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HomeMy WebLinkAboutexhibit7EMS 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 XX Matching ID. Code (The State Bureau of EMS will assign the ID Code — leave this blank) 1. Organization Name: City of Miami Fire -Rescue 2. Grant Sinner: (The applicant signatory who has authority to sign contracts, grants, and other legal documents. This individual must also sign this application) Name: Robert Ruano Position Title: Grants Administrator Address: City of Miami 444 SW 2 nd Ave, 51" Floor City: State: Telephone: E-Mail Address: Miami Florida (305) 416 1532 County: Dada Zip Code: 33130 Fax Number: (305) 416-2151 rruano@ci.miaml.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.) Name: Captain Allen Joyce Position Title: Executive Assistant to the Fire Chief Address: 444 SW 2 Avenue, 10`" Floor City: State: Telephone: E-mail Address: OH Form 1767, Rev. June 2002 Miami Florida (305) 416-1610 Dade Zip Code: 33130 Fax Number: (305) 416-1680 a)oyce a@ci.miami.fl.us 1 4. Legal Status of Applicant Organization (Check only gne response): (1) ❑ Private Not for Profit [Attach documentation-501 (3) ©] (2) ❑ Private For Profit (3) XX City/Municipality/TownNiilage (4) El County (5) ❑ State (6) ❑ Other (specify): 5. Federal Tax ID Number (Nine Digit Number). VF 596000375 6. EMS License Number: 2276 Type: XX 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 XX 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 ail 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: < .. t �.. :._. , �; Al 9 �.-f��,. ..� Z. Date: � �. Print/Type: Name of Director Kathleen Schrank FL Med. Lic. No. 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 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, Rev. 2002 2 10. Justification Summary A) Problem description In 2002 Miami Fire Rescue (MFR) responded to 622 cardiac arrest calls. Of those, 320 were DOA, and 302 were Sudden Cardiac Arrest (SCA) patients. MFR was able to save 47 and obtain a 15.5% "save" rate. SCA is one of the leading causes of death in North America (over 250,000 annually), killing more persons than breast cancer, lung cancer and AIDs combined. Studies made by the American Heart. Association' have shown that SCA survival rate is greater than 90% when defibrillation, or "call to shock", occurs immediately and 50-70% if the patient is defibrillated within the first 3 minutes. SCA is usually caused by an irregular heart rhythm called Ventricular Fibrillation (VF). For every minute the heart remains in VF, the chance for survival decreases by 10%. In addition, resuscitation must commence in 4 minutes or less. Lives are needlessly lost because "the clock runs out" before help arrives. Miami is the nation's "poorest major city", and due to its extreme poverty level (31% of all its residents), it does not have the funding available to purchase and utilize more Automatic External Defibrillators (AEDs) beyond the 29 stationary units in its Public Access Defibrillation (PAD) Program. its hands are tied from being able to shave precious minutes off the start of defibrillation on a SCA victim. Miami has 362,470 residents and the nation's 7th largest elderly (over age 65) population. VF affects this age group more than any other. Poverty and the tack of the preventive health care that often accompanies it exacerbate the problem as welt. MFR's average response time to an SCA address is 6.1 minutes, which does not include possible delays in reaching the patients that are caused by the numerous multi -story buildings. 44 people in Miami died last year from SCA because emergency response time and therefore "call to shock time" could not be lowered to reach a 30% "save" rate. BZ Present situation When someone within city limits suffers a SCA, 911 is called, and MFR dispatches one of 23 ALS rescues currently in service, which are equipped with E?xternaai.. ripfihriiiatnr5 nr gnmetimac ona of 17 BLS units, which are equipped with AEDs. Its PAD program utilizes 42 AED units in 29 government facilities in the City, but as yet it does not have them in any mobile units outside of MFR vehicles, nor does it have a 3 large-scale citizen CPR training program that can create reliance on bystander intervention, such as exists in Seattle and Boston. As a result, MFR is only able to obtain a 15.5% (47 patients) "save" rate out of 302 SCA victims because its average response time is 6.1. minutes. C) Proposed solution MFR wants to place AEDs in mobile police vehicles patrolling throughout the city. The City of Miami Police Department has 651 patrol vehicles that are split across 3 shifts (A, B and C) and 3 districts (North, Central and South). The 100 AEDs would be allocated by 33 units per shift