the First Program Year ending
June 30, 2020.
Section 3. The City Manager is hereby authorized' to negotiate and execute any and all
necessary agreements, all in a form acceptable to the City Attorney, in order to participate in the
Partial Reimbursement Program for the First Program Year, to provide the required First
Program Year City match by intergovernmental transfer(s) of funds to ACHA, and to receive
approximately 61.47 percent back from the Federal Share of the Partial Reimbursement
Program and 38.53 percent back from the State Share of the Partial Reimbursement Program.
Section 4. An amount not to exceed eight hundred ninety-nine thousand four hundred
seven dollars and forty eight cents ($899,407.48) is authorized' and appropriated from Account
No. 00001.181000.891000 to be transferred to ACHA which is approximately 38.53 percent of
the funding required to be paid as the City match by January 2020, or such other time as
designated in writing by AHCA, in order for the City to participate in the Partial Reimbursement
Program for the First Program Year.
Section 5. The City Manager and the Department, beginning October 1, 2020, are
required to provide to the City Commission an annual report on the First Program Year's
participation and partial reimbursements to the City.
Section 6. The City Manager is further authorized' to negotiate and execute, in a form
acceptable to the City Attorney, all amendments, extensions, renewals, and modifications to any
and all First Program Year Agreements for the Partial Reimbursement Program.
Section 7. This Resolution shall become effective immediately upon its adoption and
signature of the Mayor.2
APPROVED AS TO FORM AND CORRECTNESS:
ndez, ity ttor ey 12/2/2019
1 The herein authorization is further subject to compliance with all requirements that may be imposed by
the City Attorney including but not limited to those prescribed by applicable City Charter and City Code
provisions.
2 If the Mayor does not sign this Resolution, it shall become effective at the end of ten (10) calendar days
from the date it was passed and adopted. If the Mayor vetoes this Resolution, it shall become effective
immediately upon override of the veto by the City Commission.