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2025-204
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2025-204
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Last modified
10/6/2025 11:50:53 AM
Creation date
10/6/2025 11:50:26 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
09/23/2025
Control Number
2025-204
Agenda Item Number
9.R.
Entity Name
State of Florida Agency for Health Care Administration
Subject
Public Emergency Medical Transportation Letter of Agreement
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A. TRUE COPY <br />%:E.RTIFICATION ON LAST PAGE <br />L_ E11_ITLER, 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, 2025, through June 30, 2026, and shall be <br />terminated September 30, 2026, 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 2025-2026 <br />Estimated IGTs $571,385.02 <br />Total Funding Not to Exceed $571,385.02 <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 />SERVICESDIST RCT <br />SIGNED <br />BY: �a <br />NAME: John A. Titkanich, Jr. <br />TITLE: <br />County Administrator <br />DATE: SeptE� 23, 2025 <br />APPROVED AS TO FORM <br />AND LEGAL SUFFICIENCY <br />BY � � • �J _ <br />ANNIFER W. SHULER <br />COUNTY ATTORNEY <br />STATE OF FLORIDA, AGENCY FOR <br />HEALTH CARE ADMINISTRATION <br />SIGNED <br />BY: <br />NAME: Stephanie Scanlon <br />TITLE: Chief of Medicaid Program <br />Finance <br />DATE: <br />Indian River County Emergency Services Distirct_ Indian River County ALS_PEM LOA SFY 2025-26 <br />
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