Bradenton Area Convention Center One Haben Boulevard, Palmetto - Longboat Key Room 9:00 a.m. - September 29, 2020
REVISED - September 29, 2020 - Regular Meeting
Agenda Item #33

Adoption of Resolution R-20-145 Authorizing the Public Safety Department to Participate in the Intergovernmental Transfer Program with the State of Florida Agency for Health Care Administration


Contact and/or Presenter Information
James Crutchfield, Emergency Medical Services Chief, 941-749-3500 x1648

Action Requested
Adoption of Resolution R-20-145 authorizing the Public Safety Department to participate in the Intergovernmental Transfer (IGT) Program with the State of Florida Agency for Health Care Administration's (AHCA), approving the form agreement for the IGT, and designating authority for the Director of Public Safety Department to execute form agreement(s) and other documents necessary to participate in the program.

Enabling/Regulating Authority
Florida Constitution and Florida Statute Section 125.01 authorize the County to exercise home rule powers for the health, safety, and welfare of the general public.

Background Discussion
Manatee County EMS transports approximately 32,000 patients annually, generating approximately $10 million annually:
    - Patients are billed and payments collected via a contract with Ambulance Medical Billing
    - Approximately 12 percent of total transports annually are insured by Medicaid
    - The average reimbursement for Medicaid patient transport is $163  
    - This amount is significantly lower compared to patients with Medicare ($443 per patient transport) and private insurance ($635 per patient transport)

Recently, the State of Florida, Agency for Health Care Administration (AHCA) established a Medicaid Supplemental Program to address Medicaid payment inadequacy. The Florida Medicaid Managed Care Supplemental Payment Program (MCO Program) will allow qualifying government owned ambulance providers to receive supplemental payments to help close the gap between cost incurred and revenue received, for each emergency transport of a Medicaid managed care patient.

On September 15, 2020, the Board of County Commissioners accepted Year 1 funds from the MCO program and authority was given to execute each MCO agreement.  Manatee is receiving an approximate amount of $839k for participating in Year 1 of the MCO Program. 

For Year 2 of the MCO program, the Federal Government has appropriated $54,786,711.  Participating providers in the State of Florida are projected to contribute a combined $20,840,865 through intergovernmental transfer (IGT).

Manatee County will provide the state share through IGT in the approximate amount of $342,520.48, while the 60 percent Federal Share is leveraged.  Allowing the state to certify the public expenditure incurred by Manatee County Emergency Medical Service (MCEMS) as the State share.

Manatee County is anticipating receiving approximately $900,421 for participation in Year 2 of the MCO program; netting approximately $557,900

AHCA will disburse $33,945,846 to each Managed Care Organizations (MCO) based on their number of subscribers.  Each MCO will be tasked to disburse the funds to qualified government owned ambulance providers. 

Manatee County currently has 7 MCO's:  Aetna Better Health, WellCare, Simply Healthcare, Humana, Florida Community Care, United Healthcare, and Sunshine Health

Manatee County's Public Safety Director will need to execute the agreement with AHCA to remit IGT funds

County Attorney Review
Formal Written Review (Opinion memo must be attached)

Explanation of Other

Reviewing Attorney

Instructions to Board Records


Please provide the original & email copies of the signed Resolution to james.crutchfield@mymanatee.org, renee.isrel@mymanatee.org, and mary.allred@mymanatee.orgPublic Safety will pick up the original from Board Records.  The resolution and agreement are due to the State no later than October 1st, 2020.  We may send an electronic copy but the original document must be postmarked by October 1st.

Cost and Funds Source Account Number and Name
0010007101 EMS Operations/0010000000 342600 EMS GenFund Revenue

Amount and Frequency of Recurring Costs
$342,520.48 - one time

Attachment:  CAO Response Memo 9-15-2020.pdf
Attachment:  Resolution R-20-145.pdf