Agenda 09/10/2013 Item #16E 3 9/10/2013 16.E.3.
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
Medical/Rescue Equipment and Supplies in the amount of $72,335 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 awarding Collier County
$72,335.00 for fiscal year 2013. 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 the Collier County Board of Commissioners. These documents
also constitute grant acceptance.
FISCAL IMPACT: There is no local match required for this program. Funds will be allocated
to and disbursed from EMS Grant Fund(493), Project 33288. A Budget Amendment is necessary
to appropriate the grant award in the amount of$72,335.00.
LEGAL CONSIDERATIONS: This item is approved as to form and legality and requires a
majority vote for Board action. - JAB
GROWTH MANAGEMENT IMPACT: None.
RECOMMENDATION: That the Board 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; authorizes the Chairwoman to execute these documents;
and, authorizes the Budget Amendment in the amount of $72,335.00 to appropriate the grant
funds.
PREPARED BY: Artie R. Bay, Supervisor- Admin., Emergency Medical Services
Attachments: Award letter_ application. distribution form anc resolution
Packet Page -1449-
9/10/2013 16.E.3.
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.16.E.16.E.3.
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 Medical/Rescue Equipment and Supplies in the amount of$72,335 and to approve a
Budget Amendment.
Meeting Date: 9/10/2013
Prepared By
Name: BayArtie
Title: Supervisor-Accounting,EMS Operations
7/25/2013 9:45:55 AM
Approved By
Name: SummersDan
Title: Director-Bureau of Emergency Services,
Date: 7/25/2013 11:32:12 AM
Name: KopkaWalter
Date: 7/25/2013 1:21:36 PM
Name: pochopinpat
Title: Administrative Assistant,Facilities Management
Date: 7/29/2013 10:03:45 AM
Name: Joshua Thomas
Title: Grants Support Specialist,
Date: 7/29/2013 10:41:17 AM
N ame: Belnedio.iennife-
Title: Assistant County Attorney,County Attorney
Date: 8/6/2013 1:56:56 PM
• Name: PriceLen
Title:Administrator, Administrative Services
Date: 8/21/2013 1:32:27 PM
Packet Page -1450-
9/10/2013 16.E.3.
Amok
Name: PryorCheryl
Title: Management/Budget Analyst, Senior,Office of Manag
Date: 8/21/2013 2:15:44 PM
Name: StanleyTherese
Title: Management/Budget Analyst, Senior,Office of Manage
Date: 8/22/2013 7:42:35 PM
Name: KlatzkowJeff
Title: County Attorney
Date: 8/23/2013 2:59:05 PM
Name: OchsLeo
Title: County Manager
Date: 8/25/2013 9:54:28 AM
Amok
Packet Page -1451-
9/10/2013 16.E.3.
Rick 5COtt
Mission: - Governor
To protect,promote&improve the health
of all people in Florida through integrated L C; John H.Armstrong, MD, FACS
state,county&community efforts. State Surgeon General&Secretary
HEALITH
Vision:To be the Healthiest State in the Nation
July 16, 2013 RGC V
._ M
Chairperson EMS Dept
Collier County Board of
County Commissioners
Building H —Third Floor
3299 East Tamiami Trail, Suite 303
Naples, Florida 34112
Dear Chairperson:
We are pleased to announce that you may now request the annual emergency medical services (EMS)
county grant funds for the improvement and expansion of your county's pre-hospital EMS. The amount
for your county this year is $72,335.00.
The stipulation for improvement and expansion is mandated by section 401.113 (1), Florida Statutes
that requires counties to use the funds solely to improve and expand pre-hospital EMS. Therefore,
costs are not allowed for replacement, ongoing expenses, and recurring dues or payments of any kind.
Your total grant budget must equal the amount cited above; although, you may request changes during
the grant period.
We are again using the 2008 edition grant booklet and forms. You can access the PDF form online at
http://www.fl-ems.com/Forms/Forms.html or contact state grant staff for the forms in Microsoft Word.
To obtain the funds, the county must appropriately complete and send to the state one signed original
and one copy of the two-page application, DH Form 1684; Request for Grant Fund Distribution page,
DH Form 1767P; and a resolution described in Item#4 of the application form. Send to: Attn. Alan Van
Lewen, DOH EMS Program County Grants, 4052 Bald Cypress Way, Mail Bin A22, Tallahassee, FL
32399-1722. The deadline for us to receive completed applications is November 15, 2013.
Thank you for your previous cooperation and support to improve and expand quality EMS. Please
contact me, if you have any questions.
