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Backup Documents 01/24/2017 Item #16E5 ORIGINAL DOCUMENTS CHECKLIST & ROITIteTAP TO ACCOMPANY ALL ORIGINAL DOCUMENTS ::•!� , THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNAT Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to tht..ounty Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Board meeting. **NEW** ROUTING SLIP Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office. Route to Addressee(s) (List in routing order) Office Initials Date 1. 2. 3. County Attorney Office County Attorney Office W,n, I/2.41/2.41/4. BCC Office Board of County 7.0 Commissioners / 5. Minutes and Records Clerk of Court's Office ‘7.-5\ of(25lr1 PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above,may need to contact staff for additional or missing information. Name of Primary Staff Artie Bay Phone Number 252-3756 Contact/ Department Agenda Date Item was ,14.1-Off- Agenda Item Number 16.E5 Approved by the BCC � r M I II Type of Document Grant Application Number of Original 1 Attached fi Documents Attached PO number or account number if document is to be recorded INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A" in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signature? aj 2. Does the document need to be sent to another agency for additional signatures? If yes, provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. QC 3. Original document has been signed/initialed for legal sufficiency. (All documents to be signed by the Chairman,with the exception of most letters,must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain ��- time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on enter date)and all changes made during the meeting have been inco'p t to in the attached document. G��j The County Attorney's Office has reviewed the changes,if applicable. `� 9. Initials of attorney verifying that the attached document is the version approved by the BCC, all changes directed by the BCC have been made, and the document is ready for t Chairman's signature. E rnS 1e.f1+v i lMIA —CC c 6 APf L c 170 /'J poE S No i Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/3T377----- (2...E q 1/3671R..Ec v €. CN " i2 sIGN)4Ttil2F . AS s)c- f (-- AL. 0 iLfIgLOC 16 E5 Ann P. Jennejohn From: Ann P.Jennejohn Sent: Monday,January 30, 2017 3:27 PM To: Bay, Artie Subject: Item #16E5 (1-24-17 BCC Meeting) Attachments: Item #16E5 1-24-17 BCC Meeting.pdf Hi Artie, A copy of Item #16E5, from last week's BCC Meeting, is attached For your records. Thavtk you! Ann Jennejohn, Deputy Clerk Clerk of the Circuit Court Clerk to the Value Adjustment Board Collier County Board Minutes & Records Dept. 239-252-8406 Fax 239-252-8408 1 ioE5 EMS MATCHING GRANT APPLICATION FLORIDA DEPARTMENT OF HEALTH 1-.On .` Emergency Medical Services Program HEALTH Complete all items unless instructed differently within the application Type of Grant Requested: ❑ Rural ® Matching ID. Code (The State Bureau of EMS will assign the ID Code—leave this blank) 1. Organization Name: Collier County Board of County Commissioners-EMS 2. Grant Signer: (The applicant signatory who has authority to sign contracts, grants, and other legal documents. This indivirliinl must also pian this application) Name: \,P&c fl�.Ta.k31QY Position Title: Chairman Address: 3299 Tamiami Trail East Suite 303 City: Naples County: Collier State: Florida Zip Code: 34112 Telephone: 239-252-8097 Fax Number: 239-252-362 E-Mail Address: 3. Contact Person: (The individual with direct knowledge of the project on a day-to-day basis and responsibility for the implementation of the grant activities. This person may sign project reports and may request project changes. The signer and the contact person may be the same.) Name: Artie R. Bay Position Title: Supervisor—EMS Admin. Address: 8075 Lely Cultural Pkwy Suite 267 City: Naples County: FL State: Florida Zip Code: 34113 Telephone: 239-252-3740 Fax Number: 239-252-3298 E-Mail Address:Artiebay@colliergov.net DH FORM 1767[2013] 64J-1.015, F.A.C. 1 IZO[ 16E 5 4. Legal Status of Applicant Organization (Check only one response): (1) ❑ Private Not for Profit[Attach documentation-501 (3)©] (2) ❑ Private For Profit (3) ❑ City/Municipality/TownNillage (4) ® County (5) ❑ State (6) 0 Other(specify): 5. Federal Tax ID Number(Nine Digit Number). VF 59-604Q0558 _ 6. EMS License Number: 3886 Type: ❑Transport ❑Non-transport ®Both 7. Number of permitted vehicles by type: BLS; 40 ALS Transport; 10 ALS non-transport. 8. Type of Service(check one): ❑ Rescue; ❑ Fire; ®Third Service(County or City Government, nonfire); ❑Air ambulance; 0 Fixed wing; 0 Rotowing; ❑ Both; ❑Other(specify) 9. Medical Director of licensed EMS provider: If this project is approved, I agree by signing below that I will affirm my authority and responsibility for the use of all medical equipment and/or the provision of all continuing EMS education in this project. [No signature is needed if medical equipment and professional EMS education are not in this project.] Signature: Date: Print/Type: Name of Director FL Med. Lic. No. Note: All organizations that are not licensed EMS providers must obtain the signature of the medical director of the licensed EMS provider responsible for EMS services in their area of operation for projects that involve medical equipment and/or continuing EMS education. If your activity is a research or evaluation project,omit Items 10, 11, 12, 13, and skip to Item Number 14. Otherwise, proceed to Item 10 and the following items. 