HomeMy WebLinkAboutMINUTES - 08081995 - C49 To: BOARD OF SUPERVISORS
FROIM: Mark Finucane, Health Services Director Contra
. Costa
DATE: July 27, 1995 County
SUBJECT: Approve Standard Agreement #29-311-1 with the State
Emergency Medical Services Authority
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION
I. RECO ENDED ACTION:
Approve and authorize the Chair, Board of Supervisors, to execute on
behalf of the County, a Statement of Compliance, the required Drug
Free Workplace Certification and Standard Agreement #29-311-1 (EMS-
4042) with the State Emergency Medical Services (EMS) Authority, for
the period from June 25, 1995 through June 24, 1996, in the amount
4 of $46, 000, for the Poison Control Center Alternatives Study.
II. FINANCIAL IMPACT:
Approval of this Agreement will result in $46, 000 of funding from
the State EMS Authority, for the period from June 25, 1995 through
June 24, 1996. No County funds are required.
III. REASONS FOR RECOMMENDATIONS/BACKGROUND:
On October 25, 1994, the Board of Supervisors approved Standard
Agreement Contract #29-311 with the State Emergency Medical Services
Authority which provided funding for first year of the Poison
Control Center Alternatives Study.
Approval of this Agreement #29-311-1 will provide funding for the
second year of the Poison Control Center Alternatives Study. Two
model programs will be designed and developed for implementation;
(1) through an existing "nurse screening" system, and (2) through
trained emergency medical dispatchers working in a secondary "9-1-1"
Public Safety Answering Point.
The Board Chair should sign nine copies of the agreement. Eight
copies of the agreement and four sealed and certified copies of this
Board order should be returned to the Contracts and Grants Unit for
submission to the State Emergency Medical Services Authority.
CONTINUED ON ATTACHMENT: YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE(S)
ACTION OF BOARD ON q 6 AA A APPROVED AS RECOMMENDED sel OTHER
VOTE OF SUPERVISORS
UNANIMOUS (ABSENT ) 1 HEREBY CERTIFY THAT THIS IS A TRUE
AYES: NOES: AND CORRECT COPY OF AN ACTION TAKEN
ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD
OF SUPERVISORS ON THE DATE SHOWN.
' Contact: Art Lathrop (646-4690)
Cc: Health Services (Contracts) ATTESTED -1��
State EMS Authority Phil Batch or, Clerk of t e Board of
_. _ Suporvi;Iors and Cpunty Administrator
M382/7-83 BY q% DEPUTY
STATE Of CALIFORN`ff.
APPROVED BY THE CONTRACT NUMBER AM.Na
STANDARD AGREEMENT-
ATTORNEY GENERAL EMS-4042
STD.2(REV.5.91)
25 June 95 TAXPAYERS FEDERAL EMPLOYEA IDWIFICAT"V YaFti
THIS AGREEMENT.made and entered into this day of , 19—,
in the State of California,by and between State of California,through its duly elected or appointed,qualified and acting
TITLE OF OFFICER ACTING FOR STATE AGENCY
Director Emergency Medical Services Authority ,hereafter called the State,and
CONTRACTOR'S NAME ®
Contra Costa EMS Agency 2r A 11 '° ,hereafter called the Contactor.
WITNESSETH: That the Contractor for and in consideration of the covenants,conditions,agreements,and stipulations of the State hereinafter expressed,
does hereby agree to furnish to the State services and materials as follows: (Set forth service to be rendered by Contractor,amount to be paid Contractor,
time for performance or completion,and attach plans and specifications,if any.)
1. The Contractor shall complete the objectives as identified in the Section entitled
"Objectives." These are made g part of this agreement by this reference.
2. The period of this Agreement shall be from June 25, 1995 through June 25, 1996.
3. The total amount payable by the State to the Contractor shall not exceed 146,000.
4. The attachment entitled "Budget" is made a part of .this Agreement by this reference.
CONTINUED ON SHEETS,EACH BEARING NAME OF CONTRACTOR AND CONTRACT NUMBER.
The provisions on the reverse side hereof constitute a part of this agreement
IN WITNESS WHEREOF,this agreement has been executed by the parties hereto,upon the date fast above written.
