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Emergency Medical Services (EMS) County Grant Application
State Of Florida
Department of Health
Bureau of Emergency Medical Services
Grant No. C
1 Board of County Commissioners (grantee) Identification:
Name of County: Indian River County
Business Address: 1840 25th Street
Vero Beach, Florida 32960
Phone # (561) 567-8000
1 SunCom # 224-1444
2. Certification: I, the undersigned official of the previously named county, certify that to the
best of my knowledge and belief all information and data contained in this EMS county Award
Application and its attachments are true and correct.
My signature acknowledges and ensures that I have read, understood, and will comply fully
with the Florida EMS County Grant Manual.
Printed Name.- Douglas M. Nyright Title: Director of Emergency Services
Signature: ` .,, ate Signed:
(Authorized County Official)
3. Authorized Contact Person: Person designated authority and responsibility to provide the
department with reports and documentation on all activities, services, and expenditures which
involve this grant. I
Name; James A. Judge, II Title: EMS Chief, Indian River County
Business Address: Indian River County Emergency Services, 1840 25th Street
Vero Beach, Florida 32960
4 County's Federal Tax Identification Number: VF596000674
H Form 1684. Jan. 98
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GRANT NAME: Department of Health County Grant Funds GRANT #
AMOUNT OF GRANT: $51,865.23
DEPARTMENT RECEIVING GRANT: Emergency Medical Services
CONTACT PERSON: Douglas M. Wright, Director PHONE NUMBER: 561-567-8000 ext. 225
1.
2.
3.
4.
5.
6.
7
8.
How long is the grant for? 2 years Starting Date: October I, 1999
Does the grant require you to fund this function after the grant is over? Yes X No
Does the grant require a match? Yes X No
Ifyes, does the grant allow the match to be In Kind Services? Yes No
Percentage of match %
Grant match amount required $
Where are the matching funds coming from (i.e. In Kind Services; Reserve for Contingency)?
Does the grant cover capital costs or start -tip costs'?Yes No
If no, how much do you think will be needed in capital costs or start up costs
(Attach a detail listing of costs) $
Are you adding any additional positions utilizing the grant funds'?Yes ___X_No
If yes, please list. (If additional space is needed, please attach a schedule.) r_—
Acct.
Description Position Position Position Position Position
011.12
Regular Salaries
011.13
Other Salaries & Wages (PT)
012.11
Social Security
012.12
Retirement -Contributions
012.13
Insurance -Life & Health
012.14
Worker's Compensation
012.17
S/Sec. Medicare Matching
$
TOTAL
9. What is the total cost of each position including benefits, capital, start-up, auto expense, travel and operating?
Salary and Benefits Operating Costs Capital Total Costs
I
10. What is the estimated cost of the grant to the county over five years? $_2,500 (possible repairs and maintenance)
Grant
Other Match Costs
First Year
$
$
$
$
Second Year
$
$
$
$ – -
Third Year
$
$
$
$
Fourth Year
$
$
$
$
Fifth Year
$
$
$
$
40
5 Resolution: Attach a resolution from the Board of County Commissioners certifying the
monies from the EMS County Grant will improve and expand the county's prehospital
EMS system and that the grant monies will not be used to supplant existing county EMS
budget allocations.
Work Plan:
Work Activities:
Time Frames:
Helicopter Landing Zone Kit - Temporarily establish portable helicopter 30 days
landing zone, clearly identified day or night. Added response from rotary
wing aircraft at EMS scenes, needs increased safety to carry out operations.
The landing zone kit provides visibility from rh mi. with standard rotary
wing landing lights. Devices are maintenance free and without batteries or
electronic parts. The landing kits will be put on Fire and EMS vehicles for
proper use. Devices can be used for nighttime application (ie. vehicle
accidents, protect emergency services staff in low light condition).
Color Printer - The color computer printer will improve and expand 30 days
services by allowing the EMS Division and Training Division to produce
color enhanced documents for training and public education and awareness
programs. The addition of this printer will produce a more effective
presentation for the training of department staff.
EMS HAZ-MAT Training Program - This training program focuses toward 60 days
EMS personnel responding to HAZ-MAT incidents. It will be adjunct to the
Fire Division training program in place and allow EMS to expand their role
at HAZ-MAT scenes, providing a more effective response and rehabil-
itation of all personnel involved. Current EMS training in HAZ-MAT is
limited to level 1 and 2 certification. Instructor program, ISFSI #11800
will provide department paramedics with increased knowledge of the
dangers and inner workings at die HAZ-MAT scene.
Computer Tape Back un System - Currently the designated PC for patient 30 days
reports uses an undependable back up system and poses a possible failure
in maintaining EMS medical reports as regulated by state statute. A larger,
more reliable back up system to the EMS -PRO software system will
pruvnic it rciiabic mean w resmre the database in the event of a failure.
LifePak 12 -The EMS Division currently use LifePak 11 defibrillators on 60 days
each of the ambulances in service around the county. This equipment has
been in constant use for over 5 years. In an effort to keep current and
provide the highest possible service to the community, it has become
necessary to improve and expand our EKG equipment by upgrading the
current units. The new LifePak 12's provide a diagnostic quality EKG,
and will eliminate the high maintenance of older and outdated EKG units
currently in use. The reliability and accuracy of a patient's EKG will
increase. The new units will provide die ability to view multiple wave
forms at a time. The LifePak 12 with our cardiac alert program, will
decrease the door to drug time for thrombolytic administration. The
receiving physician will receive the diagnostic level 12 -lead EKG strips
upon arrival of the patient to die emergency roost.
40
8 APPLICATION (Requires Signature)
REQUEST FOR COUNTY GRANT DISTRIBUTION (ADVANCE PAYMENT)
EMERGENCY MEDICAL SERVICES (EMS)
COUNTY GRANT PROGRAM
In accordance wide die provisions of section 401.112(2)(a), F.S., the undersigned hereby
requests an EMS county grant distribution (advance payment) for die improvement and
expansion of preliospital EMS.
Payment To: Indian River County Board of County Commissioners
Name of Board of County Commissioners (Payee)
Federal `I'.... Nu�Nerof County: VF596000674
Authori ' g County Official
SIGNUVRE: Date: y-;2/_9
PrinteR. Macht Title: Chairman, Ward of County
Commissioners
SIGN AND RETURN WITH YOUR GRANT APPLICATION TO:
Department of Health
Bureau of Emergency Medical Services
EMS County Grants
2002D Old St. Augustine Road
Tallahassee, Florida 32301-4881
For Use Only by Department of Health
Bureau of Emergency Medical Services
Amount: $ Grant Number:
Approved By: Date:
Signature, State EMS Grant Officer
Fiscal Year: Amount:$
Or anization Code E$ - Ob
..O. •ec� t Code
_UUU
Federal Tax I. D. VF 730060
Beginning Date: Ending Date: