Resolution 351-1992
James R. Paros
Publ~:~~fet1!~tv[$)~r
RESOLUTION NO. 351
- 1992 '92 JUL 23 P2 :18
A RESOLUTION OF THE BOARD OF COUNTY COMMI~~~S OF . ',;t-
MONROE COUNTY, FLORIDA, AUTHORIZING THE SUBMt~~;rqN tPW
GRANT APPLICATIONS TO THE FLORIDA DEPARTNflROOW [f{EM.\'I<< FLt,
AND REHABILITATIVE SERVICES, OFFICE OF EMERGENCY
MEDICAL SERVICES, TO FUND THE ACQUISITION OF MEDICAL/
RESCUE EQUIPMENT AND DIRECTING THE EXECUTION OF SAME BY
THE PROPER COUNTY AUTHORITIES.
WHEREAS, The Florida Department of Health and Rehabilitative
Services, Office of Emergency Medical Services is accepting
applications for Emergency Medical Services (EMS) Matching Grant
funds, and
WHEREAS, the grant is for the period beginning on October 1, 1992
and ending on September 30, 1993; and
WHEREAS, the total grant application is for $ 167,760.00 , with
a ~% match requirement; and
WHEREAS, the $ 41 ,940.00 match requirement is proposed for
inclusion in the County budget requests for Fiscal Year 1993; and
WHEREAS, the medical/rescue equipment project if awarded and
accepted, will be used to purchase advanced medical patient
assessment and monitoring equipment; now therefore
BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE
COUNTY, FLORIDA AS FOLLOWS:
1. That said Board has been notified of the availability of
matching grant program funds from the Florida Department of Health
and Rehabilitative Services, Office of Emergency Medical Services.
2. That the Monroe County Department of Emergency Medical
Services is hereby authorized to submit applications for grant funds
to the Florida Department of Health and Rehabilitative Services,
Office of Emergency Medical Services, to improve and expand Monroe
County's EMS systems.
3. That said Board hereby directs the execution of the grant
applications by the proper County Authorities.
4. That this Resolution shall become effective immediately upon
adoption by the Board and execution by the Presiding Officer and
Clerk.
PASSED AND ADOPTED by the Board of County Commissioners of Monroe
County, Florida at a regular meeting of said Board held on the 15th
day or July , A.D. 1992.
Mayor Harvey
Mayor Pro Tern London
Commissioner Cheal
Commissioner Jones
Commissioner Stormont
Yes
~
~
N~esent
.:ill-
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
'-"-' .
By ~. ..",,0 ~......'"
Mayor
. ~ ~ ~-~
~. ~
(Seal)
AttestDANNY 1.. J(OLHAGE, Clerk
Approved as to form and legal
sufficiency. 1
By ~U \r--- .
County Attorney's Office
~./~1~/
Cler
ID Code to be Assigned by State EMS Office: M2 _ _ _
Florida Department of Health and Rehabilitative Services
Office of Emergency Medical Services (EMS)
MATCHING GRANT APPLICATION
1. Legal Name of
Agency/Organization: Board of County Cornnissioners, Monroe County, Florida
Name and Title of Wilhelmina Harvey, Mayor /Chairrnan
Grant Signer:
Mailing 490 63rd Street, Suite 140
Address: Marathon, Fl. 33050 County: Monroe
Telephone Number: (305) 289-6002 SunCom Number: 472-6002
2. Name and Title of
Contact Person: Janes R. "Reggie" Paros, Public Safety Director
Mailing 490 63rd Street, Suite 140
Address: Marathon, Fl. 33050
Telephone Number: (305) 289-6002 SunCom Number: 472-6002
3.
Legal Status of
Agency/Organization: (Cheek only one)
Private Not for Profit (you must provide copy of certificate)
Private for Profit -X Public
Your fISCal year:
10/01 9/30
BEGINS
ENDS
4. Agency/Organization's Federal
Tax Identification Number nine digits VF 2.. .....2.. --2. ~ ~ ~ .....l-L -L
5. Identify the one state plan objective thil project primarily addreuel: Objective': 13 . 5
6. Type of Project: (Check only one):
CommunicatioDl Continuing ProfelSioDlI Education (medical director must lip Item 16a)
Emergency Tranaport Vehiclel Public Education
System Evaluation/Quality Anurance Research
-X MedicallReacue Equipment (Iignaturel required for Itema 16b and 16c)
DocI your project include the purchaae of any communicatioDl equipment?
x
yes
No
HRS Form 1767. March 89
1
For both the need and outcome statements: include all available numeric data, the time frame
for the data, the data source, the number of people who will directly receive project services,
and other information which clearly identifies your need and expected outcome for this project.