STATE OF CALIFORNIA CONTRACTOR
AGENCY Emergency Medical Services Authority CONTRACTOR,,r«herthan an,dwjduet state whether a co,,,,Atx-%p,,,,k,sh;.etc)
P,
BY(AUTHORIZED SIGNATURE) BY(AUT SIGNATURE)
BY
PRINTED NAME OFflSOGit orales, M.D. P INT D NAME D TITLE OF PERSON SIGN'
7SC Il Chair, Board of Supervisors
TITLE Director ADDRESS
651 Pine Street, Martinez CA 94553
AMOUNT ENCUMBERED BY THIS PROGRAWCATEGORY(CODE AND AAE) i FUND TITLE Federal Department of General Services
DOCUMENT 11 Uv
$ 46,000 use only
(OPTION ) \
PRIOR AMOUNT ENCUMBERED FOR \ ,
TMS CONTRACT VVV���IIIJJJ
$ ITEM 4120-101-890 C>S1pP�ER ( srA 4 FiSC`J4/YJ
TOTAL AMOUNT ENCUMBERED TO
DATE OBJECT OF EXPENDITURE(CODE AND TITLE)
$ 0010-702-50000
I hereby certify upon my own personal knowledge that budgeted funds T.BA NO. B.R.NO.
are available for the period and purpose of the expenditure stated above.
SIGNATURE OF ACCOUNT F DA
CONTRACTOR STATE AGENCY DEPT.OF GEN.SER. CONTROLLER
5. The Contractor may make changes in any individual line item in the budget without
prior authorization, provided that such changes in the aggregate as to any line itenit
shall not exceed $2,000. If changes exceed $2,000, the Contractor must submit an.
explanation of the need for such excess and specifically identify the line item(s) to be
reduced in order to increase the excess line item(s) and provided further that the State
reserves the right to deny any such claim for any excess reimbursement on any item.
It is further understood that in no event shall the maximum amount specified in
Paragraph 3 of this Agreement be exceeded.
6. In consideration of duties performed in a manner acceptable to the State, the State
shall reimburse the Contractor, upon submission of an invoice, stating the time period
covered and the contract number, for actual expenditures in accordance with the
Budget (as shown at Exhibit F) to: State EMS Authority, 1930 Ninth Street, Suite
100, Sacramento, CA 95814.
7. Pursuant to the Public Health Services Act, Title XIX Part A, Section 1905(c)(6), with
respect to the activities to be supported by this grant, the local EMS agency agrees to
maintain local expenditures for those activities at a level that is not less than the
average level of such expenditures maintained by the local EMS agency for those
activities for the 2-year period preceding the fiscal year for which the local agency is
applying to receive payments.
8. Pursuant to Health and Safety Code Section 1797.110, the State may pay up to twenty-
five percent (25%) of the total amount payable under this Agreement in advance upon
request of the Contractor. This advance payment will appear as a credit to the
contracting agency's account, and costs incurred by the contracting agency will be
deducted from the credit until the advance funds are exhausted or the contract period
expires. In the event there is a credit surplus at the end of the term of.this Agreement,
or in the event there is a credit surplus and the Agreement is canceled by either party,
the Contractor will reimburse the credit to the State.
9. The content and language of State Standard Form 17A (Nondiscrimination Clause), as
shown at Exhibit A, is adopted and is fully effective for all operations and services
called for in performance of this contract.
10. The content and language of State Standard Form 19 (Nondiscrimination Compliance
Statement), as shown at Exhibit B, is adopted and is fully effective for all operations
and services called for in performance of this Agreement.
11. The content and language of State Standard Form 21 (Drug-Free Workplace
Certification), as shown at Exhibit C, is adopted and is fully effective for all
operations and services called for in performance of this Agreement.
12. Exhibit D entitled "Federal Contract Funds" is made a part of this agreement by this
reference.
Standard Agreement
Page 2
13. The Contractor agrees to abide with the following policies and procedures:
A. The Contractor shall allow the EMS Authority, or its"duly authorized
representatives, (a) to inspect or otherwise evaluate the quality, appropriateness,
and timeliness of services performed under this Agreement, (b) to inspect,
evaluate, and audit any and all books and records maintained by Contractor or
any subcontractor pertaining to such services at any time during normal
business hours. Books and records shall include, but are not limited to, all
physical records originated or prepared pursuant to performance under this
Agreement including working papers, reports, financial records, and books of
account. Upon request, at any time during the period of this Agreement, the
Contractor shall furnish any such records, or copies thereof, to the State EMS
Authority. Any reproduction costs which result from such a request will be
paid by the Contractor.
