Agenda 10/13/2015 Item #16E210/13/2015 16.E.2.
EXECUTIVE SUMMARY
Recommendation to approve a Florida Emergency Medical Services County Grant Application,
Request for Grant Fund Distribution form and Resolution for the funding of Training and
Medical/Rescue Equipment in the amount of $65,176 and to approve a Budget Amendment.
OBJECTIVE: To expand and improve pre - hospital emergency medical services utilizing State
grant money.
CONSIDERATIONS: The State of Florida established the Emergency Medical Services Grant
Award Program for the expansion and /or improvement of emergency medical services. A grant
award notice was recently received from the State of Florida indicating that Collier County's
grant allocation for the upcoming fiscal year will be $65,176.00. A resolution is required to be
included with the grant application stating that funds will not be used to supplant the EMS
budget and certifying that the grant funds will be used to improve the County's emergency
medical services. Also included with the application is a Request for Grant Fund Distribution,
which directs the Florida Department of Health to remit the grant funds to Collier County Board
of Commissioners. Approval of these documents also constitutes acceptance of the grant when
awarded.
FISCAL IMPACT: Qualified purchases will be totally funded by the State of Florida
Emergency Medical Services Grant Award Program. Funds will be allocated to and disbursed
from Fund 493 — EMS Grants, Project 33432. A Budget Amendment is necessary to appropriate
the grant award of $65,176.00 for FYI 6.
LEGAL CONSIDERATIONS: This item has been reviewed by the County Attorney, is
approved as to form and legality, and requires majority vote for approval. —JAK
GROWTH MANAGEMENT IMPACT: There are no Growth Management impacts
associated with this Executive Summary.
RECOMMENDATION: That the Board of County Commissioners:
1. Approves the Florida Emergency Medical Services County Grant Application, the
Request for Grant Distribution form requesting grant funds be remitted to the Collier
County Board of Commissioners, and the Resolution stating that grant funds will not
supplant the EMS budget;
2. Authorizes the Chairman to execute the application, Request for Grant Distribution and a
Resolution stating that grant funds will not supplant the EMS budget; and,
3. Authorizes a Budget Amendment in the amount of $65,176.00 to appropriate the grant
funds.
Prepared By: Artie R. Bay, Supervisor- Admin., Emergency Medical Services
Attachments: 1) Grant Application; 2) Resolution; and 3) Grant Award Letter
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COLLIER COUNTY
Board of County Commissioners
Item Number: 16.16.E.16.E.2.
Item Summary: Recommendation to approve a Florida Emergency Medical Services
County Grant Application, Request for Grant Fund Distribution form and Resolution for the
funding of Training and Medical /Rescue Equipment in the amount of $65,176 and to approve a
Budget Amendment.
Meeting Date: 10/13/2015
Prepared By
Name: FrancoMaria
Title: Administrative Assistant, Administrative Services Department
9/14/2015 8:11:55 AM
Approved By
Name: KopkaWalter
Title: Chief - Emergency Medical Services, Administrative Services Department
Date: 9/14/2015 8:42:37 AM
Name: Joshua Thomas
Title: Grants Support Specialist, Grants Management Office
Date: 9/15/2015 9:14:17 AM
Name: KlatzkowJeff
Title: County Attorney,
Date: 9/23/2015 11:57:18 AM
Name: PriceLen
Title: Department Head - Administrative Svc, Administrative Services Department
Date: 9/28/2015 9:54:04 AM
Name: KlatzkowJeff
Title: County Attorney,
Date: 9/28/2015 9:55:46 AM
Name: KlatzkowJeff
Title: County Attorney,
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10/13/2015 16.E.2.
