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2024-206
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2024-206
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Last modified
10/15/2024 2:13:10 PM
Creation date
10/15/2024 2:09:53 PM
Metadata
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Template:
Official Documents
Official Document Type
Agreement
Approved Date
09/10/2024
Control Number
2024-206
Agenda Item Number
8.M.
Entity Name
Agency for Health Care Administration
Subject
Public Medical Transportation Letter of Agreement
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A TRUE COPY <br />CERTIFICATION ON LAST PAGE <br />RYAN L. BUTLER, CLERK <br />direct any portion of these aforementioned supplemental payments in order to satisfy non - <br />Medicaid, non -uninsured, and non -underinsured activities. <br />7. The IGT Provider agrees the following provision shall be included in any agreements <br />between IGT Provider and local providers where IGT funding is provided pursuant to this <br />LOA. Funding provided in this agreement shall be prioritized so that designated IGT <br />funding shall first be used to fund the Medicaid program and used secondarily for other <br />purposes. <br />8. This LOA covers the period of July 1, 2024, through June 30, 2025, and shall be <br />terminated September 30, 2025, which includes the state's certified forward period. <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 2024-2025 <br />Estimated IGTs $361,565.57 <br />Total Funding Not to Exceed $361,565.57 <br />IN WITNESS WHEREOF, the parties have caused this page Letter of Agreement to be <br />executed by their undersigned officials as duly authorized. <br />INDIAN RIVER COUNTY EMERGENCY <br />SERVICES DIST ICT <br />SIGNED <br />BY: Z ",/ <br />NAME: John A. Titkanich, Jr. 61 <br />TITLE. County Administrator <br />DATE: <br />STATE OF FLORIDA, AGENCY FOR <br />HEALTH CARE ADMINISTRATION <br />SIGNED <br />BY: <br />NAME: Tom Wallace <br />TITLE: Deputy Secretary for Health Care <br />Finance and Data <br />DATE: <br />Indian River County Emergency Services District_ Indian River County ALS—PEM LOA_SFY 2024-25 <br />
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