HomeMy WebLinkAboutO-12402J-03-635
07/16/03
1240
ORDINANCE NO.
AN ORDINANCE OF THE MIAMI CITY COMMISSION
ESTABLISHING A NEW SPECIAL REVENUE FUND
ENTITLED: "STATE OF FLORIDA EMERGENCY MEDICAL
SERVICES ("EMS") MATCHING GRANT M3004 AWARD
(FY 2003)," FOR THE IMPLEMENTATION OF A
PUBLIC ACCESS DEFIBRILLATION ("PAD") PROGRAM,
AND APPROPRIATING FUNDS FOR THE OPERATION OF
SAME, IN THE AMOUNT OF $161,989, CONSISTING
OF A GRANT, IN THE AMOUNT OF $121,492, FROM
THE STATE OF FLORIDA DEPARTMENT OF HEALTH,
WITH MATCHING FUNDS, IN THE AMOUNT OF
$40,497, ALLOCATED FROM THE CITY OF MIAMI
OPERATING BUDGET, ACCOUNT CODE
NO. 001000.921002.6.270; AUTHORIZING THE CITY
MANAGER TO ACCEPT THE GRANT AND TO EXECUTE
THE NECESSARY DOCUMENTS, IN A FORM ACCEPTABLE
TO THE CITY ATTORNEY, FOR SAID PURPOSE;
CONTAINING A REPEALER PROVISION, A
SEVERABILITY CLAUSE AND PROVIDING FOR AN
EFFECTIVE DATE.
WHEREAS, the City of Miami has been awarded a grant, in the
amount of $121,492, from the State of Florida, Department of
Health, pursuant to §401.113(2)(b), Florida Statutes, to provide
grants for the improvement, expansion and continuation of
pre -hospital emergency medical services ("EMS"); and
WHEREAS, matching funds from the City of Miami, in the
amount of $40,497, is required as a condition of said grant, and
is available from the City of Miami Operating Budget, Account
Code No. 001000.921002.6.270;
12402
NOW, THEREFORE, BE IT ORDAINED BY THE COMMISSION OF THE CITY OF
MIAMI, FLORIDA:
Section 1. The recitals and findings contained in the
Preamble to this Ordinance are adopted by reference and
incorporated as if fully set forth in this Section.
Section 2. The following Special Revenue Fund is
established and resources are appropriated as described below:
FUND TITLE: "State of Florida Emergency Medical
Services ("EMS") Matching Grant M3004
Award (FY 2003)
RESOURCES: State of Florida Department of Health,
Florida Emergency Medical Services
Grant Program for EMS Organizations $121,492
City of Miami Matching Grant from
Account Code No. 001000.921002.6.270 $40,497
APPROPRIATIONS: $161,989
Section 3. The City Manager is authorized!' to accept
the grant from the State of Florida Department of Health and to
execute the necessary document(s), in a form acceptable to the
City Attorney, for said purpose.
�i The herein authorization is further subject to compliance with
all requirements that may be imposed by the City Attorney,
including but not limited to those prescribed by applicable City
Charter and Code provisions.
Page 2 of 4 1240 `�
Section 4. The City Manager is authorized:' to expend
monies from this Fund for the operation of the Program.
Section 5. All ordinances or parts of ordinances insofar
as they are inconsistent or in conflict with the provisions of
this Ordinance are hereby repealed.
Section 6. If any section, part of section, paragraph,
clause, phrase or word of this Ordinance is declared invalid, the
remaining provisions of this Ordinance shall not be affected.
Section 7. This Ordinance shall become effective thirty
(30) days after final reading and adoption thereof.21
PASSED ON FIRST READING BY TITLE ONLY this
July 2003.
24th day of
zi This Ordinance shall become effective as specified herein unless
vetoed by the Mayor within ten days from the date it was passed
and adopted. If the Mayor vetoes this Ordinance, it shall become
effective immediately upon override of the veto by the City
Commission or upon the effective date stated herein, whichever is
later.
Page 3 of 4
12402
PASSED AND ADOPTED ON SECOND AND FINAL READING BY TITLE ONLY
this 11th day of September , 2003.
ATTEST:
WA; �a
44�L ' A�J��
PRISCILLA A. THOMPSON
rTTY rT.RRK
NESS : l/
Page 4 of 4
A. DI.DIAZ, MAYO.
12402
Second Reading Ordinance
TO Honorable or d
embers f the City Commi i n
Cl-
FROM : J e Arrlola
ief Administrator/City Manager
RECOMMENDATION
DATE
i�
JT_ E 6 20')3 FILE . FM-073.doc
SUBJECT: Establish a Special Revenue Fund
"State of Florida EMS Matching
Grant M3004 Award (FY 2003)"
REFERENCES:
ENCLOSURES:
Ordinance
It is respectfully recommended that the City Commission adopt the attached Ordinance
establishing a new special revenue fund entitled: "State of Florida Emergency Medical Services
(EMS) Matching Grant M3004 Award (FY 2003)" for the implementation of a Public Access
Defibrillation (PAD) program; and appropriating said funds, in the amount of $161,989. The
funds consist of a $121,492 grant apportioned by the State of Florida Department of Health and
$40,497 matching funds from the City of Miami Operating Budget Account Code No.
001000.921002.6.270, for the period beginning April 21, 2003 through May 4, 2004.
BACKGROUND
The State of Florida Department of Health is authorized by Chapter 401, Part I1, Florida Statutes,
to provide grants to Emergency Medical Services (EMS) Organizations to improve and expand
pre -hospital emergency medical services system.
The State of Florida Department of Health awarded a grant to the City of Miami entitled, "EMS
Matching Grant M3004", in the amount of $121,492, to be apportioned to initiate a Public
Access Defibrillation (PAD) program for the Department of Fire -Rescue and citywide as
specified in the Grant applications. Specifically, the City of Miami will use these funds along
with the matching funds allocated by the City of Miami for $40,497 as stipulated by the grant, for
the purchase of automatic external defibrillators (AED's) citywide, and training of City of Miami
civilian employees.
It is now appropriate to accept said grant award, establish a special revenue fund, and appropriate
the said grant award therein for this fiscal year. ¢ .
JA/WWBIMLK/TF/jam
Fiscal Impact: None.
