HomeMy WebLinkAboutR-1994-110RESOLUTION NO 110-94
A RESOLUTION OF THE CITY OF DANIA, FLORIDA, AUTHORIZING
THE CITY MANAGER OR HIS DESIGNEE TO APPLY FOR A GRANT
BEING OFFERED THROUGH THE STATE OF FLORIDA DEPARTMENT
OF HEALTH AND REHABILITATIVE SERVICES, OFFICE OF
EMERGENCY MEDICAL SERVICES, FOR EMS PEN BASED
COMPUTER REPORTING SYSTEM, AND PROVIDING FOR AN
EFFECTIVE DATE.
BE IT RESOLVED BY THE CITY COMMISSION OF THE CITY OF DANIA, FLORIDA:
Section 1. That the City Commission of the City of Dania, Florida, hereby
authorizes the city manager or his designee to pursue the application for a grant being
offered through the State Of Florida Department Of Health And Rehabilitative Services,
Office Of Emergency Medical Services, for an EMS Pen Based Computer Reporting
System, a copy of which is attached hereto as "Exhibit A".
Section 2. That this resolution shall be in force and take effect immediately upon
its passage and adoption.
PASSED and ADOPTED this 2 6 day of July ,1994
YO ONER
ATTEST:
4A/
,,
CITY CLERK AUDITOR
APPROVED FOR FORM AND CORRECTNESS
er, **'1 (' f'&"-"
Frank C. Adler, City Attorney
EMS Pen Based Computer Reporting System
Matching Grant Application
Florida Department of Health and Rehabilitative Services
Office of Emergency Medical Services @MS)
James E. Mulford, Division Chief
ra
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I-
&
THE
ontp
luly 20, 1994
The City of Dania Fire Rescue Department
Grant Liaison:
f.'
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CITY OF DANIA
lOO W. DANIA BEACH BLVD.
P.O. BOX 1708
DANIA, FL 33004
Phone:
Fax:.
921-8700
921-2601
luly 20, 1994
Department of Health and Rehabilitative Services
OfEce ofEMS
EMS Matching Grant Application
t 317 Winewood Boulevard
Tallahassee, Florida 32399-0700
Re EMS Pen Based Computer Reporting System
Florida Department of HRS
Office of Emergenry Medical Services @MS)
Matching Grant Application
Dear Sir:
Please find enclosed one original and eight (8) copies ofthe above subject matching grant
application.
The City of Dania is dedicated to the advancement of the quality of pre-hospital EMS activities
and services.
We hope you will support our grant application and look upon them favorably. If you have any
questions, or need additional information please contact me.
Very truly yours,
Crr/-a)/
ames E. Mulford
DMsion Chief
(305)
(305)
-- Code to be Assigoed by State EIIS Oflice: LL
- - -Florida Depanment of Elealt! eud Rehabilitative Services
Oflice of Energeocy Medical Services (EIVIS)
MATCEING GRANT APPLICATION
4 Agency/Organi--tion's Federal
Tax Identificatioa Nrrrnls1 uine digits IT 5 -g 6 0 0 0 3_- o 2
I Legal liame of
A geocy/Orga'' i'- tion:City of Dania Fire-Rescue
Name and Titie of
Grant Signer:
Mailing
Address:
l- 0 0 West Dani-a Beach Blvd .
Dania, F1a. 33004 Counry: Bro\^rard
Teiephone Number: (305) 92I-8700 SunCom Number:
1 Na.me and Title of
CoEtact Person:
Jarnes MulfordDivision Chief-EMs
Maiiing
Address
100 west Dania Beach BIvd.Dania, F1a. 33004
Telcphone Number: (305) 921_8700 x308 SunCom Number:
I-egal Status of
Agency/Organi."tioE: (o'.cL only oh.)
hiyrl. Nol for Ptoft Olou trur Ptovid. coP, o( clnificrE)
Pivrra for Prtu X rutic
Your frscal ycar:
Ll/L 9/30
BEGNS ENDS
5. Ecaiff thc orr ertc pl.n obj.ctiy. rti. t'oi.c! prirr.it, .ddrE ..t: Obr.ctiv. ,:1.'1 3.5, 33.1, 13.t,68.4
1
ConmunicrdoE _ ConrinuiDs PEfcaiorul Educrtion (nrdicri dir€cbr trllrn d8n lLlt 16r)
E crScrEy Tnnpon v..hiclc.
