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EMS Grant Prgm. Expenditure Report
Department of Health EMS GRANT PROGRAM EXPENDITURE REPORT Name of Grantee: Grant ID Code: Time Period Covered: Beginning Date: Ending Date: Earned Interest: Amount $ as of: Day Month Year Final Report (Check one): ❑Yes ❑No Major Line Items Approved Budget Expenditure by Major Line Item(s) TOTAL BUDGETED EXPENDITURES $ TOTAL Approved Expenditure to Date by Major Line Item(s) TOTAL EXPENDITURES 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 the grant progress. I certify the above reports are true and correct, Expenditures were made only for items allowed by the above referenced grant. Signature of Authorized Official Date DH 1684, December 200B 64J-1.015, F.A.C. 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, and a summary of expenditures on a state Expenditure Report Form. A report shall be submitted by the due date whether or not any action or expenditures have occurred. FINAL REPORTS A final report shall be submitted to the department. The final report shall at a minimum contain a summary of expenditures on an Expenditure Report Form and a narrative describing the activities conducted including any bid or purchasing process and a copy of all invoices, canceled checks relating to the purchase of any equipment and supplies. If the activity funded was for training, a list of all individuals receiving the training shall be submitted along with the dates, times and location of the training. If the grant was for training to be obtained by staff then a copy of all invoices and payment documents for the training shall also be submitted. Any unmatched state funds and all interest earned on state funds, if any, must be returned to the department within two weeks of sending the final report. In addition, please include your assessment of the impact of the project, 19 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 assign the ID Code — leave this blank) 1. Or.anization Name: Cit of Miami Department of Fire -Rescue 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: Lillian Blondet Position Title: Director of Grants and Sustainable Initiatives Address: City of Miami 444 SW 2 nd Ave, 5th Floor City: Miami County: Dade State: Florida Zip Code: 33130 Telephone: (305) 416-1536 Fax Number: (305) 416-1505 E-Mail Address: Iblondet@miamigov com 3. Contact Person: Name: Captain Robert Turner Grants Liaison City of Miami Department of Fire -Rescue rturnera(imiamigov.com, p: (305)416-5438 f: (305)400-5315 Position Title: Fire Captain Address: 1151 NW 7 St. 3rd Floor City: Miami County Miami -Dade State: Florida Zip Code: 33136 Telephone: 305.416.5438 Fax Number: 305.400.5315 E-mail Address: rturner@miamigov.com DH Form 767, Rev. June 2002 1 4. Legal Status of Applicant Organization (Check only one response): (1) ❑ Private Not for Profit [Attach documentation-501 (3) ©] (2) ❑ Private For Profit (3) ®City/Municipality/TownNillage (4) ❑ County (5) ❑ State (6) ❑ 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 20 ALS Transport 1 ALS non -transport 8. Type of Service (check one): ®Rescue ❑Fire ['Third Service (County or City Govemment, 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: Date: Print/Type: Name of Director Dr. Kathleen Schrank, M.D. 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 ITEM 10. Justification Summary 3 Pages A) Problem Description: Out -of -hospital sudden cardiac arrests account for 50% of all cardiovascular deaths., Additionally, Cardiovascular Diseases (CVD) claim more lives each year than the next five leading causes of death combined.2 Nearly 2,500 Americans die of CVD each day, an average of one death every 35 seconds.3 In surviving a cardiac emergency, experts agree time is the single most important critical factor. The most tragic thing about sudden cardiac arrest is the fact that despite the finest cardiologists, hospitals, emergency rooms, and pre -hospital care, the survival rate is less than 5% nationally. This low survival rate is due to the fact that most cardiac arrests are do not occur in hospitals but at home or in public spaces. To have a chance of surviving, victims of sudden cardiac arrest must receive a life-saving defibrillation utilizing an Automatic External Defibrillator (AED) within the first 4 — 6 minutes of an attack, when brain and permanent death start to occur.4 The survival rates are further improved when the first responder can get a read on the actual victim's cardiac rhythm to apply in order provide customized care, rather than simply making a "shock or no shock" decision. The City of Miami's Fire Rescue (MFR) is charged with responding to all emergency calls within its jurisdiction and to provide mutual aid in four other municipalities. MFR is dedicated to continuous quality improvement of its services for residents, inclusive of rapid on -scene arrival. This dedication to patient care has resulted in a 27% save rate compared to the national rate of 5%. To achieve this, MFR has optimized its BLS response, which are typically first on -scene, and equipped them with AEDs to begin the resuscitation process before the Advanced Life Support (ALS) vehicles arrives. Beyond rapid response, these rates are further improved when the AED unit is 1) biphasic 2) able to serve pediatric and adults 3) provide a visual display that provides instructions and cardio rhythm analysis so that first responders can calibrate shock to be most effective and 4) generate downloadable files for hospital use and post -response analysis for Continual Quality Improvement. Unfortunately, MFR's BLS vehicles AED units do not match this description. MFR's current AEDs (Lifepak 500), purchased in 2000, do not have these capabilities and have been discontinued by Physio-Control. Our Lifepak 500's have outdated monophasic technology, with no infant or pediatric care capability. Further, they are not compatible with our medical service provider's facilities or our ALS vehicle units. 3 Compatibility and customized patient care are central recommendations of the AHA for 2010; currently MFR would be considered non -compliant with these guidelines. The urgency for replacement is not only due to need to conform to industry standards, but also due to the trends in residential population MFR serves, specifically an increase in cardiac arrests for the general population and those using Miami's recreational waters. From 2009 to 2010 MFR saw an increase in cardiac arrest calls and does not anticipate this situation reducing. At the same time, Miami's proximity to recreational waters in Biscayne Bay, residential pools, and the Miami River, results in higher risks for cardiac arrests due to drowning for adults and children. The State of Florida' has the highest drown rate of children in the nation, and Miami -Dade is the highest rate amongst Florida's counties. The ability to calibrate the AED for pediatric resuscitation is a key capability that MFR currently lacks with the Lifepak 500 AEDs on its BLS vehicles. B) Present Situation: Currently, MFR's outdated AEDs (Lifepak 500) limit MFR's provision of care for cardiac arrest victims, and are difficult to maintain due to their discontinuation by the manufacturer. All MFR BLS vehicles carry a Lifepak 500 AEDs which were purchased over 11 years ago and are limited in comparison to the LifePak 1000. These units are in need of replacement due to 1) age and potential unreliability, 2) lack of advanced features (LCD screen, EKG reading software, 3 lead compatibility with medical institutions, downloadable records and greater choices in voltage differentials) and 3) lack of pediatric resuscitation adapters and protocols. To address the issue of having reliable AEDs capable of serving adults and pediatric patients on the fastest response vehicles at its disposal, MFR proposes installing new AED's on all of its Basic Life Support Vehicles. In addition, MFR wants to safeguard its first responders and the public by installing these AEDs in its training center, dispatch call center, and central headquarters which are utilized by first responders from MFR, Miami Police Department and mutual aid department who are at high risk of heart attack. C) Proposed Solution: Disappointing survival rates from out -of -hospital cardiac arrests increases the urgency for rapid deployment of high quality AEDs to serve children and adults in the field. The proposed project would provide a higher quality of defibrillation delivered more quickly and make MFR more compliant with AHA guidelines. MFR requests financial support to purchase twenty (24) Automated External Defibrillators (Lifepak National Institutes of Health. 