B. The Contractor shall prepare and maintain such books and records as may be
necessary to disclose the manner in which it discharged its obligations under
this Agreement. These books and records shall include records of employee
time devoted to work under this Agreement, the amount of payment made for
that time, the services performed by subcontractors, and the manner and
amount of payment made for those services.
Such books and records shall include, but are not limited to, all physical
records originated or prepared pursuant to the performance under this
Agreement, including working papers and financial records. These books and
records shall be maintained for a minimum of three (3) years from the
termination date of this Agreement, or in the event the Contractor has been
duly notified that the EMS Authority has commenced an audit or investigation
of the Agreement, or such time as the matter has been resolved, whichever is
later.
C. All subcontracts entered into by the Contractor to carry out the terms of this
Agreement shall be in writing and contain all of the following:
1. Full disclosure of the method and amount of compensation or other
consideration to be received by the subcontractor from the Contractor;
2. specification of the services to be provided;
3. a statement that the subcontract shall be governed by and construed in
accordance with all laws, regulations, and contractual obligations
binding on the Contractor;
4. subcontractor's agreement to submit reports as required by the
Contractor; and,
5. the provisions of Exhibit A, D, C, and D of this Agreement.
Standard Agreement
Page 3
14. Subcontracts over $10,000 must contain language stating that they meet the
requirements of Public Contracts Code Sections 10115 et seq. This section requires
state contracts to have participation goals of not less than 15 percent for minority
business enterprises and not less than 5 percent for women business enterprises.
15. A subcontract entered into shall not become effective until it has been approved by the
EMS Authority in writing, unless the State has acknowledged receipt of the proposed
subcontract and has failed to approve or disapprove the proposed subcontract within
thirty (30) days of receipt. Subcontract amendments shall be submitted to the EMS
Authority for prior approval at least forty-five (45) days before the effective date of
any proposed changes. Any such amendment shall become effective unless the EMS
Authority expressly disapproves in writing such amendment and written notice thereof
is received by the Contractor within said 45-day period.
16, Subcontracts entered into by the Contractor pursuant to this Agreement and all
information received in accordance with this section shall be public records on file
with the EMS Authority.
17. The Contractor shall secure the agreement of any subcontractor to make all of its
books and records, pertaining to the goods and services furnished under the terms of
the subcontract, available for inspection, examination or copying by State, as follows:
at all reasonable times at the subcontractor's place of business, or at such other
mutually agreeable location in California; in a form maintained in accordance with the
general standards applicable to such books or record keeping; and for a term of at least
three (3) years following the close of the calendar year in which the subcontract was
terminated. Further, any agreement with a subcontractor shall also contain:
subcontractor's agreement that assignments or delegation of the contract shall be void
unless prior written approval is obtained by Contractor from the EMS Authority;
subcontractor's agreement to maintain and make available to the EMS Authority upon
request, copies of all written subcontracts and make applicable items 13-C-1 through
13-C-5, hereinabove to its subcontractors; and subcontractor's agreement to hold
harmless State in the event Contractor will not pay for services performed by the
subcontractor pursuant to the subcontract.
18. The Contractor agrees, to abide by all policies and procedures as stated in the "Funding
of Emergency Medical Services Agencies With Federal Block Grants" (January 1995,
EMSA #105).
19. The Contractor or subcontractors shall not be authorized to copyright any documents
related to this project without written approval of the Director of the EMS Authority.
20. Publication rights to any documents produced as a result of this Agreement are
reserved to the EMS Authority.
Standard Agreement
Page 4
21. All materials and information collected or prepared under this Agreement shall become
the joint property of the EMS Authority and the Contractor. The EMS Authority shall
have access to information collected as a result of this Agreement.
22. Any printed materials or videos developed for distribution with grant money awarded
by the EMS Authority must include the following statement: "Funding provided by
the State of California Emergency Medical Services (EMS) Authority under Special
Project Grant #EMS-2028."
23. No equipment may be purchased by the Contractor for this project without prior
approval from the EMS Authority. ' All equipment purchased with funds received
through this contract will become the property of the State of California.
24. This Agreement may be terminated at any time for breach and the EMS Authority may
terminate unilaterally and without cause upon thirty (30) working days written notice
to the Contractor. All work performed pursuant to the Agreement and prior to the date
of termination may be claimed for reimbursement.
25. The Contractor shall not assign or transfer interest in this Agreement without the prior
written consent of the EMS Authority.