10. Justification Summary: Provide on no more than three one sided, double spaced pages a summary addressing this project, covering each topic listed below. A) Problem description (Provide a narrative of the problem or need); B) Present situation (Describe how the situation is being handled now); C) The proposed solution (Present your proposed solution); D) Consequences if not funded (Explain what will happen if this project is not funded); E) The geographic area to be addressed (Provide a narrative description of the geographic area); F) The proposed time frames (Provide a list of the time frame(s)for completing this project); G) Data Sources (Provide a complete description of data source(s)you cite); H) Statement attesting that the proposal is not a duplication of a previous effort(State that this project doesn't duplicate what you've done on other grant projects under this grant program). DH FORM 1767[2013] 2 41 10. Justification Summary 16E5 A)Problem Description Collier County EMS — Medflight Department is the sole HEMS provider of 9-1-1. It is a trauma helicopter providing emergency care and transportation for the second largest county in the state of Florida. This includes major cities and rural areas in need of rapid transport to facilities located in surrounding counties of the state. The specification of the helicopter require the crew to lift heavy loads from an awkward body position which puts our crew in a situation that can easily lead to an injury to the crewmember or the patient. The Multifunction Training System is intended to increase strength, stamina, and stability to the crew. B) Present Situation Current fitness equipment is minimal, in poor condition (most of which has been personally donated by Flight Medics and/or the pilots over the years) and does not provide the type of workout to attain the physical goals we wish to achieve. In addition, due to the age and condition of the current equipment, continued use could result in an accidental injury or equipment malfunction. Because CCEMS Medflight covers a vast rural area and staffs only two medical personnel on the aircraft, a request for an additional unit to provide lifting assistance can take a considerable amount of time and delay patient transport. This puts Flight Medics in a situation where they may lift a load heavier than they are capable, injuring themselves in an effort to prevent the patient condition being compromised due to lack of man power. Over the last three years, EMS employees reported 80 injury claims, 22 of these (nearly 30%) may have been prevented or minimized by strength training. It is crucial that we have the ability to maintain the standards set forth by: 1. Collier County EMS Standard Operating Guidelines: Medflight Operations Section 3. Medflight Staffing: a. Maximum weight limit of 215 lbs. per Flight Medic(with flight suit,helmet, boots) b. Have the ability to lift a 200 lb.patient into the aircraft 5 2. Aviation Human Factors Training Course: "good health keeps our level of situational awareness high which allows us to effectively process information in our surroundings and in job performances." 3. Union Contract, Article 31, Section 31.2-Minimum Equipment Each station shall be supplied with the following minimum equipment and supplies: Physical Fitness Equipment. C) Proposed Solution Based on the study of injury claims, along with our lack of strength training equipment, the addition of a Multifunctional Training System could greatly reduce injuries. Also, due to the limited space in the Medflight Hanger, a Multifunctional Training System would maximize space and exercise options. Full body resistance training can be performed within one complete system. A weighted pulley system decreases the need for a safety spotter,therefore reducing potential injuries. Utilizing this physical fitness equipment will improve job performance, general health and situational awareness; thus decreasing Workers Compensation Claims/Injuries, lost days and the expense associated with these injuries. D) Consequences If this grant is not funded,there will continue to be a risk to personnel and patients each time a flight is taken. With the findings of the injury claims and the fact that almost 30% could have been prevented or minimized through strength training, it would be reasonable to expect that injuries will continue to plague our crews. E) Geographical Area Collier County covers 2,026 square miles and provides care for 350,514 full time residents. At times of peak season, population can increase by an additional 100,000 people (US Census Bureau 2010). With major highways such as 1-75 and US-41 running through Collier County there is increased potential for vehicle accidents that could become large scale incidents. Along with Collier County, Medflight covers the surrounding counties including: Lee, Broward, Hendry, Glades, and Dade. 1 6 E5 F) Proposed Time Frame Upon notification of award, we would obtain a purchase order for the equipment and expect delivery within 60 days. Training would begin immediately upon delivery and continue as new crew members/pilots come on board. G) Data Sources Collier County Government Comprehensive Planning Collier County Risk Management United States Census Bureau. H) Statement Attesting To No Duplication This grant application is not a duplication of a previously applied for grant and CCEMS does not have any other grant projects under this grant program. 