4 1000), compatible with its ALS vehicles and hospitals, for its 21 BLS vehicles and 3 MFR facilities, along with the necessary training materials, to bring its response up to date with current AED technologies and AHA guidelines. D) Consequences If Not Funded: Should this project not receive funding, meeting the current standard of care of biphasic defibrillation, pediatric/infant defibrillation and 3-lead ECG monitoring will be delayed until an ALS (versus the BLS) vehicle arrives on the scene, which can be several minutes later. This delay may be the difference between survival and cardiovascular death. MFR did not budget for the purchase of new ones due to budget cuts E) The geographic area to be addressed: The City of Miami is comprised of 34 sq. miles with approximately 480,000 residents. Daily, the population swells to nearly 1 million during working hours. Current vulnerabilities are: 1) High rates of ill -health due to poverty: Miami is the NATION'S FIFTH POOREST MAJOR CITY with a 28.3% poverty rate overall; 2) High rates of elders: The City has the nation's 7th largest elderly population (over age 65) comprising 17% of the total population; 3) High rates of ethnic diversity and rates of cardiac, diabetic individuals and those without swimming expertise; 4) Mutual Aid Obligations- MFR provides automatic aid to the Village of Key Biscayne, and mutual aid to Miami -Dade County, and the Cities of Miami Beach, Coral Gables and Hialeah. F) The proposed time frames: Months 1 to 4: present award to the City commissioners for approval, research supply, purchase equipment; Month 5: After ordering, MFR anticipates units will arrive two to four weeks from the date ordered. Months 6 to 8, Training and testing of 500 communication operations, EMS personnel, and clerical personnel at MFR facilities. Month 8 to 12: implement units on trucks and facilities, training, document personnel trained. Record improvement in life-saving measures. G) Data Sources:1National Heart Attack Alert Program.; 1995. "Staffing and Equipping Emergency Medical Services System: Rapid Identification and Treatment of Acute Myocardial Infarction." American Journal of Emergency Medicine. Volume 18: pages 806-811.; 2 American Heart Association, Inc. 2006. Heart Disease and Stroke Statistics — 2006 Update. Page 10.; 3American Heart Association, www.americanheart.orq H) Statement of Non -Duplication: The requested Lifepak 1000 Defibrillators will replace outdated equipment and establish new response capacity in MFR facilities. The City of Miami has not received funding for mobile AED from the Florida EMS matching grant program before and does not duplicate the work of, any other grant funded initiative. 5 ITEM 11. Statutory Considerations and Criteria: (2 pages) A) Quantify Situation in Last 12 Months: From January 1, 2010 through December 31, 2010, MFR responded to 91,240 incidents. Of those, Fire calls accounted for 14,493; BLS accounted for 19, 810; ALS accounted for 56,937 for a total 76,747 patients with medical and/or cardiac symptoms alone requiring further emergency medical assistance. The average response time, for BLS vehicles was under 5 minutes. Currently MFR has allocated approximately 200 Fire/EMS staff per shift, with a minimum manning of 149 on a daily basis to respond to the needs of the City (total population to 1,000,000 during business hours). At any given moment there are 50 fire -rescue vehicles and 1 Fireboat ready to be deployed. It is imperative that these units have up to date life saving equipment. MFR's call rate is one of the highest in the country as is our save rate. This is due in part to our staged response strategy wherein BLS vehicles are deployed before ALS vehicles. In order to maintain our save rate of 27% with up to date equipment that will allow first responders to interpret the EKGs, MFR faces complete replacements of the AED units currently deployed on our BLS, but without a budgeted line item to fund them. B) Data of Change with Project Implementation: Implementation of the Lifepak 1000 AEDs in all City of Miami Fire -Rescue Department BLS vehicles will make MFR compatible with new technologies