-
Arblic Educ.uon
Sy.r.m Ey.iu{ioi/Qurlhy Ar.rrrrE! _ ncsrEh
M.li$l/Rcruc E4uipticai (rijruorrlt rcquircd for ll!m. l6b .r'd l5c)
Der ].oor proiclr irtl'rd. G. purdrrE of .nt convnunicrtionr cquignrr{?
-
ygs
-I-
NO
Hnl Foni 1767, Mr.!h t9
Robert FlatleyCity Manaqer
6. Type of hoj ect: (Gr.t ody oo.):
For both the r,--.r god outcooe strteBelts: include eU aveilable uum,- data, tbe ti'r'e f!2.8e
for the &te, tbe &te source, the uuraber of p€ople who will dirrtly receive- project set-ices,
eod other i.uior.oation whicb clesrly ideutifies your need aud expetled outcolDe for this Projed.
7. Need Stateoent (use only the spacc b.lo*), o"rri. Fire-Rescue 1993 EI\.rs patient
run reports, numbering 3151, were nanually written and subjected to
manual quality assurance control analysis. No written reports rrrere
gathered in the format now required by the statewide reportj-ng system
legislation. I'Ie need to collect, store, retrieve, and transmit data
electronically to comply with state hride reporting legisJ-ation.
t. Outcome Statenert (r.rse only &e space below): t6. 'nstallation of this data
collection system will al1ow Danj.a Fire-Rescue the ability to
electronically capture, store, analyze, and transmit aI1 the required
data elements to the state IIRS office. This system wj-11 upgrade Dania'
current quality assurance program with e:nphaiis on thorough documentati
consistent with training and continuj-ty of patient care, providing
hospital staff wj-th patient report hardcopies.
9. Improvemeot and Expansion of Pr€hospital E\4S. Dcssribc how your projce imorovcs ud cxpra&
preUospiul E!(S. illso, show bow it buiids coordiarrion rod coopcrarion with other EMS s,vsaos.
Patient information will be captured faster and more accurately using
a pen based computer. Time previously spent on paperwork will be time
converted to improving patient care. Accuracy will improve, eliminatin
the amount of time spent correcting patient information. Time currentl
spent on data entry wirr re reduced. In sunmary, with the installation
of this system, we will be able to electronically capture, store
analyze, and transmit data to the state. Not only will this system
give us the data to meet state requirements but it wj-1l enhance and
improve Dania Fire-Rescue's quality assurance program.
10. Research hojects OuIy:
It rq, .lt !g coodult$t . rt*rr!"l ptir*! tif thit iErn .nd F to IErrt I l.
II you rrc conductiq r ltr.r!! proic.r. tg..! rha cod of rlr rpplicrdon coEir. ,xltrc'rl, oilhc h)?odctit, da.if/rllclhod, ialnrmcar, arabodr
16 ptot ct !um.. tlbi*r.. rtt, lilriudoi. isvolyint rb. -dy, r!...rrl in tnxn.ns! fottu ud lirittt of orh.t Ei.Y.nt Erdi...
n
11. tr4.qjor Work Activities and TiEe Fra.mes (Usc oaly the sprcc bclow):
-Order equipment 90 days after receipt of grant funds
-Installation of hardware,
sof t\rare. and training .180 days
day s
after
after
rec e j.pt
receiDt
of
of
grant €unds
grant funds-Begin data coflection.. . ...... .2L0
APPLICANT
TOTAL
12. Selaries end Benelits:
N,/A 0 0 0
TOTAL SALARIES snd BENEtrTrS
0 0 0
CATEGOR,IES
CrsbMra.n
13. Expenses
Tra ining
Support and service agreementsoftware--2 years
Software state EI{S rePort, quality
a s surance
Network for 2 station, 4 administra-tion offices
250
570
3136
4043
750
1710
9409
r 2131
1000
2280
t2545
t6t7 4
TOTAL EXPENSES 7 999 24000 3r999
StateGrrnt
Funds
CATEGORIES
APPLICANT
Cash
Match TOTAL
14. Equipment: Pen-based EMS computer
system
(5)
(s)
(1)
(1)
field data collection 486 computer
(ALS vehicles )printer s-hospit.al hard coPY
Vehicle plug in mounting brackets
Supervisor grid laptop convertible
Necessary cabling and installation
Server unit for network capabiliti es
8750
415
625
1375
200
700
26250
l.245
1875
600
210 0
3s000
1660
2500
5500
800
2800
TOTAL EQUIPMEIYT COSTS
12065 3619s 48260
3
StBte
Grant
Funds
StstrGrart
Funds
Note You Ery .ttach 8 prgc or pegcs o cxpleia rod justify tll necessary the need for ray rnd ell positions, expcnscs, rod
cquiprDcot i! tcrns of thc itcms, lheir quentitics, their costs, snd thcir roles in tbe projcct-
I.IOTE:software for driving pen base is included.