FM.073.doc 12402
1. Department Fire -Rescue
2. Agenda Item # (if available)
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3
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Budgetary Impact Analysis
Division Emergency Response Division
Title and brief description of legislation or attach ordinance/resolution:
This ordinance establishes a special revenue fund entitled: " State of Florida Emergency Medical
Services (EMS) Matching Grant M3004 Award (FY 2003)" for the implementation of a Public
Access Defibrillation (PAD) program; and appropriating_ said funds in the amount of $161,989. The
funds consist of a $121,492 grant from the State of Florida Department of Health, and matching funds
in the amount of $40,497 to be provided by the City of Miami.
4. Is this item related to revenue? NO: YES X (If yes, skip to item #7.)
5. Are there sufficient funds in Line Item?
YES: X Index Code 921002 Minor Obj. Code 270 Amount $40,497 (Matching Funds)
NO: _ Complete the following questions.-
6.
uestions:6. Source of funds: Amount budgeted in the Line Item $
Balance in Line Item $
Amount needed in the Line Item $
Sufficient funds will be transferred from the following line items:
ACTION ACCOUNT NUMBER
ACCOUNT NAME TOTAL
Index/Minor Object/Project No.
Transfer done by: (Not
applicable)
From
$
From
$
From
$
To
$
7. Any additional comments?
The City of Miami Department of Fire -Rescue will use these funds as stipulated by the grant, for the
purchase of automatic external defibrillators (AED's) citywide and training of City of Miami civilian
8. Approved:
i l_/
Department Direetor/Designee
Date At
FOR DEPARTMENT OF MANAGEMENT AND BUDGET USE ONLY
Acknowled d y:
Acknowledged by:
Transfer done by: (Not
applicable)
Chief 6YStrAe is la ng, udgeting, and
Performarnc_e cto /Designee
Date t� 6�
Budget Analyst
Date
Budget Analyst
Date
RHE: fA!L:T1
April 21, 2003
Mr. Carlos Gimenez, City Manager
City of Miami
3500 Pan American Drive
Miami, FL 33133
Dear Mr. Gimenez:
It gives me great pleasure to hereby award your organization an emergency medical services
matching grant M3004 in the amount of $121,492.00, which is 75% of the total project costs
approved by the Florida Department of Health as prescribed in section 401.113 Florida Statutes.
The grant is 75% state funds, and 25% matching funds, which must be provided by the
applicant. Your required cash match for this grant is $40,497.00. The purpose of this matching
grant is to support the pre -hospital activities and other emergency medical services items
specified in your application and any revisions, which are on file with the Department's Bureau
of Emergency Medical Services.
You acknowledge acceptance of the grant teras and conditions when you draw or otherwise
obtain funds from the grant payment system. Your signed grant application acknowledges you
have read, understood and will comply with all terms and conditions of the approved grant and
departmental rules. You may place these funds in any type of bank account you choose;
however, any interest earned on these funds must be returned to the department.
By separate letter, the Bureau of Emergency Medical Services will provide you and the
individual identified as the contact person in your application, a copy of the approved grant
budget, a list of any special grant conditions and the due dates of the required grant reports.
This matching grant begins on the date of this letter and will end May 4, 2004. Failure to submit
the required reports by the due dates may irroact any future grant applications submitted by
your organization.
Thank you for your continued support and involvement in improving and expanding the Florida
pre -hospital emergency medical services system.
JOA/gct
cc: Juan R. Mestas
Sincerely,
John O. Agwunobi, M.D., M.B.A.
Secretary, Department of Health
405_2 saili ('tTrocc \.Lo., . T). 11..L____ - n -__ -
J2 V 6
10044,1,5 �kmlbi
HEAL
FLORIDA DEPARTMENT OF HEALTH
BUREAU OF EMERGENCY MEDICAL SERVICES
EMS MATCHING GRANT PROGRAM
APPLICATION PACKET
Revised: June 2002 12 40
TABLE OF CONTENTS
Introduction
Eligibility
Application
Request for Grant Fund Distribution
EMS Grant Program Change Request
EMS Grant Program Expenditure Report
Matching Grants Evaluation Worksheet
Financial and Compliance Audit Requirements
State Funded
Conditions Applicable to For -Profit Organizations
Section 215.97 F. S.
Submission of Audit Reports
Records Retention
Disallowed Expenditures
Vehicles and Equipment
Transfer of Property
Requests for Change
Early Ending Date
Supplanting Funds
Deposit of Funds
Reports
Grant Signature
Records
Final Reports
Communications Equipment
Expenditures
Credit Statement
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THIS DOCUMENT CONTAINS THE EMS GRANT PROGRAM APPLICATION, GUIDELINES
AND GRANT EVALUATION WORKSHEET REFERRED TO IN CHAPTER 64E-2, FLORIDA
ADMINISTRATIVE CODE (F.A.C.). THIS APPLICATION IS TO BE USED FOR BOTH THE
RURAL AND MATCHING GRANT PROGRAMS
INTRODUCTION
This grant program provides emergency medical services providers, first responder
organizations, and other emergency medical service related organizations with funds for
projects to acquire, repair, improve, or upgrade emergency medical services systems, or
equipment.
To apply for an EMS Matching Grant, an applicant must meet specific eligibility requirements:
Applicants certify that they meet all requirements in this application and guidelines when they
sign and submit the application to the Bureau of Emergency Medical Services.
You may submit any number of applications, and there is no limit on the amount of funds you
may request for each application. Do not place more than one project in one application.
However, do not fragment a request into more than one application if the activities are related.
For example, a request for an ambulance, with medical equipment and radios for the
ambulance, should all be in one application. However, a communication base station and
dispatch equipment or training should not be included with the request for funding to purchase
an ambulance.
ELIGIBILITY
WHO IS ELIGIBLE:
To be eligible for funding under the Rural and Matching Grant Programs, an applicant must
meet the following criteria:
1. Eligible rural counties are defined in section 401.107(5), Florida Statutes, (F.S.) as "a
county with a total population of 100, 000 or fewer people and density of less than 100
people per square mile."
2. Only boards of county commissioners and emergency medical services organizations
determined by statute to be rural are eligible for rural grants.
3. Rural emergency medical service providers may also apply for funding from the matching
grant program (75% state 25% local matching funds).
4. Emergency medical services providers, first responders and other EMS related
organizations are eligible for the matching grant program.