and software implemented in its partner medical institutions and with national AHA guidelines to provide superior save rates due to biphasic defibrillation technology. Therefore, MFR expects that it will see maintenance or improvement in: a) save rate; b) water -related adult/pediatric save rates c) response times. C) Justification and Explanation of Above Data: Information given in question (A) and (B) was obtained using data from the Miami Fire -Rescue Department data collection system and other outside resources. D) Additional Outcomes: The City of Miami Fire -Rescue Department BLS units with AED 1000s will enable us to meet our goal of rapid access to biphasic defibrillation. Our citizens deserve and expect the consistent state of the art treatment these units will provide. E) Integration into Agency's Five Year Plan: Miami Fire -Rescue's five year plan includes a complete review of our current treatment protocols and equipment needs, and the impact of AHA guidelines. This project integrates seamlessly into the achievement of MFR's goals. 6 ITEM 15. Statutory Considerations and Criteria: A) Serving the Requirements of the Population of Miami: As stated before, there were 92,870 individual emergency medical patients seen by the fire -rescue department in the City of Miami last year. Many of them were cardiac related. The City of Miami is a residential community with a sizeable business and warehouse districts. Studies have shown that sudden cardiac arrest occurs most often in the home (57%-76%); followed by public locations. Risks of cardiac emergencies increase for those middle age to elderly; Miami has high rates of both. Such possible victims of sudden cardiac arrest would benefit from the Miami Fire -Rescue Department's acquisition and implementation of the twenty (20) Lifepak 1000 AEDs within the community they live. B) Enabling of Emergency Vehicles to Conform to Standards: This proposal will enable us to offer biphasic defibrillation, infant/pediatric defibrillation, and 3-lead ECG capability in all our emergency response vehicles, conforming to AHA guidelines and standards of care. C) Enabling BLS Vehicles to remain compliant with AHA Guidelines: The Lifepak 1000 AEDs are compliant with AHA guidelines, having software capable of being updated if guidelines change, and the same Quik-Combo electrodes compatible with Miami Fire Rescue ALS vehicles. Clinically the units offer the same adaptive biphasic technology as Miami Fire -Rescue's Lifepak 12, which has direct communication linkup with local hospitals through our SafetyPad report system. D) Enabling the Organization to Improve Services and Communications: As a first responding agency, this equipment procurement will allow the City of Miami Fire -Rescue Department to provide the current standard of care that is offered by neighboring fire -rescue departments. The equipment requested will also allow for communication and data transfer after the event for Continuous Quality Improvement (CQI) process implemented by MFR. 7 16. Work activities and time frames: Indicate the major activities for completing the project (use only the space than six months and if it is a communications makes of ambulances, it takes at least nine provided). Be reasonable, most projects cannot be completed in less project, it will take about a year. Also, if you are purchasing certain months for them to be delivered after the bid is let. Work Activity Number of Months after Grant Starts Begin End Grant Acceptance (commission approval) 1 3 Bid Issuance and vendor selection 3 5 Purchase of LifePak unit 5 5 Training 6 8 Unit Deployment 9 9 17. County Govemments: 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. N/A DH Form 1767, Rev. 2002 18. Budget: 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. Costs Justification: Provide a brief justification why each of the positions and the numbers of hours are necessary for this project. n/a $0 TOTAL: 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 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. expenditures classified as operating capital outlay (see next category). n/a $0 DH Form 1767, Rev. 2002 9 Vehicles, equipment, and other Costs: Justification: State why each of the items and quantities listed is a necessary component of this project. -24—Life Pak units r $527416 The unit is sold at $2,184.00 as a set, comprised of LIFEPAK 1000 (Kit.