Date: 9/28/2015 10:08:33 AM ^
Name: StanleyTherese
Title: Manager - Grants Compliance, Grants Management Office
Date: 10/2/2015 9:32:52 PM
Name: CasalanguidaNick
Title: Deputy County Manager, County Managers Office
Date: 10/3/2015 8:49:07 AM
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EMS COUNTY GRANT APPLICATION
FLORIDA DEPARTMENT OF HEALTH
Bureau of Emergency Medical Services
Complete all items
ID. Code (The State Bureau of EMS will assign the ID Code - leave this blank) C
Federal Tax ID Number
documents for the county) I certify that all information and data in this EMS county grant application and its
attachments are true and correct. My signature acknowledges and assures that the County shall comply
fully with the conditions outlined in the Florida EMS County Grant Application,
Signature: Date:
Printed Name: Tim Nance
3. Contact Person: (The individual with direct knowledge of the project on a day - today basis and has
responsibility for the implementation of the grant activities. This person is authorized to sign project
reports and may request project changes. The signer and the contact person may be the same.)
Name: Artie Bay
Position Title: Supervisor — EMS Admin.
Address: 8075 Lely Cultural Parkway, Suite 267
apes,
Telephone: 239 - 252 -3740 Fax Number. 239-252 -3298
E -mail Address: artiebay @collliergov.net
4. Resolution: Attach a current resolution from the Board of County Commissioners certifying the grant
funds will improve and expand the county pre - hospital EMS system and will not be used to supplant
current levels of county expenditures.
5. Budget: Complete a budget page(s) for each organization to which you shall provide funds. List
the organization(s) below. (Use additional pages if necessary)
Collier County Emergency Medical Services
�121
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BUDGET PAGE 1-1
A. Salaries and Benefits:
For each position title, provide the amount of salary per hour, FICA per
hour, other fringe benefits, and the total number of hours. I Amount
Grand total Salaries and FICA
B. Expenses: These are travel costs and the usual, ordinary, and incidental expenditures by an
agency, such as, commodities and supplies of a consumable nature excluding expenditures classified as
operating capital outlay (see next category).
C. Vehicles, equipment, and other operating capital outlay means equipment, fixtures, and other
tangible personal property of a non consumable and non expendable nature with a normal expected life
of one (1) year or more.
List the item and, if applicable, the quantity
Medical/Rescue Equipment
Amount
50,176.00
TOTAL
$ 50,176.00
Grand Total
DH Form 1684, December 2008
$ 65,176.00
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FLORIDA DEPARTMENT OF HEALTH
EMS GRANT PROGRAM
REQUEST FOR GRANT FUND DISTRIBUTION
In accordance with the provisions of Section 401.113(2)(a), F. S., the undersigned hereby
requests an EMS grant fund distribution for the improvement and expansion of pre - hospital
EMS.
DOH Remit Payment To:
Name of Agency: Collier County Board of County Commissioners
Mailing Address: 3299 Tamiami Trail East Suite 303
Naples, FL 34112
Federal Identification number 59- 6000558
Authorized Official:
Signature Date
Tim Nance, Chairman
Type Name and Title
Sign and return this page with your application to_
Florida Department of Health
BEMS Grant Program
4052 Bald Cypress Way, Bin C98
Tallahassee, Florida 32399 -9738
Do not write below this line. For use by Bureau of Emergency Medical Services personnel only
' Grant Amount For State To Pay: $ Grant ID: Code:
Approved By :
Signature of EMS Grant Officer
State Fiscal Year
Organization Code E.O. OCA
64- 42- 10- 00-000
Federal Tax ID: VF
Grant Beginning Date:
Object Code
750000
Grant Ending Date:
__k\
DH 1767P, December 2008 64J- 1.015, F.A.C.
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GENERAL CONDITIONS AND REQUIREMENTS
The EMS County grant general conditions and requirements are an integral part of the county
grant agreement between the agency /organization (grantee) and the state of Florida,
Department of Health (grantor or department). In the event of a conflict, the following
requirements shall always be controlling:
FINANCIAL
FUND ACCOUNTING:
All state EMS grant funds shall be deposited by the grantee in an account maintained by the
grantee, and assigned an unique accounting code designator for all grant deposits and
disbursements or expenditures thereof. All state EMS grant funds in the account maintained by
the grantee shall be accounted for separately from all other grantee funds.
