HomeMy WebLinkAboutFD Medi-Cal Transportation Intergovernmental Transfer Program for Calenday Year 2026____________________________________________________________________________________
FOR CITY CLERK ONLY
Council Meeting: December 15, 2025
Disposition: Resolution 15490
Agenda Item No: 2.g
Meeting Date: December 15, 2025
SAN RAFAEL CITY COUNCIL AGENDA REPORT
Department: Fire
Prepared by: Abraham Roman, Fire Chief
Thomas Wong, Senior
Management Analyst
City Manager Approval: ______________
TOPIC: MEDI-CAL TRANSPORTATION INTERGOVERNMENTAL TRANSFER PROGRAM
FOR CALENDAR YEAR 2026
SUBJECT: RESOLUTION OF THE SAN RAFAEL CITY COUNCIL AUTHORIZING THE CITY
MANAGER TO EXECUTE A CERTIFICATION FORM FOR THE SAN RAFAEL FIRE
DEPARTMENT TO PARTICIPATE IN AN INTERGOVERNMENTAL TRANSFER (IGT)
WITH THE CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES (DHCS) FOR
REIMBURSEMENT OF PUBLIC PROVIDER GROUND EMERGENCY MEDICAL
TRANSPORTATION (PP-GEMT) SERVICES FOR THE SERVICE PERIOD OF
JANUARY 1, 2026, THROUGH DECEMBER 31, 2026, AND TRANSFERS TO DHCS
NOT TO EXCEED $946,000
RECOMMENDATION:
Staff recommends that the City Council authorize the City Manager to execute a certification form for
the San Rafael Fire Department to participate in a Medi-Cal Intergovernmental Transfer (IGT) program
with the California Department of Health Care Services (DHCS) for reimbursement of Provider Ground
Emergency Medical Transportation (PP-GEMT) services for the service period of January 1, 2026,
through December 31, 2026, and make transfers not to exceed $946,000.
BACKGROUND:
In accordance with California Assembly Bill 1705 (Chapter 544, Statutes of 2019), DHCS developed the
PP-GEMT program to reimburse eligible emergency medical transportation providers for costs
associated with transporting individuals covered by Medi-Cal. This is the third year the City has
participated, with 2023 being the program's inaugural year. This program starts on January 1, 2026.
The PP-GEMT program assists the City in recovering costs associated with the provision of Emergency
Medical Services (EMS) to individuals who Medi-Cal covers.
ANALYSIS:
Participation in the PP-GEMT program is mandatory for public provider agencies like the City. The
program provides an important opportunity for the City to collect additional ambulance transport fees
that would otherwise be unavailable. This mandatory participation requires the City to collect and
receive these additional ambulance transport fees for each Medi-Cal transport it provides.
While the PP-GEMT program is mandatory, cities, counties, and other public providers in the State may
optionally transfer funds to the State to support the program. This optional transfer is highly encouraged
SAN RAFAEL CITY COUNCIL AGENDA REPORT / Page: 2
as it allows the PP-GEMT program to secure Federal matching funds that are the basis for providing
higher reimbursement rates for each Medi-Cal patient transported. The State would not have adequate
funds to receive the full Federal match without enough transfers from public providers. This would lead
to the elimination of the existing program. While the transfer is optional, the staff recommends that the
City provide it to ensure ongoing revenues associated with PP-GEMT continue.
FISCAL IMPACT:
Yearly costs and benefits to the City from the program depend on the number of Medi-Cal transports
the City provides in a calendar year and the number of contributing agencies. Using 2025’s Medi-Cal
transport data, the City’s 2026 IGT transfer to the State is estimated to be $860,000, which includes a
10% administrative fee. The City estimates that the PP-GEMT program will generate $1,500,000 in
additional Medi-Cal payments for each Medi-Cal transport the City provides. This will result in an
estimated $640,000 in net new funds. The total proposed funds to be transferred to the State will be
allocated from the Department’s Paramedic Tax Service Fund (210) and disbursed in four tranches in
accordance with the PP-GEMT program’s requirements. The Paramedic Tax Service Fund is used to
provide emergency medical services, including ambulances and paramedics, at San Rafael Fire
Stations.
Time Period Funding
Source
Estimated
Transfer Amount
to DHCS
Estimated Funds
Returned to City
Estimated Net
New Funds
Calendar Year
2026 Fund 210 $860,000 $ 1,500,000 $640,000
Staff recommends that the City Council authorize total transfers not to exceed $946,000, which would
account for a 10% contingency. This contingency would cover cost increases if fewer agencies
participate or the Fire Department transports additional Medi-Cal patients, which would result in higher
transfers than expected.
OPTIONS:
The City Council has the following options to consider on this matter:
1.Authorize the City Manager to execute the Certification Form.
2.Direct staff to return with more information.
3.Take no action.
RECOMMENDED ACTION:
Staff recommends that the City Council authorize the City Manager to execute a certification form for
the San Rafael Fire Department to participate in a Medi-Cal Intergovernmental Transfer (IGT) program
with the California Department of Health Care Services (DHCS) for reimbursement of Provider Ground
Emergency Medical Transportation (PP-GEMT) services for the service period of January 1, 2026,
through December 31, 2026, and make transfers not to exceed $946,000.