Systen includes:
-Handheld computers
-Data management, EI'"IS and archive software.
-A,/c adap ter/r ec harg er units
-Mounts-Printer s
-Spare batteries
-12 volt in car chargers
Network unit with additional server unit for
downloading into main system is required and priced.
1)
3
CATEGORIES
APPLICANT
Clsh
Mrach TOTAI
15. Fbsl $rrmrnaqr - Total of salaries
and beDefits, expenses 8Dd equipmeDt'
all combiaed
s 20064
Th. rbovG fiSurr
rrru( .qurl 25 pctcc
of thc roul
-t-u-o-t-r-t
Thc rbovc fit!.!
mun 4url ?5
P€rc. oftb.
t6Ll
3 80295
*:;;;;:-
rrul cqud thc
tlrttl ofth.
prEcdin, tl,o
4
16. Medical dirA's signeturcs: Complete thls iten only if your pro'r-\is e MedicallRescue
Equipoeut, or hr. .ond Education Project.
e Prolessional Educatiou
AII continuing education alescrib€d in this application is developed and conducted
with my input end approval.
Medical Director's Signature Date
Medical Director's Priuted Nr"'e
b. Medical EquiPment hojects:
I hereby eccept authority aud responsibilify for tbe.rse of Medicel Anti-Shock
Trousers fUeSn, EiopuiiJOutti"tot Aqit"ys tEO- as),-semi-autooatic aD.d automatic
i"nU.U"t"*' a.t.S equ:ip--eot identifred in Chapter -1.0Pi6.1 F.'{'C': aud equipment not
ia*tifr.ai" tl"pi."'fOildl-f.6t. Etlirres:pousibility is delegated, both the delegated
physician and th6 medical dirtctor must sign this sectiou.
Date
7t 20t94
L.Scott- tl l i
-- _- -= -:1'.---_---_>
n- M l)
Medical Director's Printed N"me
and Delegated Physician, if anY
Medical Directorr s Signature
and Delegated Physician' if anY
c.IherebyackaowledgethatthelpplicaDt_IEPondsroutinelytorescueorEe
inciileots under wriiteu agreeme-ut with my liceosed EIVIS systeo'
Date
Printed Name
Medical Dir€ctor's or Authorized Persou's Signature
dical
5
APPUCATION ffEN{ 17 (signarure required)
REQT'ESTFORMATCHINGGRANTDISTRIBUTION(ADVANCEPAYMENT)
EIVTERGEI{CY MEDICAL SERVICES (EI\{S)
Governmentel Agency and Non-profit Entity ONLY
b eccor&rcc wirh thc provisions of prngnph /ol.rr3(2xb), F.S., the uadersig3ed hcrtby rcqucsts ra EMS ortchiag
greatdisuibutiou(Edv.Dc!P.yMt)forthcioProvemcntradcxPersionofprcbospitelEMS.
'I 00 wes nan i a Rea oh Rl rzd
Address
Dania 33004
(City)(St8le)
Official
SIGNATURE:DATE:
Printed Name:bert Flatley Title:City Manaqer
SIGN AND RETURN WITH YOUR MATCHING GRANT APPLICATION TO:
Dcprrtocot of Hcelth rnd Rehsbililative Sewiccs
Of6cc of Eocrgcocy Mcdiet Scwices (IISTM)
EMS Matching Grents
131? Winewood Boulevard
Tdlahrsscc, Florida 32399{700
(zip)
Matchilg Grrat A.EouDt: $
For U.. Ooly by DcP..tsrcd of H..ilh rrd Rchrbiliutivc Scrviccr'
Ofice of E:ncrycrrY Mdic'l s€lvicct
Grant ID Codc:
Approvcd By;
Signeturc, Slrte EMS Grant Officer
State fi8cal Year: Amount: S
oroanization code
50-20-60-3 0-100
clant Beginning Date:
4
Drtc:
obiect Code
Ending Date:
-
E.O.