and 10 per district. Officers would then be trained to initiate CPR with AEDs and have their, vehicles dispatched on all SCA calls. D) Consequences if not funded Brain death can begin after 4 minutes of deprived oxygen. Without funding, it is estimated that 30% of current SCA victims who could be saved with shortened "call to shock time" will die due to our inability to lower the response and shock time. Based on current annual figures, MFR can anticipate that 44 of its SCA victims will die needlessly. This total will continue to multiply as the population follows its usual growth increase and will extend to the added suffering of family members and other loved ones who depend on the patient, not to mention the loss of a productive citizen to the city. E) Geographic area to be addressed The entire 34.5 square miles of City of Miami will be addressed by this grant. Miami is home to 362,470 but that number swells to over 750,000 during working hours. Traffic congestion, a significant problem throughout the city, adds to MFR's response time. In addition, there are over 400 multi -story buildings within the city, with 190 of them being greater than 5 stories in height. Ascending these 400+ buildings delays "call to shock" time even more. F) Proposed time frames Month 1-3: present award to the City commissioners for approval, research supply, meet with sales representatives, write specifications for the equipment to be purchased and develop training curriculum in collaboration with Police Department. Month 3 to 5: purchase equipment and set up training. Month 6 to 10: set up training schedule, begin training, document officer training, issue certifications and begin placement of AEDs in police cars. 4 G) Data Sources American Community Survey, 2002, from www.census.gov National Center for Early Defibrillation, 2002, from http://198.65.239.253// American Heart Association, Public Access Defibrillation, June 1995. City of Miami Management Information System Davis, R. Six minutes to live or die. USA Today, 07/30/2003 Fire -Rescue's incident Report System, 2002 and 2003 data Mullin, J. We're number one! A special report - Part 2 Miami New Times. Oct 3, 2003 Fire Engineering Magazine, July 2003, from www FireEnuineering.cam City of Miami Department of Fire -Rescue 5 Year Strategic Plan, last amended 6/9/03 City of Miami Department of Fire -Rescue "Standard of Coverage" File H) Statement attesting non -duplication The project to equip AEDs in police cars is a new one by the City of Miami. It does not duplicate any previous effort or activity on another grant project under this grant program. 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. 11. Outcome For Projects That Provide or Effect Direct Services To Emeraencv 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) Explain the derivation of all numbers. D) How does this integrate into your agency's five year plan? DR Form 1767, Rev. 2002 6 11. Outcome For Projects That Provide or Effect Direct Services To Emergency Victims A) Quantification of the situation in the most recent 12 months From January 1, 2002 to December 31, 2002, the City of Miami Fire -Rescue (MFR) responded to 622 SCA calls. The average total response time for these calls was 6.1 minutes. Not included in this time were the delay minutes that resulted when EMS crews had to ascend into the numerous multi -story buildings in the city. Of the 622 CA victims, 320 were determined to be dead on arrival (DOAs). This left 302 working arrests, of which only 47 survived. According to our calculations 44 people in Miami needlessly died last year from SCA because emergency response time and therefore "call to shock time" could not be lowered to reach a 30% "save rate". According to this data from Fire -Rescue's Incident Report System, this indicates that the success rate of victims to survivors was 15.5%, but it also means that of 622 persons experiencing cardiac arrest in Miami, 575 died. B) Estimate of what the above numbers should become in the 12 months after this project's resources are on-line Unlike responders on call at the fire stations, on -duty police officers may already be physically closer to SCA patients when a call comes in, plus they can go right to travel without being delayed by the turnout time required by the firefighters. Prepared medical responders - these police officers in their vehicles, trained to initiate user-friendly AEDs - could take 3 minutes off the average response time of 6.1 minutes. With a possible range of 3 minutes or less, MFR estimates that it could theoretically save 91 lives in a year, an increase of 94%. C) Justification and explanation of how above numbers were derived DdLd iiuiii Life studies by the American Heart