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Grant M9037 06/16/2021 Mlasion: Ron DeSantla To protect,prarlote 6 improve the health Governor of all people in Florida thnwgh Integrated °p� ra�0���a N�° state,county 8 community efforts. '�'ouN � � t �. Scott If. Rivlceea,MD State Surgeon General Vision:To be the Heatthlest State In the Nation May 5, 2021 Roman Gastesi, County Administrator Monroe County Board of County Commissioners 1100 Simonton Street Key West, Florida 33040 Dear Mr. Gastesi: The Florida Department of Health (DOH) is pleased to award an Emergency Medical Services (EMS) Matching Grant, ID Code M9037 in the amount of$11,250.00 to Monroe County Board of County Commissioners. This grant program is funded by the DOH, EMS Trust Fund. There are no federal funds involved. The purpose of this grant is to improve and expand EMS by assisting your organization to purchase ten AirTraq video laryngoscopes with advance management for pediatric and infant patients. The grant begins the date of this letter and ends June 30, 2022. Your required local cash match is $3,750.00 with a total budget of$15,000.00. You are required to report grant activities and purchases to the state pursuant to section 401.113 (2) (b), Florida Statutes, and in compliance with the Florida Catalog of State Financial Assistance, program number 64.003. The reports are due the third week of October 2021, February 2022, and the final report by the grant ending date of June 30, 2022. Your signed grant application affirms you have read, understand, and will comply with the conditions and requirements in the "Florida EMS Matching Grant Program Application Packet, December 2008." You may obtain a copy of the grant application packet from your identified state contact person. Thank you for your participation in this state EMS grant. If you need assistance, please contact the Bureau of Emergency Medical Oversight, EMS Section, Health Services and Facilities Consultant, Alan Van Lewen at (850) 558-9550. Sincerely, 4^ Douglas H. Woodlief Division Director Emergency Preparedness and Community Support DHWlavl cc: Jeff Manning, Senior Emergency Management Planner Florida Department of Health Division of Emergency Preparedness and Community support Bureau of Emergency Medical Oversight Accredit;,„ I,,,lelti'i Delartr'nent 4052 Bald Cypress Way,Bin A-22-Tallahassee,FL 32399-1722 Irm 'Nc Health CC ftabo U�30 rd PHONE:85012454440•FAX:8501488-9408 FlorldaHealth.9ov Applicant Information Special Note: Section 401.111, Florida Statutes, requires the state to assist private nonprofit youth athletic organizations that work in conjunction with local EMS with costs for automated external defibrillators. We intend to fund grant requests of this type. Optional: In your application package cover letter you may request to be, or recommend a person to be, a reviewer of matching grant applications during this grant cycle. Request for Grant Fund Distribution Page: This page is the last page of the grant application. You must complete the top part of the form and state EMS staff will complete the bottom portion, as indicated on the form. Ask a staff member of your organization who does cash transactions with the state for the organization name to use on the Distribution Form and the exact corresponding address of its 9- digit federal tax ID plus its 3-digit sequence code. Number of Pages: Each application must be no more than 15 one-sided pages, including the form and all content. However, you may submit a one-page cover letter and letters of recommendation. These pages will not count against the total page limit. Please note, reviewers are not required to read anything over 15 one-sided pages. Fastening. If you send a paper application, do not use a booklet cover. Simply staple it in the upper left corner, with the first page of the application form the first of the stapled pages. While preparing the application, you may contact state EMS staff for assistance. EMS MATCHING GRANT APPLICATION - FLORIDA DEPARTMENT OF HEALTH �lu�yr�i�� r���i �yvii�i! i f�i c:,,/� ,,, Emergency Medical Services Section �mm rvi gimrr ,, t i (Complete all items unless instructed differently within the application) Type of Grant Requested: X❑ Rural X❑ Matching ID Code The State EMS Section will assign the ID Code— leave this blank 1. Organization Name: Monroe County BOCC 490 63rd St Ocean Marathon, FL 33050 2. Grant Signer: (The applicant signatory who has authority to sign contracts, grants, and other legal documents. This individual must also sign this application.) Name: Roman Gastesi Position Title: County Administrator Address: 1100 Simonton St City: Key West FL 33040 County: Monroe State: Florida Zio Code: 33044 Tele hone: 305 292-4441 Fax Number: 305 292-4544 Email Address: gastesi-roman@monroecounty-fl.gov 3. Contact Person: (The individual with direct knowledge of the project on a day-to-day basis and responsibility for the implementation of the grant activities. This person may sign project reports and may request project changes. The signer and the contact person may be the same.) Name: Jeff