TO: Honorable Mayor & Members of the North Port Commission
FROM: A. Jerome Fletcher II, ICMA-CM, MPA, City Manager
TITLE: Approve the Public Emergency Medical Transportation (PEMT) Letter of Agreement by and Between the City of North Port on Behalf of North Port Fire Rescue EMS and the State of Florida, Agency for Healthcare Administration (AHCA) in the Amount of $316,864.71.
Recommended Action
Option 1: Approve the Public Emergency Medical Transportation (PEMT) Letter of Agreement by and between the City of North Port on behalf of North Port Fire Rescue EMS and the State of Florida, Agency for Healthcare Administration (AHCA) in the amount of $316,864.71.
Commission Options
Option 1: Approve the Public Emergency Medical Transportation (PEMT) Letter of Agreement by and between the City of North Port on behalf of North Port Fire Rescue EMS and the State of Florida, Agency for Healthcare Administration (AHCA) in the amount of $316,864.71.
• Pros:
o Enables the City to leverage federal matching funds through the PEMT Program.
o Provides additional net new revenue of $394,072.49 for the City’s Emergency Medical Services (EMS) operations.
o Supports continuation of the statewide PEMT Program that benefits EMS providers.
• Cons:
o Requires upfront intergovernmental transfer (IGT) of $316,864.71 by the City before reimbursement.
Option 2: Move to deny the Public Emergency Medical Transportation (PEMT) Letter of Agreement by and Between the City of North Port on Behalf of North Port Fire Rescue EMS and the State of Florida, Agency for Healthcare Administration (AHCA) in the amount of $316,864.71.
• Pros:
o Avoids the need for the City to IGT funds to the State.
• Cons:
o City forfeits $394,072.49 in net new federal funding.
o City would not participate in the Fiscal Year 2027 PEMT Program, losing access to total revenues of $710,937.20.
Background Information
Beginning in 2016, the Medicaid Fee for Service (FFS) PEMT Program has generated millions in additional federal dollars to Florida’s Public EMS provider community.
The Managed Care Organization (MCO) Program has a different funding mechanism than the FFS Program. This funding mechanism begins with an Intergovernmental Transfer, or IGT. What this means for providers is that in order for the additional funding to be generated, the provider community will need to transfer specific dollar amounts determined by the State Medicaid Agency, AHCA, and this allows AHCA to draw down the additional Federal funding. These IGT amounts will be returned to providers along with the additional federal dollars in the form of pass-through payments made by the Managed Care Organizations.
The City of North Port has 7 MCOs in its region and a total of $710,937.20 will be transferred to the City of North Port in Fiscal Year 2027-2028 contingent on approval of this PEMT Letter of Agreement.
The Public Emergency Medical Transportation Letter of Agreement by and between the City of North Port on behalf of North Port Fire Rescue and the State of Florida, Agency for Healthcare Administration (AHCA) has been reviewed by the City Attorney and is legally correct as to form.
The Public Emergency Medical Transportation Letter of Agreement was provided to the City Clerk on September 18, 2026, for signature, subject to Commission approval.
Strategic Plan
Safe Community
Financial Impact
The City of North Port Fire Rescue Department shall issue payment in the amount of $316,864.71 to the State of Florida Agency for Health Care Administration. Funds are budgeted in the Fiscal Year 2026-2027 account number 001-2222-526.31-05.
The return funding to the City of North Port as a result of this program is estimated at $710,937.20 in revenue during Fiscal Year 2027-2028, account string 001-0000-342.20-10.
Procurement
This PEMT Letter of Agreement was procured in accordance with Section 2-403 (a) 2 of the City of North Port Procurement Code: Procurement contracts between the City and nonprofit organizations, other governments or other public entities.
Attachments:
1. Letter of Agreement
Prepared by: Deputy Fire Chief Nicholas Herlihy
Department Director: Fire Chief Scott Titus