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Home My WebLink About2019-213A TRUE COPY CERTIFICATION ON LAST PAGE J.R. SMITH, CLERK Public Emergency Medical Transportation Letter of Agreement THIS LETTER OF AGREEMENT (LOA) is made and entered into in duplicate on the day of 2019, by and between Indian River County Emergency Services District on behalf of Indian River County Emergency Services District, and the State of Florida, Agency for Health Care Administration (the "Agency"), for good and valuable consideration, the receipt and sufficiency of which is acknowledged. DEFINITIONS "Intergovernmental Transfers (IGTs)" means transfers of funds from a non -Medicaid governmental entity (e.g., counties, hospital taxing districts, providers operated by state or local government) to the Medicaid agency. IGTs must be compliant with 42 CFR Part 433 Subpart B. "Medicaid" means the medical assistance program authorized by Title XIX of the Social Security Act, 42 LIS.C. §§ 1396 et seq., and regulations thereunder, as administered in Florida by the Agency. "Public Emergency Medical Transportation (PEMT)," pursuant to the General Appropriation Act, Laws of Florida 2019-115, is the program that provides supplemental payments for eligible Public Emergency Medical Transportation (PEMT) entities that meet specified requirements and provide emergency medical transportation services to Medicaid beneficiaries. A. GENERAL PROVISIONS Per Senate Bill 2500, the General Appropriations Act of State Fiscal Year 2019-2020, passed by the 2019 Florida Legislature, Indian River County Emergency Services District and the Agency agree that Indian River County Emergency Services District will remit IGT funds to the Agency in an amount not to exceed the total of $146,342.14. Indian River County Emergency Services District and the Agency have agreed that these IGT funds will only be used for the PEMT program. 2. Indian River County Emergency Services District will return the signed LOA to the Agency. 3. Indian River County Emergency Services District will pay IGT funds to the Agency in an amount not to exceed the total of $146,342.14. Indian River County Emergency Services District will transfer payments to the Agency in the following manner: a. Per Florida Statute 409.908, annual payments for the months of July 2019 thru June 2020 are due to the Agency no later than October 31, 2019 unless an alternative plan is specifically approved by the agency. b. The Agency will bill Indian River County Emergency Services District when payment is due. 4. Indian River County Emergency Services District and the Agency agree that the Agency will maintain necessary records and supporting documentation applicable to health Indian River County Emergency Services District—PEMT LOA_SFY 2019-20 A TRUE COPY CERTIFICATION ON LAST PAGE J.R. SMITH, CLERK services covered by this LOA in accordance with public records laws and established retention schedules. a. AUDITS AND RECORDS i. Indian River County Emergency Services District agrees to maintain books, records, and documents (including electronic storage media) pertinent to performance under this LOA in accordance with generally accepted accounting procedures and practices, which sufficiently and properly reflect all revenues and expenditures of funds provided. ii. Indian River County Emergency Services District agrees to assure that these records shall be subject at all reasonable times to inspection, review, or audit by state personnel and other personnel duly authorized by the Agency, as well as by federal personnel. iii. Indian River County Emergency Services District agrees to comply with public record laws as outlined in section 119.0701, Florida Statutes. b. RETENTION OF RECORDS The Indian River County Emergency Services District agrees to retain all financial records, supporting documents, statistical records, and any other documents (including electronic storage media) pertinent to performance under this LOA for a period of six (6) years after termination of this LOA, or if an audit has been initiated and audit findings have not been resolved at the end of six (6) years, the records shall be retained until resolution of the audit findings. ii. Persons duly authorized by the Agency and federal auditors shall have full access to and the right to examine any of said records and documents. iii. The rights of access in this section must not be limited to the required retention period but shall last as long as the records are retained. c. MONITORING i. Indian River County Emergency Services District agrees to permit persons duly authorized by the Agency to inspect any records, papers, and documents of the Indian River County Emergency Services District which are relevant to this LOA. d. ASSIGNMENT AND SUBCONTRACTS i. The Indian River County Emergency Services District agrees to neither assign the responsibility of this LOA to another party nor subcontract for any of the work contemplated under this LOA without prior written approval of the Agency. No such approval by the Agency of any assignment or subcontract shall be deemed in any event or in any manner to provide for the incurrence of any obligation of the Agency in addition to the total dollar amount agreed upon in this LOA. All such assignments or subcontracts shall be subject to the conditions of this LOA and to any conditions of approval that the Agency shall deem necessary. 5. This LOA may only be amended upon written agreement signed by both parties. Indian River County Emergency Services District_PEMT LOA_SFY 2019-20 The Indian River County Emergency Services District and the Agency agree that any modifications to this LOA shall be in the same form, namely the exchange of signed copies of a revised LOA. 6. Indian River County Emergency Services District confirms that there are no pre -arranged agreements (contractual or otherwise) between the respective counties, taxing districts, and/or the providers to re -direct any portion of these aforementioned supplemental payments in order to satisfy non -Medicaid, non -uninsured, and non -underinsured activities. 7. Indian River County Emergency Services District agrees the following provision shall be included in any agreements between Indian River County Emergency Services District and local providers where IGT funding is provided pursuant to this LOA. Funding provided in this agreement shall be prioritized so that designated IGT funding shall first be used to fund the Medicaid program and used secondarily for other purposes. 8. This LOA covers the period of July 1, 2019 through June 30, 2020 and shall be terminated June 30, 2020. 9. This LOA may be executed in multiple counterparts, each of which shall constitute an original, and each of which shall be fully binding on any party signing at least one counterpart. IN WITNESS WHEREOF, the parties have caused this page Letter of Agreement to be executed by their undersigned officials as duly authorized. Indian River County Emergency Services STATE OF FLORIDA, AGENCY FOR District ,..,••'' • r� •V HEALTH CARE ADMINISTRATION = _-_IFY THAT THIS IS `a CORRECT COPY OF ON FILE IN THIS SIGNE F` SIGNED BY: BY: 0 = NAME: Su n Adams ',o'• NAME: TITLE: .o Chairman •�-9;�Fq••o`t;'� TITLE: 0 � crnr ". �� DATE: December 17, 2019 DATE: d� 'a cn APPROVED AS TOFOR 0 3 Ate LEGAL UFFICIE C 1/1", g?a cM n � � wILLIA. i•c. �BFeAAL Then River County 1 b•r Tfy_g1 Dij9& PrMT LOA_SFY 2019-20 = _-_IFY THAT THIS IS `a CORRECT COPY OF ON FILE IN THIS