#5) ECG Display, Standard Setup wlcarry case, battery & electrodes Included at No Charge: 41425-00001, ShipKit, 11425-000007 Carrying Case, 11425- 000002 Strap for Carrying Case, 11141-000101 Battery, 11996- 000017 QUIK-COMBO REDI-PAK electrodes (2 pair per unit), 11111-000016 3-Wire Monitoring Cable, 11425- 000001 Accessory Pouch , 11100-000001 LIFEPATCH ECG ELECTRODES (3 per package), 26500-001964 Operating Instructions 24 Electrode replacement infantichild reduced energy $2,020 $84.15 per unit. This allows the LifePak to be used with adults and children increasing the applicability and safety of the unit to be used throughout the community. 54,436 TOTAL COST State Amount XX Matching: 75 Percent ❑ Rural: 90 Percent Local Match Amount XX Matching: 25 Percent ❑ Rural: 10 Percent Grand Total $40427, $ t3;609-•--- $6, DH Form 1767, Rev. 2002 10 19. Certification: My 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 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 at 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 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 MM / DD / YY (Individual Identified in Item 2) DH Form 1767, Rev. June 2002 11 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: City of Miami Department of Fire — Rescue Mailing Address: 1151 NW 7 St. 3rd Floor Miami, FL 33136 Federal Identification Number VF 596000375 Authorized Agency Official: Signature Date Lillian Blondet, Director of Grants and Sustainable Initiatives 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 1767P, Rev. June 2002 12 Attachments: 1) Letter of endorsement from Commission-n/a 2) EMS MOU-n/a 3) Tax-exempt Status a) Enclose a copy of your 501(C) 3 certification indicating non-profit status. (nternat:Reverue Service Department of the Treasury P. O. Box'2508 Cincinnati. OH 45201 Date: Avaust 3..2003 Person to Contact:. 'Delphene Naegeie 31-04012- Custorrter Service'Seecia:ist City of Miami A ;counting Di visron Toll Free .Telephone ;Number; 1000 Broke', { ieSte, 1010 8.00 AM.'to 6:30 P-M. est Miami, FL 33-, 31-3014 877-829.5500 Fax.Nurnber: 513-263-3756 Federa ride ntlfication Number: 59-6000375 Dear Sir or Ma Tam. This is in resp• nse to your request of August 6. 2003:.regarding your organization's federal, tax status. Our records inrticate-that your organization may be: agovemmental instrumentality or a political subdivisionof i stale. No provision"( 'tneJnternal Revenue Code imposes, a.tax on the income or governmental°units (such as atale•r.and their political. subdivisions). Therefore:it has .been the position -of'. the Service that ir rope of governmenterunits is net generally subject -tie federal income taxation, If, however- a:, entity rs not itself a governmental•unit (or an "integral part"thereof), its income will be subtec' to tax unless en'exdusion or exemption applies. 'One exclusior Is provided by.sectian 115(1)-of the Coda. which excludes from gross incorne: •income"derrved from .:,-the exercise:of:any essentialgovernrnen:ai'function. and- eeteuing toa:Staff,:. m any political subdivision 1. --'nt . Your organizs. ion's-income may, not Ce subject to tax. either because'the'organizalion'isa. governmental urirr(or an ."integral part' thereof),:o1 because the income is.excluded'under' ;saran 115. 1 addition, your. organization may also be eligible=10 racaive charitable contributions, which ire. deductible For federal,income, estate• and g,ft'tax purposes.- Atso--your organization i probably exempt:from manyfederal excise taxes_ Your organize ion' may obtain a -letter ruling on its status under section 1.15=by following the, 'procedures sr ecified Rev. Proo..2002.1 or its su.: .ssor Your organize ion maye(so_qualify forexemption From federal -income tax,as.on-organization described in ; aclionr501(c)(3).of the Code: its the organization is an entity separate-from.1(10 state- county, ermunicipal government, and if i1 does. not havee-powers or purposes. inconsistent vdth exemption -(such as the power.to tax or to exercise enforcernent of regulatory powers), your organize'; on would quarify under section 501(c)(3). To apply for ezempGon- comprete For 11023 and pay. the required user fee. -2- city of -Miarni A ;counting Division 59-6000375 .Sometimes go ernmental Units are.asked to provide proof of their status as pert cf-a.grant application. If our organization is applying for a grant from 3 private foundatian..