Manning Position Title: Senior Emergency Management Planner Address: 490 63rd ST Ocean City: Marathon County: Monroe State: Florida Zip Code: 33050 Telephone: 305 747-0690 Fax Number: 305 289-6333 Email Address: manning-jeff@monroecounty-fl.gov DH FORM 1767 [2013] 64J-1.015, F.A.C. 1 4 Legal Stags of Applicant ant Organization (Check only one response): (1) ❑ Private Not for Profit[Attach documentation-501 (3)©] (2) ❑ Private for Profit (3) ❑ City/Municipality/Town/Village (4) XX County (5) ❑ State (6) ❑ Other(specify) 5. Federal Tax ID Number(Nine Digit Number):._YE!j26JWD7_49 6. EMS License Number: 4403 Type: X Transport ❑Non-transport Both 7. Number.of Permitted Vehicles by Type: BLS 15 ALS Transport 112 ALS non- transport 8. Type of Service (check one): ❑ Rescue ❑ Fire ❑ Third Service (County or City Government, non fire) ❑ Air Ambulance ❑ Fixed Wing ❑ Rotor Wing X Both ❑ Other (speci _..__.. 9. Medical Director of Licensed EMS Provider: If this project is approved, I agree by signing below that I will affirm my authority and responsibility for the use of all medical equipment and/or the provision lontinuin EMS education in this project. [No signature is needed if medical equipme nd p>r essional EMS education are not in this project.] Signature: Date: Print/Type:Name of Director Sandra Schwemmeri D.O. Florida License Number OS 4022 Note: All organizations that are not licensed EMS providers must obtain the signature of the medical director of the licensed EMS provider responsible for EMS services in their area of o eration for projects that involve medical equipment and/or continuipg S education. 10. Justification Summary: Provide on no more than three one-sided, double-spaced pages, a surnmary addressing this project covering each topic listed below. A) Problem description (Provide a narrative of the problem or need); B) Present situation (Describe how the situation is being handled now); C) The proposed solution (Present your proposed solution); D) Consequences if not funded (Explain what will happen if this project is not funded); E) The geographic area to be addressed (Provide a narrative description of the geographic area); F) The proposed time frames (Provide a list of the time frame(s) for completing this project); G) Data sources (Provide a complete description of data source(s) you cite); H) Statement attesting that the proposal is not a duplication of a previous effort(State that this project doesn't duplicate what you've done on other grant projects under this grant program). H FORM 1767 [2013] 2 Next, ounllly cournlllnlllctc p„iP1p„ of tlllnc °tollllllowliiinq: Items 11, 12, 13 or 14. Read all four and then select and complete the one that pertains the most to the preceding Justification Summary. Note that on all, that credible before-after differences for emergency victim data are the highest scoring items on the Matching Grants Evaluation Worksheet used by reviewers to evaluate your application form. 11. Outcorne for roLgg. ... . that ...I...r...o.......v......ld.......e...........o........IT..........................................A.......in.....:..:...c......t......S........e....i.r....c.......li..c......e....s...........t...o...........:......u.i...n....g,r.... .e,ny....Y.l.i.c......t....r.....n............... This ................. may include vehicles, medical and rescue equipment, communications, navigation, dispatch, and all other things that impact upon on-site treatment, rescue, and benefit of emergency victims at the emergency scene. Use no more than two additional one-sided, double-spaced pages for your response. Include the following. A) Quantify what the situation has been in the most recent 12 months for which you have data (include the dates). The strongest data will include numbers of deaths and injuries during this time. B) In the 12 months after this project's resources are on-line, estimate what the numbers you provided under the preceding "(A)" should become. C) Justify and explain how you derived the numbers in (A) and (B), above. D) What other outcome of this project do you expect? Be quantitative and explain the derivation of your figures. E) How does this integrate into your agency's five-year plan? 12. Outcome for Training Projects: This includes training of all types for the public, first responders, law enforcement personnel, EMS and other healthcare staff. Use no more than two additional one-sided, double-spaced pages for your response. Include the following: A) How many people received the training this project proposes in the most recent 12-month time period for which you have data (include the dates)? B) How many people do you estimate will successfully complete this training in the 12 months after training begins? C) If this training is designed to have an impact on injuries, deaths, or other emergency victim data, provide the impact data for the 12 months before the training and project what the data should be in the 12 months after the training. D) Explain the derivation of all figures. E) How does this integrate into your agency's five-year plan? 13. Outcome for Other Projects: This includes quality assurance, management, administrative, and other. Provide numeric data in your responses, if possible, that bear directly upon the project and emergency victim deaths, injuries, and/or other data. Use no more than two additional one-sided, double-spaced pages for your response. Include the following A) What has the situation been in the most recent 12 months for which you have data (include the dates)? B) What will the situation be in the 12 months after the project services are on-line? C) If this project is designed to have an impact on injuries, deaths, or other emergency victim data, provide the impact data for the 12 months before the project and what the data should be in the 12 months after the project. D) Explain the derivation of all numbers. E) How does this integrate into your agency's five-year plan? DH FORM 1767 [2013] 3 10. Ja.s;flfiicaflon Surnuin u, : rove ide on no a oin:? than ilhin e one... li nde , doutfle space �na e , a ;nurnuin r add in:?sslion dts Dro: jest coveiIng each i:nlpn c Illi iste Iln6 ow Problem description: Monroe County Fire Rescue (MCFR) currently faces a capability gap in dealing with airway issues for pediatric patients. Equipment currently available and deployed on ALS Transports rely upon direct laryngoscopy and supraglottic airways for all pediatric patients, resulting an overall delay in obtaining a secure, definitive airway. Additionally, this equipment requires specific techniques and practices which pose challenges for use even with adult patients. To mitigate this challenge,we are requesting funding to place Video Laryngoscopes on all of our ALS transport units.The addition of the AirTraq tools will allow our providers to establish a definitive airway faster and more accurately with minimal staffing. The AirTraq is unique in a couple of different features.The first is that it offers multiple blade sizes to accommodate the placement of advanced airways in patients ranging from infant to adult. Infant and pediatric patients are notoriously difficult for airway management due to the natural anatomy of these smaller patients.The second feature is that the screen can be attached to the blades from different directions which allows the user to intubate more easily from non-traditional orientations.With the current emphasis on aggressive airway management in critical patients, this tool would be priceless for our organization. The AirTraq also provides additional training and reporting possibilities through its ability to record and capture images. Personnel will be able to upload an image of the proper placement of ET tubes to our reporting software and videos can be taken and utilized in training and quality management to improve our service to the community. Present situation: Monroe County Fire Rescue currently relies upon older equipment that presents less flexibility and technological capability than the new equipment being sought under this matching grant program. The equipment requires that the patient be intubated from one specific orientation, posing often unnecessary challenges to the responding providers. Consequences if not funded: As noted above,the current equipment simply cannot be utilized for infant and pediatric patients. Given the unique geography of the Florida Keys, (approximately 50 miles between each of the three hospitals along the 120-mile island chain) both of these conditions may result in a delay in providing aggressive airway management, threatening positive outcomes for patients, even potentially resulting in loss of life that may have been prevented with the newer equipment. The geographic area to be addressed: Monroe County Fire Rescue's first area of responsibility includes all of unincorporated Monroe County: From the northern boundary of the City of Key West to the southern boundary of the City of Marathon, approximately 45 linear miles, from the northern boundary of Marathon to the southern boundary of the Village of Islamorada, approximately 16 linear miles, and from the northern boundary of Islamorada to the Key Largo Fire and Ambulance District, approximately 10 linear miles. Additionally, Monroe County Fire Rescue is the primary response agency for Key West International Airport, located within the City of Key West. The location of the three hospitals, as stated above, mean that transport of ALS sometimes takes longer than desired, especially if there are traffic problems on the single highway running through the Keys. Trauma patients are flown by air ambulance to hospitals on the mainland in Miami-Dade County. The proposed time frames: If funding is approved, the equipment will be purchased immediately. In accordance with Monroe County purchasing policy, after delivery, we will schedule training on the use, maintenance, and care of the devices. As part of our commitment, we will continue to supply all the necessary equipment to keep the project sustained after the initial purchase is made. We believe procurement could be completed within three months of an award; training of personnel completed within one month; and equipment deployed on all Rescue units within the following month; meaning the complete project would be operational within no more than six months. Data sources: In developing this application, we utilized ESO Analytics and Operative IQ. ESO is where call and intervention statistics were derived from. Operative IQ is where we retrieved the usage report for specific airway equipment. Both are in-house software programs. Statement attesting that the proposal is not a duplication of a previous effort: This proposal will not duplicate efforts of current or previous grant activities. This application seeks to replace older equipment with enhanced capability, and to fill a current gap in service as relates to infant and pediatric patients. 