26. This Agreement may be canceled at any time by either party, by giving thirty (30)
days advance written notice to the other party.
27. The Contractor agrees that, in the interest of enhancing public participation and
knowledge, meetings of it's governing authority will be open to the public. Meetings
which deal with legal or personnel matters shall be exempt. Notice of each public
meeting shall be in accordance with Government Code Sections 54950 through 54961.
28. The Contractor agrees to maintain a mailing list of interested individuals and
organization contacts. If there is a reduction in federal funds supporting the program
under which this Agreement is financed, the Contractor agrees to inform these
individuals and organization contacts of the funding reduction.
29. In addition to the final project report required in Section H of the "Funding of
Emergency Medical Services Agencies With Federal Block Grants," the Contractor
shall, within sixty days following the end of the contract period, submit to the EMS
Authority, a Project Abstract Report. This separate report shall be 10 to 15 pages,
double spaced and submitted on an IBM compatible computer disc (WordPerfect
format preferred). This document shall be suitable for reprint/publication for
distribution to all appropriate EMS constituents. This report shall include all of the
following sections: Introduction, Project Description; Tasks/Methodology; General
Discussion; Results and; Conclusions.
NONDISCRIMINATION CLAUSE (OCP-1) EAuffi t A
STD.VA(REV.2-0
1. During the performance of this contract,contractor and its subcontractors shall not unlawfully discriminate,
harass or allow harassment,against any employee or applicant for employment because of sex,race,color,
ancestry, religious creed,national origin,physical disability(including HIV and AIDS),mental disability,
medical condition (cancer), age (over 40), marital status, and denial of family care Ieave. Contractors and
subcontractors shall insure that the evaluation and treatment of their employees and applicants for
employment are free from such discrimination and harassment Contractor and subcontractors shall comply
with the provisions of the Fair Employment and Housing Act(Goverment Code,Section 12900 et seq.)and
the applicable regulations promulgated thereunder(California Code of Regulations,Title 2,Section 7285.0
et seq.). The applicable regulations of the Fair Employment and Housing Commission implementing
Government Code,Section 12990(a-f),set forth in Chapter 5 of Division 4 of Title 2 of the California Code
of Regulations are incorporated into this contract by reference and made a pan hereof as if set forth in full.
Contractor and its subcontractors shall give written notice of their obligations under this clause to labor
organizations with which they have a collective bargaining or other agreement.
2. This contractor shall include the nondiscrimination and compliance provisions of this clause in all
subcontracts to perform work under the contract.
nv)vv),,)i.rVIVIINAIIVN UUMFLIANUt IATEMLNT Exhibit B
STD.19(REV.391)
COMPANY NAME
The company named above (hereinafter referred to as "prospective contractor") hereby certifies,
unless specifically exempted, compliance with Government Code Section 12990 and California
Code of Regulations, Title 2, Division 4, Chapter 5 in matters relating to the development,
implementation and maintenance of a nondiscrimination program. Prospective contractor agrees
not to unlawfully discriminate against any employee or applicant for employment because of race,
religion, color, national origin, ancestry, physical handicap, medical condition (cancer related),
marital status, sex or age (over forty).
CERTIFICATION
1, the official named below, hereby swear that am duly authorized to legally bind the prospective
contractor to the above described certification.I am fully aware that this certification,executed on
the date and in the county below, is made under penalty of perjury under the laws of the State of
California.
OFFiC;AL'S NAME
DATE EXECUTED EMCUTED IN THE COUNTY OF
x�PROS )CTfVE CONTRACTWS SIGNATURE
l
AAMPSC/NE CCNTRACTCFCS ITTLFJ
PRCSP£CTIVE CrNTRACTCRS FEDERAL EMPLOYER IDENTIFiCATrN NUM8ER
STD.21(NEW 11-9M
Exhibit C
COMPANY/ORGANIZAT)ON NAME
The contractor or grant recipient named above hereby certifies compliance with Government Code
Section 8355 in matters relating to providing a drug-free workplace. The above named contractor or
grant recipient will:
1. Publish a statement notifying employees that unlawful manufacture, distribution, dispensation,
possession,or use of a controlled substance is prohibited and specifying actions to be taken against
employees for violations, as required by Government Code Section 8355(a).
2. Establish a Drug-Free Awareness Program as required by Government Code Section 8355(b), to
inform employees about all of the following-
(a)
ollowing(a) The dangers of drug abuse in the workplace,
(b) The person's or organization's policy of maintaining a drug-free workplace,
(c) Any available counseling, rehabilitation and employee assistance programs,and
,'(d) Penalties that maybe imposed upon employees for drug abuse violations.
