Resolution 493-1991
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James R. Paros
Public Safety Division
RESOLUTION NO. 493
- 1991
A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF
MONROE COUNTY, FLORIDA, AUTHORIZING THE SUBMISSION OF
GRANT APPLICATIONS TO THE FLORIDA DEPARTMENT OF HEALTH
AND REHABILITATIVE SERVICES, OFFICE OF EMERGENCY
MEDICAL SERVICES, TO FUND THE ACQUISITION OF EQUIPMENT
TO BE UTILIZED IN THE SYSTEM EVALUATION/QUALITY ASSURANCE
PROGRAM 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 January 1, 1992
and ending on June 30, 1993; and
WHEREAS, the total grant application is for $ 9,000.00, with a
50% match requirement; and
WHEREAS, the $ 4,500.00 match requirement would be included in
the district budget request for Fiscal Year 1993, as follows,
District 5 - $ 4,500.00; and
WHEREAS, the system evaluation/quality assurance project if
awarded and accepted, will be used to purchase computer and data
transmission hardware and software for District 5; 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.
-2-
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
20th day of November, A.D. 1991.
Mayor Harvey
Mayor Pro Tern London
Commissioner Cheal
Commissioner Jones
Commissioner Stormont
YES
YES
YES
YES
YES
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
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By ~ .tI~a.6 Y> .. . "--. - . ' \
Mayor
(Seal)
Attest :DANNY L. KOlliAGE, Clerk
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Cler
Approved as to form and legal
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Attorney s 0 fice
ID Code to be Assigned by State EMS Office: Ml _ _ _
Florida Department of Health and Rehabilitative Services
Office of Emergency Medical Services (EMS)
MA TCHING GRANT APPLICATION
1. Legal Name of
Agency/Organization: OOARD OF COCWl'Y COMISSI(BERS, ~ COCWl'Y, FLORIDA
Name and Title of
Grant Signer: WiJ.l1plmina Harvey, Mayor/OJaiDlBll
Mailing 5192 OVerseas Highway
Address: Marathon, Florida 33050 County: ~
Telephone Number: (305) 289-6002 SunCom Number: 472-6002
2. Name and Title of
Contact Person: James R. Paras, Public Safety Director
Mailing 5192 OVerseas Highway
Address: Marathon, Florida 33050
Telephone Number: (305) 289-6002 SunCom Number: 472-6002
3.
Legal Status of
Agency/Organization: (Check only one)
Your fiscal year:
10/01 09/30
Private Not for Profit (y"" must provide copy of ce'1ificate)
BEGINS
ENL':;
Private for Profit
x
Public
4. Agency/Organization's Federal
Tax Identification Number nine digits VF ~ L ~ ~ ~ ~ L ~ --.2...
5. Application Status: (Check only one)
This is the continuation of a project already funded by the state EMS matching grant program,
x
This is not the continuation of a project already funded by the state EMS matching grant program,
6. Type of Project: (Check only one)
Communications Continuing Professional Education (medical director must sign Item 153)
Emergency Transpol1 Vehicles Public Education
...x.. System Evaluation/Quality Assurance Research
Medical/Rescue Equipment (signatures required (or Items 15b and 150)
HRS Form 1767, Dee 90 (Obsoletes previous editions)
Al
6A. State Plan Goals, Objectives, and Improvement and Expansion:
State E.MS Plan Goal: Identify in the space below the specific goals and their page numbers in the FY 1991-93 state
EMS plan, which your project will help accomplish, Describe how your project will do this, and if possible, the
percentage of the goals you will accomplish.
System Eva1.uation/Qual.i ty Assurance
Goal 11:
fBIical Directien, Goal 2:
Establish.a uniform quality assurance system for prehospital ~
care providers. (Page 23)
State EMS Plan Objective: Identify in the space below the specific objectives and their page numbers in the state
plan, which your project will help accomplish. Describe how your project will do this, and if possible, the percentage of
the objectives you will accomplish.
Objective 2.2
By Januazy 1992, develop a Dlde1 quality assurance .review CXIIIIIittee.
Improvement and Expansion of Prehospital EMS. Describe as quantitatively as possible, how your project
will both improve and expand prehospital EMS in Florida.
'Jbe enhanced ability to CDlpile data en the operational perfODmJCe
of our system such as infOlllBtien en the frequency and types of ~
medical calls, the perfozmance levels of the mtS personnel, IIIaIlpOIfer
requirem::nts, and response times. 'Ibis infoDlBtien can be used in
accurately evaluating specific needs and iDprovaaents in both equi~t
and personnel. 'Ibis will also allow for accurate sul:IIl:i ttal of data
to the state EMS office.
A2
Ie for the data,
'For both the nee~.. outcome statements: include numeric data, the tim
the data source, and the target population and geographic area.
7. Need Statement (use only the space below): 'l11e ca1l log for Tavernier VollBlteer
Ambul.ance Corps. indicates that there liere approx::iJDate1y 800 ca1ls during the
last 12 IIDIlths and the ca11 vol1m! is ~ to increase. This service provides
AIS service, maintains 3 transport vehicles, and currently has 32 1Ml's and
:parauedics in addition to persamel who are first respcnder/driver only. Using
manual quality assurance review reduces the efficiency and accuracy of information
obtained and may not indicate potential problems in a tilDely manner. This depar-
tDe1t needs to evaluate data B>re expeditiously and accurately.
