Resolution 399-1987
,-
James R. Paros, Director
Emergency Services
RESOLUTION NO. 399 -1987
A RESOLUTION PROVIDING THAT MONROE COUNTY
APPLY FOR STATE FUNDS FOR AN EMERGENCY
MEDICAL SERVICES TRAINING PROGRAM AND
AUTHORIZING THE MAYOR OF THE BOARD OF COUNTY
COMMISSIONERS OF MONROE COUNTY, FLORIDA, TO
EXECUTE A STATE OF FLORIDA DEPARTMENT OF
HEALTH AND REHABILITATIVE SERVICES GRANT
APPLICATION AND ALL APPLICABLE DOCUMENTATION.
WHEREAS, Monroe County is in need of an in-service training
program for the County's Emergency Medical Services, and
WHEREAS, such a program will improve and expand Monroe
County's pre-hospital Emergency Medical Services system, and
WHEREAS, the State has made funds available for such a
training program, and
WHEREAS, use of the State funds will not be used to supplant
the existing Monroe County Emergency Medical Services budget
allocation, now, therefore,
BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF
MONROE COUNTY, FLORIDA, as follows:
1. Monroe County shall apply for State funds for an
Emergency Medical Services in-service training program, and
2. The Mayor of the Board is hereby authorized to execute a
State of Florida Department of Health and Rehabilitative Services
grant application, a copy of same being attached hereto, and all
other applicable documentation.
PASSED AND ADOPTED by the Board of County Commissioners of
Monroe County, Florida, at a regular meeting of said Board held
on the 20th day of October, A.D. 1987.
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
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BY:U.L-<' . . ~/.....b/,
RO TEM
(SEAL)
ATTEST:~~Y 4 ~OLHAGE, glerk
-eo AS TO FORM
A f ;.;tAL SUFFle/Eke
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IWo'ncv's Office
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C ERK
STATE OF FLOIUDA
DEPARTMENT OF HEALTH AND UHAaIUTAnft SDVlCES
OFFICE OF EMERGENCY MEDICAl. SUlVICES
1317 1VINEWOOD aouuv AIlD
TALLAHASSEE, nOIUDA 33399-0100
lli~j
APPUCATION '011 JlVNDING
COUNTY EMERGENCY MEDICAL SIJIIVlCD (EIIS).A 1FAllDS
COMPLBTING THE COUNTY EMS A 'IF A.IfD 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 Cot:nmissioners 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.
INSTllUCTIONS
A. The Board of County Commissioners is requested to submit two identical original signature
copies of the typed and completed application. AU completed applications must be received on
or before the date requested by the department.
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B. Application packages are to be sent to the following address:
County EMS A ward AppUcation
Office of Emergency Medical Services
Depanment of Health A Reh.wtative Services
1317 Winewood Boulenrd
Tallahassee, Florida 32399-0700
Telephone (904) 487-1911 or SC 277-1911
...
1. BOllrtl of Co"nty C",.",'..lo"fIn It1tHtt(fk.tIOft: Give county identification informa-
tion as it appears on contracts.
Name of County: lbu:oe County BoaJ:d of County Camlissiaters
Business Address: P. O. Box 1980
Key West, FL 33040
(City)
Telephone: (305) 294-4641
(Are;! Code)
(Zip Code)
472-9000
(SunCom)
2. County Offlcilll(s) Authorlzt!d to Sign ConlNcl:
Name: Jerry Hernandez, Jr.
Title: Mayor/Chainnan
Name:
Title:
3. Autborlzed 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: James R. (Reggie) Paros
Title: Director, ~ Services
Business Address:
M:mroe County Em:;rgency SeJ:vices
10600 Aviation Blvd.
Marathon, FL
(City)
Telephone: (305) 743-6619
(Are;! Code)
33050
(Zip Code)
472-9155
(SunCom)
.
" ---
4.
WorJr Pllln.
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 Time Frarr.es
To provide centralized County
Coordinated, high quality, and
accessible in-service training
programs for all levels of pre-
oospita1 persormel, specifically
EM!' IS, Pararredics, Dispatchers,
and First ReSJ:X>nders.
1. Plan didactic arK'! clinical 3 Months
training activities for
paid and volunteer pre-
hospital EM) personnel.
2. Purchase needed .-terials, 3 M::>nths
supplies, ard equipnent.
3. Int>lement traininq activities. On-Going
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· Attach additional sheets if necessary.
.5.
-- ---:
Proposed Co""tj endlt"re PIli": Prepare a line Item budFt.. tify all expen-
ditures to be purchased with county EMS award monies. Telephone your state EMS contact
person if guidance is needed.
Provider/
Recipient
Line
Item
Unit
Price
Quantity
Total
Cost
Monroe County
Capital OUtla ~
~van~ 1 e
C ination IOefibri11ator
Cardiac Arrhythnia Sina1lator
Training ~s
Positive Pressure Oemim:! Valve
Resusitators
OVerhead Projector
Suction Units
MI\ST Suits
Stethosropes
K.E.D.
Moulage Kits
Slide Projector
Scoop Stretcher
Sub-total
1
1
1
7
$13,000.00
7,700.00
1,210.00
4,235.00
2
1
2
4
10
2
1
1
1
800.00
500.00
800.00
1,600.00
200.00
278.00
560.00
400.00
255.00
31,538.00
Training Supplies and Materials
Slide Sets
Misc. Visual Aids
Sub-total
1,000.00
500.00
1,500.00
Medical Supplies
Intubation Sets
Blood Pressure Cuffs
Stethoscopes
Assorted Splints
BVM Devices
Backboards
Sub-total
3
10
10
4
5
2,400.00
500.00
200.00
500.00
520.00
750.00
4,870.00
Grand Total
$37,908.00
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· Note: The county is not eligible for more than the amount aenetated when the department ap-
plies the allocation formula specified in section 401.113 (2) (a) (F .S.). Any costs above the
generated amount are the respon~ibility of the county.
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6. 'Communications ApprovII1: If funds are requested for the purchase 01 communications
equipment, before any final decision can be made on this application, the Department of
General Services, Division of Communications must first approve the communications re-
quest. This approval should be attached to your returned application.
7. R~$olutloll: 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:
59-6000-749
9. C~rtlflclltlo": 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.
Printed Name:
Signature:
Jerry Hernandez, Jr.
(Person named in tl2, County Official Authorized to SilJftContract)
Date Signed:
Notary Seal
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Date
Notary SiBnature
,