Exhibit 3 Page 1 of 11 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 RESOLUTION NO. 2013- A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF BROWARD COUNTY, FLORIDA, AUTHORIZING SUBMITTAL OF AN EMERGENCY MEDICAL SERVICES (EMS) GRANT APPLICATION IN THE AMOUNT OF TWO HUNDRED TWO THOUSAND FIVE HUNDRED TEN DOLLARS ($202,510.00), TO THE STATE OF FLORIDA, DEPARTMENT OF HEALTH (DOH), FOR THE PURPOSE OF IMPROVING AND EXPANDING PRE- HOSPITAL EMERGENCY MEDICAL SERVICES IN BROWARD COUNTY; AUTHORIZING THE COUNTY ADMINISTRATOR TO EXECUTE THE APPLICATION PROVIDING CERTIFICATION RELATING TO USE OF EMS COUNTY GRANT FUNDS, APPROVING COUNTY'S EMS GRANT PROGRAM FUNDING DISTRIBUTION; AUTHORIZING THE COUNTY ADMINISTRATOR TO EXECUTE AGREEMENTS AND AMENDMENTS TO AGREEMENTS AS PROVIDED FOR IN THE RESOLUTION; AUTHORIZING THE COUNTY ADMINISTRATOR TO TAKE THE NECESSARY ADMINISTRATIVE AND BUDGETARY ACTIONS FOR IMPLEMENTATION OF SAME; PROVIDING FOR SEVERABILITY AND AN EFFECTIVE DATE. WHEREAS, the Broward County Board of County Commissioners ("Board"), desires to submit to the State of Florida, Department of Health (DOH), Bureau of Emergency Medical Services, Broward County's FY 2014 Emergency Medical Services Grant Application ("Application") for EMS County Grant Funds in the amount of Two Hundred Two Thousand Five Hundred Ten Dollars ($202,510.00); and WHEREAS, the Board certifies that EMS County Grant Funds will be used to improve and expand pre-hospital EMS in Broward County, and not used to supplant existing County budget allocations for EMS; and 23 24
Exhibit 3 Page 2 of 11 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 WHEREAS, the Board desires to approve the EMS County Grant Program's funding distribution, subject to approval of the Application by DOH, NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF BROWARD COUNTY, FLORIDA: Section 1. The Broward County Board of County Commissioners ("Board") authorizes the County Administrator to execute and submit to the State of Florida, Department of Health (DOH), Broward County's FY 2014 Emergency Medical Services Grant Application ("Application"), attached hereto as "Exhibit 3-A," for EMS County Grant Funds in the amount of Two Hundred Two Thousand Five Hundred Ten Dollars ($202,510.00). Section 2. Broward County certifies that the EMS County Grant Funds will improve and expand Broward County's pre-hospital emergency medical system and not be used to supplant existing Broward County budget allocations for EMS. Section 3. Broward County approves the DOH EMS Grant Program's Request for Grant Fund Distribution attached hereto as "Exhibit 3-B." Section 4. Upon approval of the Application by DOH, the County Administrator is authorized to execute agreements in a form approved by the Office of the County Attorney, which shall include County standard form agreement provisions and incorporate insurance provisions approved by the County's Risk Management Division. The County Administrator is authorized to execute amendments to the agreements, in
Exhibit 3 Page 3 of 11 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 forms approved by the Office of the County Attorney, revising Project Leaders, extending the term, or increasing the funding amount for the partially funded grant described in Exhibit "3-C," by utilizing unexpended EMS County Grant Funds allocated for FY 2014 projects. Section 5. The County Administrator is authorized to take all necessary administrative and budgetary actions for implementation of same and no County match is required. Section 6. SEVERABILITY. If any portion of this Resolution is determined by any Court to be invalid, the invalid portion shall be stricken, and such striking shall not affect the validity of the remainder of this Resolution. If any Court determines that this Resolution, or any portion hereof, cannot be legally applied to any individual(s), group(s), entity(ies), property(ies), or circumstance(s), such determination shall not affect the applicability hereof to any other individual, group, entity, property, or circumstance. Section 7. EFFECTIVE DATE. This Resolution shall become effective upon its adoption. ADOPTED this day of, 2013. 20 21 22 23 24 PME:hb Exhibit 3 EMS Grant App 2014 Reso 09-17-13.docx 09/17/13 #13-072.00
