HomeMy WebLinkAboutItem 09 Approval of Emergency Medical Services Interlocal Agreement Between Orange County and the City of Ocoee
center of Good Lt
~
AGENDA ITEM COVER SHEET
Meeting Date: September 6, 2005
Item # --9
~~
/
Subject: Approval to execute Emergency Medical Services Interlocal Agreement between Orange
County, Florida and Ocoee, Florida
Pete McNeil
407 -905-3127
Reviewed By:
Department Director:
City Manager:
Contact Name:
Contact Number:
Background Summary:
In order to improve and expand the City of Ocoee's pre-hospital Emergency Medical Services the Fire Department
requested and was awarded a 100% non-matching grant from Orange County EMS for the purchase of 16
Automatic External Defibrillators (AEDs) to be distributed to City Facilities and Police vehicles.
Issue:
The 16 AEDs and accompanying pediatric kits valued at a total of $30,721.60 were purchased by Orange County
EMS for the City of Ocoee. These AEDs are now in place throughout the city and are readily available for use by
citizens or city employees in the event of a cardiac arrest. The subject Interlocal agreement must be executed in
f')rder to complete the award process.
tecommendatlons
Recommend approval to execute the Emergency Medical Services Interlocal Agreement
Attachments:
Emergency Medical Services Interlocal Agreement
EMS Equipment Awards pick-up list
EMS County Grant General Conditions
Financial Impact:
This agreement will have no financial impact on our budget. The EMS Grant addressed in this Interlocal
Agreement is fully funded by Orange County EMS. No cost is incurred by the City of Ocoee.
Type of Item: (please mark with an "xj
Public Hearing
- Ordinance First Reading
- Resolution
-X Commission Approval
- Discussion & Direction
For Clerk's DeDf Use:
_____ ConsentAgenda
_ Public Hearing
_ Regular Agenda
X Original Document/Contract Attached for Execution by City Clerk.
== Original Document/Contract Held by Department for Execution
~eviewed by City Attorney
Reviewed by Finance Dept.
Reviewed by ( )
NlA
N/A
N/A
City Mana2:er
Robert Frank
Commissioners
Dannv Howell. District 1
Scott Anderson. District 2
Rusty Johnson. District 3
Nancy J. Parker. District 4
Mayor
S. Scott\Tander2Tut
STAFF REPORT
TO:
The Honorable Mayor and City Commissioners
FROM:
Pete McNeil, Deputy Fire Chief
DATE:
August 31, 2005
RE:
Approval to execute Emergency Medical Services Interlocal Agreement
ISSUE
In order to improve and expand the City of Ocoee's pre-hospital Emergency Medical Services the Fire
Department requested and was awarded a 100% non-matching grant from Orange County EMS for
the purchase of 16 Automatic External Defibrillators (AEDs) to be distributed to City Facilities and
Police vehicles.
The subject Interlocal agreement must be executed in order to complete the award process.
BACKGROUNDIDISCUSSION
Sixteen Automatic External Defibrillators (AEDs) and accompanying pediatric kits valued at a total of
$30,721.60 were purchased by Orange County EMS for the City of Ocoee. These AEDs are now in
place throughout the city and are readily available for use by citizens or city employees in the event of
a cardiac arrest. The added availability of these potentially lifesaving units will enhance the
effectiveness in our City's aJrrent CPRlAED citizen and employee training program.
This agreement will have no financial impact on our budget. The EMS Grant addressed in this
Interlocal Agreement is fully funded by Orange County EMS. No cost is incurred by the City of Ocoee.
Therefore, it is the recommendation of Fire Department management that the City Commission
approve the execution of the Emergency Medical Services Interlocal Agreement between Orange
County, Florida and Ocoee, Florida.
EMERGENCY MEDICAL SERVICES
INTERLOCAL AGREEMENT
BETWEEN
ORANGE COUNTY, FLORIDA
AND
OCOEE, FLORIDA
THIS EMERGENCY MEDICAL SERVICES INTERLOCAL
AGREEMENT is entered into this day of ,2005,
by and between Orange County, a political subdivision of the State of Florida,
hereinafter referred to as the "COUNTY," and to the City of Ocoee, hereinafter
referred to as the "OWNER."