ATTACHMENTS:
1. Resolution
2.Calendar Year 2026 PP-GEMT Certification Form
1
RESOLUTION NO. 15490
RESOLUTION OF THE SAN RAFAEL CITY COUNCIL AUTHORIZING THE CITY MANAGER
TO EXECUTE A CERTIFICATION FORM FOR THE SAN RAFAEL FIRE DEPARTMENT TO
PARTICIPATE IN AN INTERGOVERNMENTAL TRANSFER (IGT) WITH THE CALIFORNIA
DEPARTMENT OF HEALTH CARE SERVICES (DHCS) FOR REIMBURSEMENT OF PUBLIC
PROVIDER GROUND EMERGENCY MEDICAL TRANSPORTATION (PP-GEMT) SERVICES
FOR THE SERVICE PERIOD OF JANUARY 1, 2026, THROUGH DECEMBER 31, 2026, AND
TRANSFERS TO DEPARTMENT OF HEALTH CARE SERVICES NOT TO EXCEED $946,000
WHEREAS, the City of San Rafael, through its Fire Department, regularly provides
emergency ambulance transport to persons who are Medi-Cal patients; and
WHEREAS, the City participates in various governmental programs that provide
reimbursement of costs incurred in providing such emergency services to Medi-Cal patients; and
WHEREAS, pursuant to California Assembly Bill 1705 (Chapter 544, Statutes of 2019),
San Rafael, as a public provider agency, is required to participate in the PP-GEMT Program; and
WHEREAS, the City may optionally transfer funds to the State to support the program,
which is highly encouraged as it allows the PP-GEMT program to secure Federal matching funds
that are the basis for providing higher reimbursement rates for each Medi-Cal patient transported;
and
WHEREAS, by participating in the Intergovernmental Transfer Program, the City will
receive reimbursements for a larger proportion of its actual costs for providing emergency
ambulance transport to Medi-Cal patients; and
NOW, THEREFORE, BE IT RESOLVED, by the San Rafael City Council as follows:
1. The San Rafael Fire Department is hereby authorized to participate in an
intergovernmental transfer (IGT) with the California Department of Health Care
Services (DHCS) for reimbursement of public provider ground emergency medical
transportation (PP-GEMT) services for the service period of January 1, 2026, through
December 31, 2026
2. The City Manager is authorized to execute a certification form DHCS, subject to final
approval as to form by the City Attorney.
3. The City Council hereby authorizes the transfer of funds to DHCS pursuant to such
agreement, in an amount approved by the City Manager and in accordance with a
mutually agreed upon schedule, to be used solely as an elective IGT made pursuant
to W&I Code sections 14105.945 and 14164 for transports from January 1, 2026,
through December 31, 2026.
2
I, LINDSAY LARA, Clerk of the City of San Rafael, hereby certify that the foregoing
Resolution was duly and regularly introduced and adopted at a regular meeting of the City Council
of said City held on Monday, the 15th day of December 2025 by the following vote, to wit:
AYES: Councilmembers: Bushey, Hill, Kertz, Llorens Gulati & Mayor Kate
NOES: Councilmembers: None
ABSENT: Councilmembers: None
Lindsay Lara, City Clerk
Michelle Baass | Director
PUBLIC PROVIDER GROUND EMERGENCY MEDICAL TRANSPORTATION PROGRAM
INTERGOVERNMENTAL TRANSFER CERTIFICATION FORM
STATE CALENDAR YEAR 2026
California Department of Health Care Services
Capitated Rates Development Division
1501 Capitol Avenue, P.O. Box 997413
Sacramento, CA | 95899-7413 MS 4413 | www.dhcs.ca.gov
State of California
Gavin Newsom, Governor
California Health and Human Services Agency
I, the undersigned, hereby declare and certify on behalf of
_____________________________________________________________ (the “Public Entity”) as follows:
1.As a public administrator, a public officer, or other public individual, I am duly
authorized to make this certification.
2.The Public Entity elects to make this intergovernmental transfer (IGT) to the
Department of Health Care Service (DHCS) as a voluntary contribution to the
non-federal share (NFS) of Medi-Cal expenditures for purposes of Assembly Bill
1705 (2019) pursuant to Sections 14105.94, 14105.945, 14129, 14129.3, and
14164 of the Welfare and Institutions (W&I) Code. All funds transferred pursuant
to this certification qualify for federal financial participation (FFP) pursuant to
Section 1903(w) of the Social Security Act and Title 42 of the Code of Federal
Regulations, Section 433 Subpart B, and are not derived from impermissible
sources such as recycled Medicaid payments, federal money excluded from use
as the NFS, impermissible health care-related taxes, or non-bona fide provider-
related donations.