7. Need Statement (use only the space below):
Activity S\.1IT!'l'ary Reports on file in the Monroe County EMS Office show that
funroe County EMS, Tavernier and Key Largo Volunteer Ambulance Corps responded
on 379 cardiac related calls during calendar year 1991. The reports also show
that the average transport ti.rre to the nearest hospital was 15 minutes; this
is due to the unique geography of the Florida Keys and the distance between
hospitals.
8. Outcome Statement (use only the space below):
It has been proven that in a patient who is having a myocardial infarction, the
sooner the patient receives thranbolytic therapy, the better the outcane for
the patient. This equipment is needed in order to make the diagnosis of an
acute myocardial infarction earlier and prevent myocardial damage and death.
9. Improvement and Expansion of Prehospital EMS. Describe how your project improves and expands
prehospital EMS. Also, show how it builds coordination and cooperation with other EMS systems.
OUr intention is to be able to make the diagnosis of a mYocardial infarction in
the field so that thrombolytic therapy can be imnediately given up:m arrival at
the hospital. We will improve and expand the care given by Paramedics by
training them to perfonn 12 lead EKG, as. well as recognize EKG signs of myocardial
infarction, either by the actual EKG or via interpretation by the nearest hospital.
10. Research Projects Only:
If you are !!Q! conductin& a re_rch project, lkip thil item and 10 to Item II.
If you are conducting a re_rch project, attach at the end of the application concise statements of the hypothesil, delign/method, instruments, methods
to protect human subjects, any limitations involving the study, re_rch instrumenta, fonns and lilltings of other relevant studiel.
11. Major Work Activities and Time Frames (Use only the space below):
Bid, purchase and install the 12 lead EKG equi];.ffi3nt within 6 m:mths after
grant begins.
Train Paramedics to perfonn 12 lead EKG and recognize EKG signs of myocardial
infarction within 8 months after grant begins.
Begin performing 12 lead EKG on all patients assessed as having cardiac problems
within 10 rnonths after grant begins.
2
APPLICANT
State
Cash Grant
CATEGORIES Match Funds TOTAL
12. Salaries and Benefits:
TOTAL SALARIES and BENEFITS
13. Expenses
Training for 56 Paramedics in 12 Lead EKG 1,540.00 4,620.00 6,160.00
Interpretation at University of Miami
@$110.o0 per person
TOTAL EXPENSES 1,540.00 4,620.00 6,160.00
APPLICANT
State
CATEGORIES Cash Grant
Match Funds TOTAL
14. Equipment:
(3) Base Station 12 Lead EKG @$6,000.00 4,500.00 13,500.00 ' 18,000..00
( 3) Base Station Modems @$1,200.00 900.00 2,700.00 3,600.00
(14) Monitors for 12 Lead @$8,000.00 28,000.00 84,000.00 112,000.00
( 14) Modems & Cellular Phones @$2,000.00 7,000.00 21,000.00 28,000.00
TOTAL EQUIPMENT COSTS
40,400.00 121,200.00 161,600.00
3
APPLICANT
State
Cash Grant
CATEGORIES Match Funds TOTAL
15. Final Summary - Total of salaries
and benefits, expenses and equipment,
all combined
$ 41,940 SJ.25,82o $167,760
========= ======= ====:z===
The above figure The above figure The above figure
mult equal 25 percent mult equal 75 mult equal the
of the total Percent of the sum of the
total precedm, two
columna
Note: You may attach a page or pages to explain and justify as necessary the need for any and all positions, expenses, and
equipment in terms of the items, their quantities, their costs, and their roles in the project.
4
16. Medical director's signatures: Complete this item only if your project is a MedicallRescue
Equipment, or ProCessional Education Project.
a. ProCessional Education
All continuing education described in this application is developed and conducted
with my input and approval.
Medical Director's Signature
Date
Medical Director's Printed Name
;t b.
Medical Equipment Projects:
I hereby accept authority and responsibility Cor the use oC Medical Anti-Shock
Trousers (MAST), Esophageal Obturator Airways (EOAs), semi-automatic and automatic
defibrillators, AlS equipment identified in Chapter 10D-66, F.A.C., and equipment not
identified in Chapter lOD-66, F.A.C. H this responsibility is delegated, both the delegated
physician and the medical director must sign this section.
t ~ ;2~~ 9;;..