1 6 E 5 Next, only complete one of the following: Items 11, 12,or 13. Read all three and then select and complete the one that pertains the most to the preceding Justification Summary. Note that on all three,that before-after differences for emergency victim data are the highest scoring items on the Matching Grants Evaluation Worksheet used by reviewers to evaluate your application form. 11. Outcome For Projects That Provide or Effect Direct Services To Emergency Victims: This may include vehicles, medical and rescue equipment, communications, navigation, dispatch, and all other things that impact upon on-site treatment, rescue, and benefit of emergency victims at the emergency scene. Use no more than two additional one sided, double-spaced pages for your response. Include the following. A) Quantify what the situation has been in the most recent 12 months for which you have data(include the dates). The strongest data will include numbers of deaths and injuries during this time. B) In the 12 months after this project's resources are on-line, estimate what the numbers you provided under the preceding"(A)"should become. C) Justify and explain how you derived the numbers in (A)and (B), above. D) What other outcome of this project do you expect? Be quantitative and explain the derivation of your figures. E) How does this integrate into your agency's five year plan? 12. Outcome For Training Projects: This includes training of all types for the public, first responders, law enforcement personnel, EMS and other healthcare staff. Use no more than two additional one sided, double-spaced pages for your response. Include the following: A) How many people received the training this project proposes in the most recent 12 month time period for which you have data (include the dates). B) How many people do you estimate will successfully complete this training in the 12 months after training begins? C) If this training is designed to have an impact on injuries, deaths, or other emergency victim data, provide the impact data for the 12 months before the training and project what the data should be in the 12 months after the training. D) Explain the derivation of all figures. E) How does this integrate into your agency's five year plan? 13. Outcome For Other Projects: This includes quality assurance, management, administrative, and other. Provide numeric data in your responses, if possible, that bear directly upon the project and emergency victim deaths, injuries, and/or other data. Use no more than two additional one sided, double- spaced pages for your response. Include the following. A) What has the situation been in the most recent 12 months for which you have data(include the dates)? B) What will the situation be in the 12 months after the project services are on-line? C) If this project is designed to have an impact on injuries, deaths, or other emergency victim data, provide the impact data for the 12 months before the project and what the data should be in the 12 months after the project. D) Explain the derivation of all numbers. E) How does this integrate into your agency's five year plan? DH FORM 1767[2013] 3 [ 160 [ 11. Outcome for Projects 1 6 E 5 A) The Most Recent 12 Months During fiscal year 2016 CC EMS responded to 39,698 emergency medical calls of which 28,619 patients were transported to the hospital. In addition, there were 311 EMS flights and 299 patients transported. During this period, seven of our personnel experienced injuries as result of loading/unloading patients. These injuries not only resulted in substantial medical claims and lost days, but also are a detriment to our responders' future health and welfare. 12 Months Following Project The repetitive lifting of a heavy load and its negative effects on the spine is well documented. It is only logical to assume that strength training will have an effect on injury reduction. In addition, this physical training will assist in reducing other injuries that are directly related to the helicopter since we have experienced several injuries over the past several years from crewmembers stepping onto or off of the platform. Strength training and the additional benefits of balance and stability should help to reduce all of these injuries. B) Justification Strength training is an important aspect of many occupations, including the military,for improving fitness and resilience. It is additionally important for first responders and particularly flight crew members,who must not only move heavy loads, but must maintain a high level of situational awareness during traumas that are not only stressful and demanding, but also may occur in highly volatile and dangerous surroundings. C) Other Outcomes Patient safety is another outcome of a healthy and physically fit crew, including their treatment and efficient loading into the helicopter. Speed and efficiency will result in better patient outcomes. 1 6 E5 D) Agency's Five Year Plan Training utilizing a Multifunctional Training System aligns with our agencies 5 year plan because our mission is to provide the best care and safest environment to our employees,residents and those that visit Collier County. The proposed equipment will offer full body strength training and reduce the risks for further injury to our crews and patients. Additionally,we anticipate that a healthier flight crew will inspire other crews to strive for the same level of fitness. 