Agenda Report
Fullerton City Council
MEETING DATE: December 19, 2023
TO: CITY COUNCIL / SUCCESSOR AGENCY
SUBMITTED BY: adam loeser, fire chief
PREPARED BY: ANDREW YANG, ADMINSTRATIVE ANALYST I
SUBJECT: CITY participation in state of california department of health care services program FOR public provider ground emergency medical transport intergovernmental transfer
SUMMARY
Staff requests City Council approval for participation in the Public Provider Ground Emergency Medical Transport (PP-GEMT) Intergovernmental Transfer program administered by the State of California Department of Health Care Services and for corresponding budget appropriation.
RECOMMENDATION
Authorize City Manager, or designee, to issue and execute $875,000 Purchase Order for City participation in the PP-GEMT Intergovernmental Transfer program administered by the State of California Department of Health Care Services.
Approve $655,000 budget appropriation from available General Fund (Fund 10) fund balance to the Fire Department Fire EMS Program (Subprogram 246).
CITY MANAGER REMARKS
The City Manager recommends approval. Due to timing this will be a ratification of the action.
PRIORITY POLICY STATEMENT
This item matches the following Priority Policy Statements:
Fiscal and Organizational Stability
Public Safety.
FISCAL IMPACT
The City cost share under the new PP-GEMT program for Fiscal Year (FY) 2023-2024 totals approximately $875,000, including a 10% Administrative Fee levied by the California Department of Health Care Services. This includes $220,000 in the FY 2023-24 Adopted Budget for the previous iteration of the program. The difference in annual upfront costs between QAF and PP-GEMT programs totals $655,000, will be offset by new program revenues. Staff anticipates the net revenue increase from this PP-GEMT add-on to the General Fund (Fund 10) would total approximately $2.5M.
DISCUSSION
The City has engaged in Intergovernmental Transfer (IGT) programs for several years. The City participated in the Ground Emergency Medical Transport Quality Assurance Fee (QAF) program from 2019 to 2023. Under QAF, the City contributed between $25.23 to $34.37 per ambulance transport, including non-Medi-Cal transports. This enabled the City to receive a $220.80 Medi-Cal add-on reimbursement in addition to the $118.20 base rate, totaling $339.00 per Medi-Cal transport. The annual cost to the City totaled about $220,000, generating roughly $980,000 in gross revenues.
California Assembly Bill 1705 (2019) established the PP-GEMT program, offering enhanced reimbursements and replacing the former SB 523 and GEMT programs. Administrative hurdles delayed implementation until 2023. This change promises improved cost recovery for the City. The PP-GEMT program increases the add-on amount to $946.92, with the base rate remaining at $118.20. This results in a total Medi-Cal reimbursement of $1,065.12 per transport ($1,126.84 for neo-natal transports). The anticipated gross revenue from the PP-GEMT add-on is approximately $4.2M.
Although participation in PP-GEMT must be legally designated as voluntary, the continued viability of the program is entirely contingent on statewide funding adequacy from participants to match federal contributions; otherwise, California Department of Health Care Services (CA DHCS) will revert to the previous SB523 and annual GEMT reimbursement programs. This would result in the City losing $2.5 million in additional revenue.
Attachments:
Attachment 1 – CA DHCS PP-GEMT Program Reference Guide
Attachment 2 – CA Assembly Bill 1705
cc: City Manager Eric J Levitt
Public Provider Ground Emergency Medical Transport Participation December 19, 2023 - Page 2