-the foundation ma. be -requesting certain informatiorrfrom your Organization- because of [he restrictions imr oSed by the Code onsuch foundationsOhe such restriction imPoSei aitak.on private foUnda oris thatimake any'taxable expenditures." Under sectioriA945(el)ind (h) of the Code, "tax breiexpenditures"includei(i) any grantito an organizationiuniessi'exCepteO),. iuniess the fou: dation exercises 'expenditure responsibility' with.respectito thei,grant;:nd (2) any eipenditu. ? for non -charitable piirposei. Underisection 4942 of the,Cocle, private foUndationsimi ist also distribute certain amaunts.for charitable purposes each year-i'-'qualifyingi distributions"-- it incur aitax.on the undiStnbuted amount: "Qualifying distKbutionsl! include certain am oun 3 paid to .accomplish charitable purposes, Private fOundaion.grants to governMental units:foi public or chantable purposes are nat. taxable- expen itures•Under these provisions; regardless of whether the foundationexercises "expenditureli sponsioility." Under sectioni53.4945-5(a)(4)(ii) of the Foundation and Siniiiar Tax Re rulations. erper. e responsibitityiis not rep.: i -id for grantsifor charitable purposet 10 gt;vetnrnental units (as defineriiiri section 170(c)(1) of the code). Similarly, grants to government si units for public purposes are ''qualifyingdistributions". under sect Oft .53 4942(a)-3(:,) of the reguialions; and. if they are for chartable purposes, wilt nol be.taxable expenaitures, .inder section 53.4945-6(a) of the regulations. Most grants to governmental units will qualiri as being far charitableas well as public) purposes Because of lh .se restrictions. some private foundationsirequire grant appicants to submit letter from the Service determining there be exempt lying under section:501(cfi if3) andicletsied. .as a nort-priva•e ; ridation. Such a letter. or ,. requirement grantee be•a- public charity: s not legally required to be relieved from the restrictions detaioed.above. when. the prospectiv !.grantee -is a governmehtal unit andithe.grant is:for.qualifying (PubtiC o( charitable) pui oses. We believe thi tigene'ral informationwill be pf assistancelo your organization, Thisdenc however is ne t a ruling end may not be relied on as suci If yoU have any questions, 'please. call us at the t dephone number shown ri the heading of this letter. Sincerely. • john.F. Ricketts:Director., TE.)C'S customer AcCount-ServideS 14 REC EI\TED FEB 16 2011 ea:c,1f BY: 12y14talt5 ( Budgetary Impact Analysis Department Miami Fire Rescue Division Administration 2. Title and brief description of legislation or attach ordinance/resolution: Application to Florida Department Of Health for a State EMS Matching Grant to fund the purchase of LIFEPAK 1000 Automatic External Defibrillator machines. State will fund 75% of total project cost with a 250/0 cash match requirement. 3. Is this a revenue -producing program? NO: X YES 4. Are City of Miami snatch funds required? NO: YES X (If no, skip to item. #7) 5. Amount of matching funds required: $ 13,609 Source of funds: Fire -Rescue Aclmin. / Budget Reserve Su Amount budgeted in the Line Item $ 63, 553.00 (see Transfer) Balance in Line Item $ 63, 553.00 Amount needed in the Line Item $ 4,352.00 cient funds'will be transferred from the following line items: ACTION ACCOUNT NUMBER ACCOUNT NAME TOTAL Index/Minor Object/Project No. From 00001.181000.531000.0.0. Professional Services $ 4,352.00 From $ From $ To 00001.181000.896000.0,..0. Budget Reserve * $ 4,352.00 7. Any additional comments? Successful applicants will be notified intermittently after February 2011 and given a one year period -of -performance. Therefore, the $13,609 cash match (25%) must be available prior to the end of the one year Period -of -performance. Transfer of Funds Request Form attached. 8. Approved i epart ent Directoij esigi se ate Grants Director Date OR DEPA:11`MENT OF MANA EMENT AND BU GET USE ONLY Verified by: Department of Management and Budget • Director/Designee Date Verifi Budge Ana yst Date 21)8 If Revised 2008