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2021-138
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2021-138
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Last modified
10/13/2021 4:03:11 PM
Creation date
10/1/2021 12:55:30 PM
Metadata
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Template:
Official Documents
Official Document Type
Agreement
Approved Date
09/14/2021
Control Number
2021-138
Agenda Item Number
15.A.4.
Entity Name
Agency for Health Care Administration (AHCA)
Emergency Services District
Subject
Letter of Agreement for Public Emergency Medical Transportation (PEMT)
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The Indian River County Emergency Services District and the Agency agree that any <br />modifications to this LOA shall be in the same form, namely the exchange of signed copies <br />of a revised LOA. <br />6. Indian River County Emergency Services District confirms that there are no pre- <br />arranged agreements (contractual or otherwise) between the respective counties, taxing <br />districts, and/or the providers to re -direct any portion of these aforementioned <br />supplemental payments in order to satisfy non -Medicaid, non -uninsured, and non - <br />underinsured activities. <br />7. Indian River County Emergency Services District agrees the following provision shall <br />be included in any agreements between Indian River County Emergency Services <br />District and local providers where IGT funding is provided pursuant to this LOA. Funding <br />provided in this agreement shall be prioritized so that designated IGT funding shall first be <br />used to fund the Medicaid program and used secondarily for other purposes. <br />8. This LOA covers the period of July 1, 2021 through June 30, 2022 and shall be terminated <br />June 30, 2022. <br />9. This LOA may be executed in multiple counterparts, each of which shall constitute an <br />original, and each of which shall be fully binding on any party signing at least one <br />counterpart. <br />PEMT Local Intergovernmental Transfers <br />Program / Amount State Fiscal Year 2021-2022 <br />Minimum Fee Schedule/MCO IGTs $212,912.84 <br />Total Funding $212,912.84 <br />IN WITNESS WHEREOF, the parties have caused this page Letter of Agreement to be <br />executed by their undersigned officials as duly 4L" �•.. <br />Indian River County Emergency Service F�►�1s OF FLORIDA, AGENCY FOR <br />District EH CARE ADMINISTRATION <br />SIGNED SIGNED <br />BY: <br />E: Joseph E. Flescher •�^��'�RCOu�l�1-tFAME: <br />T E: Chairman TITLE: <br />DATE: September 14, 2021 DATE: <br />Itis <br />APPP,� t .: is Y <br />A ,+'+ <br />O �.. n'.a'!b �• <br />R ; Attest: Jeffrey R. Smith, Clerk of <br />Indian River County ertterj "A(iges t,#f'Tndia�+I(I 4#&ft4 dGMhPb 6r SFY 2021-22 <br />00.'.O' l z t <br />By <br />k �'* <br />Deputy Clerk <br />
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