WHEREAS, under Section 401.113(2), Florida Statutes, the
Department of Health: Bureau of Emergency Medical Services, hereinafter
referred to as the "DEPARTMENT" shall annually dispense funds contained in
the Emergency Medical Services Trust Fund; and
WHEREAS, the COUNTY has applied for its proportion of funds from
said Trust Fund; and
WHEREAS, Section 401. 11 3 (2)(a), Florida Statutes (hereinafter the
"Statute"), provides that an individual Board of County Commissioners may
distribute funds received under the Statute to licensed Emergency Medical
Services Providers within the County as designated' by the Emergency Medical
Service (EMS) grant award; and the City of Ocoee
WHEREAS, Such grant money shall be used solely to improve and
expand pre-hospital emergency medical services and will not be used to supplant
or replace any other funds; and
WHEREAS, the Board of County Commissioners of Orange County,
Florida, has agreed to purchase and distribute equipment and/or services or both,
pursuant to grant awards #C4048 to the City of Ocoee, (OWNER).
1
NOW, THEREFORE, the parties hereto agree as follows:
1. OWNER agrees, warrants and covenants as follows.
a. To use the facilities, vehicles, and equipment purchased under the
grant award, solely for EMS throughout their useful life. Failure to use the
facilities, vehicles and equipment for EMS will result in termination of this
Agreement, items being returned to the COUNTY and further restrictions on
future allocations.
b. To accept full title to all designated equipment purchased with EMS
grant funds. An Equipment Release Form will be provided at the time of
distribution (Attached as Exhibit "A ").
c. To clearly document the assignment of equipment and usage and
provide such documentation to the COUNTY within thirty (30) days of the
assignment.
d. To be responsible for properly insuring, licensing and maintaining
equipment purchased with county EMS grant funds for the useful life of the
equipment.
e. To notify the COUNTY upon the loss, destruction, or theft of the
equipment.
f. To not sell, lease, rent, lend, encumber or dispose of said equipment
without the written permission from the COUNTY.
g. To provide access to all such information, reports and documents as
may be required for the COUNTY to monitor the grant.
h. To comply with all tenns and conditions imposed on the COUNTY
as "original owner" of the equipment. A copy of the grant requirements is
attached as Exhibit "B" and incorporated herein.
2
i. That OWNER is duly authorized by law to provide pre-hospital
emergency medical services and shall maintain all licenses and approvals
required by any law, rule or regulation of the State of Florida required for the
rendering of pre-hospital emergency medical services.
j. That the COUNTY's sole responsibility is to distribute the designated
equipment and/or services or both, pursuant to the grant award.
k. That the undersigned possesses the authority to legally execute and
bind OWNER to the terms of this Agreement.
2. COUNTY agrees, covenants and warrants:
a. To comply with all terms and conditions as "Grantee" of the grant
award.
b. To purchase and distribute the designated EMS equipment and/or
services or both to OWNER.
c. To transfer title of the designated equipment to OWNER at the time
of distribution.
3. This Agreement may be tenninated upon the OWNER returning all
equipment purchased with EMS grant funds to the COUNTY.
3
IN WITNESS WHEREOF, the parties hereto have caused this Interlocal
Agreement to be executed by their undersigned officials as duly authorized.
Orange County, Florida
By: Board of County Commissioners
By: I ~ d ..4.:.. ew-..~ L' ·
I
/ Coun Mayor
7*
Date: 7.} 1.-oS
Attest: Martha Haynie, Comptroller
As Clerk to the B of County Commissioners Ii
y.
City of Ocoee, Florida
By:~~tthd~~ .~
Title:
Date:
Federal Employer LD. #
Attest:
Title:
By:
4
CITY OF OCOEE SIGNATURE PAGE
ATTEST:
Beth Eikenberry, City Clerk
(SEAL)
FOR USE AND RELIANCE ONLY BY
THE CITY OF OCOEE, FLORIDA
APPROVED AS TO FORM AND LEGALITY ON
this day of , 2005.
FOLEY & LARDNER LLP
By:
City Attorney
APPROVED:
CITY OF OCOEE, FLORIDA
S. Scott Vandergrift, Mayor
DATE:
APPROVED BY THE OCOEE CITY
COMMISSION AT A MEETING HELD
,2005,
UNDER AGENDA ITEM NO. .
