HomeMy WebLinkAbout1991-175RESOLUTION NO., 91-115._
A RESOLUTION OF THE BOARD OF COUNTY
COMMISSIONERS OF INDIAN RIVER COUNTY, FLORIDA,
AUTHORIZING THEAPPLICATION FOR FUNDING COUNTY
EMERGENCY MEDICAL SERVICES (EMS) MATCHING
GRANT AWARDS TO BE SUBMITTED TO THE STATE OF
FLORIDA DEPARTMENT OF HEALTH AND
REHABILITATIVE SERVICES.
WHEREAS, The Florida Department of Health and Rehabilitative
Services has announced that applications for funding County
Emergency Medical Services (EMS) Matching Grant awards are now
being accepted and a grant application has been prepared for Indian
River County; and
WHEREAS, an application for matching grant funds fiscal year
1992-93 has been prepared by the County; and
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY COM-
MISSIONERS OF INDIAN RIVER COUNTY, FLORIDA, that the Chairman is
authorized to sign and execute the application for matching grant
funds certifying that monies from the EMS Grant Program For
Counties will improve and expand the County's pre -hospital EMS
system and that the funds will not be used to supplant existing
County EMS budget allocations.
The foregoing Resolution was offered by Commissioner
Eaaert who moved its adoption. The motion was seconded
by Commissioner Scurlock and, upon being put to a vote, the
vote was as follows:
Chairman Richard N. Bird
Vice -Chairman Gary C. Wheeler
Commissioner Don C. Scurlock, Jr.
Commissioner Margaret C. Bowman
Commissioner Carolyn K. Eggert
Aye
Aye
Aye
Aye
Ayp
The Chairman thereupon declared the resolution duly passed and
adopted this 19 day of November , 1991.
BOARD OF COUNTY COMMISSIONERS
INDIAN RIVER
COUNTY, FLORIDA
BY:
Richard N. Bird, Chairman
Inman Sim ca
Approved
Date
Admin.
re
if/ -1.?-?/
Legal
_J \
/1--1L
Eudyet
11 •/::',.
Dept.
j,- ,z4r
Aisle Mgr.
/?A
a..0_u.
ID Code to be Assigned by State EMS Office: MI
Florida Department of Health and Rehabilitative Services
Office of Emergency Medical Services (EMS)
MATCHING GRANT APPLICATION
4. Agency/Organization's Federal
Tax Identification Number nine digits VF 9 _5_ Q g . � Z
5. Application Status: (coot only o.$)
xx
This 1. dror soatirw.do. of • p,ojat shady hods/ by dr..r.w. EMS siwhlo/ goat potww.
This is pN doe sondrsr doa of s yrvjwt shady Minded by dr. M. P1Ws .wehh>t rent prog.s.
6. Type of Project: (flak only a..):
ca.w.r.ie.does _ Condamine Profs Taal R/wod.: Wass' &Wm omni. ass IS.)
XX Ilimsrremsy Tamped V Ms?,, !/...d..
Sydow R,sk.ds lQ..firy Aaw..to _ assea.0
_. MedkaJR..ew fy.y.r.r. (eid.wa is uI./ fir Isms IA ..d IA)
Dees yoer Project krlts& do* ywch.a of soy tomwr.kaiw.«dy.md
_ Yes __XX
1.
Legal Name of
Agency/Organization: Indian River County Emergency Medical Services
Name and Title of
GrantSigner. Richard N. Bird, Chairman Board of County Commissioners
Mailing 1840 25th Street
Address: Vero Beach, FL 32960
County: Indian River
Telephone Number: (407) 567-2154
SunCom Number. 224-1444
2.
Name and Title of
Contact Person: James A. Judge, Chief of Emergency Medical Services
Mailing 1840 25th Street
Address: Vero Beach, FL 32960
Telephone Number: (407) 567-2154
SunCom Number: 224-1444
3.
Legal Status of
Agency/Organization: (Chat only on.)
Pdvw Not for Profit (jai.md provide my etaNfkw)
Your lbeal leer:
10/1/92 9/30/93
MINS INDS
Nom for Profit Malls
_
4. Agency/Organization's Federal
Tax Identification Number nine digits VF 9 _5_ Q g . � Z
5. Application Status: (coot only o.$)
xx
This 1. dror soatirw.do. of • p,ojat shady hods/ by dr..r.w. EMS siwhlo/ goat potww.
This is pN doe sondrsr doa of s yrvjwt shady Minded by dr. M. P1Ws .wehh>t rent prog.s.
6. Type of Project: (flak only a..):
ca.w.r.ie.does _ Condamine Profs Taal R/wod.: Wass' &Wm omni. ass IS.)
XX Ilimsrremsy Tamped V Ms?,, !/...d..
Sydow R,sk.ds lQ..firy Aaw..to _ assea.0
_. MedkaJR..ew fy.y.r.r. (eid.wa is uI./ fir Isms IA ..d IA)
Dees yoer Project krlts& do* ywch.a of soy tomwr.kaiw.«dy.md
_ Yes __XX
6A. State Plan Goal, Objective, and Improvement and Expansion:
1
State EMS Plan Goal: Identify is the spice below the specific good and its pope number is tie FY 1991-93 Mate
EMS plan, which your project will help accomplish. Describe bow your project addresses Ms goal.