11. ��` utco�ne for IC: uIT �. �Iln � IC: rovlde^ uIT IC: IC:::�liuIT� t Seirvlice t IC: rn r �] Vc lrn; This .................................................................................U...............................................................................................................................................................................................................................................................?.................... ............................................ may include vehicles, medical and rescue equipment, communications, navigation, dispatch, and all other things that impact upon on-site treatment, rescue, and benefit of emergency victims at the emergency scene. Use no more than two additional one-sided, double-spaced pages for your response. Include the following. A) Quantify what the situation has been in the most recent 12 months for which you have data (include the dates). The strongest data will include numbers of deaths and injuries during this time. To date, MCFR has performed 0 out-of-hospital advanced airways in infant and pediatric patients. This is due to lack in visualization of the anatomy needed to perform direct laryngoscopy. All airway management of infant and pediatric airways has been accomplished through BLS intervention or supraglottic airway. B) In the 12 months after this project's resources are on-line, estimate what the numbers you provided under the preceding "(A)" should become. It is difficult to predict the frequency of intubation for the coming 12 months after this project is funded, however considering our complete lack of video assisted Iaryngoscopy for infant and pediatric patients it is reasonable to infer that there will be an increase over the previous 12 months. C) Justify and explain how you derived the numbers in (A) and (B), above. The above statistics were found by reviewing agency EMS reports for interventions and examining equipment usage reports. D) What other outcome of this project do you expect? Be quantitative and explain the derivation of your figures. The AirTraq is also expected to improve the first pass intubation rate of adult patients. Current statistics show a first pass success rate above 80%, with the addition of easier use from multiple angles the first pass rate can be expected to improve above 90%. E) How does this integrate into your agency's five-year plan? This device will keep with MCFR's plan to provide quality AILS care to the residents of our communities and continuously improve as new technology and techniques become available. Skip Item 14 and go to Item 15, unless your project is research and evaluation and you have not completed the preceding Justification Summary and one outcome item. 14. Research and Evaluation Justification Summary and Outcome: You may use no more than three additional one-sided, double-spaced pages for this item. A) Justify the need for this project as it relates to EMS. B) Identify (1) location and (2) population to which this research pertains. C) Among population identified in 14(B) above, specify a past time frame, and provide the number of deaths, injuries, or other adverse conditions during this time that you estimate the practical application of this research will reduce (or positive effect that it will increase). D) (1) Provide the expected numeric change when the anticipated findings of this project are placed into practical use. (2) Explain the basis for your estimates. E) State your hypothesis. F) Provide the method and design for this project. G) Attach any questionnaires or involved documents that will be used. H) If human or other living subjects are involved in this research, provide documentation that you will comply with all applicable federal and state laws regarding research subjects. 1) Describe how you will collect and analyze the data. IL...IIL... SIC: IC: IL...II 1N..11.S II iJ S..IC �`�III IC:�IL...II II : III 15 15. Statutoryu� li ^uIT i9i u� u� uITlii ^uITli The followin are based on s. 401.113 2 band ......................................... ................................................................................................................................................. 