3.Voluntary contributions attributable to the period of January 1, 2024, through
December 31, 2026, will be made via recurring transfers as indicated on the
invoices provided to the Public Entity by DHCS. The voluntary contributions made
by the Public Entity may also include adjustments related to the calendar year
(CY) 2024 and CY 2025 rating period’s NFS reconciliation as described in
paragraph 7 below. Please note, the total IGT amount at the bottom of this IGT
certification will continue to be itemized on your invoice which is sent to you
along with this IGT certification form 45-days in advance of the IGT contribution
due date. The Public Entity acknowledges that any transfers made pursuant to
this certification during this time period are considered an elective IGT made
pursuant to W&I Code sections 14105.945 and 14164, to be used by DHCS,
subject to paragraph four herein, exclusively as the source for the NFS of ground
emergency medical transport public provider supplemental payments in both
t)HCS
CALIFORNIA DEPARTMENT OF
HEAL TH CARE SERVICES
PUBLIC PROVIDER GROUND EMERGENCY MEDICAL TRANSPORTATION PROGRAM
INTERGOVERNMENTAL TRANSFER CERTIFICATION FORM
STATE CALENDAR YEAR 2026
California Department of Health Care Services Capitated Rates Development Division
1501 Capitol Avenue, P.O. Box 997413
Sacramento, CA | 95899-7413
MS 4413 | www.dhcs.ca.gov
State of California Gavin Newsom, Governor
California Health and Human Services Agency
Medi-Cal fee for service (FFS) payments and the portion of the risk-based
capitation rate to Medi-Cal managed care health plans associated with
reimbursement made in accordance with Section 14105.945, subdivision (h)(1)
(hereafter, the AB 1705 Public Provider (PP) Ground Emergency Medical
Transportation (GEMT) Program, or the (PP-GEMT Program), and DHCS costs
associated with administering the PP-GEMT Program.
4. DHCS may accept this voluntary contribution to the extent it is able to obtain FFP
for the PP-GEMT Program as permitted by federal law. In the event DHCS is
unable to obtain FFP for the PP-GEMT Program, or the full payments cannot
otherwise be made to and retained by eligible public providers, and, therefore, all
or a portion of the transferred amount cannot be used as the NFS of payments,
DHCS will notify the Public Entity via e-mail and return the applicable portion of
the unused IGT amount.
5. The Public Entity acknowledges that state law in W&I Code section 14105.945,
subdivision (h)(2) authorizes DHCS, upon obtaining any necessary approvals, to
assess a ten percent (10%) fee on each transfer of public funds to the state to pay
for health care coverage and to reimburse DHCS its costs associated with
administering the PP-GEMT Program. The Public Entity acknowledges that while
DHCS is not assessing this fee currently pending federal approval, DHCS has not
waived its right to assess the administrative fee under state law upon obtaining
any necessary federal approvals.
6. The Public Entity acknowledges that the IGT is to be used by DHCS for the filing
of a claim with the federal government for federal funds and understands that
any misrepresentation regarding the IGT may violate federal and state law.
7. The amount voluntarily transferred to DHCS is based on the estimated Medi-Cal
FFS and Medi-Cal managed care NFS of ground emergency medical transport
payments, as referenced in paragraph three herein. Since the amount to be
voluntarily transferred to DHCS will be based on an estimate, the Public Entity
acknowledges that a reconciliation of the voluntary NFS contributions to the
actual NFS expenditures will occur. To the degree necessary to fund the NFS for
the PP-GEMT Program, amounts due to or owed by Public Entity as a result of the
reconciliation may be offset against, or added to, future transfers as applicable
PUBLIC PROVIDER GROUND EMERGENCY MEDICAL TRANSPORTATION PROGRAM
INTERGOVERNMENTAL TRANSFER CERTIFICATION FORM
STATE CALENDAR YEAR 2026
California Department of Health Care Services Capitated Rates Development Division
1501 Capitol Avenue, P.O. Box 997413
Sacramento, CA | 95899-7413
MS 4413 | www.dhcs.ca.gov
State of California Gavin Newsom, Governor
California Health and Human Services Agency
and as determined by DHCS. DHCS may accept a voluntary contribution to the
extent it is able to obtain FFP for PP-GEMT payments as permitted by federal law.
8. The Public Entity acknowledges that all records of funds transferred are subject to
review and audit upon DHCS’ request. The Public Entity will maintain
documentation supporting the allowable funding source of the IGTs.
9. Upon notice from the federal government of a disallowance or deferral related to
this IGT, the Public Entity responsible for this IGT shall be the entity responsible
for the federal portion of that expenditure.
I hereby declare under penalty of perjury under the law of the United States that the
foregoing is true and correct to the best of my knowledge. I further understand that the
known filing of a false or fraudulent claim, or making false statements in support of a
claim, may violate the Federal False Claims Act or other applicable statute and federal law and may be punishable thereunder.
Executed on this ______ day of ____________, 20__ at ______________________________, California.
Signature of Authorized Person: ____________________________________________________
Name of Authorized Person: ________________________________________________________
Title of Authorized Person: __________________________________________________________
Name of Public Entity: _______________________________________________________________
NPI of Public Entity: _______________________________________________
Amount of IGT: $____________________________