EQUIPMENT FOR: Ocoee Fire Department
EMS AWARDS C-4048 Year 2004-2005
Item Part Number Quantity SIN POI
LifePak 500 81401-000001 16 M19109
Infant/child Rduced Energy
Electrode 111 01-00001 7 16 M 19109
EQUIPMENT PICKED UP BY:
".-;)
"l'~& m CV\)f~,L.-
.
Print Name
(/3 J6~
DATE
rr~,
'--tT-
~
\i ,;;;~
Orange County EMS Representative
JUL.-14-'::~~~ J.'+'sr
CI.ICr<:LJCI't.... \ I'\C.IJ. ....ML... ;:>Cr<:V.....c:.
0_ _ .-...JU -''-t~'-' r . J::.J~' ~u
EMS C.ounty Grant
General Conditions
1 . The arantee herebY aarees to:
a. improve the existing quality of
prehospital EMS activities, services, or to
decrease patient mortrality and morbidity; and
b. to expand the extent, size or nur:nber
of existing prehospital EMS activities or services.
The activities and services to be provided are
described in the EMS county grant application
and its department approved revisions on file in
the state of Florida, Department of Health, Bureau
of EMS, Tallahassee. Florida.
2 Statute and Rule: Prehospital EMS
a~tivities will be rendered by the grantee in a
manner consistent with Chapter 401, Florida
Statutes Chapter 64E-2.030, Florida
Administr~tive Code. and the work plan in the
grantee's EMS county grant application ~nd its
. , department approved revisions on file With the
department. Further, the grantee agrees. to
, implement provisions of this grant in accordance
with federal, state, and local laws, and rules,
regulations, and policies.
J. Confidentialitv: The grantee shall not use
or disclose any client/patient information under
this grant for any purpose not in conformity with
state regulations and federal regulations (45 CFR,
. Part 205.50) except upon written consent of the
client/patient or hislher responsible parent or
. ' guardian as authorized by law.
4. Incident Recortina:
a. Client Risk Prevention. If services
to clients will be provided under this grar:at, the
grantee and any subcontractors. shall, in
accordance with the client risk prevention system, .
report those situations listed in Department ~f
Children and Familities 215-6, Pa~graph 5, In
the manner prescribed in that regulation.
b. Abuse, Neglect and Exploitation
Reporting. In compliance with Chapter 415, F.S.,
an employee of the grantee who knows, or has
reasonable cause to suspect, that a child, aged
person or disabled adult is or has been abused,
neglected, or exploited, shall immediately report
such knowledge or suspicion to the central abuse
"egistry and ~cking system of the department
.m the single statewide toll-free telephone number
(1-S00-95ABUSE).
5. Availabilitv of Funds: EMS county grants
are subject to the availability of funds. The
department's performance and 'obligation to pay
under this grant is contingent upon a sufficient
annual appropriation by the Florida Legislature
and adequate cash in the EMS Trust Fund.
6. Decals: The department may provide the
grantee DOH logos and decals. If so, the grantee .
shall affix these, in a prominent location, to all
equipment purchased in whole or part with grant
funds.
7. Comcuter Hardware/Software: The
grantee agrees that all computer hardware and
software shall be approved in writing by the state
Bureau of EMS. Costs of computer equipment
and activities which do not have this prepurchase
approval are not allowable.
8. Communications: The grantee agrees that
all communications:o:;oactivitiesj services, and
equipment shall be approved in writing by the
Florida Department of Management Services,
Information Technology Program (ITP) as required
by chapter 401.024, F.S. The written approval
must be dated after the. beginning date of the
grant and prior to any commitment to purchase
the requested equipment and/or services. This
approval is required in addition to any previous
ITP recommendation, review, conceptual or other
approyal dated prior to the' beginning date of ~e
grant. Costs incurred prior to the grant starting
date cannot be paid under th~ grant For further
information contact:
Director .
Information Technology Program
Department of Management Services
4050 Esplanade Way, Building 4030
Tallahassee, Florida 32399-0950
(8s.o>922-7415 or (5C)292-7415
9. Travel/cer diem: Travel and per diem
expenses shall be in compliance with seeton
112.061. F.S. The grantee shall be solely
responsible for all costs:
a. which the grantee 'pays prior to the
beginning date C?f the project;
b. which the grantee does not
encumber before the grant ending date, and
c. which the grantee encumbered
before the grant ending date but pays 41. or
more days after the ending date of the grant.
