HomeMy WebLinkAbout1987-08440
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RESOLUTION NO. 87-84
A RESOLUTION AUTHORIZING AND DIRECTING THE CHAIRMAN
OF THE BOARD OF COUNTY COMMISSIONERS, INDIAN RIVER
COUNTY, FLORIDA TO SIGN AN APPLICATION FOR FUNDING
COUNTY EMERGENCY MEDICAL SERVICES (EMS) 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) Awards are now being accepted
and fund allocations have been identified for Indian River
County, Florida; and
WHEREAS, an application for funding has been prepared and
approved by the County EMS Agencies; and
WHEREAS, funds in the amount of $40,987.00 have been
allocated to Indian River County, Florida;
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF INDIAN RIVER COUNTY, FLORIDA, that the Chairman
is authorized to sign the application for funding certifying that
monies from the County EMS Award will improve and expand the
County's prehospital EMS System and that the funds will not be
used to supplant existing County EMS budget allocations.
The foregoing Resolution was offered by Commissioner Bird
who moved its adoption. The motion was seconded by Commissioner
Bowman and, upon being put to a•vote, the vote was as follows:
Chairman Don C. Scurlock, Jr. Aye
Vice Chairman Margaret C. Bowman Aye
Commissioner Richard K. Bird Aye
Commissioner Carolyn K. Eggert Absent
Commissioner Gary C. Wheeler Aye
The Chairman thereupon declared the Resolution fully Passed
and adopted this 18th day of August, 1987.
ATTEST:
Freda Wrig t,Clerk
Approved as to form
and legal sufficiency:
County Attorney
BOARD OF COUNTY COMMISSIONERS
INDIAN RIVER COUNTY, FLORIDA
By� �
Don C.cur��—
Chairman
Ll
w
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
OFFICE OF EMERGENCY MEDICAL SERVICES
1317 WINEWOOD BOULEVARD
TALLAHASSEE, FLORIDA 32399.0700
APPLICATION Pali .FUNDING
COUNTY EMERGENCY MEDICAL SERVICES (EMS) AWARDS
COMPLETING THE COUNTY EMS AWARD APPLICATION
Each Board of County Commissioners must complete this application in order for the county to
receive its proportionate share of the Department of Health and Rehabilitative Services (hereinafter
referred to as the department), Emergency Medical Services (EMS) grants program funds. Please
follow these instructions carefully so your application may be processed quickly and accurately.
The department cannot process an application which is incomplete. If there are any deficiencies in
the application, the Board of County Commissioners will be notified in writing, and the application
will be returned to the county for correction and resubmission. The corrected application must be
received by the department no later than 21 days from the county's receipt of the returned applica-
tion.
The Board of County Commissioners should notify the county contract manager, in writing, of
changes to the application prior to the contract being resubmitted.
INSTRUCTIONS
A. The Board of County Commissioners is requested to submit two identical original signature
copies of the typed and completed application. All completed applications must be received on
or before the date requested by the department.
B. Application package's are to be sent to the following address:
County EMS Award Application
Office of Emergency Medical Services
Department of Health & Rehabilitative Services
1317 Winewood Boulevard
Tallahassee, Florida 32399-0700
Telephone (904) 487-1911 or SC 277-1911 79
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I . Board of County Commissioners Identification: GIve county Identification Informa-
tion as it appears on contracts.
Name of County: Indian River County Board of County Commissioners
Business Address: 1840 25th StrQet
Vero Beach, Florida 32960
(City) (zip Code)
Telephone:( 30.1 567-8000 224-1444
(Arn Coda) (SunCom)
2. County Officials) Authorized to Sign Contract:
Name: Don C. Scurlock Jr
Title: -Chairman Indian River rO rn y Board County CnmmiccinnA
Name:
Title:
3. Autborized Contact Person: This is the person who has full authority and responsibility
for providing the department with information and documentation on all activities, services,
and expenditures which involve county EMS award monies.
Name: Douglas M. Wriqht
Title: Director, Department of Emergency Management
Business Address: 1840 25th Street
Vero Beach, Florida 32960
(City)
(zip code)
Telephone: (3 0 5 ) 567-8000 Ext: 443 224-1443
(Area Code) (SunCom)
79
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S . Proposed County Expenditure Plan: Prepare a line item budget.' Identify all expen-
ditures to be purchased with county EMS award monies. Telephone your state EMS contact
person if guidance is needed.
Provider/ Line Unit Total
Recipient Item Price Quantity Cost
(1) Indian River Portable $5,100 ea Seven (7) $35,700
Memorial Hospital oxygen -powered --
Advanced Life Automatic CPR
Support "Thumper"
(2) Indian 'River
Computer
$1,893
One (1)
1,893
County Volun-
w/640k memory,
teer Ambulance
printer, and
Squad
monitor. In-
cludes cable &
Hard Disk Card/
(3) Sebastian
Computer
$1,893
One (1)
1,893
Volunteer
w/640k memory,
Ambulance
printer, and
Squad
monitor. In-
cludes cable &
Hard Disk Card.
(4) Fellsmere
Office Copier
$1,501
One (1)
1,501
Volunteer
Ambulance
Squad
TOTAL $40,987
'Note: The county is not eligible for more than the amount generated when the department ap-
plies the allocation formula specified in section 401.113 (2) (a) (F.S.). Any costs above the
generated amount are the responsibility of the county. 90
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4. Work Plan'
Section a: Objectives are specific quantifiable statements Identifying activities and services.
Section b: Actions are the processes that enable completion of the specific objectives.
Section c: Time frames provide limits within which the activities, services, objectives, and actions
are initiated and completed, and may be stated as the number of weeks or months after
the effective date of the contract.
Section a Section b Section c
Measurable Objectives Actions Timc Frames
(1) Provide effective CPR
while freeing medic to
do ALS therapy
:)& (3) Improve and expand EMT
Training Program for
ambulance squads
(4) Improve ambulance squads'
training program, and
continually update
operational procedures
manuals.
' Attach additional sheets if necessary.
Purchase seven (7)
Within
approxi -
thumpers (mechanical
mately
two (2)
CPR adjunct)
months
of con-
tracting
Purchase two
Within
approxi -
computers with
mately
two (2)
printers, monitors,
months
of con -
cables, and hard disk.
tracting.
Purchase office copier.
Within
approxi-
mately
two (2)
months
of con-
tracting.
on
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6. Communications Approval: If funds. are requested for the purchase of communications
equipment, before any final decision can be made on this application, the Department of
General Services, DIvision of Communications must first approve the communications re-
quest. This approval should be attached to your returned application.
7. Resolution: Attach a signed resolution from the Board of County Commissioners certifying
that monies from the county EMS award will improve and expand the county's prehospital
EMS system and that the funds will not be used to supplant existing county EMS budget alloca-
tions.
8. Write your county's Federal Tax Identification number: 59-80-0032K
9. Certification: I, the undersigned representative of the previously named county, certify that
to the best of my knowledge all statements contained in this application and its attachments are
true and correct.
Date
Printed Name: Don C. Scurlock, Jr., Chairman
Signature:
Date Signed:
(Person named in N2, County Official Authorized to Sign Contract)
Notary Seal
Notary Signature