8. Outcome Statement (use only the space below): A CaIplterized. system. capable
of analyzing nm reports on patient's condition, frequency/type of call, care
given, response tilDe, personnel skill level, certification, and training will
enable tilDely and accurate quality assurance data ocmpilation, and indicate l;.<here
improveuI:!nts are needed. This will also enable electronic transfer of data to
the State EMS office which is both timely and accurate. It will also enhance
the ability to retrieve statistica1 data to be used to ~re our level of service
to that of other areas.
9. Research Projects Only:
If you are not conducting a research project, skip this item and go to Item 10.
If you are conducting a research project, attach at the end of the application concise statements of the hypothesis, design/method, instruments, methods
to prolect human subjects, any limitalions involving the study, research instruments, forms and listings of other relevant studies,
10. Work Activities, Objectives and Time Frames (Use only the space below):
Detennine exact needs and equiplE!llt specification prior to the start of the
grant period. Purchase and install canputer hardvare/softvare equipuent within
two IIDlths after the grant period begins.
Review quality assurance data on nm reports and personnel data on a IIDlthly
basis to determine what areas need ~t. Detennine what actions need
to be taken to make improvements and ~re future IIDlths statistics to verify
effectiveness of actic:ms taken.
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, (Round to Nean lr)
APPLICANT
In-Kind ~tate
~ash rant
CA TEGORIES atch Match unds TOTAL
11. Salaries and Benefits:
a. New positions. Do Not Write
In This Area
N/A
b. Existing/In-Kind Positions
Do Not Write Do Not Write
In This Area In This Area
N/A
c. Total Salaries and Benefits
12. Expenses Do Not Write
a. New Expenses In This Area
N/A
b. Existing/ln- Kind Do Not Write Do Not Write
In This Area In This Area
N/A
c. Total Expenses
(Attach additional pages if needed)
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. (Round to NC<lfCSt L....... J
APPLICANT
~tate
~ash In-Kind fant TOTAL
CATEGORIES l\ atch Match unds
13. Equipment:
a. New equipment. Do Not Write
In This Area
CaIplter and data transmiSSial
hardware and software.
4,500. 4,500. 9,000.
b. Existing/ln- Kind Equipment
Do Not Write Do Not Wri'te
In This Area In This Area
N/A
c. Total Equipment Costs
4,500. 4,500. 9,000.
14. Financial Summary - Total of salaries
and benefits, expenses, and equipment,
all combined.
$ 4,500. $ $ 4,500. $ 9,000.
-------- -------- -------- --------
-------- -------- -------- --------
Cash The above figure The above figure The above figure
Match must be equal musl equal the must equal the
Grand to or less than the sum of the the sum of the
Tala I the cash match two preceding preceding three
Grand Total columns three columns
, ,
(Attach additIOnal pages If needed)
AS
APPLICATION ITEM 16 (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 Commissioners, Monroe County, Florida
Legal Name of Agency/Organization
5192 Overseas Highway
Address
Marathon, FL 33050
(City)
(State)
cl~~k
ATTEST: DANNY L. KOLHAGE,
By
Authorized Official Deputy C 1 e'rk
D TE: November 20, 1991
Title: Mayor/Chairman
SIGN AND RETURN WITH YOUR MATCHING GRANT APPLICATION TO:
Department of Health and Rehabilitative Services
Office of Emergency Medical Services (HSTM)
EMS Matching Grants
1317 Winewood Boulevard
Tallahassee, Florida 32399-0700
For Use Only by Department of Health and Rehabilitative Services,
OffiCe of Emergency Medical Services
Matching Grant Amount:$
Approved By:
Grant ID Code:
Date:
Signature, Title, State EMS Grant Officer
State Fiscal Year:
Amount: S
Orqanization Code
60-20-60-30-100
E.O.
HS
Obiect Code
Federal Tax 1D V F:
Grant Beginning Date:
Ending Date:
By
D;;:ts
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17. ASSURANCES AND APPLICATION SIGNATURE (Applications without an appropriate signature
for this item will not be considered for funding):
Certification of Standards Statement
I, the undersigned, certi fy that if granted funds under Chapter 401, Part 11, F, S,; as amended, all applicable regulations and
standards will be adhered to including: Chapter 401, F.S,; Chapter 100-66, F.A,C.; Mimmum Wage Act; Title VI of the
Civil Rights Act of 1964 (42 ISC 20000 d. 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 Ca"h & In-Kind Commitment
I, the undersigned, certify that cash and in-kind 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 in-kind 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 Terms and Conditions
Acceptance of the grant terms and conditions in Appendix C of the booklet, "Florida Emergency Medial Services Matching
Grant Program 1991", by the Department of Health and Rehabilitative Services is acknowledged by the grantee when funds
are drawn or otherwise obtained from the grant payment system.
Disclaimer
I, the undersigned, hereby certi fy 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.; Chapter 100-66, F,A.C.; as 3mended
by Chapter 85-167, Laws of Florida, may be revoked, and any monies erronCDusly paid and interest earned will be
refunded to the department with any penalties which may be imposed by law or applicable regulations.
Notification of A wards
I 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,
Signature of Authorized Grant Signer
(Individual IdentI fied in Item I)
November 20, 1991
Date
AT7EST: DANNY L. KOLHAGE, CLERK
By:
'\
NOTE:
Please check to insure that all required signatures have been made for Items 15, 16, and 17.
Deputy Clerk
By
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