EMS COUNTY GRANT APPLICATION FLORIDA DEPARTMENT OF HEALTH Bureau of Emergency Medical Services Exhibit 3 -A Page 4 of 11 Complete all items ID. Code (The State Bureau of EMS will assign the ID Code leave this blank) C 1. County Name: Broward County Business Address: 115 South Andrews Avenue Ft. Lauderdale, FL 33301 Telephone: 954-357-5234 Federal Tax ID Number (Nine Digit Number). VF 5 9 6 0 0 0 5 3 1 2. Certification: (The applicant signatory who has authority to sign contracts, grants, and other legal documents for the county) I certify that all information and data in this EMS county grant application and its attachments are true and correct. My signature acknowledges and assures that the County shall comply fully with the conditions outlined in the Florida EMS County Grant Application. Signature: Date: Printed Name: Bertha Henry Position Title: Broward County Administrator 3. Contact Person: (The individual with direct knowledge of the project on a day-to-day basis and has responsibility for the implementation of the grant activities. This person is authorized to sign project reports and may request project changes. The signer and the contact person may be the same.) Name: Cheryl Rashkin Position Title: Manager, Trauma Management Agency Address: Office of Medical Examiner and Trauma Services 5301 SW 31 Avenue Ft. Lauderdale, FL 33312 Telephone: 954-357-5234 Fax Number: 954-327-6580 E-mail Address: Crashkin@broward.org 4. Resolution: Attach a current resolution from the Board of County Commissioners certifying the grant funds will improve and expand the county pre-hospital EMS system and will not be used to supplant current levels of county expenditures. 5. Budget: Complete a budget page(s) for each organization to which you shall provide funds. List the organization(s) below. (Use additional pages if necessary) Attached Projects 5.14.01 5.14.04 DH 1684, December 2008 64J-1.015, F.A.C.
BUDGET PAGE A. Salaries and Benefits: For each position title, provide the amount of salary per hour, FICA per hour, other fringe benefits, and the total number of hours. Attached Projects 5.14.01 5.14.04 Exhibit 3 -A Page 5 of 11 TOTAL Salaries TOTAL FICA Grand total Salaries and FICA B. Expenses: These are travel costs and the usual, ordinary, and incidental expenditures by an agency, such as, commodities and supplies of a consumable nature excluding expenditures classified as operating capital outlay (see next category). Attached Projects 5.14.01 5.14.04 TOTAL $ C. Vehicles, equipment, and other operating capital outlay means equipment, fixtures, and other tangible personal property of a non consumable and non expendable nature with a normal expected life of one (1) year or more. Attached Projects 5.14.01 5.14.04 NOTE: Project 5.14.04 is for partial funding and has been decreased from $104,860.00 to $8,860.00 TOTAL $ Grand Total $ 202,510.00 DH1684, December 2008
5. Budget: Complete a budget page(s) for each organization to which you shall provide funds. List the organization(s) below. (Use additional pages if necessary) PROJECT 5.14.01. 2014 First There Fire Care EMS Conference. County-wide. Organization: Fire Chiefs' Association of Broward County Project Budget: $50,000.00 Exhibit 3 Page 6 of 11 -A A. Salaries and Benefits: For each position title, provide the amount of salary per hour, FICA per hour, other fringe benefits, and the total number of hours. B. Expenses: These are travel costs and the usual, ordinary, and incidental expenditures by an agency, such as, commodities and supplies of a consumable nature excluding expenditures classified as operating capital outlay (see next category). 2 day EMS conference location and ancillary supplies $ 50,000.00 (To include: Advertising; printing and photography (still and video); and honorariums) C. Vehicles, equipment, and other operating capital outlay means equipment, fixtures, and other tangible personal property of a non consumable and non expendable nature with a normal expected life of one (1) year or more. TOTAL Grand Total $50,000.00 Page 5.14.01 DH Form 1684, Rev. June 2002
5. Budget: Complete a budget page(s) for each organization to which you shall provide funds. List the organization(s) below. (Use additional pages if necessary) PROJECT 5.14.02. Purchase and Implement EVOC Driver Simulator Program. County-wide. Organization: City of Hollywood Fire Rescue Department Project Budget: $110,000.00 Exhibit 3 -A Page 7 of 11 A. Salaries and Benefits: For each position title, provide the amount of salary per hour, FICA per hour, other fringe benefits, and the total number of hours. B. Expenses: These are travel costs and the usual, ordinary, and incidental expenditures by an agency, such as, commodities and supplies of a consumable nature excluding expenditures classified as operating capital outlay (see next category). $ C. Vehicles, equipment, and other operating capital outlay means equipment, fixtures, and other tangible personal property of a non consumable and non expendable nature with a normal expected life of one (1) year or more. The Driver EVOC Simulator Training System purchase $110,000.00 Simulator training program ongoing after initial purchase of simulator (Includes simulator, installation, scenarios, three-day training, on site instructors and one-year warranty) TOTAL $110,000.00 Grand Total $110,000.00 Page 5.14.02 DH Form 1684, Rev. June 2002