Association (1995) correlate survival rates with the amount of time before commencing of defibrillation. Every minute cut before the start of 7 ventricular fibrillation on a SCA victim raises survival by nearly 10%. Cutting 3 minutes x 10% would produce a 30% increase and would be realistic and achievable after the project's first year. At the same incidence of 302 SCA victims per year x 30%, 91 lives would be saved, 44 more than last year's total of 47, an increase of 94%. D) Other outcomes expected of this protect i, One hundred Police officers will receive 4 hours each of CPR/AED training to be able to respond to SCA calls quickly, professionally and equipped with a life saving AED, which will save lives and can foster favorable and beneficial experience for law enforcement personnel. ii: The AEDs distribution will be split across 3 shifts (A, B and`C) and 3 districts (North, Central and South). This would result in 33 AEDs per shift and 11 per district. At any given time (24/7) the distribution would provide equal coverage city wide. Interoperability between Fire -Rescue and Police will become more smoothly coordinated, and their dispatch functions will work together more efficiently due to these 622 SCA calls. iv. Community members will come to view police officers in a more positive perspective when they begin providing such important life saving assistance with the anticipated 44 additional "saves". v. Saving lives is a major outcome, but it can not be ignored that faster resuscitation is cost- effective because of the decreases in the amount of medical equipment used, the reduced amount of time a patient would stay in the hospital, and the major expense of long-term care when brain damage may occur. E) Integration into the agency's five year plan This project to equip police cars with AEDs and train officers to initiate CPR integrates well into the Five Year Strategic Plan of the City of Miami Department of Fire -Rescue. It corresponds to the first of the Emergency Response Division's Goals & Objectives, which is to "Improve the average emergency response time" and with goal 10.2 "Work with Police to deliver better joint service delivery on emergency incidents. 8 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 Tor 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. 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 NIA 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, Rev. 2002 9 15. Statutory Considerations and Criteria Justify that this project will: A) Serve the requirements of the population upon which it will impact Miami is a geographic -small but population -dense urban area with a significant proportion of residents who are vulnerable and disadvantaged, as detailed in the description of the area on item 10. With the ability to place AED devicesin police cars from which trained officers can quickly arrive and initiate 'a life saving shocks and/or CPR on SCA arrest victims, the City of Miami will be able to cut down critical response time and save lives, particularly for the 17% of its residents aged 65+ and the 31% who live in poverty. Through these actions we will be able to better serve our population. B) Enable emergency vehicles and their staff to conform to state standards established by law or rute of the department. NA 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. NA D) Enable the vehicles of your organization to have, at a minimum, a direct communications linkup with the operating base and hospital. NA E) Enable your organization to improve or expand the provision of: 3) Fire -Rescue dispatch will work with Police Department dispatch to improve "Call to Shock Time" by creating an interoperability link for dispatching units from both departments on all SCA calls, from the closest of 14 fire stations and AED equipped Police vehicles 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, continuing with CPR and early defibrillation, and ultimately transferring to advanced care. The missing link is access cu eariydefibrillation, which could be solved when AEDs are also put on police vehicles. 