WHAT IS ELIGIBLE:
1. The matching grant funds must be used for the improvement, and expansion of
emergency medical services. Rural matching grant funds may be used to maintain
services.
2. The grant funds must be used for one, or more of the activities outlined in section
401.113(2)(b), F.S.
MANDATORY CRITERIA REVIEW:
Applications shall be reviewed to determine that the applicant meets the following criteria
applicable to the type grant submitted:
1. The grant applicant organization shall be based in a rural county if applying for 90%
funding.
2. The applicant has received a letter endorsing the grant application from their Board of
County Commissioners or the local EMS provider if not a licensed EMS provider.
3. The application is complete and signed.
4. The applicant demonstrates the grant will be used to reduce morbidity and mortality in the
identified service area in an efficient and effective manner.
5. First responder organizations must attach a copy of the memorandum of understanding
(MOU) with a licensed emergency medical services provider. If there is no MOU, then
documentation must be attached to the application that demonstrates the applicant has
made a reasonable effort to obtain one or that the applicant did not receive a response
from the providers in the area of operation.
6. If a Private Not -For -Profit organization, a copy -of IRS 501 (c)(3) letter or other legal
documentation of this status must be attached to the application.
7. The application may not exceed the number of pages listed in the application packet.
Letters of support will not be counted as pages, but may be submitted.
8. The following application form, a facsimile of it or an electronic copy shall be used.
However, the content of the form shall be identical to the copy received from the Bureau or
from its web page. The applicant shall comply with all the instructions provided by the
Bureau.
EMS MATCHING GRANT APPLICATION
FLORIDA DEPARTMENT OF HEALTH
Bureau of Emergency Medical Services
Complete all items unless instructed differently within the application
Type of Grant Requested: ❑ Rural . X Matching
ID. Code (The State Bureau of EMS will assian the ID Code — leave this blank) -1
1. Or anization Name: City of Miami
2. Grant Signer: (The applicant signatory who has authority to sign contracts, grants, and other legal
documents. This individual must also sign this application)
Name: Carlos Gimenez
Position Title: City Manager
Address: 3500 Pan American Drive
L _
City: Miami County: Dade
State: Florida Zip Code: 33133
Telephone: 305 250-5400 Fax Number: (305)250-5410
E -Mail Address: c imenez ci.miami.fl.us
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.)
I
Name: Juan R. Mestas i
I
i
Position Title: Battalion Chief
i Address: 444 S.W. 2" Ave.
—City: Miami I County: Dade s
State.- Florida I Zip Code: 33130
Telephone: (305) 495-1749 Fax Number: 305 416-1680
E-mail Address: 'rmestas ci.miami.fl.us or 'rmesta01msn.com
DH Form 1767, Rev. June 1,002
3
162402
! Jia:US cl ,�,ociicani (�,nec,< Or,,,/ ore -esOcrse
(1) ❑ Private Not for Profit (Attach documentation-501 (3) C]
(2) ❑ Private For Profit
(3) X City/Municipality/Town/Village
(4) ❑ County
(5) ❑ State
(6) ❑ Other (specify):
5. Federal Tax ID Number (Nine Digit Number). VF 5 9 6 0 0 0-3 7 5
6. EMS License Number. 2276 Type: X Transport ❑Non -transport ❑Both
7. Number of permitted vehicles by type: BLS 37 ALS Transport 1 ALS non -transport.
8. Type of Service (check one): ❑Rescue X Fire ❑Third Service (County or City Government,
nonfire) ❑Air ambulance: []Fixed wing ❑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:
Print/Type: Name of Director Kathleen Schrank
ME 39896
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 eaui:oment and/or continuing EMS education.
Lf 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)
ow);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 d�ographic area);
F) The proposed time frames (Provide a list of the time frame(s) for completing this pFoject);
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_ Rev 2002
4
11). Justification Sumrn-in
A) In the twenty Cite of Miami buildings slated for AED placement. a total of 486
emergencies occurred in Fiscal Year 2001/2002, which required EMS services.
A prime example is the City of Miami's main administration building, which houses the
office of the Mayor, City Manager, Public Works, Fire Department, etc. It receives an
average 450 visitors per day, adding up to 2,250 visits per week, making a grand total of
117,000 visitors per year. Additionally, the City employs 4,092 people.
Only yesterday, on December 18. 2002, a worker was electrocuted inside this main
building. The worker accidentally came across high voltage wires while working in an
electrical room. Fortunately one of our own Miami Fire Department Inspectors made his
way to the victim and gave CPR until Advanced Life Support units arrived. The victim
was successfully resuscitated, largely thanks to the proximity, willingness and CPR skills
of the inspector to give unprotected CPR. An AED, along with the respiratory
resuscitation equipment applied for in this grant, would have allowed the victim a quicker
lifesaving response and would have offered protection against exposure to the inspector.
The number of civilian employees and civilian visitors in our City buildings is versus Fire
Rescue personnel is disproportionately high, therefore increasing chances for a person
lacking CPR skills being first on the scene. `:
The American Heart Association notes that for every minute that defibrillation is delayed.
the chances for survival decrease by 10 percent. The implementation of this Public
Access Defibrillation (PAD) program can place Automatic External Defibrillators
12402
(AED's) within three minutes of a patient in cardiac arrest. This program will
Sometimes, all the data about the number of alarms and the efficacy of PAD programs
can be no better than a real, human story. This headline and article appeared as recently
as Monday, December 16, 2002 in The Miami Herald.
Heart Device Saves Man at Port
Lambert and Ruth Ayres were supposed to depart for a long awaited cruise Sunday. Instead, they were in
the emergency room at Broward General Medical center after 79 year-old Lambert had a heart attack in a
Port Everglades terminal. Everything turned out well, though. An external defibrillator, a set of which
the county had installed in the terminals just a few.months before, was used to shock Ayres' heart
back into its regular rhythm about 1230 p.m. Sunday. Another fortunate turn of events: Three fellow
passengers waiting in the terminal just happened to be .doctors. Though the Ayres of Lewes, Del,. were sad
about missing the cruise to the Caribbean, they were thankful that Lambert was alive. The Defibrillator
"saved his life," said Ruth Ayres 75. Emergency room physician Matt Ferenc said the outcome could
have been much worse, if the defibrillator had not been used so quickly.