5. Budget: Complete a budget page(s) for each organization to which you shall provide funds. List the organization(s) below. (Use additional pages if necessary) PROJECT 5.14.03. 911 Emergency Medical Dispatch. County-wide. Organization: Sunrise Fire Rescue Project Budget: $33,650.00 Exhibit 3 -A Page 8 of 11 A. Salaries and Benefits: For each position title, provide the amount of salary per hour, FICA per hour, other fringe benefits, and the total number of hours. B. Expenses: These are travel costs and the usual, ordinary, and incidental expenditures by an agency, such as, commodities and supplies of a consumable nature excluding expenditures classified as operating capital outlay (see next category). EMD Training $ 33.650.00 (two classes, for 70 participants and software) C. Vehicles, equipment, and other operating capital outlay means equipment, fixtures, and other tangible personal property of a non consumable and non expendable nature with a normal expected life of one (1) year or more. TOTAL Grand Total $33,650.00 Page 5.14.03 DH Form 1684, Rev. June 2002
5. Budget: Complete a budget page(s) for each organization to which you shall provide funds. List the organization(s) below. (Use additional pages if necessary) PROJECT 5.14.04. Mass Casualty Incident (MCI) Equipment. Multiple agencies. Organization: Davie Fire Rescue Project Budget: $8,860.00 Exhibit 3 -A Page 9 of 11 A. Salaries and Benefits: For each position title, provide the amount of salary per hour, FICA per hour, other fringe benefits, and the total number of hours. B. Expenses: These are travel costs and the usual, ordinary, and incidental expenditures by an agency, such as, commodities and supplies of a consumable nature excluding expenditures classified as operating capital outlay (see next category). $ C. Vehicles, equipment, and other operating capital outlay means equipment, fixtures, and other tangible personal property of a non consumable and non expendable nature with a normal expected life of one (1) year or more. Purchase MCI Equipment bags for all 911 responders in Broward County TOTAL 8,860.00 Grand Total $8,860.00 Page 5.14.04 DH Form 1684, Rev. June 2002
FLORIDA DEPARTMENT OF HEALTH EMS GRANT PROGRAM Exhibit 3 -B Page 10 of 11 REQUEST FOR GRANT FUND DISTRIBUTION In accordance with the provisions of Section 401.113(2)(a), F. S., the undersigned hereby requests an EMS grant fund distribution for the improvement and expansion of pre-hospital EMS. DOH Remit Payment To: Name of Agency: BROWARD COUNTY BOARD OF COUNTY COMMISSIONERS Mailing Address: 115 South Andrews Avenue Ft. Lauderdale, FL 33301 Federal Identification number 59-6000531 Authorized Official: Signature Bertha Henry, County Administrator Type Name and Title Date 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 For State To Pay: $ Grant ID: Code: Approved By : Signature of EMS Grant Officer Date State Fiscal Year: - Organization Code E.O. OCA Object Code 64-42-10-00-000 750000 Federal Tax ID: VF _ Grant Beginning Date: Grant Ending Date: DH 1767P, December 2008 64J-1.015, F.A.C. 5
Exhibit 3 Page 11 of 11 -C FY 2014 EMS Grant Ranking Final Recommended Funding Project No. Project Name Total Score Funding Requested 14-OMETS-04 2014 First There First Care Conference and ALS Compet 87.00 $ 50,000.00 $ 50,000.00 14-OMETS-05 EVOC Driver Simulation Training 82.50 $ 110,000.00 $ 110,000.00 14-OMETS-01 911 Emergency Medical Dispatch 77.50 $ 33,650.00 $ 33,650.00 14-OMETS-07 Mass Casualty Incident (MCI) Equipment 72.50 $ 104,860.00 $ 8,860.00 14-OMETS-06 Ultraviolet Germicidal Irradiation Lamp 65.00 $ 10,710.00 14-OMETS-03 Video Laryngoscope Set 56.00 $ 161,800.00 14-OMETS-02 Critical Care Paramedic Class with Certification 51.00 $ 50,000.00 Total Funding Requested $ 521,020.00 FY 2014 Grant Funds Available $ 202,510.00 Total Funded $ 202,510.00 Total Unfunded $ 318,510.00