Transportation, Goal 1.2 of the State Plan: Purchase and ALS license two (2) Type
III Modular Ambulances, increasing the number of ALS ambulances within Indian
River County. Improve delivery of EMS service and decrease the time ambulances
are out of service for repair. Have additional ambulances available to stand-by
for numerous large ppblic gatherings and for transporting patients during evacuation
or multiple casualty incidents. Expand current ambulance backup resources.
(See Pages 29-30 of State Plan)
State EMS Plan Objective: Identify is the spoor below the specific objeclivo sod its psis ■umber is dm Mc phis,
which your project will help accomplish. Describe haw your project will address this objective.
Transportation, Objective 1.2 of the State Plan: Decrease response times with
two new and dependable ALS Transport ambulances. Increase availability of
ALS transport units. Have two additional ALS licensed units available for
emergency response during man made or natural disasters.
(See Pages 29-30 of State Plan)
Improvement and Expansion of Prehospital EMS. Describe in measurable terms. bow your project will both
improve and expand probospital EMS.
Two new Modular Ambulances would reduce the cost of maintenance on older transport
vehicles by placing them in a backup capacity. The savings would be utilized
to improve other areas of EMS such as training, public education, and accident
prevention; the expansion will greatly improve the dependability of ALS transport
ambulances.
The addition of two Modular Ambulances will greatly improve the prehospital
delivery of EMS within Indian River County. The additions will expand the
resources available for the residents and visitors with an increase in lives
saved.
S. Outcome Statement (use only the space below):
This project will increase the number of ALS transport ambulances available in
Indian River County, providing residents with reliable up-to-date transport capabilities.
Provide for backup units at multi-casuality incidents, large public gatherings,
or during man made or natural disasters with multiple casualties. Additional
units would be available to transport patients to the Special Needs Shelters during
an emergency evacuation.
IV_
For both the need and outcome statements: bxhlde numeric data, the time frame for the data,
the data source, and the target population and geographic area.
7. Need Statement (use only the space below): New transport vehicles will reduce
response time by placing high mileage units in a backup capacity. Indian River
County F1IS will respond to approximately 15,000 medical responses in 1992. The
additional ambulances proposed would be stationed in high call volume areas.
Ambulance"A" will be stationed in the City of Vero Beach with a population of
40,000 and 30% of the Sall volume. Ambulance "B" will be stationed in the city
of Sebastian, the second largest populated city with 10,000 residents and 18%
of tha mall unl uma _
9. Research Projects Only:
If Foe No •os o••dal,r • eewueb point. Ai/ Etio Nen fall gobble 10.
H 1a oro eadoetlng • ,aoo eb pejost. oeueb oft s on/ of los onikotteo oe•eNo miss ofilto bmpoiloodo. dsdddwle/. LMa■ore. weeds
to prowl boom ouljoeY. soy I,, iidoeo MehM/ /n wady. tooeonr Yw•soete. ate• owl Moo of eese ohne l dk,
10. Work Activities, Objectives and Time Frames Ohs only to apses below):
Bid, purchase and Advance Life Support license two (2) Modular Type III Ambulances
within three to four months after the grant begins. Once the units have been
properly equipped and ALS licensed, they would be placed into on-line emergency
service. Older units with high mileage would move into a necessary backup capacity.
11
CATEGORIES
APPLICANT
i
TOTAL
Mali Matchaaseta
11. Salaries and Benefits:
a. New positions.
N/A
Do Not Writ.
la This This Alva
Do Not Writ.
beak An.
Do Nat Writ.
In This Area
-
b. Existing/In Kind Positions
Do Not Writ.
Innis Area
Do Not Wtit.
Zo Ibis Area
TOTAL SALARIES and BENEFITS
12. Expenses
a. New Expenses
N/A
Do Na Writ.
la The Area
b. Existing/In-Kind
Do Not Writ.
la This This Alva
Do Nat Writ.
In This Area
TOTAL EXPENSES
CATEGORIES
APPLICANT
e
fateata
ful31
TOTAL
��
1Na�tchh h %t V
13. Equipment:
a. New equipment.
Two new Modular Type III Transport
ALS Ambulances
1
"A" Unit
$30,000.00
"B" Unit
$30,000.00
Do Na Writ.
laIlis Area
"A" Unit
$30,000.00
"B" Unit
$30,000.00
$60,000.00
$60,000.00
b. Existing/In-Kind Equipment
Do Not Writ.
to This Area
Do Na Write
IIs The Are.
TOTAL EQUIPMENT COSTS
$60,000.00
$60,000.00
$120,000.00
14. Financial Summary - Total of salaries
and benefits, expenses, and equipment,
all combined.
$ 60,000.00s
:24:19:22
1120100000
Cash
The above figure
The above figure
The above figure
Match
must be equal
must equal the
dw
swat equal
the sum of the
Grand
to or less than
the sum of the
ToW
the cult numb
two preceding
preceding three
Orad ToW
volumes
seisms
L
15. Medical director's signatures: Skip this item if your protect is pni a Medical Rescue
Equipment or Professional Education Project.
a. Professional Education
All continuing education described in this application is developed and conducted
with my input and approval.