B) Our greatest interaction with the public often occurs at our City of Miami
facilities. EMS crews currently respond from the nearest Fire Station. Because of distance
and difficulty of access to the patient at these large, sometimes multi -story- buildings,
chances for a successful defibrillation are severely compromised, therefore, ,ve lose
valuable time and/or an experienced civilian attempts at CPR which in some cases,
perform more harm than good.
C) This project calls for placing AED's in twenty City of Miami buildings. The
realization of a PAD program and deployment of AED's coupled with Trained personnel
comprised of either security guards, or easily assembled "Rapid Response "teams" made
up of volunteer City of Miami employees would respond to calls of "person down" .
These teams would be trained to give CPR and administer defibrillaton shocks in the
shortest time possible, thereby improving final outcomes for visitors and employees and
outside workers. 6 y'.
,i,,n the l:%' o' `Iia;-cii
current form. Defibrillation would not be available until EMS crews arrived.
E) The City of Miami is comprised of approximately 34.5 square miles and contains a
series of public buildings including but not limited City Hall, Police, and 13
Neighborhood Enhancement Teams (NET) offices. With the many different cultures that
this diverse City has, it's unrealistic to assume that everyone in our City buildings has
even minimal CPR skills. This AED program implements simple techniques that anyone
can use.
F) Program implementation is planned for four phases:
Phase 1: Receive award: submit to City Commission for Grant approval
(3 months)
Phase II: Research and purchase AED (? months)
Phase III: Train responders (3 months)
Phase IV: Position AED's (1 month)
G) Data Sources:
The Miami Herald
American Heart Association Website
a
City of Miami MIS (Management Information Systems)
H) Currently. buildings in the City of Miami have no AED's installed in any public
facilities, therefore this is not a duplicated effort.
! 12402
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 precedin Justification Summary.
11. Outcome For Proiects That Provide or Effect Direct Services To Emergency Victims: This may
ude vehicles, medical and rescue equipment, communication
incls, 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 Proiects: 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) Explain the derivation of all numbers.
D) How does this integrate into your agency's five year plan?
DH Form 1767. Rev. 2002
i•1
/A 0
1 Outcome For Projects That Provide or Effect Direct Ser -,ices To Emerzenc" Victims
A) This project calls for placing AED's in twenty City of Miami buildings. Our greatest
interaction with the public often occurs at our City facilities. EMS crews currently respond from
the nearest Fire Station. Because of distance and difficulty of access to the patient at these large,
sometimes multi -story buildings, chances for a successful defibrillation are severely
compromised.
In the twenty City of Miami buildings slated for AED placement, a total of 486 emergencies
occurred in Fiscal Year 2001/2002 which required EMS services.
A prime example is the Miami Riverside Center (MRC) which houses the office of the Mayor,
City Manager, Public Works. Fire Department, etc. The MRC receives an average of 450 visitors
per day, adding up to 2,250 visits per week, making a grand total of 117,000 visitors per year.
Additionally, the City employs 4,092 people.
A specific situation occurred as recently as, on December 18 2002, where a worker was
electrocuted inside the MRC. The worker accidentally came across high voltage wires while
working in an electrical room. Fortunately a Miami Fire Department inspector made his way to
the victim and gave CPR until Advanced Life Support units arrived. The victim was
successfully resuscitated, largely thanks to the proximity and willingness of the inspector to give
unprotected CPR. An AED along with the respiratory resuscitation equipment applied for in this
grant would have been given the victim more immediate lifesaving aid. The security guard that
was first on the scene would have been trained to summon help, give CPR and early
defibrillation. Additionally, the respiratory equipment would have offered protection against
exposure and improved ventilatory assistance.
EMS response to the City's 34.5 square miles is dispatched from 12 fire stations distributed
throughout the City. The American Heart Association speaks of a Chain of Survival that begins
LL)eni:a ped ! sz t:.
and caria defibrillation. and ultimat,-l} transfer to advanced care. The nussin�, link is access W
early defibrillation through a Public Access Defibrillation (PAD) program.
Most sudden cardiac arrest victims are in ventricular fibrillation (VF). VF is an abnormal,
chaotic heart rhythm that prevents the heart from pumping blood. VF causes more cardiac
arrests than any other rhythm. (about 80% to 90% of cases). You must defibrillate a
victim immediately to stop VF and allow a normal heart rhythm to resume. The sooner
you provide defibrillation with. the AED, the better the victim's chances of survival. If
you provide defibrillation within the first 5 minutes of a cardiac arrest, the odds are about
50% that you can save the victim's life. But with each passing minute during a cardiac
arrest, the chance of successful resuscitation is reduced by 7% to 10%. After 10 minutes
there is very little chance of successful rescue �.
American Heart Association Website
B) Once implemented, four hundred and eighty six (486) EMS calls would have had access to
early defibrillation.
C) City of Miami Management Information Systems (MIS) FY 2001-2002.
American Heart Association website
D) As part of the program. approximately 200 personnel (City of Miami employees and private
service contractor security guards) will be trained in CPR, minor first aid and the use of AED's
at each facility. Training a minimum of ten people per facility will allow a minimum of two
R
people available to form Rapid Response Teams (RRT) at any time.
E) There are currently no plans to put any AED's in place in any public building within city
limits.
J-24 4 0 '�
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.
1) Describe how you will collect and analyze the data.
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.
orm
6
1.2,402
1 5. Statutory Considerations and Criteria
A) The number of civilian employees and civilian visitors in our City buildin:s is versus
Fire Rescue personnel is disproportionately high, therefore increasing chances for a
person lacking CPR skills being first on the scene. .
The American Heart Association notes that for every minute that defibrillation is
delayed, the chances for survival decrease by 10 percent. The implementation of this
Public Access Defibrillation (PAD) program can place Automatic External Defibrillators
(AED's) within three minutes of a patient in cardiac arrest. This program will
dramatically increase service to both visitors and workers who may otherwise succumb
to cardiac arrest while in City buildings.
B) N/A
C) N/A
D) NI/A
E) ENIS response to the City's 3-1.5 square miles is dispatched from 12 fire stations
distributed throughout the City. The American Heart Association speaks of a Chain of
Survival that begins with recognition of the emergency, followed by enhanced 911
services and continues with CPR and early defibrillation, and ultimately transfer to
advanced care. The missing link is access to early defibrillation through a Public Access
Defibrillation (PAD) program
12402
15 ` i -.rt active:=s ara time ar-es ^�;ca'e major activices ar ccrnpler^_ .-e fro;a:t; -a riy ,7e -
^ter= nrnvirlorl vQ� r��cnn�nip rt'1(`S'-'7�(11Pr'!c rannnt !Hnn cv mnnthc and i; i, c
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
B in . End
Receipt of award to commission approval
First month Third month
Purchase AED's
Third month Fifth month
Train users
Fifth month Eighth month
Placement of AED's
Eighth month Ninth month
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.