10 16. Work activities and time frames: Indicate the major activities for completing the project (use only the in Tess than six months and if it is a purchasing certain makes of after the bid is let. space provided). Be reasonable, most projects cannot be completed communications project, it will take about a year. Also, if you are ambulances, it takes at least nine months for them to be delivered Work Activity Number of Months After Grant Starts Begin End Present award to the City commissioners for approval 1 2 Research supply and final prices, meet with sales representatives, and write specifications for the equipment to be purchased 1 3 Develop training curriculum - 1 3 Purchase equipment 3 5 - Prepare training ; 3... Set up training schedule 6 10 . Begin training 6 10 1 Document of officer certification 6 10 Begin placement of AEDs in police cars 6 10 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. NA OH Form 1767, Rev. 2002 11 Salaries and Benefits: For each position title, provide the amount of salary per hour, FICA per hour, fringe benefits, and the total number of hours. Miami Fire -Rescue lieutenants to perform: 18. Budget: Costs JustiifiCation: Provide a brief justification why each of the positions and the numbers of hours are necessary for this project. curriculum development certification and data recording research & meet with sales reps writing of equip. specifications purchase and distribution of equipment training $ 11,400 salary $ 4,560 fringe $ ' 7,200 salary $ 2,880 fringe. Various duties to be performed p/t over (largely) the first 4 months of the project that are essential to the implementation & success of project: total of 228 hrs x $50/hr = $ 11,400 x 40% = $4,560 2. instructors will train officers at 6hr sessions 12 sessions required to train 100 2x6= 12x 12=144x$50=57,200 x 40% = $2,880 TOTAL: $ 26,040 Expenses: These are travel costs and the usual, ordinary, and incidental expenditures by an agency, such as, commodities and supplies of a consumable nature, excluding expenditures cfassified as operating capital outlay (see next category). 1 AED training device, training pads, textbook, and instructor kit 100 sets of replacement AED pads, 1 spare set for each unit Shipping per AED unit Educational & record -keeping supplies; copies Costs: List the price and source(s) of the price identified. Justification: Justify why each of the expense items and quantities are necessary to this project. $460 @ x 1 = $460 Required to provide training $30 @ x 100 = $3,000 $50 @ x 100 = $5,000 Required to continue extended use of AED devices in the field Suppliers are not local Indirect Cost Fed. negotiated rate of 23.5% applied to total project expenses less operating capital outlay $125/mo x 10 = $1,250. $8,401 Prices are per supplier quotations received by MFR within the past 3 months For training, certification, and project evaluation For costs related to grant program but shared among other F-R functions $235,750 - $200,000 = $35,750 x 23.5% = $8,401 OH Form 1767, Rev. 2002 TOTAL: 12 Vehicles, equipment, and other operating capital outlay means equipment, fixtures, and other tangible personal property of a non consumable and non expendable nature, and the normal expected life of which is 1 year or more. I00 AED units, each with a set of pads, a ready kit, and a battery TOTAL: FINAL TOTAL: State Amount (Check applicable program) XX Matching: 75 Percent ❑ Rural: 90 Percent Local Match Amount (Check applicable program) XX Matching: 25 Percent ❑ Rural: 10 Percent (rand Tn+a1 DM Form 1767, Rev. 2002 Costs: List the price of the item and the source(s) used to identify the price. $2000@x100= $200,000 Prices are per supplier quotations received by MFR within the past 3 months $ 200,000 S 244,151 Justification: State why each of the items and quantities fisted is a necessary component of this project. A quantity of 100 units will enable preparation of 100 police officers as rapid, trained responders to SCA emergencies $ 183.1I3 . S 6I,038 . $ 244,151 . 13 19. Certification: My signature below certifies the following. 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 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 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 1 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 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. - Signature of Authorized Grant Signer (Individual Identified in Item 2) PH Form 1767, Rev. June 2002 iZ / /0/05 MM/DD/YY 14 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 or continuation of pre -hospital EMS. DOH Remit Payment To: Name of Agency: Mailing Address: City of Miami Fire - Rescue 444 SW 2 Avenue, 10"' Floor Miami, FL 33130 Federal Identification Number ,ice VF 596000375 Authorized Agency Official: Signature Robert Ruano, Grants Administrator Type Name and Title Sign and return this page with your application to: Florida Department of Health BEMS Grant Program 4052 Bald Cypress Way, Bin C18 Tallahassee, Florida 32399-1738 Do not write below this line. For use by Bureau of Emergency Medical Services personnel only Grant Amount For State To Pay: $ Grant ID Code: Approved By: Signature of EMS Grant Officer Date State Fiscal Year: Organization Code E.O.. OCA Object Code 64-25-60-00-000 N_ N2000 7 Federal Tax ID: VF Grant Beginning Date: Grant Ending Date: DH Form 17R7P Rau .l'inp ?On? 15