06-04-2019 - Item 06 - Consideration of A Budget Amendment For The Ground Emergency Medical Transport Quality Assurance Fee Program For Fiscal Year 2018AGENDA ITEM NO.6
AGENDA STAFF REPORT
City of West Covina I Office of the City Manager
DATE: June 4, 2019
TO: Mayor and City Council
FROM: David Carmany
Interim City Manager
SUBJECT: CONSIDERATION OF A BUDGET AMENDMENT FOR THE GROUND EMERGENCY
MEDICAL TRANSPORT QUALITY ASSURANCE FEE PROGRAM FOR FISCAL YEAR
2018-19
RECOMMENDATION:
It is recommended that the City Council adopt the following resolution:
RESOLUTION NO.2019-36 — A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF
WEST COVINA, CALIFORNIA, ADOPTING A BUDGET AMENDMENT FOR THE FISCAL
YEAR COMMENCING JULY 1, 2018 AND ENDING JUNE 30, 2019 (GROUND EMERGENCY
MEDICAL TRANSPORT QUALITY ASSURANCE FEE PROGRAM)
BACKGROUND:
The West Covina Fire Department (Fire Department) provides Ground Emergency Medical Transportation
(GEMT) services to Medi-Cal beneficiaries. Medi-Cal is part of California's national health coverage program
called Medicaid. Each state operates its own Medicaid program. Medi-Cal pays for a variety of medical services
for children and adults with limited income and resources. Medi-Cal is supported by federal and state taxes.
GEMT Program Overview California Welfare and Institutions (W&I) Code § 14105.94, enacted by the State
Legislature on October 2, 2011, authorized the Ground Emergency Medical Transportation Services (GEMT)
supplemental reimbursement program. This voluntary Certified Public Expenditure (CPE) based program provides
additional funding to eligible governmental entities that provide GEMT services to Medi-Cal beneficiaries. The
Centers for Medicare and Medicaid Services (CMS) approved State Plan Amendment (SPA) 09-024 on September
4, 2013, authorizing the federal share of the supplemental reimbursement payments based on uncompensated costs
for Medi-Cal fee -for -service transports, effective January 30, 2010.
In October 2017, Senate Bill 523 (Chapter 773, Statutes of 2017) was signed into law, and established a mandatory
GEMT Quality Assurance Fee (QAF) program. Senate Bill 523 authorizes DHCS to collect data from GEMT
providers including: (1) on a quarterly basis, the number of emergency medical transports, by payor type; and (2)
on an annual basis, gross receipts received from the provision of emergency medical transports per fiscal year. All
providers of GEMT services are required to submit data to DHCS. The data collected is used to calculate an annual
GEMT QAF rate that will be imposed on each emergency medical transport provided by each GEMT provider
subject to the GEMT QAF. The GEMT QAF will be collected to increase reimbursement to GEMT providers by
application of an add -on to the fee -for -service fee schedule rate for the affected emergency medical transport billing
codes.
DISCUSSION:
Although Senate Bill 523 was approved in October 2017, the Fire Department was unaware of the amount owed for
the GEMT QAF program until April 24, 2019. On that day, DHCS notified the Fire Department that the GEMT
QAF payments, based on a rate of $25.23 per transport, must be paid for dates of service between Quarter 1 (Q 1) of
2018 through Q1 of 2019, retroactive to July 1, 2018. Because of the delayed GEMT QAF program
implementation, DHCS set the following GEMT QAF payment due dates:
Due Date
Reporting Period
QAF Amount Due
April 30, 2019
Q2 (April - June) of 2018
$25,002.93
May 15, 2019
1 Q3 (July - September) of 2018
$25,734.60
May 15, 2019
Q1 (January- March) of 2019
$23,716.20
June 15, 2
IQ1 (January - March) of 20
1$25,204.77
June 15, 2
1 Q4 (October - December) o
1$24,422.64
Sub-Total-71
1$124,081.14
The regular schedule for GEMT QAF collections will start on July 1, 2019. GEMT QAF payments will be due on
or before the first day of each quarter for transports reflected in the preceding quarter.
ENVIRONMENTAL REVIEW:
This project is a General Exemption under the California Environmental Quality Act.
Prepared by: Russell Narahara, Management Analyst II
Additional Approval: Mike Hambel, Acting Fire Chief
Additional Approval: Robbeyn Bird, Interim Finance Director
Fiscal Impact
FISCAL IMPACT:
Due to the delayed implementation of the GEMT QAF program, no funds were budgeted in the Fire Department's
Fiscal Year 2018-19 budget. Therefore, appropriation from the General Fund balance in the amount of
$124,081.14 is needed.
Attachments
Attachment No. 1 - Resolution No. 2019-36
Exhibit 1 - Budget Amendment No. 090