The entire City of Miami Grant allocation from Miami -Dade County Grants is being used for the
following:
EMS equipment
EMS Travel
Public Education
Any funds taken from the aforementioned projects would mean discontinuing those projects.
DH Form 1767, Rev. 2002
7 162462
_ _3 SudGet:
Salaries and Benefits: For eac; 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.
Salary and benefits for four
$26,540
Train a "Rapid Response" teams at each
Miami Fire Department
site in CPR/First Aid and the use of an
Instructors, two will be teaching
AED. Ten hours CPR/First Aid and 2
at a time at 350.00 per hour, $ 0
hours AED use. Total of 240 hours times
FICA, $5.50 per hour fringe
two instructors for a total of 480 hours
benefits for a total of 480 hours
Salary and benefits for a Miami
$42,292 salary
Need to have an overall project leader.
Fire Department Lieutenant to
$16,917 fringe
implement the grant project and
administer the grant for six
months.
TOTAL:
$85,749
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).
Travel to each site using a Fire
$160.00
Two six hour classes will be given at
Department Vehicle at $.40 per
each site. One for CPR/First Aid, and
mile. Average round trip 10
one for AED use.
miles. Forty classes/200 miles.
One hour travel, one-hour setup,
$4,440
Minimum of one-hour setup and
before each class. One-hour
takedown for CPR mannequin, AED use -
takedown, one-hour travel after
and class setup.
each class.
Total of 80 hours as outlined
above for personnel costs.
TOTAL:
1 $4,600
DH Form 1767. Rev. 2002
8 124(12
Vehicles, equipment. and other Costs: ist the price of Justification: S.Gte y eac^ of the
operating capital outlay means the item and the and quantities iisted is a necessary
...,,e.,t fi-+ , n i nthar cntirra(c1 ttcnri to^mn nt ni thio nrniart
i 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.
Twenty (20) Physio Control
$63,940 total .
One AED for each site
Lifepak 500 AED's, with Wall
AED Superstore
Mounted Rescue Station
www.aedsuperstore.com
Cabinets with Alarm
$3,197 each
Five Year Life Expectancy (five
year manufacturer's warranty)
Twenty (20) Oxygen Supply Kit
$7,700 total
One Oxygen Supply Kit for each site
$385 each
AED Superstore
www.aedsuperstore.com
One Laptop Computer
$3,000
Trained personnel database
administration
TOTAL:
$71,640
State Amount
(Check applicable program)
X Matching: 75 Percent
$ 121,492
❑ Rural: g0 Percent
Local Match Amount
(Check applicable program)
X Matching: 25 Percent
$ 40.497
❑ Rural: 10 Percent
j $.161,989
Grand Total II
DH Form 1767 Rev 2062
9
12402
-3. Cartification:
Py signature below certifies the following.
I am aware that any omissions, falsifications, misstatements, 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 1 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 received, 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 protest 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
rant 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
rant.
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.
Carlos Gimenez
Signature of Authorized Grant Signer MM / DD / YY
(Individual Identified in Item 2)
DH Form 1767, Rev. June 2002
10
_�, 402
FLORIDA DEPARTMENT Or 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 or continuation of
pre -hospital EMS.
Name of Agency: City of Miami
Mailing Address: 3500 Pan America Drive
Miami, FL 33176
Federal Identification Number VF 5 9 6 0 0 0 3 7 5
Authorized Agency Official:
Signature Date
Carlos Gimenez, City Manager
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 Emen
Grant Amount For State To Pay: $
Medical Services personnel on
Grant ID Code:
Approved By:
Signature of EMS Grant Officer
State Fiscal Year: -
Organization Code E.Q.. OCA Obiect Code
64-25-60-00-000 N N2000 7
Federal Tax ID: VF_ _ _ _ _ _ _ _ _
Grant Beginning Date:
DH Form 1767P, Rev. June 2002
Grant Ending Date:
11
Date
12402
Department of Health
EMS GRANT PROGRAM CHANGE REQUEST
Name of Grantee:
Grant ID Code:
BUDGET LINE ITEM
CHANGE FROM
CHANGE TO
TOTAL
$
$
Justification For Change:
Signature of Authorized Official Date
For department use only
Approved Yes F-1 No E] Change No:
Department's Authorized Representative
DH Form 1684C, Rev. June 2002
12
Date
_ x:1)2
Department of Health
EMS GRANT PROGRAM EXPENDITURE REPORT
Name of Grantee:
Time Period Covered: Beginning Date:
Earned Interest: Amount $ ; as of
Grant ID Code:
Ending Date:
Day Month Year
Major Line Items
TOTAL
Approved Budget Expenditure by Major Line Item(s)
$
TOTAL BUDGETED EXPENDITURES
$
Actual Expenditure to Date by Major Line Item(s) I $
TOTAL EXPENDITURES I $
BALANCE (Budgeted Less Actual Expenditures) $
Include with the progress notes an explanation of how project personnel, equipment, and any problems or barriers
may impact on me grant progress.
I certify the above reports are true and correct. Expenditures were made only for items allowed by
the above referenced grant.
A
nature of Authorized Official
DH Form 1684A, Rev. June 2002
13
Date
.12402
MATCHING GRANTS EVALUATION WORKSHEET
INSTRUCTIONS FOR 75/25 PERCENT STATE EMS MATCHING GRANTS:
The scores will always be 0, 1, or 2. Unless specified otherwise within the form: 2 = the answer
of the applicant is complete with no more than one fact omitted; 1 = more than one fact omitted
but there is at least one fact present; and 0 = there is no useful information. Fractional scores
between 0 and 2 may also be used (e.g. .5, 1.25, 1.5, etc.), but none greater than 2.
In order to place the total on a scale of 100, the total for each section is adjusted or multiplied
by .69444. Adjusted scores of 55 or above will automatically be eligible for funding. The scores
on the following evaluation sections show the maximum scores for each item and section. Note
that the maximum score of 100 derives from adding the maximum totals of 11.11 and 88.89 in
the two sections shown following.