3. Provide as required by Government Code Section 8355(c),that every employee who works on the
proposed contract or grant:
(a) Will receive a copy of the company's drug-free policy statement, and
(b) Will agree to abide by the terms of the company's statement as a condition of employment on
the contract or grant.
CERTIFICATION
I, the official named below,hereby swear that I am duly authorized legally to bind the contractor or
grant recipient to the above described certification.I am fully aware that this certification,executed on
the date and in the county below, is made under penalty of perjury under the laws of the State of
California.
OFFiCLAL'S NAME
DATE EXECUTED I EXECUTED W THE COUNTY OF
CCNTRACTCR gr GRANT REC:P!ENT SI A L:AE
FEDERAL LMNUMSER
9t 90@D
Exhibit D
FEDERAL CONTRACT FUNDS
1. It is mutually understood between the parties that this contract may have been written
before ascertaining the availability of congressional appropriation of funds for the
mutual benefit of both parties in order to avoid program and fiscal delays which
would occur if the contract were executed after that determination was made.
2. This contract is valid and enforceable only if sufficient funds are made available to
the State by the United States Government for the purposes of this program. In
addition, this contract is subject to any additional restrictions, limitations, or
conditions enacted by the Congress or any statute enacted by the Congress which may
affect the provisions, terms, or funding of this contract in any manner.
3. It is mutually agreed that if the Congress does not appropriate sufficient funds for the
program, this contract shall be amended to reflect any reduction in funds.
4. The Department has the option to void the contract under the 30-day cancellation
clause or to amend the contract to reflect any reduction of funds.
f
3. Project Objectives
The specific objective of the second year of this project are:
1. To complete the design of two alternative PCC model programs.
2. To implement the two model programs.
3. To complete the evaluation methodology for weighing the effectiveness of
the alternative models against each other and against the traditional
regional poison control program.
4. To implement the evaluation methodology.
5. To prepare a written report on the results of the implementation and initial
model evaluation.
6. To coordinate the project and solicit input from appropriate local and state
agencies.
The following tables summarize the project's objectives, evaluation methodology,
resource needs, implementation schedule, and outcome objectives:
Page 7
Poison Control Alternatives
Contra Costa EMS Agency
Objective 1. To complete the design of two alternative PCC model programs.
ActiVity/Taslk Evaluation/ Resources.; Implementation Outeame
Methodoto y Needed ;I. Schedule
1.1 Complete Prepare PCC data Sept. 1995 Written and
implementa implementation Project consultant approved
tion work work plan. Program implementation work plan.
plan for two work plan and its approval by
model sponsoring agencies, EMSA
program and the SF PCC.
implementa
tion.
1.2 Prepare Completion of Sponsoring agencies Sept 1995 Signed
final signed contracts.. Project consultant. written
contract for contracts
the two
providers of
service
procedure.
1.3 Prepare Completion of Marketing support from October 1995 Written
and initiate marketing plan and sponsoring agencies. summary of
marketing products. Project consultant. market
materials analysis.
for the
client
access of
services.
1.4 Begin Program initiation. Sponsoring agencies. October 1995- Final
program EMS Agency. June 1996 written
initiation. Project consultant. report of
Year 2
results.
Page 8
Poison Control Alternatives
Contra Costa EMS Agency
Objective 2. To implement the two model PCC programs in Contra Costa
County.
Activit
y/Task Evaluation, Resources Implementation Outcome
Methoclolo Needed:;: Schedule
2.1 Implement two Completion of Sponsoring agencies. Oct 1995 Approved
model contracts and their contracts.
programs. initiation.
2.2 Conduct early Conduct meetings Sponsoring agencies Oct-Dec 1995 Written
coordination and prepare summary EMS Agency meeting
and problem of issues and their Project consultant. summaries.
solving resolution.
meetings with
sponsoring
organizations.
2.3 Meet/prepare Completion of EMS Oct-Dec 1995 Written
action plan for meetings/written plan Agency/agencies plan of
program fine of action. staff,consultant.. action.
tuning.
Page 9
Poison Control Alternatives
Contra Costa EMS Agency
Objective 3. To complete the evaluation methodology for weighing the
effectiveness of the alternative models against each of the
models and the traditional regional poison control program.