10. Purchasina: A Vendor Ombudsman ~as
been established within the department of BankIng
13
~U~ .~-~~~w .~.~(
1::.1 . U;;.r\.UJ:::.1 "'t\." I ." U=.JJ J. \",ML... .;Jc.r::. V J. .......1::.
o~~ ~OO j~~O ,.~~~~O
and Finance. The duties of this individual include
acting as an advocate for vendors who may be
experiencing problems 'in obtaining timely
payment(s) from the state agency. The Vendor
Ombudsman may be contacted at (850) 488-2924
or the State Comptroller's Hotline. 1-600-848-
3792.
11. Ownership/Assianment: The grantee shall
own all items including vehicles, buildings and
equipment purchased with state EMS county grant
funds unless otherwise described in the grant
application. The grantee shall clearly document
the assignment of equipment ownership and
usage, and maintain these documents so they
are available during monitoring by the state. The
owner of vehicles and equipment purchased with
state EMS grant funds shall be responsible for its
proper insurance, licensing, permitting, and
maintenance.
When any state EMS grant funded equipment
ceases to have any useful life it may be sold for
_ , scrap or disposed of in the customary way that
the agency disposes of equipment which has no
further fundi,onal use. The grantee must use the
. resulting funds, if any, for prehospital EMS in
Florida.
-f a private organization'is the owner of any
equipment funded in whole or part by state EMS
grant funds, and purchased that equiprnent to
provide services for a municipality, county."or
other public agency, and the services cease
. within five years after the grant ends" the
,ownership of the equipment must be transferred
. to that municipality, county or other public agency.
There shall be no cost to the recipient
organization. This is applicable even when
services cease due to a contract ending or for
any other reason.
12. Maintenance of Efforts: Any improvement
,or expansion brought about in whole or part by
grant funds shall be maintained for five years
after the projed ends. Reduction within the five
years which is not approved by the Bureau,
shall necessitate the return by the grantee of the
involved project's funds plus interest if any, as
specified by the department. The grantee must
.send the funds within 40 days of written
notification by the department
~er the five years, all equiprnent purchased with
~tate EMS grant funds must continue to be used
r prehospital EMS in Florida throughout its useful
I/fe, whether owned by the grantee or others. If
a violation is found at any time after the five years,
regardless of equipment ownership at that time,
"-
one, half of current value of the items must be
returned to the state by the grantee who received
the grant under which the original purchases were
made.
13. Lobbvina: The grantee agrees to, comply
with the provisions of sections 11-.062 and
216.347, F.S., which prohibit the expenditure of
grant funds for the purpose of lobbying the
Legislature, judicial branch, or a state agency.
14. Monitorina: The grantee agrees to assign
a person to maintain a file for each grant which
includes a copy of the Notice of Grant. Award
Jetter, Bu~eau approved application including
approved budget and all appendixes, approved
changes, and this grant manual. .The grantee
shall ensure that any financial documents related
to this activity are made available to the bureau
or its designee upon request, for a period of five
years fro~ the endil')g date of the grant. The
grantee, hIS subgrantee(s) or contractor(s) and
assignee(s) shall provide during reasonable hours
whatever information is necessary for the
department to monitor the grant, including access
to client records related to the grant.
15. Income. Fees. and Other Cash: If project
activity results in the payment to the grantee or
other party of income, fees, or cash of any other
kind, the total amount of that cash shall be applied
to the costs of the project.
Before any state funds can be assigned as
allowable costs, the total amount of such. cash
paid during the grant shall be applied to the total
activity costs after the ending of the grant and all
costs are final.
EMS County Grant
General Requirements
The EMS County grant general conditions and
requirements are an integral part of the county grant
agreement between the agency/organization (grantee)
ancfthe state of Florida, Department of Health (grantor
or department). In the event of a conflict. the following
requirements shall always be controlling:
1. Records: The grantee shalJ maintain financial
and other documents related to the grants to support
all revenue and expenditures. The final expenditure
report shaU indude all expenditures of the EMS County
Grant funds for the grant period.