Justification Summary: On no more than three one sided double spaced pages, provide a summary
addressing this project for each topic listed below.
Item
Score
Weight.
Total
Team Comments
A) Problem description (Provide
2
1
2
a narrative of the problem or
need and the population
impacted).
B) Present situation (Describe
2
1
2
how the situation is being
handled now).
C) The proposed solution
2
1
2
Present your proposed solution).
D) Consequences if not funded
2
1
2
(Explain what will happen if this
project is not funded).
E) The geographic area to be
2
1
2
addressed (Provide a narrative
description of the geographic
area).
F) The proposed time frames,
2
1
2
(Provide a list of the time
frame(s) for completing this
project).
G) Data Sources (Provide a
2
1
2
complete description of data
sourcesyou cite).
H) Statement attesting that the
2
1
2
proposal is not a duplication of a
previous effort. (State this
project doesn't duplicate what
you've done on other grant
projects under this grant
program).
TOTAL
XXX
XXX
16
ADJ. TIMES .69444
XXX
XXX
11.11
DH Form 1767G, Rev. June 2002 14
Outcome For Proiects 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 doubles aced a es for your response. include the following:
Item
Score
Weight
Total
Team Comments
A) Quantify what the situation
2
3
6
the training this project proposes
has been in the most recent 12
in the most recent 12 month time
months for which you have data
period for which you have data
(include the dates). The
include the dates).
strongest data will include
B) How many people do you
numbers of deaths and injuries
3
6
estimate will successfully
during this time.
complete this training in the 12
B) In the 12 months after this
2
3
6
months after training begins?
project's resources are on-line,
Before and After Difference
estimate what the numbers you
13
26
`
C) If this training is designed to
provided under the preceding
40
80
have an impact on injuries,
"(A)" should become.
deaths, or other emergency
C) Justify and explain how you
2
5
10
victim data, provide the impact
derived the numbers in (A) and
data for the 12 months before the
(B), above.
project and what the data should
lefore and After Difference
2
50
100
be in the 12 months after the
D) What other outcome of this
2
31
6
,training.
project do you expect? Be
D) Explain the derivation of all
quantitative and explain the
5
10
derivation of your figures.
SUBTOTAL
I XXX
I XXX
128
Multiply subtotal if the data and information have high
documentation and credibility by 1; .5 for doubtful
credibility; and .1 for low credibility. Any decimals
between .1 and 1 may also be used for judgments that
fall between the decimals cited. The result is the new
subtotal. Write the multiplication figure used
128
ADJ. TIMES .69444 J XXX XXX
1 88.89
Outcome For Training Projects: This includes all 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
doubles aced pages for your res nse. Include the followin :
Item
Score
Wei ht
Total
Team Comments
A) How many people received
2
3
6
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
2
3
6
estimate will successfully
complete this training in the 12
months after training begins?
Before and After Difference
2
13
26
`
C) If this training is designed to
2
40
80
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
,training.
D) Explain the derivation of all
2
5
10
DH Form 1767G, Rev. June 2002 15 ��
12
figures.
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:
Item
SUBTOTAL
XXX
XXX
128
A) What has the situation been
Multiply subtotal if the data and information have high
3
6
documentation and credibility by 1; .5 for doubtful
in the most recent 12 months
credibility; and .1 for low credibility. Any decimals
B) Identify (1) location and (2)
between .1 and 1 may also be used for judgments that
2
4
fall between the decimals cited. The result is the new
population to which this
the dates)?
subtotal. Write the multiplication figure used
128
ADJ. TIMES .69444 XXX
XXX 1
88.89
3-
GRAND TOTAL ALL ITEMS XXX
XXX 1
100.0 1
XXXXXXXXXXXXXXXXXXXX
Outcome For Other Projects: This includes quality assurance, management, administrative, and others.
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:
Item
Score
Weight
Total
Team Comments
A) What has the situation been
2
3
6
project as it relates to EMS.
in the most recent 12 months
B) Identify (1) location and (2)
for which you have data (include
2
4
population to which this
the dates)?
research pertains.
B) What will the situation be in
2
3-
6
C) Among population identified
the 12 months after the project
5
10
in 14(B) of the application,
services are on-line?
specify a past time frame, and
Before and After Difference
2
13
26
provide the number of deaths,
C) If this project is designed to
2
40
80
injuries, or other adverse
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
2
5
10
figures.
SUBTOTAL
XXX
XXX
128
Multiply subtotal if the data and information have high
documentation and credibility by 1; .5 for doubtful
credibility; and .1 for low credibility. Any decimals
between .1 and 1 may also be used for judgments that
fall between the decimals cited. The result is the new
subtotal. Write the multiplication figure used
128
ADJ. TIMES .69444 XXX XXX
88.89
GRAND TOTAL ALL ITEMS XXX XXX
100.0 1
XXXXXXXXXXXXXXXXXXXXXX
Research and Evaluation Justification
Sum
arv, and Outcome
Item
Score
Weight
Total
Team Comments
A) Justify the need for this
2
4
8
-.
project as it relates to EMS.
B) Identify (1) location and (2)
2
2
4
population to which this
research pertains.
C) Among population identified
2
5
10
in 14(B) of the application,
specify a past time frame, and
provide the number of deaths,
injuries, or other adverse
DH Form 1767G, Rev. June 2002 16
2402
conditions during this time that
401.117, F.S.
Item
Score
Weight
you estimate the practical
Team Comments
A) Serve the requirements of
2
1
application of this research will
the population upon which
reduce (or positive effect that it
project will impact.
will increase).
B) Enable emergency vehicles
2
1
D) (1) Provide the expected
2
50
86
numeric change when the
state standards established by
anticipated findings of this
law or rule of the department.
project are placed into practical
C) Enable the vehicles of your
2
1
use.
organization to contain at least
D) (2) Explain the basis for
2
8
16
our estimates.
_
supplies as required by law, rule
E State your hypothesis.
2
2
4
F) Provide the method and
2
2
4
1
design for this project.
organization to have, at a
G) Attach any questionnaires or
2
2
4
involved documents that will be
communications linkup with the
used.
operating base and hospital
H) If human or other living
2
2
4
subjects are involved in this
research, provide
documentation that you will
comply with all applicable
federal and state laws regarding
research subjects.