USE OF COUNTY GRANT FUNDS:
All state EMS grant funds shall be used between the beginning and ending dates of the grant
solely for activities as outlined in the Notice of Grant Award letter, its attachments if any, and
the application including its budget with its revisions, if any, on file in the state EMS office.
The grantee is not restricted to staying within the line item amounts within the approved grant
budget. However, the grantee must adhere to the approved total grant budget. Any
expenditures beyond this budget are the full responsibility of the grantee.
ROLLOVERS
Any unencumbered EMS county grant program funds as of September 30, of each year,
including interest, remaining in the assigned grantee account at the end of a grant period shall be
reported to the department. The grantee will retain these funds in the EMS County Grant account
and include them in a budget revision request after receipt of approval of their next county grant
application.
N.
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11-%, DISALLOWED EXPENDITURES
10/13/2015 16.E.2.
No expenditures are allowable as grant costs unless they are clearly specified as a line item in the
approved grant budget, including approved change requests, or are clearly included under an
existing line item.
Any disallowed EMS county grant expenditure shall be returned to the EMS county grant
account maintained by the grantee within 40 days after the department's notification. The
costs of disallowed items are the responsibility of the county.
VEHICLES AND EQUIPMENT
The grantee shall own all items, including vehicles and equipment purchased with the state
EMS grant funds, unless otherwise described in the approved grant application. The grantee
shall clearly document the assignment of equipment ownership and usage; and maintain these
documents so they are available to the department. The owner of the vehicle shall be
responsible for the proper insurance, licensing and, permitting and maintenance. All
equipment purchased with grant funds shall continue to be used for pre - hospital EMS or the
purpose for which it was purchased throughout its useful life. When any grant - funded
equipment is no longer usable, it may be sold for scrap or disposed of in the customary
procedure of the receiving agency.
TRANSFER OF PROPERTY
A private organization owning any equipment funded through the grant program in whole or in
part and purchased that equipment to provide services for a municipality, county or other
public agency ceasing operation within five years of the ending date of a grant awarded to the
organization shall transfer the equipment or other items to the local agency. There shall be no
cost to the recipient organization. This provision is applicable when services cease operating due
to a contract ending as well as any other reason.
REQUESTS FOR CHANGE
After a grant has been awarded, all requests for change shall be on DH Form 1684C EMS
Grant Program Change Request, December 2008. The grantee shall obtain written approval
from the department prior to making the requested changes. The following changes must be
requested:
1. Changes in the project activities.
2. Redistribution of the funds between entities or equipment approved.
3. Establishing a new line item in the budget.
4. Changing a salary rate more than 10 %.
SUPPLANTING FUNDS
The applicant cannot propose to use grant funds to supplant or replace any county or other
n funding source. Funds received under the county award grant program cannot be used to
fulfill the matching requirement for the matching grant program.
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DEPOSIT OF FUNDS
County grant funds provided to an applicant shall be deposited in a separate account. All
interest earned shall be documented on the required reports.
REPORTS
Each grantee shall submit two reports to the department. The due dates for the required
reports shall be specified in the letter from the department notifying the grantee of the grant
award. These reports shall include, at a minimum, a narrative of the activities completed or the
progress of grant activities during the reporting period. A report shall be submitted by the due
date whether or not any action or expenditures have occurred.
GRANT SIGNATURE
The authorized individual listed on page one of the application shall sign each original
application. Should this not be possible before the due date a letter shall be submitted to the
department explaining why and when the signed application shall be received.
RECORDS
The grantee shall maintain financial and other documents related to the grant to support all
revenue and expenditures. A file shall be maintained by the grantee, which includes a copy of the
"Notice of Grant Award" letter, a copy of the application and department approved budget and a
copy of all approved changes.
FINAL REPORTS
Within 120 days of the grant ending date a final report shall be submitted to the department The
final report shall at a minimum contain a narrative describing the activities conducted
including any bid or purchasing process and a copy of all invoices, canceled checks relating to the
purchase of any equipment and supplies. If the activity funded was for training a list of all
individuals receiving the training shall be submitted along with the dates, times and location of the
training. If the grant was for training to be obtained by staff then a copy of all invoices and
payment documents for the training shall also be submitted.