Sincerely,
Alan Van Lewen
Health Services and Facilities Consultant
EMS Program Grants Unit
cc: Mr. Walter Kopka
Florida Department of Health www.FloridasHealth.com
Bureau of Emergency Medical Oversight,EMS Program TWITTER:HealthyFLA
4052 Bald Cypress Way,Bin A-22•Tallahassee,FL 32399-1722 FACEBOOK:FLDepartmentofHealth
PHONE:(850 245-4440,Ext.2734•FAX(850)245-4378 YOUTUBE:fldoh
Packet Page -1452-
9/10/2013 16.E.3.
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
1. County Name: Collier
Business Address: 3299 Tamiami Trail East, Suite 303
Naples, FL 34112
Telephone: 239-352-3740
Federal Tax ID Number(Nine Digit Number). VF_59-6000558_
2. Certification: (The applicant signatory who has authority to sign contracts, grants, and other legal
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: Georgia A. Hiller, Esq.
Position Title: Chairwoman
3. Contact Person: (The individual with direct knowledge of the project on a day-to-day 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
Naples, FL 34112
Telephone: 239-252-3740 f Fax Number: 239-252-3298
E-mail Address: artiebay @colliergov.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
DH Form 1684, December 2008 64J-1.015,F.A.C.
k_ E`. 3 Approved as to form and legality
WIGHT T F BR M, Cr
Assistant County Attoibey
Packet Page -1453-
9/10/2013 16.E.3.
BUDGET PAGE
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. Amount
TOTAL Salaries
-TOTAL FICA
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).
List the item and, if applicable,the quantity Amount
—Medics uipment/ pu plies 6,0007
TOTAL j $6,000.00
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 —__— Amount
Medical/Rescue Equipment 66,335.00
TOTAL ! $66,335.00
i I
Grand Total $72,335.00
DH Form 1684, December 2008
4
Packet Page -1454- cq
9/10/2013 16.E.3.
FLORIDA DEPARTMENT OF HEALTH AIMOW
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
Georgia A.Hiller,Esq., Chairwoman
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 C18
Tallahassee, Florida 32399-1738
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 Date
State Fiscal Year: -
Organization Code E.O.. OCA Object Code
64-42-10-00-000 750000
Federal 79x ID. VF
Grant Beginning Date Grant Ending Date:
Approved as to form and legality
DH 1767gllegitiper 2008 64J-1.015,F.A.C. r
NIGHT E. SROa, CLEW Asstittant County Atto1<ney
5
Packet Page-1455-
9/10/2013 16.E.3.
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.
8
Packet Page -1456- �-
9/10/2013 16.E.3.
DISALLOWED EXPENDITURES
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. Cnanging a salary rate more than 10°/:,.
SUPPLANTING FUNDS
The applicant cannot propose to use grant funds to supplant or replace any county or other
funding source. Funds received under the county award grant program cannot be used to
fulfill the matching requirement for the matching grant program.
9
Packet Page-1457-
9/10/2013 16.E.3.
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 ir.
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.
10
Packet Page -1458-
9/10/2013 16.E.3.
EXPENDITURES
No expenditures may be incurred prior to the grant starting date or after the grant ending date.
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 witn section 215.9 7. F.S. by the Auditor General shall satisfy the requirement cf
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 Adook
a rate contract based on a set state or area-wide fixed rate for service, and of which less that
11
Packet Page -1459-
9/10/2013 16.E.3.
$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.
12
Packet Page -1460-
9/10/2013 16.E.3.
RECORDS RETENTION Amok
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.
Alek
13
-7(j Packet Page -1461-
9/10/2013 16.E.3.
RESOLUTION NO. 2013 -
A RESOLUTION OF THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA,
CERTIFYING THAT THE FLORIDA EMERGENCY MEDICAL
SERVICES COUNTY GRANT FOR EMS COUNTY GRANT FUNDS
WILL IMPROVE AND EXPAND PRE-HOSPITAL EMS
DEPARTMENT ACTIVITIES AND WILL NOT SUPPLANT
EXISTING COUNTY EMS BUDGET ALLOCATIONS.
WHEREAS, Collier County EMS is applying for a Florida Emergency Medical Services
Grant to benefit pre-hospital EMS Services, and
WHEREAS, Collier County 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 supplies funded with grant funds shall
improve and expand the effectiveness of pre-hospital emergency medical care; and
WHEREAS, pursuant to the grant terms and conditions, the funds will not be used to
supplant EMS Department budget allocations.
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA,that:
The $72,335.00 in the EMS County Grant will be used to purchase medical/rescue
supplies/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 , 2013.
ATTEST: BOARD OF COUNTY COMMISSIONERS,
DWIGHT E. BROCK, Clerk COLLIER COUNTY, FLORIDA
BY:
Deputy Clerk GEORGIA A. HILLER, ESQ., Cnairwoman
• oved as to form and legality:
•ssistant County Attorney
}
Packet Page -1462-