SOls and payment records for fees or other
compensation for selVices and expenses shall be
maintained by the grantee in sufficient detail forthe
14
JU~-~q-~~~~ ~~.~~
c:.1'1C.~l,.;;iC.1 't"""' I .oll;;:.J.J J. \"'r"U.. Ot:.["'\,. v J. \.".oC,
c~~ ~~U J~~O r.~~'~o
proper pre-audit, post-audit, and monitoring review of
the grantee's records by the department.
2. Indemnification: If the grantee is a state
agency or subdivision as defined in section 768.26, F.S..
only the following paragraph DbD is applicable. Other
than state agencies or subdivisions only paragraph aa"
is applicable.
a. The grantee agrees to be liable for all
claims, suits, judgements, or damages, including court
costs and attorney's fees, arising out of the negligent or
Intentional acts or omissions of the grantee and its
agents, subcontradors, and employees, in the coursa.
of the operation of this grant Further, the grantee agrees
to indemnify 1he department against all claims, suits,
judgements, or damages, including court costs and
attorney's fees, arising out of the negligent or intentional
acts or omissions of the grantee and its agents,
subcontractors, and employees, in the course of the
operation of this gram. Also, the grantee agrees to
defend the department. upon receMng timely written
notification from the department, against all claims,
suits, judgements, or damages, including costs and
- ,attorney fees, arising out of negligent or intentional
acts or omissions of the grantee and its agents,
subcontractors, and employees, in the course of
'the operation of this grant. Where the grantee
and the department commit joint negligent acts,
the grantee shan not be liable for nor have any
)bligation to defend the department with respect
to the part of the joint negligent act committed by
the department. In no event shall the grantee be
liable for or have obligation to defend the
department against such claims, suits, judgements,
. or damages, including costs and attomey fees,
.' arising out of the sole negligent acts of the
department.
b. Any grantee who is a state agency
or subdivision, as defined in section 768.28, F.S..
agrees to be fully responsible for its negligent
acts or omissions or intentional tortious acts which
result in claims or suits againSt the department,
and agrees to be liable for any damages
proximately' caused by said acts or omissions.
Nothing herein is intended to serve as a waiver
of sovereign immunity by any grantee to which
sovereign immunity applies. Nothing herein shall.
be construed as consent by a state agency or
subdivision of the State of Florida to be sued by
their parties in any matter arising out of any grant.
The grantee agrees that it is independent of the
department and not an agent or employee, unless
it is organizationally within the department.
. Notice of Grant Award: All EMS county grants
are made in accordance with section
401.113{2){a), Florida Statutes, and are made
by an EMS Notice of Grant Award letter. The
Notice of Grant Award letter (appendix A) and .
the contents of this manual. contain by reference
aU regulations, rules, and other conditions
governing this grant.
4. Advance Distribution (Pavment): The
department agrees to request advance distribution
(payment) of the full grant amount after the Notice
of Grant Award letter is sent to the grantee. This
payment will be s~n~ as cash flow permits.
5. Supplantino Funds: EMS County Grant
funds shall not be used to supplant (replace) any
part of the grantee's regular EMS cudget
allocation. The grantee shall not use any county
or matching grant funds to supplant or replace
any other funds unless specified in the approved
application. County award funds dispensed under
section 401.113(2)(a). F.S., cannot be used to
fulfill the matching reqyirement for any state.EMS
matching grant unde(section 401.11.;3(2)(b), F.S.
6. Reaffirmation of Terms and Conditions: All
terms, conditions, and provisions of this grant
and manual, and other applicable documents are
hereby reaffirmed. The grantee acknowledges
acceptance of the grant terms and conditions
when the grantee draws money or otherwise
obtains funds ~rom the state grant payment system.
Financial
1 . EMS County Fund Accountino: All state
EMS grant funds shall be deposited by the
grantee in an account maintained by the grantee,
and assigned a unique accounting code
designator for all grant deposits and
disbursements or expenditures thereof. All state
EMS grant funds in the account maintained by
the grantee shall be accounted for separately from
all other grantee funds.
2. Use of County Grant Funds: All state EMS
grant funds shall be used between the beginning
and ending sates of the grant solely for activities
as outlined in the Notice of Grant Award letter, its
attachments if any. and the application including
its budget with its revisions, if any. on file in the
state EMS office.