1) Describe how you will collect
2
2
4
and analyze the data.
SUBTOTAL
I XXX
XXX
144
Multiply subtotal if the data and information have high
documentation and credibility by 1; .5 for doubtful
credibility; and .1 for low credibility. Any decimals
between .1 and 1 may also be used for judgments that
fall between the decimals cited. The result is the new
subtotal. Write the multiplication figure used
144
ADJ. TIMES .69444 XXX XXX
100
Bonus Points for Statutory Considerations and Criteria: The following are based on s. 401.113(2)(b) and
401.117, F.S.
Item
Score
Weight
Total
Team Comments
A) Serve the requirements of
2
1
2
the population upon which
project will impact.
B) Enable emergency vehicles
2
1
2
and their staff to conform to
state standards established by
law or rule of the department.
C) Enable the vehicles of your
2
1
2
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
2
1
2
organization to have, at a
minimum, a direct
communications linkup with the
operating base and hospital
designated as the primary
DH Form 1767G, Rev. June 2002 17 12402
receiving facility
E) Enable your organization to
2
1
2
improve or expand the provision
of:
1) EMS services on a county,
multi county, or area wide basis.
Single EMS provider or
coordinated methods of
delivering services.
2) Coordination of all EMS
communication links, with
police, fire, emergency vehicles,
and other related services.
SUBTOTAL
XXX
XXX
10
INSTRUCTIONS FOR 90/10 PERCENT STATE EMS RURAL MATCHING GRANTS:
Applicant Information
1. Explain the problem.
2. Explain why the resources you are requesting will resolve the problem.
Evaluation of the Application
The likelihood, based upon the information provided by the applicant, in the next 12 months the
lives and health of the population being served will be adversely affected without the requested
resources. Scores between 0 and 5 may also be used (e.g. .5, 1.25, 2.0, 2.5, 3.5, 4, 4.5, etc.),
but none greater than 5.
5 High
3 Medium
1 Low
0 Not sufficiently established in the information provided
Explanation for assigned score.
Note: if there are tie scores among applications and it affects whether or not which ones will be
offered funding, the following priorities will prevail among the affected tie scores:
1. Medical equipment used at emergency scenes.
2. Rescue equipment used at emergency scenes.
3. Injury prevention.
4. Communications equipment.
5. EMS staff training.
DH Form 1767G, Rev. June 2002 18
�)441 J 2
FINANCIAL AND COMPLIANCE AUDIT REQUIREMENTS
This section is applicable to all grantees. An audit, performed in accordance with Section
215.97, F.S., performed by the Auditor General shall satisfy the requirement of this attachment.
STATE FUNDED
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. All
questioned costs and liabilities due to the department shall be fully disclosed in the audit report
with reference to the department grant involved.
CONDITIONS APPLICABLE TO FOR-PROFIT
ORGANIZATIONS
The method of payment to for-profit organizations is cost reimbursement. For-profit
organizations shall request reimbursement as follows:
1. Submit reimbursement requests to the department accompanied by signed invoices and
copies of both sides of the payment checks. If the grantee doesn't regularly receive
copies of checks from its financial institution., the department may accept other
documentation evidencing payment.
The invoices must clearly indicate the service or product delivered, date delivered, date
paid, item cost, total cost, and the person receiving the service or product.
2. A copy of the approved budget must be in the reimbursement material. The grantee
must show which item in the budget corresponds to each item in the reimbursement
form. Every item on the reimbursement form must be identical to or clearly included
under the approved budget items.
3. The grantee shall submit invoices for personnel services and fees q a time/rate basis.
The invoices must identify each individual by name, state the services provided, the time
period covered by the invoice, and the hourly rate and number of hours worked for each
individual. Appropriate time sheets or time logs must accompany the invoice.
4. The grantee must submit a final invoice for payment to the department within 40 days
after the grant ends or is terminated. If the grantee fails to comply and does not obtain
a written waiver from the department, all rights to payment are forfeited.
19
124062
SECTION 215.97 F. S.
(GRANTS AND AIDS APPROPRIATION)
If the grantee receives funds from a grants and aids appropriation, the grantee 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. Department of Health
Office of the Inspector General
4025 Bald Cypress Way, Bin A03
Tallahassee, Florida 32399-0704
B. Department of Health
Bureau of Emergency Medical Services
Matching Grant Manager
4025 Bald Cypress Way, Bin C18
Tallahassee, Florida 32399-1735
C. Submit to this address only those audits performed or attestation statements
prepared in accordance with Section 215:97, F. S.:
Office of the Auditor General
Post Office Box 1735
Tallahassee, Florida 32302
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.
20 12 1 �
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 grant expenditure shall be returned to the department by the grantee
within 40 days after the department's notification. The costs of disallowed items are the
responsibility of the grantee.
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, June 2002. The grantee shall obtain written approval from
the department prior to making the requested changes. The following changes must be
requested:
1. Extension of the grant's ending date. If an extension is being requested, the proposed new
ending date shall be identified in the request. The grant extension request shall be received by
the department prior to the ending date indicated in the award letter.
2. Changes in the project activities.
3. Redistribution of the funds between entities or equipment approved.
4. Establishing a new line item in the budget.
5. Changing a salary rate more than 10%.
21 12402
EARLY ENDING DATE
If the project accomplishes the listed objectives and all funds have been expended, the grantee
may request that the grant be closed prior to the ending date indicated in the award letter. The
grantee shall submit a final expenditure report and a written narrative description of the grant
activities and the impact the purchase or training had on the delivery of EMS.
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.
DEPOSIT OF FUNDS
Matching grant funds provided to an applicant shall be deposited in a separate account and any
interest earned shall be returned to the department with the final report. 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. The department
shall receive the signed application no less than 5 working days prior to the grant review team
meeting, published in the FAW.
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
22
2402
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.
EXPENDITURES
No expenditures may be incurred prior to the grant starting date or after the grant ending date.
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.