HS
Fedelal lax ID v F:-
-
6
Payment To: city of nania Fi re-Rescue
Icgd Neme of AgeacY/Orgeuizetion
IE. ASSURANCES AND APPLICATION SIGNATURE
Certificstion of Stlndards Stst tent
I, rbc uodcrsigucd, clnify th8! if gr.lr€d fiuds uoder Cheptcr 4Ol, Pan II, F.S.; r-s emcadcd, dl eppliczblc rcgulations rad
sgo&rds will bc sdbcrrd 19 i5cludilg: Cb.por 4Ol, F.S.; Cbaptcr 10D56, F.A-C.; Miaiouo Wege Act: TitlcVIof thc
Civil RiSbts Act of 1964 (42 ISC 2O@D ct. scg.); DHEW Rcgulrrioo (45 CFR Pert EO); Rehabiliutiou Act (Scc 5O4);
Dcvelopmcota.lly Diseblcd Assisurcc eod Bill of RiSbB of 1975 (P.L.95{02) rs aoeoded by Title V of the
Comprehcusive Rehebiliretivc Serviccs ADrcodEcuts of l97t: Confideotiality; HuE .u RiSbs; Habiliution Plans;
Eoploymeot of thc Hrodicapped; Sewiccs for Perrcns Uoeblc o Pey.
Stetefient of Cash Commitrnent
I, thc uadcrsigocd, crnify lb8t cash Earch will b€ rvail.blc duri-o8 thc 8r8nt Pcriod end uscd i! dircct suPPod of this graat
projccr. Stst€ rad fcdcnl iu& r*ill Dot bc uscd for o:tchiag rcquircocats, ua.lcss spccificd by lew. No costs or third-
peny contributions coust towrrds sarisffing r nutchiag rcquircmcnt of e depanEeol gr.nt if tbcy rrc uscd to setisfy I
oerching rcquireoclt of eootber statc or fcdenl grant, Cash, salrrics, fringe bcoefis, exPens€s, equipment, eod otber
cxpcascs es lisrcd oa this application sball bc committcd urd uscd for the depanmeut's frnal approvcd project duriag thc
great pcriod.
Acceptance of Terms rnd Conditions
I, tbc undcrsigacd, rc4cpt tbc gr..ot tcrurs 8nd conditions in Appcudix B of tbc bookl4, '1992 Flori& EMS Matchiag
Grant Progren'. by tbc Deperrocot of Health aod Rebebiliretivc Scnices and ecknowledge this whcn funds rc dnrva or
othcrwisc obteined from thc graat prymcat systcE.
Disclaimer
I, tbc undcrsigned, hereby ccnify thst the facts and iaformation cont inei in this applietiou and any follow-up docurDeEB
lre lruc erd corrccr ro tbe besr of my knowledge, inforrnetioo, end bclief. I funber understand that if it is subsequcotly
dcaroi.ucd thaa this is uot corlccr, the gralt funded under Chaptcr 401, Pan II, F.S. .nd CbaPter 10D66, F.A.C., oay bc
rcvokcd, aad eny monics crroreously paid aod iaterest eerned will be refunded to the dcpanment with roy pcnalties whicb
oay bc imposcd by law or applieble rcgulalions.
Notification of Awards
I, tbe uodersigned, urderstand tbc availability of the uoticc of award will bc advertised il tlre Flori& Admraistretivc
Wcekly, end that 30 elcodar days efter this Flori& Admilistrative Wcckly 8dvenisement I waivc any right to cballcnge or
protest i.D rayway tbe dccisions to award gran6.
I\{aintenance of Imorovernent and Exoansion
I, the uodersiglcd, agrec that aDy improvemcot or cxpansion brought about in whole or part by Srant funds, will bc
Eailtaincd for five ycers after thc projcct euds, unlcss spccificd othcrwise io the approved application or unlcss thc
depanrDctrl 88rcas lD wnllDg to dlo* s cbalge- Any unautborized change withia the five years will Dealssitatc ttre rcturu
ofgrant funds i-nvol if yto t.
7- t7- r
Signature Authorized Grant Sner
(l.odividuel Identified i! ltc6 l)
Dare
NOTE: Please check to insure that all re4uired signatures have been made for ltems 16, 17, and 18.
The application will not be considered for funding without any required signature.
7