The grantee is not restricted to staying within the
line item amounts within the" approved grant
budget However, the grantee must stay within
the approved total grant budget. Any expenditures
beyond this budget are the full responsibility of
the grantee.
3.
15
The authority to spen~ or encumber grant
JU~-lq-~~~~ ~~'q~
~TIt:::Kl.Jt:::Nl. Y "It:::.lJ ! l.H~ ::.t:::KV! (,,;1=.
b~~ 4~~ ~4~~ P.05/08
funds expires on the ending date. of the grant
time period, which is cited in the Notice of Grant
Award letter. Encumbered funds must be paid
within 40 days of the grant ending date. .
Unen'cumbered EMS County
Grant Funds (Relievers)
Any unemcumbered EMS county grant program
funds, including interest, remaining in the
assigned grantee account at the end of a grant
period shall be reported to the department. The
grantee will retain these funds in the EMS County
Grant account and include them in the budget of
the next county grant application.
Disallowed Expenditures
No expenditures are allowable as grant costs
unless they clearly are 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 county grant expenditure
shall be returned to the EMS county grant account
maintained by the grantee within 40 days after
,e department's notification. The costs of
..Jisallowed items are the responsibility of the
. county.
Revisions
. 'The grantee shall obtain written approval from the
state EMS grant manager, on the Grant Change
Request form (Appenr;fix B) prior to .any of the
following changes to the approved grant budget
1. Adding a new line item to the
approved budget.
2. Increasing a salary rate of payor
other payment rate to an individual for services,
by more than ten percent
3. Beginning a sub-grantee .or
contractor relationship that is .not specifically
identified in the approved budget or application.
Reports and Documentation
Due Dates: The grantee shall send to the
_~te EMS grant manager one original and one
copy of the required reports by the date specified
- in the Notice of Award letter. progam activity
and expenditure reports will be used to ensure
16
adequate monitoring and auditing of the grantee.
2. Excenditure Recorts: The Expenditure
Report (Appendix C-1) indicates aU agreed upon
budget expenditures and contains columns to be
~mpleted for reports. Reports cover a six, nine
and twelve month period of activities (final report).
The expenditure Plan (Item 7) in your approved
application has a blank "expenditures year-to-
date- column to report eXpenditures and a place
to write the amount of interest earned on the state
funds. Copy this page, complete it, and submit it
for your expenditure reports.
3. Prooram Activity Recort: The Prograni" Activity
Report (DH Fonn 1684A, Jan. 98) must be provided at
the end by the date specified in the Notice of Grant Award
letter. Report all program activities as described in the
approved grant Y!Qrk plan and subsequent amendments
approved in Change Requests. The report must cover
the entire grant period. .:'
,j
4. Withheld. Pavment: Any payments due the
grantee under the tenns of this grant may be withheld
~ntil the grantee provides all reports that the grantee
owes to the department, and the department has .
approved all of the grantee's reports and is satisfied the
grantee has met all obligations. .
5. Earlv Termination: If .the project
accomplishes all of its objectives before the grant
ending date, the grantee may request that the
grant be closed, and send a final expenditure
and program activity report. If the state EMS
grant manager approves, the manager will close
the grant. Thereafter, because the grant has
ended, there can be no further activities or
expenditures under the grant.
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, Office of Emergency
Medical Services..
JUL-14-20~~ 14:40
EMER~cNCY McV1CHL o~RVICE
~u 4d~ ~4~~ ~.~b/~~
If the sponsorship reference is in written or other visual
material, the word, "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 (free) 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, pidorial reproductions, drawings, or
other graphic representations and works of any similar
nature, the department has the right to use, duplicate
and discl~se, such materials in whole or in part, in any
manner, for any purpose whatsoever and to have others
- acting on behalf of the department to do so. 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 applicatio"n forthe same, will
vest in the state of Florida, Department of State, for the
.!xclusive use and benefrts of the state. Pursuant to
section 286.021, 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.
Civil Rights Assurance
The grantee gives these assurances for federal grants,
loans, contracts (except contracts of insurance or
guaranty), property, cflSCOunts" or other federal financial
assistance to programs or activities receiving or
benefiting from federal financial assistance.