9 OO 401.117, F.S. Use no more than „p f, ad6flonaII doutfle space I�Dage t complete this item. Write N/A for those things in this section that do not pertain to this project. Respond to all others. Justify that this project will: A) Serve the requirements of the population upon which it will impact. B) Enable emergency vehicles and their staff to conform to state standards established by law or rule of the department. C) Enable the vehicles of your organization to contain at least the minimum equipment and supplies as required by law, rule or regulation of the department. D) Enable the vehicles of your organization to have, at a minimum, a direct communications linkup with the operating base and hospital designated as the primary receiving facility. E) Enable your organization to improve or expand the provision of: 1) EMS services on a county, multi county, or area wide basis. 2) Single EMS provider or coordinated methods of delivering services. 3) Coordination of all EMS communication links with police, fire, emergency vehicles, and other related services. DH FORM 1767 [2013] 4 15. St ta,!toIT a li ^uIT �1i u a uITli� ^uITli The followin are based on s. 401.113 2 band 401.117, F.S. Use no more than p f ad6flonaII doutfle spaced 13 ^ to complete this item. Write N/A for those things in this section that do not pertain to this project. Respond to all others. Justify that this project will: A) Serve the requirements of the population upon which it will impact. Currently, Monroe County Fire Rescue cannot meet potential needs for infant and pediatric direct laryngoscopy. All airway management of infant and pediatric airways has been accomplished through BLS intervention or supraglottic airway. This project seeks to remove a gap by providing that capability to provide potentially life-saving care to the residents and thousands of visitors to Monroe County every year. B) Enable emergency vehicles and their staff to conform to state standards established by law or rule of the department. N/A C) Enable the vehicles of your organization to contain at least the minimum equipment and supplies as required by law, rule or regulation of the department. N/A D) Enable the vehicles of your organization to have, at a minimum, a direct communications linkup with the operating base and hospital designated as the primary receiving facility. N/A E) Enable your organization to improve or expand the provision of: 1) EMS services on a county, multi county, or area wide basis. N/A 2) Single EMS provider or coordinated methods of delivering services. N/A 3) Coordination of all EMS communication links with police, fire, emergency vehicles, and other related services. N/A 16. Work Activities and Time Frames: Indicate the major activities for completing the project (use only the space provided). Be reasonable, most projects cannot be completed in less than six months and if it is a communications project, it will take about a year. Also, if you are purchasing certain makes of ambulances, it takes at least nine months for them to be delivered after the bid is let. Work Activity Number of Months After Grant Starts Begin End Complete Procurement Upon Award Less than 3 months Train personnel Fourth month Fifth to sixth month Deploy Equipment Fifth Month Sixth to Seventh Month 17. County Governments: If this application is being submitted by a county agency, describe in the space below why this request cannot be paid for out of funds awarded under the state EMS county grant program. Include in the explanation why any unspent county grant funds, which are now in your county accounts, cannot be allocated in whole or part for the costs herein. Current EMS Grant funds have been approved and allocated to complete procurement of needed monitor/ defibrillator units to equip ALS Transports . DH FORM 1767 [2013] 5 18. Budget: Salaries and Benefits: For Costs Justification: Provide a brief each position title, provide the justification why each of the positions amount of salary per hour, and the numbers of hours are FICA per hour, fringe benefits, necessary for this project. and the total number of hours. TOTAL: 0.00 Right click on 0.00 then left click on "Update Field" to calculate Total Expenses: These are travel Costs: List the Justification: Justify why each of the costs and the usual, ordinary, price and source(s) expense items and quantities are and incidental expenditures by of the price necessary to this project. an agency, such as, identified. commodities and supplies of a consumable nature, excluding expenditures classified as operating capital outlay (see next category). TOTAL: 0.00 Right click on 0.00 then left click on "Update Field" to calculate Total DH FORM 1767 [2013] 6 Vehicles, Equipment, and Costs: List the Justification: State why each of the Other: Operating capital outlay price of the item items and quantities listed is a means equipment, fixtures, and and the source(s) necessary component of this project. other tangible personal used to identify the property of a non-consumable price. and non-expendable nature, and the normal expected life of, which is 1 year or more. Provides one complete piece of equipment to AirTraq Video Laryngoscopes $1500.00 Each (x10) outfit ten ALS transports with advance airway