ActryitylTask EvaluatioN:: Resources tmptementatioo` Outcome
Methodology Needed Schedule .
3.1 Retain Completion of meetings Research consultant. August-Sept Written
evaluation and preliminary Project consultant. 1995 prelim-
expert to research design. EMS Agency staff inary
complete the PCC staff. research
design of design.
evaluation
methodology.
3.2 Design data Completion of data Project consultant, August-Oct Written
collection tools. collection tools and agency staff. 1995 data
procedures. tools/pro-
cedures.
3.3 Prepare final Completion of final EMS Agency/agencies Sept-Oct 1995 revaluation
tten
evaluation evaluation plan. staff,consultant.
plan. n.
3.4 Obtain approval Written approval by Project consultant Oct 1995 tten
.of final EMSA. EMS Agency. approval.
evaluation plan EMSA staff.
of alternative SF PCC.
poison
program
models.
Page 10
Poison Control Alternatives
Contra Costa EMS Agency
Objective 4. To prepare a written report on the results of the implementation
and initial model evaluation
Activity/Task Evaluation/ Resources Irr►ptementatwn outcome
Method'I Needed Schedule
4.1 Prepare final Completion of draft Project consultant June 1996 Written
written written report. EMS Agency staff, final plan.
report of
results of
program..
4.2 Submittal of Approval of final report. Project consultant, June 1996 Written
draft report agency staff, EMS approval of
for approval. Agency staff report.
EMSA staff.
Objective 5. To coordinate the project and solicit input form appropriate
local and state agencies.
.............. _ _ . _ . . _ _ ...... _
_......._ ...... ..._ _. _._ _ _ _
Activity/Task Evaluation/ Resources Implementation' Outcome
Methodology Needed. $chedute
5.1 Solicit input Completion of meetings, Project consultant July 1995-June Written
from PCCs correspondence. EMS Agency staff. 1996 minutes and
and other Staff from correspond-
relevant appropriate ence.
agencies. agencies.
5.2 Solicit input Completion of meetings, Project consultant, As appointed Written
and correspondence. EMS Agency staff minutes and
conduct Other study correspond-
project principals. ence.
coordination
with other
relevant PCC
studies(e.g.
CDC, Blue
Cross, etc. ).
Page 11
Poison Control Alternatives
Contra Costa EMS Agency
4o Implementation Timetable and Milestones
The EMS Agency is aware that delays in project approval, amendments to
the budget and contract finalization have delayed this project. An
accelerated timetable has been developed for year one of this project. To
mitigate against further delays, year two financial support is only requested
for the time period of October 1995 - June 1996. However, the timetable
submitted as part of this year's request includes all tasks and timetables to
be completed from July 1995 - June 1996.
The following table lists the project timetable, milestones and anticipated
completion.date for each task to be completed during FY 1995/96.
Page 12
Poison Control Alternatives
Contra Costa EMS Agency
1A In � M CD to Ip LO l0 N
M
d � M M M M M cCl)
EO 0) CD co 0)
.......................
:: co
C)
c
co
rn .
m
co
rn
CLQ
co
C)
m
rn
m
co
>: > a'
cc
�i'D rn
. ........... Q
o
W
O
uU _ °'
m
Uo ® °'
co
�U
o m �
sm. '16
c
...;: ca w
::::;:: :.
d p m m o c = ca
U O m m m
U E O c 3 c m
d O N y w 0 -
10
'w
E c o m d p E v v 4 p n
ca n
o o E U n o
E
°c w o
YU vi v m m o c cc
0 0 c g n m a E > _
3 w m m v rn c w c is ca y (a m
r°m
opd
—
CL
mC 00 O 0 co C E d m CO mo UE Ep m c o m m E m m m 'mc_
m e O
(D ca
m m o
m m E o v_ - w m m mwv >
n m c E c �` m m N > m o
CL H
m E E c c (D m m m m w m :� C n
nE m E cc m m o a m V m m nm D v mCLto
E m n m c`a ca cCO
o n E $ E > o c c c
a am c E :° m 'a m E ca �' °' a m
m rn E m m y o► H n c m H w m
p 0 O .. U m p 0 O m O L m m m
<) d d d m m - (� U H m C D LL o
ID
N cq d r N
O r r r r O N N N O 0 co M co
o
m CD CD w (D
a rn (D rn cm
E m
'. •• cn ci. c i
m
m co w to
co
...... ----
CL
........... .............