COMMUNICATIONS EQUIPMENT
The grantee shall have all communications activities, services, and equipment approved in
writing by the Department of Management Services, Information Technology Program (ITP).
The approval shall be dated after the beginning date of the grant Any commitment to
purchase the requested equipment and service shall also be dated after the beginning date of
the grant.
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� EXPENDITURES
No expenditures may be incurred prior to the grant starting date or after the grant ending date.
Rollover funds may be used to meet expenditures prior to receipt of current year funds.
CREDIT STATEMENT
The grantee ensures that where activities supported by this grant produce original writing,
sound recording, pictorial reproductions, drawings or other graphic representations and works of
any other nature, notices, informational pamphlets, press releases, advertisements,
descriptions of the sponsorship of the program, research reports, and similar public notices
prepared and released by the provider shall include the statement:
"Sponsored by [Your Organization's Name] and the State of Florida, Department of
Health, Bureau of Emergency Medical Services."
If the sponsorship reference is in written or other visual material, the words, "State of Florida,
Department of Health, Bureau of Emergency Medical Services" shall appear in the same size
letter or type as the name of the grantee's organization.
One complimentary copy of all such materials shall be sent to the department within three
weeks of their reproduction and delivery to the grantee.
If the proper credit statement is not included, or if a copy of each item produced is not provided
�. to the department within three weeks, the cost for any such materials produced shall be
disallowed.
Where activities supported by this grant produce writing, sound recordings, pictorial
reproductions, drawings, or other graphic representations and works of any similar nature, the
department has the right to use, duplicate and disclose such materials in whole or in part, in any
manner or purpose whatsoever and others acting on behalf of the department. If the
materials so developed are subject to copyright, trademark, or patent, legal title and every
right, interest, claim, or demand of any kind in and to any patent, trademark or copyright, or
application for the same, will vest in the State of Florida, Department of State, for the exclusive
use and benefits of the state. Pursuant to section 286.02 (1), F.S., no person, firm or
corporation, including parties to this grant, shall be entitled to use the copyright, patent or
trademark without the prior written consent of the Department of State.
FINANCIAL AND COMPLIANCE AUDIT REQUIREMENTS
This is applicable, if the provider or grantee, hereinafter referred to as provider, is any local
government entity, nonprofit organization, or for - profit organization. An audit, performed in
accordance with section 215.97, F.S. by the Auditor General shall satisfy the requirement of
this attachment.
STATE FUNDED
This part is applicable if the provider is a nonprofit organization that expends a total of
$100,000 or more in funds from the department during its fiscal year, which was not paid from
a rate contract based on a set state or area -wide fixed rate for service, and of which less that
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$300,000 is federally funded. The determination of when a provider has "expended" funds is
based on when the activity related to the award occurs.
The grantee agrees to have an annual financial audit performed by independent auditors in
accordance with the current Government Auditing Standards issued by the Comptroller
General of the United States. Such audits shall cover the entire organization for the
organization's fiscal year. The scope of the audit performed shall cover the financial
statements and include reports on internal control and compliance. The reporting package
shall include a schedule that discloses the amount of expenditures and /or receipts by grant
number for each grant with the department in effect during the audit period. Compliance
findings related to grants with the department shall be based on the grant requirements,
including any rules, regulations, or statutes referenced in the grant. The financial statements
shall disclose whether or not the matching requirement was met for each applicable grant. All
questioned costs and liabilities due to the department shall be fully disclosed in the audit
report with reference to the department grant involved. If the grantee receives funds from a
grants and aids appropriation, the provider shall have an audit, or submit an attestation
statement, in accordance with Section 215.97, F. S. The audit report shall include a schedule
of financial assistance, which discloses each state grant by number and indicates which grants
are funded from state grants and aids appropriations. The grantee has "received" funds when
it has obtained cash from the department or when it has incurred reimbursable expenses.