1 6 E5 Skip Item 14 and go to Item 15, unless your project is research and evaluation and you have not completed the preceding Justification Summary and one outcome item. 14. Research and Evaluation Justification Summary, and Outcome: You may use no more than three additional one sided, double spaced pages for this item. A) Justify the need for this project as it relates to EMS. B) Identify (1) location and (2) population to which this research pertains. C) Among population identified in 14(B)above, specify a past time frame, and provide the number of deaths, injuries, or other adverse conditions during this time that you estimate the practical application of this research will reduce (or positive effect that it will increase). D) (1) Provide the expected numeric change when the anticipated findings of this project are placed into practical use. (2) Explain the basis for your estimates. E) State your hypothesis. F) Provide the method and design for this project. G) Attach any questionnaires or involved documents that will be used. H) If human or other living subjects are involved in this research, provide documentation that you will comply with all applicable federal and state laws regarding research subjects. I) Describe how you will collect and analyze the data. ALL APPLICANTS MUST COMPLETE ITEM 15. 15. Statutory Considerations and Criteria: The following are based on s. 401.113(2)(b) and 401.117, F.S. Use no more than one additional double spaced page to complete this item. Write N/A for those things in this section that do not pertain to this project. Respond to all others. Justify that this project will: A) Serve the requirements of the population upon which it will impact. B) Enable emergency vehicles and their staff to conform to state standards established by law or rule of the department. C) Enable the vehicles of your organization to contain at least the minimum equipment and supplies as required by law, rule or regulation of the department. D) Enable the vehicles of your organization to have, at a minimum, a direct communications linkup with the operating base and hospital designated as the primary receiving facility. E) Enable your organization to improve or expand the provision of: 1) EMS services on a county, multi county, or area wide basis. 2) Single EMS provider or coordinated methods of delivering services. 3) Coordination of all EMS communication links,with police, fire, emergency vehicles, and other related services. DH FORM 1767[2013] 4 16E5 15. Statutory Considerations A) Serve the Requirement of the Population This project will provide a higher standard of care for the population of Collier County through the reduction in risk factors associated with lack of strength, flexibility and endurance during job performances. The Multifunctional Training System increases the overall health of the flight crew, reduction in call related stress, thus promoting a well prepared crew physiologically and physically. The training system assists the Flight Crew with personal weight maximum of 215 lbs(helmet, flightsuit, boots)and the ability to lift a 200 lb. patient into the aircraft. Mitigation of these risk factors will enable rescue workers to have longer careers so that their knowledge may be passed down. B) Conform to State Standards This grant will specifically aid CCEMS MedFlight Crews in its goal to reduce the number of on the job injuries and increase efficiency in job performance. C) Minimum Equipment The Multifunctional Training System maximizes space and exercise options. Full body resistance training can be performed within one complete system. Weighted pulley system decreases the need for a safety spotter,therefore, reducing potential injuries. D) Communications n/a E) Enable your Organization to Improve or Expand The Multifunctional Training System will improve the strength of the crew, increase endurance for intense calls with lengthy flight time in an uncontrolled environment (extreme heat and cold) and promote flexibility while working in a confined aircraft with awkward movements. The training system improves crew job performance, general health and situational awareness,thus decreasing workers compensation claims/injuries. 1 6 E5 16. Work activities and time frames: Indicate the major activities for completing the project(use only the space provided). Be reasonable, most projects cannot be completed in less than six months and if it is a communications project, it will take about a year. Also, if you are purchasing certain makes of ambulances, it takes at least nine months for them to be delivered after the bid is let. Work Activity Number of Months After Grant Starts Begin End Procurement 1 2 Delivery/Installation 2 3 Training 3 Continuous 17. County Governments: If this application is being submitted by a county agency, describe in the space below why this request cannot be paid for out of funds awarded under the state EMS county grant program. Include in the explanation why any unspent county grant funds, which are now in your county accounts, cannot be allocated in whole or part for the costs herein. A multifunctional training system would greatly benefit the members of Collier County's Medflight crews. Unfortunately all of the funds awarded under the EMS county grant program were previously committed to other projects. dj1 [ DH FORM 1767[2013] 5 [ 16E5 18. Budget: Salaries and Benefits: For each Costs Justification: Provide a brief justification position title, provide the amount of why each of the positions and the numbers salary per hour, FICA per hour, of hours are necessary for this project. fringe benefits, and the total number of hours. TOTAL: $ 0.00 Right click