Date
Medi I Director's Signature
and Delegated Physician, if any
-L1:J ,'C ha e I -\ +0. {, \.j
Medical Director's Printed Name
and Delegated Physician, if any
c. I hereby acknowledge that the applicant responds routinely to rescue or medical
incidents under written agreement with my licensed EMS system.
Medical Director's or Authorized Person's Signature
Date
Pdnted Name
5
16. Medical director's signatures: Complete this item only if your project is a MedicaVRescue
Equipment, or ProCessional Educatkn Project.
a. ProCessional Education
All continuing education described in this application is developed and conducted
with my input and approval.
Medical Director's Signature
Date
Medical Director's Printed Name
-#. b. Medical Equipment Projects:
I hereby accept authority and responsibility Cor the use oC Medical Anti-Shock
Trousers (MAST), Esophageal Obturator Airways (EOAs), semi-automatic and automatic
defibrillators, AI..S equipment identified in Chapter 10D-66, F.A.C., and equipment not
identified in Chapter 10D-66, F.A.C. If this responsibility is delegated, both the delegated
physician and the dical director must sign this section.
~ ~91't 2---
Date
Medi irector's Signa re
and Delegated Physician, if any
.~ y-a SJ"wt'm (h.e. ,r ,
Medical Director's Printed Name
and Delegated Physician, if any
c. I hereby acknowledge that the applicant responds routinely to rescue or medical
incidents under written agreement with my licensed EMS system.
Medical Director's or Authorized Person's Signature
Date
Printed Name
5
APPLICATION ITEM 17 (signature required)
REQUEST 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 undersigned hereby requests an EMS matching
grant distribution (advance payment) for the improvement and expansion of prehospital EMS.
Payment To: Board of County Conmissioners, Monroe County, Florida
Legal Name of Agency/Organization
490 63rd Street, Suite 140
Marathon,
Address
(City)
FL
(State)
33050
(Zip)
SIGNATURE: '
Printed Name: Wilhelmina Harvey
uthorized Official
DATE: July 15, 1992
Title: Mayor /Chainnan
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(,,,A;l~\~WY.
----;,r~;:!r!'/'!; O/fict9
SIGN AND RETURN WITH YOUR MATCHING GRANT APPLICATION TO:
Department of Health and Rehabilitative Services ATTEST: DANNY L. KOLHAGE, CLEP
Office of Emergency Medical Services (HSTM)
EMS Matching Grants By
1317 Winewood Boulevard
Tallahassee, Florida 32399-0700
Deputy Clerk
Matching Grant Amount:$
Approved By:
For Use Only by Department of Health and Rehabilitative Services,
Office of Emergency Medical Services
Grant ID Code: m _ _ _
Date:
Signature, State EMS Grant Officer
State Fiscal Year:
Amount: $
Oraanization Code
60-20-60-30-100
E.O.
HS
Obiect Code
Federal Tax 10 V F:
Grant Beginning Date:
Ending Date:
6
18. ASSURANCES AND APPLICATION SIGNATURE
Certification of Standards Statement
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 Assistance and Bill of Rights of 1975 (p.L. 95-602) as 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 Commitment
I, the undersigned, certify that cash 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 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. Cash, salaries, fringe benefits, expenses, equipment, and other
expenses as listed on this application shall be committed and used for the department's final approved project during the
grant period.
Acceptance of Tenns and Conditions
I, the undersigned, accept the grant terms and conditions in Appendix B of the booklet, "1992 Florida EMS Matching
Grant Program", by the Department of Health and Rehabilitative Services and acknowledge this when funds are drawn or
otherwise obtained from the grant payment system.
Disclaimer
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 II, F.S. and Chapter lOD-66, F.A.C., 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 re~lations.
Notification of A wards
I, the undersigned, 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 award grants.
Maintenance of Improvement and Expansion
I, the undersigned, agree that any improvement or expansion brought about in whole or part by grant funds, will be
maintained for five years after the project ends, unless specified otherwise in the approved application or unless the
department agrees in writing to allow a change. Any unauthorized change within the five years will necessitate the return
of grant funds involved, plus int I' st if any to the department.
\
f..
Signature of Authorized Grant Signer
(Individual Identified in Hem 1)
July 15, 1992
Date
NOTE: Please check to insure that all required signatures have been made for Items 16, 17, and 18.
The application will not be considered for funding without any required signature.
ATTEST: DANNY L. KOLHAGE, CLERK
By
7
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Deputy Clerk
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