Medical Director's Signature
Medical Director's Printed Name
Date
b. Medical Equipment Projects:
I hereby accept authority and responsibility for the use of Medical Anti -Shock
Trousers (MAST), Esophageal Obturator Airways (EOAs) send -automatic and automatic
defibrillators, ALS equipment identified in Chapter 10D-66, F.A.C., and equipment not
Identified in Chapter 10D-66, F.A.C.
Medical Director's Signature
Medical Director's Printed Name
Date
c. I hereby acknowledge that the applicant responds routinely to rescue or medical
incidents under written agreement with my licensedEMS system.
Nov. 13, 1991
Medical Director's or Authorized Person's Signature Date
Roger J. Nicosia, Jr. D.O.
Printed Name
f
APPLICATION ITEM 16 (signature required)
VEST FOR MATCHING GRANT DISTRIBUTION (ADVANCE PAYMENT)
EMERGENCY MEDICAL SERVICES (EMS)
• Governmental Agency and Non-profit Entity ONLY
In accordance with the provisions of paragraph 401.113(2)(b). F.S., the underaiped hereby requesfa as EMS mating
grant distribution (advance payment) for the improvement and expaoaion of prehospital EMS.
Payment To:
•
Indian River County Emergency Medical Services
Legal Name of Agency/Organization
1840 25th Street
Vero Beach.
(City)
Address
FL 3296A
(State) (Zip)
thorized Official
SIGNATURE: �DATE // - /
Printed Name: Richard N. Bird Title: Chairman
SIGN AND RETURN WITH YOUR MATCHING GRANT APPLICATION TO:
Department of Health and Rehabilitative Services
Office of Emergency Medical Services (HSTM) • •
EMS Matching Grants
1317 Winewood Boulevard
Tallahassee, Florida 32399-0700
Far the Only by Dpannnat of Health and R.Mbnhadva Swaim,
Guise of Emstproy Mulled Unica
Matching Grant Amount:$ Grant ID Code:
Approved By: Date:
Signature. Title. State EMS Grant Officer
Stats Fiscal Years Amounts $
Oraanization Cods
60-20-60-30-100
=•O.
HS
Obiect Cod,
Federal•Tax ID V Fs
Grant Beginning Dates Ending Dates
•
17. `` ASSURANCES AND APPLICATION SIGNATURE (Applications without an appropriate signature
for this item will not be considered for funding):
Cadifuldkautalandathlialsmtal
I, the undersigned, certify that if granted funds under Chapter 401, Part II, F.S.; as amended, all applicable regulations and
standards will be adhered to including: Chapter 401, F.S.; Chapter 10D-66, F.A.C.; Minimum Wage Act; Title VI of the
Civil Rights Act of 1964 (42 ISC 2000D et. seg.); DHEW Regulation (45 CFR Part 80); Rehabilitation Act (Sec 504);
Developmentally Disabled Auistance and Bill of Rights of 1975 (P.L. 95-602) u amended by Title V of the
Comprehensive Rehabilitative Services Amendments of 1978: Confidentiality; Human Rights; Habilitation Plans;
Employment of the Handicapped; Services for Persons Unable to Pay. •
Statement of Cash & In -Kind Commitment
•
I, the undersigned, certify that cash and in-kind match will be available during the grant period and used in direct support
of this grant project. State and federal funds will not be used for matching requirements, unless specified by law. No costs
or third -party in-kind contributions count towards satisfying a matching requirement of a department grant if they are used
to satisfy a matching requirement of another state or federal grant. Cub, salaries, fringe benefits, expenses, equipment,
and other expenses u listed on this application shall be committed and used for the department's final approved project
during the grant period.
Accentante of Terms and Conditions
Acceptance of the grant terms and conditions in Appendix C of the booklet, "Florida Emergency Medial Services Matching
Grant Program 1992-93", by the Department of Health and Rehabilitative Services is acknowledged by the grantee when
funds are drawn or otherwise obtained from the grant payment system.
Disclaimer
i..
I, the undersigned, hereby certify that the facts and information contained in this application and any follow-up documents
are true and correct to the best of my knowledge, information, and belief. I further understand that if it is subsequently
determined that this is not correct, the grant funded under Chapter 401, Part 11, F.S.; Chapter 10D-66, F.A.C.; u amended
by Chapter 85-167, Laws of Florida, may be revoked, and any monies erroneously paid and interest earned will be
refunded to the department with any penalties which may be imposed by law or applicable regulations.
Notification of Award
I understand the availability of the notice of award will be advertised in the Florida Administrative Weekly, and that 30
• calendar days after this Florida Administrative Weekly advertisement I waive any right to challenge or protest in anyway
the decisions to awn 4grants.
Signature of Authorized Grant Signer
(Individual Identified in Item 1)
Date
NOTE:
Please check to insure that all required signatures have been made for Items 15, 16, and 17.
19