The grantee agrees to complete the Civil Rights
Compliance questionnaire, HRS Forms 946A and B, if
requested by the department
Although no federal funds are involved in this grant the
grantee ensures that he/she will comply with the
following the same as if. federal funds were being
Drovided:
1. 7itie VI of the Civil Rights Act of 1S64, as
. amended, 42 U.S.C. 2000d et seq., which prohibits
discrimination on the basis of race, coloJ; or national
Origin in programs and activities receiving or benefiting
from federal financial assistance.
'2. Section 504 of the Rehabilitative Act of
1973, as amended, 29 U.S.C. 794. which prohibits
discrimination ori the basis of handicap iO programs
and actMties receiving or benefiting from federal financial
. assistance.
3. TItle XI of the Education Amendments of
1972, as amended, 20 U.S.C. 1681 et seq., which
prohibits discrimination on the basis of sex in education
programs and activities receiving or benefrtiF-lg from
federal financial assistance.
4. The Age Discrimination Act of 1975, as
amended, 42 U.S.C. 6101 et seq., which prohibits
discrimination on the basis of age in programs or
activities receiving or beoefiting from federal financial
assistance. \'!
5. Section 654 of the Omnibus Budget
Reconciliation Act of 1981, as amended, 42 U.S.C:
9849, which prohibits discrimination on the basis of race,
creed, color; national origin, sex, handicaps, political
affiliation or belief.
6. The Americans with Disabilities Act of
1990, P.L. 101-3361 which prohibits discrimination on
the basis of disability and requires reasonable
accommodation for persons with disabilities.
7. U.S. Department of Health and Human
Services Regulations for Protection of Human Subjects
(45 CFR, as amended) regarding the protection of
human research subjects.
a. All regulationsl guidelines, and standards
lawfully adopted under the preceding statutes.
The grantee agrees that compliance with this assurance
constitutes a condition of continued receipt of, or benefit
from state EMS funds, and that it is binding upon the
grantee, successors, transferors. and assignees for the
period during which such assistance is provided. The
grantee further ensures that all contractors,
subcontractors, sub-grantees or others with whom ,it
arranges to provide services or: benefits to participants
or employees in connection with any of its programs
and activities are not discriminating against those
participants or employees in violation of the preceding
statutes, regulations, guidelines, and standards. In the
event of failure to comply, the grantee unde~tands that
the department may, at its discreti~n, seek a court order
17
~UL-~~-~~~~ ~~.~~
CI'ICr';(.:Il:I'I1.. T "IC.LJ! I..HL.. :::>t:.r;;V! I..C
~~~ ~OO ~~~O ~.~(/~
requiring compliance with the terms of this assurance
or seek other appropriate judicial or administrative relief,
to include this and other state EMS grants being
tenninated and further state EMS grants being denied.
The department shall not be liable for violations by
grantees of any of the federal laws, rules, regulations,
or guidelines outlined herein.
AUdit-Requirements
FINANCIAL AND
COMPLIANCE AUDIT
This attachment is applicable, if the provider or
grantee, hereinafter referred to as provider, 'is any local
government entity, nonprofit organization, or for-profit
organization. An audit performed by the Auditor General
, shall satisfy the requirement of this attachment
-, PART I: FEDERALLY FUNDED
'This part is applicable if the provider .is a Jocal
government entity or nonprofit organization and expends
a total of $300,000 or more in federal funds passed
hrough the department during its fiscal year. The
determination ofwhen a provider has lIexpended-federal
funds is based on when the activity related to the award
occurs.
,Local governments shall comply with the audit
, requirements contained in the Office of Management
'and Budget (OMB) Circular A-12S, Audits of State and
Local Governments. Nonprofit providers shall comply
with OMB Circular A-133, Audits of Institutions of Higher
Learning and other nonprofit institutions, except as
modified herein. Such audits shall cover the entire
organization for the organization's fiscal year. The
reporting package shall include a schedule that
discloses the amount of expenditures and/or receipts
by contract number for each contract with the
department in effect during the audit period.
Compliance findings related to contracts with the
department shall be based on the contract
requirements, including any rules, regulations, or
statutes referenced in the contract The financial
statements shall disclose whether or not the matching
'lquirement was met for each applicable contract. All
~uestioned costs and liabilitieS due to the department
shall be fully disclosed in the audit report with reference
,to the department contract involved.