rn
c
co
rn
"> m
rn
Q
cD
rn
to
co
rn
n
m
LL
co
sz rn
...... c
m
......: LO
C Cm
D
m
L<
z
U')
O �
to
U
E Q A A
vi
� o
d. L
m z
w E o m e
O C m V U
m C
m n c rn
O? C m m
NO
W m W N O
m 7 .V W V
L — go O C >
N y m m
m U
C CD
Oam �0
5 a
caO m
O
-= m G
O ° a v> hN
mo m m
oU ° of
O C G1
c U
md m m 4 O ._
C O U °
o c H
O m 0 m U
m@ iu O mm U
m c n c > >
CD e m m n a s
_ c>
m CL 0 CL
O O — m
CA a m n E C v v
m a m � a o o m
CL
° a Cl) F0- U) rn m
t-
m v w
N N
O s! v O to to
6. Statement of Intent
It is the intent of the Contra Costa County EMS Agency to evaluate the
impact of the current poison control system in the county and to evaluate
the potential for alternative screening programs. This statement of intent is
based on consideration of continuing program costs.
Page 17
Poison Control Alternatives
Contra Costa EMS Agency
Contra COta,C: "k. EMS A enc
9 Y
Polson Control S ecial Project s
p
flropc siW 8uctge# Year Two
Y>
Category Total Block Local
Grant Match
1. Personnel Costs
EMS Medical Director(0.05 FTE) $3,500 $0 $3,500
Project Director(.15 FTE) $7,700 $0 $7,700
Project Clerk(.15 FTE) $3,450 $0 $3,450
Benefits $3.663 $00 $3,663
Subtotal $18,313 $0 $18,313
2. Travel and Mileage Expense
In-state mileage and expense 350
Subtotal $350 $0 $350
3. Contractual services
Project coordinator $38,000 $35,089 $0
Evaluation consultant $4,050 $4,050 $0
Subtotal $42,050 $39,139 $0
4. Operating Costs
Office supplies $1,845 $945 $900
Telephone $1,705 $805 $900
Subtotal $3,550 $1,750 $1,800
5. Equipment
None
Subtotal $0 $0 $0
Project Subtotal $64,262 $40,889 $20,463
G. Departmental indirect
Contra Costa indirect costs @ 12.5% $8,033 $5,111 $2,922
Total Project Budget $69,384 $46.000 $23.384
7. Proposed Budget
• Budget Narrative
EMS Medical Director: The Contra Costa County Health Services
Department Medical Director/Health Officer is the currently designated
medical director of the EMS Agency. This position, budgeted at 0.05 FTE,
will be provided as a part of the local match. This position will serve in an
overall medical advisory capacity to the project, and will participate in
program design and evaluation.
Project Director: The Project Director will be the Contra Costa County EMS
Director. This position, budgeted at 0.15 FTE, will be provided as part of
the local match. The Project Director will have overall administrative and
fiscal responsibility for the project.
Project Clerk: Existing EMS support personnel will provide day-to-day
clerical support for the project. This is budgeted at 0.15 FTE (clerk, senior
level) and will be provided as part of the local match.
Benefits: Personnel benefits have been estimated as 25 percent of salary
costs and will be provided as a part of the local match.
Travel and Mileage: Travel and mileage will be paid in accordance with
existing County policies for travel within California for the 9 month period
(Oct. 95 - June 96) while carrying out the objectives of the project including
attendance at poison control advisory committee meetings.
Consultant Services: The project coordinator category of this budget is for
a continued contract with the consulting firm, The Abaris Group. This firm
has a considerable background in studying EMS and poison control
services. The firm coordinator will oversee and provide the professional
staffing for all phases of this project (9 months, Oct. 95 - June 96).
Approximately 300 hours of the consultant's time is projected to fulfill the
obligations of this project. Costs include all consultant's travel and office
expenses.
A project evaluation specialist is also anticipated to assist with the design of
the evaluation and validity testing of the project results. This will be a
contract with a research design specialist.
Operational costs: The estimated cost of telephone services and office
supplies for the Project Director are listed for the 9 month period (Oct. 95 -
June 96). Fifty percent of the telephone costs are proposed as in-kind.
Equipment: No equipment is requested as part of this grant.
Page 18
Poison Control Alternatives
Contra Costa EMS Agency
• Departmental indirect cost: Departmental indirect cost is calculated at 1Z.5
percent.
Page 19
Poison Control Alternatives
Contra Costa EMS Agency