23 1240
MIAMI DAILY BUSINESS REVIEW
Published Daily except Saturday, Sunday and
Legal Holidays
Miami, Miami -Dade County, Florida
STATE OF FLORIDA
COUNTY OF MIAMI-DADE:
Before the undersigned authority personally appeared
O.V. FERBEYRE, who on oath says that he or she is the
SUPERVISOR, Legal Notices of the Miami Daily Business
Review f/k/a Miami Review, a daily (except Saturday, Sunday
and Legal Holidays) newspaper, published at Miami in Miami -Dade
County, Florida; that the attached copy of advertisement,
being a Legal Advertisement of Notice in the matter of
PO #11086
CITY OF MIAMI - NOTICE OF PROPOSED
ORDINANCES - SEPT. 11, 2003
in the XXXX Court,
was published in said newspaper in the issues of
08/29/2003
Affiant further says that the said Miami Daily Business
Review is a newspaper published at Miami in said Miami -Dade
County, Florida and that the said newspaper has
heretofore been continuously published in said Miami -Dade County,
Florida, each day (except Saturday, Sunday and Legal Holidays)
and has been entered as second class mail matter at the post
office in Miami in said Miami -Dade County, Florida, for a
period of one year next preceding the first publication of the
attached copy of advertisement; and affiant further says that he or
she has neither paid nor promised any person, firm or corporation
any discount, re te, commission or refund for the purpose
of securn?210
publication in the said
newspa10 Qii
Sworn to and subscrib6d before me this
29 qday of AUGJdSy , A.D.
O.V. FERBEYRE personIIyy known 160j' 17 LI.FRENA
NOTARY PUBLIC 51 ATE OF FLORIDA
COMMISSION NO. CC 912958
MY COMMISSION EXP. TUNE 23.2004
pa+e•. � ` ��rlti�. in lh �N .
.AS
PARTIM M OF, 1
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MEOWNlFBI'N1► TRUST M44''VIRUBT
COMM NO.12866,ADOPM71PFt1L
on ALL WocTfE3WRELATED TQTHE
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THE LITTLEHAVANA HOMEOVP
80l1RD CADM1AS W 801111RM EKY 1
'9DUNDAfM FOR THB
FOM THE BOARD'S PW4KM, P(
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MAT1�H>iiWAt�� #613094 A1AM11@�X
1«IIOGM�AM, AND ` TIAs- �MH�He
FOR THE OPERATION OF SAME, IN THE AMOUNT OF
:181,9119, CONSISTING OF A GRANT, IN THE AMOUNT OF
$121,492. FROM THE STATE OF FLORIDA DEPARTMENT OF
HEALTH, WITH MATCHING FUNDS, IN THE AMOUNT OF
$40.497. ALLOCATED FROM THE CITY OF MIAMI OPERAT-
ING BUDGET, ACCOUNT CODE NO. 001000.921002.&&;
JAUTH ORWm THE CITY MAWAM TO ACCEPT L THE
GRANT AVID TQJTE THE 11f OOCYMWS.
IN A FORM ACWTAE.E TO THE CITY ATTORNEY. FOR
SAID PURPW; CQNTA0WIG A IE LER PROVISION. A
SEVERABILJrY CLAIM AND PROVIDING FOR AN EFFEC-
TIVEDA'TE.
ONDOWOOE NO.
AN011nIt641496F CITYQOhMr MONAME D -
ll i ly1APTSR >L i. 4SO TION S}t OF IM CODE
ARTIME TER• BY REPEALING SECTION
3L$ IN ITS AND at18sTRUTMG W LIEU THWtE-
OF A NEW S6CTN* 3U TO CLARIFYTHE l�AT1E8 tRalt THIE
USE OF THE gAMUEL ARTNE THEATER AND WTABLISH
NEW RATES TO THE USE OF THE FACLITY;
FURTHER Af WWO CHAPTER 53, ARTICLE 1, OW ION
W1 OF THE I,CDE OF THE CITY OF MAI, FLORIDA: AS
AMOMD,EMTTTLEO'STAORMBAND CONVENTIONCEW
TER, IN GEMMIAL, TIGET INJRtMIGE ON PAD ADI&&
SIGN To EV� To 'T AB11111MIENT OF A SM-
CH AJOEPAYMENT01iP11DAOMIeNl ATTi1E SMA .
ARTNME CQItiSAI�NTY CENTS C011f14"las A MIEPl11i.ER
PROVISION, A-SEVEIVAL17Y CLAUSE. AND PROVWAG
FORAN EFFECTIVE DATE._
OliD.'
AN Oi10NY OF7kE iN1Af►E1fSIONAMEND-
IPKi(XiAR'TiER2.8oT1om* M. '� ULEOF
CML PENALTEB,' CMpilk ARTICLE L ENTITLED
' WLtDIMGS - IN GENERWAN? REIMA AND CREAT-
ING A NEW CHAPTER EN WRAD NOISFOF THE MIAMI
CITY CODE BY ESTABLISHM FINES FOR VIOLATION OF
NOISE AND NOISE RELATED ACTIVIT M ADDING NEW
SECTIONS 10$ AND 10.7. ENTITLED. WILDING COW
STRUCTION. DREDGING AND LAND FILLJNG; PERMIT RE-
QUIRED AND WHEN PROHIBITED' AND "BUILDING CON-
STRUCTION. CERTIFICATE OF COMPLIANCE; WHEN RE-
QUIREW TO PROVIDE FORAND CLARIFY. DAYSAND TIMES
CONSTRUCTION, DREDGING AM LAW FILLING ACTIVITY
IS PERMITTED. PERMIT REQUIRED AW ENFORCEMENT
AUTHORITY AND CREATING A AEW CHAPTER 36 TO PRO-
VIDE FOR AND CLARIFY NOISE PROHIBITIONS AND UMITA-
TIONS: PROVIDING FOR INCLUSION IN THE CITY CODE,
SEVERABILITY, AND AN EFFECTIVE DATE.
Said proposed onNnermes may be hnpected by to pubk at the
OMce of the C*j Clark, 3500 Pan Amerkm Drive, Miami, Fled -
'do. Monday tlrrouph• Fdday, a mkxlkV holidays, between the
hours of 8a.m.and 5 p,m.
A# kftvosd perms may appear at ft, Ism rp and may be heard
4 with rsspecl to go proposed crdlfwvm OWN OW person desire to
afPppal any deciaiorr o/ the plyQea rlia—o w m rwpetd b any OWW to
be oarMdsnid at 1hM nNegr g. that piraon slW,wo ra Ghat a verbatim .
rarm ofthe proosedN 0 M agape Mroludinp aN Isoonrorgr and evktsnoe
Wm which any appeal my be boW -