If the provider has received any funds from a grants
and aids appropriation, the provider shall have an audit
or submit an attestation statement in accordance with
Section 216,349, Florida Statutes, and indicate on the
schedule of financial assistance which contracts are
funded from state grants and aids appropriations. The
provider has "receivecr funds when it has obtained the
cash from the department or when it has incurred
reimbursable expenses.
The provider agrees to submit the required reports as
shown in Part IV.
...
PART II: STATE FUNDED
This part is applicable if the provider is a nonprofIt
~rganization that expends a total of $1 00,000 or more
in' funds from the department during its fiscal year, which
was not paid from a ratel:contract based on a set state
or area-wide fixed rate for service, and "of Which less
that $300,000 is federally funded. The determination of
when a proVider has lIexper.lded- funds is based on when
the activity related to the award occurs.
The provider agrees to have an annual financial audit
performed by independent auditors in accordance with
the current GovemmentAuditing 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
indude reports on intemal control and compliance. The
reporting package shall incl~de a schedule that
discloses the amount of expenditures and/or receipts
by contract number for each contract with the
department in effect during the audit period.
Compliance findings related to contracts with the
department shall be based on, the contract
requirements, including any rules, regulations, or
statutes referenced in the contract. The financial
statements shalf disclose whether or not the matching
requirement was met for each applicable contract. All
questioned costs and liabilities due to the department
shall be fully disclosed in the audit report with reference
to the department contract involved.
If the provider h~s received any funds from a grants
and aids appropriation, the provider shall have an audit,
or submit an attestation statement, in accordance with
Section 216.349, Florida Statutes, and indicate on the
schedule of financial assistance which contracts are
18
JUL-14-~~~~ ~q'q~
1::.1 "It=J"'I:;;:UI::.I'I'- I I"IL..-J.J' .L '-nl- .......L-I '\. V L '-L...
--,......_ __--r__ '. ___ __
funded from state grants and aids appropriations. The
provider has "received- funds when it has obtained the
cash from the department or when it has incurred
reimbursable expenses.
The provider agrees to submit the required reports as
shown in part IV.
PART III: SECTION 216.349,
FLORIDA STATUTES (GRANTS
AND ArOS APPROPRIATIONS)
This part is applicable if the provider is either (1) a for-
profit organization, (2) a local government entity
expending less than $300,000 in federal funds passed
through the department during its fiscal year, (3) a
nonprofit organization expending less than $100,000 in
funds from the department during its fiscal year, or (4)
a nonprofit organization expending a total of $100,000
or more in funds from the department paid from a rate
contract based on a set state or area-wide fixed rate for
service, of which less than $300,000 is federal funded.
The determination of when a provider has -expended-
funds is based on when the activity related to the award
occurs. .
If the provider receives funds from a grants and aids
appropriation, the provider shall have an audit, or submit
an attestation statement, in accordance with SeCtion
216.~9, Florida Statutes. The audit report shall indude
a schedule of financial assistance which discloses each
state centrad by number and indicates which contracts
are funded from state grants and aids appropriations.
The provider has "received" funds when it has obtained
cash from the department or when it has incurred
reimburseable expenses. .
The provider agrees to submit the required reports as
shown in Part IV. Otherwise, if the provider does not
receive funds from a grants and aids appropriation, the
provider has no audit or attestation requirement under
this statement
PART IV: SUBMISSION OF
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 provider's fiscal year to
the following, unless otherwise required by Florida ..
StaMes:
A. Office of Inspector General
4052 Bald Cypress Way, Bin A03
~allahassee, Florida 32399-1704
8. Department of Health .
Bureau of Emergency Medical Services
County Grant Manager
4052 Bald Cypress Way, Bin C18
Tallahassee, Florida 32399-1738
~
C. Submit to this address only those reports
prepared in accordance with OMS Circular A.133:
Federal Audit Clearinghouse
Bureau of the Census. <
1201 E. 10th Street .
Jeffersonville, Indiana 47132
D. Submit to this address only those audits
performed or attestation statements prepared in
accordance with Section 216.349, Florida Stat-
utes :
Office of the Auditor General
Post Office box 1735
Tallahassee, Florida 32302
The provider shall ensure that audit working papers are
made avaDable to the department. or its designee, upon
requestfor a period of five years from the date the audit
report is issued, unless extended in writing by the d~
partment
19
TOTAL P. 08