on 0.00 then left click on "Update Field"to calculate Total Expenses: These are travel costs Costs: List the price Justification: Justify why each of the and the usual, ordinary, and and source(s) of the expense items and quantities are incidental expenditures by an price identified. necessary to this project. agency, such as, commodities and supplies of a consumable nature, excluding expenditures classified as operating capital outlay(see next category). p3 TOTAL: $ 0.00 Right click on 0.00 then left click on "Update Field"to calculate Total DH FORM 1767[2013] 6 { 16E5 Vehicles, equipment,and other Costs: List the price Justification: State why each of the items operating capital outlay means of the item and the and quantities listed is a necessary equipment, fixtures, and other source(s) used to component of this project. tangible personal property of a non identify the price. consumable and non expendable nature, and the normal expected life of which is 1 year or more. 1 Multifunctional Training System 6,999.00.00 This equipment will provide a full exercise regimen to each flightcrew member Rubber tiles 360.00 To be placed under equipment to protect hanger floor Weight Bench 160.00 To utilize pulley system TOTAL: $7,519.00 Right click on 0.00 then left click on "Update Field"to calculate Total State Amount (Check applicable program) Right click on 0.00 then left click on ® Matching: 75 Percent $5,639.00 "Update Field"to calculate Total Right click on 0.00 then left click on ❑ Rural: 90 Percent $0.00 "Update Field"to calculate Total Local Match Amount (Check applicable program) Right click on 0.00 then left click on ® Matching: 25 Percent $1,880.00 "Update Field"to calculate Total Right click on 0.00 then left click on ❑ Rural: 10 Percent $ 0.00 "Update Field"to calculate Total Grand Total Right click on 0.00 then left click on $7519.00 DH FORM 1767[2013] 7 [ 1 E 19. Certification: My signature below certifies thfollowing. I am aware that any omissions, hakaificmtona, nniootat»nnonta, or misrepresentations in this application may disqualify me for this grant and, if funded, may be grounds for termination at a later date. I understand that any information I give may be investigated as allowed by law. I certify that to the best of my knowledge and belief all of the statements contained herein and on any attachments are true, correct, complete, and made in good faith. I agree that any and all information submitted in this application will become a public document pursuant to Section 119.07, F.S. when received by the Florida Bureau of EMS. This includes material which the applicant might consider to be confidential or a trade secret. Any claim of confidentiality is waived by the applicant upon submission of this application pursuant to Section 119.07,F.S., effective after opening by the Florida Bureau of EMS. I accept that in the best interests of the State, the Florida Bureau of EMS reserves the right to reject or revise any and all grant proposals or waive any minor irregularity or technicality in proposals nacaived, and can exercise that right. I, the undersigned, understand and accept that the Notice of Matching Grant Awards will be advertised in the Florida Administrative Weekly, and that 21 days after this advertisement is published I waive any right to challenge or protst the awards pursuant to Chapter 120, F.S. I certify that the cash match will be expended between the beginning and ending dates of the grant and will be used in strict accordance with the content of the application and approved budget for the activities identified. In addition, the budget shall not exceed, the department, approved funds for those activities identified in the notification letter. No funds count towards satisfying this grant if the funds were also used to satisfy a matching requirement of another state grant. All cash, salaries, fringe benefits, expenses, equipment, and other expenses as listed in this application shall be committed and used for the activities approved as a part of this grant. Acceptance of Terms and Conditions: If awarded a grant, I certify that I will comply with all of the above and also accept the attached grant terms and conditions and acknowledge this by signing below. � if .7 Signature o Authoriz Grant Signer MM /DD/YY (Individual |danbf�din Item 2) DHFORM 1707� �O1 8 THE TOP PART OF THE FOLLOWiNG PAGE MUST ALSO BE COMPLETED AND SIGNED, Approved as to form and legality ATTEST:DWIGHT -apK, Clerk -- � ~ ByAssistantCounty.___ _ �� . `�����. «y _41 _ sinnature 16E5 FLORIDA DEPARTMENT OF HEALTH EMS GRANT PROGRAM REQUEST FOR GRANT FUND DISTRIBUTION In accordance with the provisions of Section 401.113(2)(b), 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 E. Tamiami Trl Suite 700 Naples, FL 34112 Federal Identification Number 59-60000558 / Authorized Agency Official: ' ci ij' 4 11, I f'� Signa ure Date Penn. Ta. �ma N.C. ype Name n Title Sign and return this page with your application to: DOH Bureau of Emergency Medical Oversight EMS Section, Grants Unit 4052 Bald Cypress Way, Bin A-22 Tallahassee, Florida 32399-1722 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 State EMS Grant Officer Date State Fiscal Year: 2016 - 2017 Organization Code ED. OCA Object Code Category 64-61-70-30-000 03 SF003 750000 059999 Federal Tax ID: VF Grant Beginning Date: Grant Ending Date: DH FORM 1767P[2013] 9 ATTE-S '.F, d . D IGPft E„ t ?CK Cl+tk Approved as to form and legality Assistant County A ney Attest as o Chairman s signature only. 2