The grantee agrees to submit the required reports.
SUBMISSION OF AUDIT REPORTS
Copies of the audit report and any management letter by the independent auditors, or
attestation statement, required by this attachment shall be submitted within 180 days after the
end of the grantee's fiscal year to the following, unless otherwise required by F. S.:
A. Send one copy to:
Florida Department of Health
Contract Administrative Monitoring Unit
4052 Bald Cypress Way, BIN B01
Tallahassee, Florida 32399 -1729
B. Submit to this address only those audits performed or attestation statements
prepared in accordance with Section 215.97, F. S.:
Send two copies to:
Auditor General's Office
Local Government Audits/342
Claude Pepper Building, Room 401
111 West Madison Street
Tallahassee, Florida 32399 -1450
C. Do not send this report to the state Bureau of EMS.
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RECORDS RETENTION
The grantee shall ensure that audit working papers are made available to the department, or its
designee, upon request for a period of five years from the date the audit report is issued, unless
extended in writing by the department.
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RESOLUTION NO. 2015 -
RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA, CERTIFYING THAT THE
APPLICATION FOR AND USE OF EMS COUNTY GRANT FUNDS
WILL IMPROVE AND EXPAND PRE- HOSPITAL EMS DEPARTMENT
ACTIVITIES AND WILL NOT SUPPLANT EXISTING COUNTY EMS
BUDGET ALLOCATIONS.
WHEREAS, EMS Department Paramedics and Paramedic /Firefighters provide basic and
advanced life support care and highly technical service to the citizens and visitors of Collier
County; and
WHEREAS, the purchase of equipment and provision of training shall greatly enhance the
effectiveness of pre- hospital emergency medical care.
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA, that:
The $65,176.00 in the EMS County Grant will be used to provide training and purchase
medical /rescue equipment and these funds will not be used to supplant existing EMS Department
budget allocations.
PASSED AND DULY ADOPTED by the Board of County Commissioners of Collier
County, Florida, this day of , 2015.
ATTEST: BOARD OF COUNTY COMMISSIONERS,
DWIGHT E. BROCK, CLERK COLLIER COUNTY, FLORIDA
an
, Deputy Clerk TIM NANCE, CHAIRMAN
lity:
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Mission:
To protect, promote & improve the health
of all people in Florida through integrated
�1 state, county & community efforts.
Chairperson
Collier County BOCC
Building H — Third Floor
3299 E. Tamiami Trail, Suite 303
Naples, FL 34112
Dear Chairperson:
HEALTH
Vision: To be the Healthiest State in the Nation
July 24, 2015
10/13/2015 16.E.2.
Rick Scott
Governor
John H. Armstrong, MD, FACE
State Surgeon General & Secretary
We are pleased to announce that you may now request your annual emergency medical services (EMS)
county grant funds. The amount for your county this year is $65,176.00. Section 401.113 (1); Florida
Statutes, requires the funds must be used solely to improve and expand pre - hospital EMS.
Your grant budget total that you submit must equal the amount cited above. After your new grant begins,
you may request the transfer of unexpended funds, if any, from your previous grant to the new grant.
To obtain the new funds, the county must submit an original and one copy of: the two -page application form,
the Request for Grant Fund Distribution page and a current resolution described by Item #4 of page one of
the application form. Completed applications must be mailed to:
Attn: Alan Van Lewen DOH EMS, County Grants,
4052 Bald Cypress Way, Mail Bin A -22
Tallahassee, FL 32399 -1722.
I have enclosed a copy of an instruction page and the forms. The deadline for completed applications is
December 16, 2015. Please contact me if you have any questions.
Enclosures
Florida Department of Health
Bureau of Emergency Medical Oversight
4052 Bald Cypress Way, Bin A -22 - Tallahassee, FL 32399 -1722
PHONE: 8501245 -4440 • FAX 8501488.9408
Sincerely,
Alan Van Lewen
Health Services and Facilities Consultant
EMS Section Grants Unit
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