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(S.A <br />DISTRICT <br />INDIAN RIVER COUNTY, FLORIDA <br />MEMORANDUM <br />TO: Honorable Emergency Services District Board of Commissioners <br />THROUGH: Jason E. Brown, County Administrator <br />FROM: Tad Stone, Director <br />Department of Emergency Services <br />DATE: December 12, 2019 <br />SUBJECT: Approval of Public Emergency Medical Transportation Letter of Agreement <br />between Indian River County Emergency Services District and the Agency for <br />Health Care Administration. <br />It is respectfully requested that the information contained herein be given formal consideration by <br />the Emergency Services District Board of Commissioners at the next regular scheduled meeting. <br />DESCRIPTION AND CONDITIONS: <br />Staff seeks consideration of a Letter of Agreement with the Agency for Health Care Administration <br />(ACHA) for the receipt of Public Emergency Medical Transportation (PEMT) payments to the <br />County for this year. <br />AHCA has significantly changed the process to receive the PEMT payments to providers over <br />prior years. The new process now requires an upfront payment from the County of $146,342.14 in <br />order to receive the PEMT payment. This payment from the County to AHCA as well as all of the <br />statewide provider's payments will be bundled as a funding mechanism to apply for federal grants. <br />It is anticipated that the funds provided to AHCA ($146,342.14) will be returned to the County as <br />well as the annual PEMT funds estimated to be $85,744 with a total return to the County of <br />$232,086.14. <br />There are several concerns associated with the agreement and they are as follows: <br />The attached agreement with AHCA for the future payment of PEMT is unilateral and not <br />subject to any changes, additions or deletions. <br />The agreement does not fully cover or explain the return of the $146,342.14 to the County. <br />The County Attorney has had conversations with AHCA regarding these issues but they <br />are hesitant to put any of their responses in writing. (See attached email from County <br />Attorney Dylan Reingold to Kristen Johnson, AHCA) <br />If the County does not enter into this letter of agreement, the annual PEMT funding will be <br />withheld and there will be a loss of revenue to the District of $85,744. <br />210 <br />