management for infant and pediatric patients. TOTAL: $ 15,000 .00 1 Right click on 0.00 then left click on "Update Field" to calculate Total State Amount (Check applicable program) Right click on 0.00 then left click on ❑ Matching: 75 Percent 0.00 "Update Field" to calculate Total ® Rural: 90 Percent Right click on 0.00 then left click on $13,500.00 "Update Field" to calculate Total Local Match Amount (Check applicable program) Right click on 0.00 then left click on ❑ Matching: 25 Percent 0.00 "Update Field" to calculate Total ® Rural: 10 Percent Right click on 0.00 then left click on $ 1500.00 "Update Field" to calculate Total Grand Total Right click on 0.00 then left click on $ 15,000.00 "Update Field" to calculate Total DH FORM 1767 [2013] 7 19. Certification: My signature below certifies the following: I am aware that any omissions, falsifications, misstatements, or misrepresentations in this application may disqualify me for this grant and, if funded, may be grounds for termination later. I understand that any information I give may be investigated as allowed by law. I certify that to the best of my knowledge and belief all the statements contained herein and, on any attachments, are true, correct, complete, and made in good faith. I agree that all information submitted in this application will become a public document pursuant to Section 119.07, F.S., when received by the Florida Bureau of Emergency Medical Oversight. This includes material that the applicant might consider to be confidential or a trade secret. Any claim of confidentiality is waived by the applicant upon submission of this application pursuant to section 119.07, F.S., effective after opening by the Florida Bureau of Emergency Medical Oversight. I accept that in the best interests of the state, the Florida Bureau of Emergency Medical Oversight reserves the right to reject or revise any and all grant proposals or waive any minor irregularity or technicality in proposals received and can exercise that right. 1, the undersigned, understand and accept that the Notice of Matching Grant Awards will be advertised in the Florida Administrative Weekly, and that 21 days after this advertisement is published I waive any right to challenge or protest the awards pursuant to Chapter 120, F.S. I certify that the cash match will be expended between the beginning and ending dates of the grant and will be used in strict accordance with the content of the application and approved budget for the activities identified. In addition, the budget shall not exceed the department approved funds for those activities identified in the notification letter. No funds count toward satisfying this grant if the funds were also used to satisfy a matching requirement of another state grant. All cash, salaries, fringe benefits, expenses, equipment, and other expenses as listed in this application shall be committed and used for the activities approved as a part of this grant. Acceptance of Terms and Conditions: If awarded a grant, I certify that I will comply with all the above and also accept any attached grant terms and conditions and acknowledge this by signing below. .,. .w 02 /04 /2021 Si°ynatu f uthcrized Grant Signer MM / DID /YY (Individual Identified in Item 2) DH FORM 1767 [2013] 8 IIIII. I ) III I ""III""' III IHNG I' III IIP7t1S""III""'A S III C 7IIIIIL...III i III':i SIIfIIIIII i NF fAE COUNTY ATTOnNEY AOv'E FORM "EU b Jul �, Date 6/8/21 FLORIDA DEPARTMENT OF HEALTH EMERGENCY MEDICAL SERVICES(EMS)GRANT UNIT REQUEST FOR GRANT FUND DISTRIBUTION In accordance with the provisions of section 401.113(2) (a), Florida Statutes, the undersigned hereby requests an EMS grant fund distribution for the improvement and expansion of pre-hospital EMS. DOH Remit Payment To: Ask a finance person in your organization who does business with the state to provide the information to complete the top part of this form, but it should be signed by the person identified in Item 2, 1st application page. Name of Agency: Monroe County Fire Rescue (Monroe County BOCC) Mailing Address: 490 63rd ST Ocean Marathon, FL 33050 Federal 9-digit Identification Number: 59-6000749 3-digit Seq. Code Authorized Count y Official: � ,� - 02.04.2021 Signature Date NROE COUNTY ATTORNEY ' HOV 7FOPM ( } Roman Gastesi, County Administrator w Type or Print Name and Title PEa o �EscA�o - Yp AMST I N1V ATTORNEY o®,P 6r8/21 Sign and return this page with your application to: Florida Department of Health Emergency Medical Services Unit, Grants 4052 Bald Cypress Way, Bin A-22 Tallahassee, Florida 32399-1722 :io not wui liitc IlbeIlow tlh s Illl ine °°our use by State PAedliicall Seiiwl ccs Scctliioin Grant Amount for State to Pay: $ Grant ID: Code: Approved By: Signature of State EMS Unit Supervisor Date Approved By: Signature of Contract Manager Date State Fiscal Year: 2019 - 2020 Organization Code EO OCA Object Code Category 64-61-70-30-000 03 SF003 751000 059999 Federal Tax ID: VF _________ Seq. Code: Grant Beginning Date: Grant Ending Date: DH 1767P, December 2008 (rev. June 8, 2018), incorporated by reference in F.A.C. 64J-1.015 9