202 KAR 7:520. Allocation of block grant funding assistance for
emergency medical services.
RELATES TO: KRS 311A.010, 311A.030(2), 311A.035,
311A.050, 311A.055, 311A.060, 311A.155, 311A.190, 2 C.F.R. 215-225
STATUTORY AUTHORITY: KRS 311A.155(3)
NECESSITY, FUNCTION, AND CONFORMITY: KRS
311A.115(3) authorizes the Kentucky Board of Emergency Medical Services to
promulgate administrative regulations concerning the receiving and disposing of
grant funds. KRS 311A.155 authorizes the Kentucky Board of Emergency Medical
Services to maintain a block grant fund program for the purpose of assisting
units of local government in the provision of emergency medical services. This
administrative regulation establishes standards and criteria governing the
allocation of emergency medical services funding assistance to eligible applicants.
Section 1. Eligibility to Receive EMS
Grant Funding. (1) A county in the Commonwealth of Kentucky shall be eligible
to apply for and may receive emergency medical services (EMS) grant funding if
the applicant county meets the requirements in this administrative regulation.
(2) A merged government shall not lose
eligibility pursuant to this administrative regulation and may apply for and
receive EMS grant funding if the applicant meets all requirements of this
administrative regulation.
(3) This administrative regulation shall not
be construed to grant an agency licensed pursuant to 202 KAR 7:501 the
authority to apply for or receive EMS grant funding independent of the county.
(4) A county or merged government that
applies for EMS grant funding shall maintain, within its boundaries and for the
benefit of its inhabitants, one (1) or more agencies that provide primary EMS
911 response and transport service.
(5) A county or merged government shall
be considered to maintain EMS 911 level of service by:
(a) Holding the license for and operating
a county-owned Class I ground ambulance service;
(b) Holding the license for a Class I ground
ambulance service but contracting with a licensed service to operate within the
county;
(c) Allowing an agency or multiple
agencies to operate within the county to provide EMS 911 level of service for
the benefit of the inhabitants of that area; or
(d) Not holding the license for, but
bearing the responsibility of, operating or allowing the operation of, an
agency or multiple agencies within the county to provide EMS 911 level of
service for the benefit of the inhabitants of that area.
(6) A county or merged government shall
be eligible to receive EMS grant funding only for agencies licensed as Class I.
Other classes of service shall not be eligible.
(7) A county or merged government shall
not disperse funds to a licensed agency that cannot provide evidence of
compliance with KBEMS’ data collection requirements pursuant to KRS 311A.190
and 202 KAR 7:540.
(8) An agency that is not compliant with
data collection requirements in KRS 311A.190 and 202 KAR 7:540 may submit a
plan of correction for approval by the executive director. A plan shall include
at least:
(a) A detailed outline of measures that shall
be taken to achieve compliance;
(b) Proof of equipment necessary to achieve
compliance;
(c) Deadlines that shall be met in
achieving compliance that shall not extend beyond two (2) years from the
approval of the plan of correction; and
(d) A stipulation that an agreed
percentage of awarded grant funds shall be used in taking measures that shall achieve
compliance with data collection requirements in KRS 311A.190 and 202 KAR 7:540.
(9) An agency that is following an approved
plan of correction for data collection compliance pursuant to KRS 311A.190 and
202 KAR 7:540 may be eligible to obtain block grant funds from an applicant
county or merged government.
(10) An agency undergoing disciplinary
action pursuant to KRS 311A.060 shall be eligible to receive funds if in
compliance with board-recommended disciplinary action.
Section 2. Eligibility for Authorized
Expenditures. (1) A county or merged government eligible to receive EMS grant
funding shall be authorized to spend funds based upon a tiered level of
compliance with 202 KAR Chapter 7.
(2) An eligible county or merged
government shall meet the requirements for one (1) of the following tiers:
(a) A Tier I applicant shall be an agency
that maintains a primary EMS 911 ground ambulance service that is substantially
compliant with 202 KAR 7:501 but has documented violations requiring on-going
plans of correction that are addressed and may be eliminated by the award of
EMS grant funds;
(b) A Tier II applicant shall be an
agency that maintains a primary EMS 911 ground ambulance service that has
operated free of documented violations requiring on-going plans of correction for
one (1) inspection cycle;
(c) A Tier III applicant shall be an
agency that maintains a primary EMS 911 ground ambulance service that has operated
free of violations for two (2) or more inspection cycles; and
(d) A Tier IV applicant shall consist of
a group of Tier III applicants eligible to combine EMS grant funds for the
common good of their primary EMS 911 ground ambulance services.
(3) A county or merged government may
request reconsideration of the tier into which the county or merged government
has been placed. Each request shall be acted upon within forty-five (45) days
of the office’s receipt of the request for reconsideration of the time limits established
in this administrative regulation.
(4)(a) If the office of the board denies the
request to change the applicant’s tier, the applicant may appeal the decision
to the board.
(b) The board’s decision after appeal
shall be final.
Section 3. Application Requirements. (1) An
applicant for EMS grant funds shall fully complete all portions of the County
Application, Kentucky Ambulance Grant, KBEMS G-1, and the Agency Application,
Kentucky Ambulance Grant, KBEMS-G2.
(2) Each application
shall be received by January 31 of each year. An applicant shall not receive
EMS grant funds if the application is not filed on or before January 31.
(3) Each application shall include an
itemized list of items intended to be purchased with EMS grant funds and a
narrative justification for the purchase of those items. An application that
does not include the itemized list or the narrative justification shall be
returned by the board office and shall not be timely filed if the applicant
does not resubmit the revised application by the filing deadline established in
subsection (2) of this section.
(4) Each applicant shall identify on the
application which agency or agencies will receive the EMS grant funds sought in
the application process.
(5) If the applicant intends for more
than one (1) agency to receive funds, the applicant shall specifically identify
every agency to which funds shall be dispersed.
(6) The service director or ambulance board
chair of an agency receiving funds from an applicant shall certify that the
agency:
(a) Is a licensed Class I ground
ambulance service in the state of Kentucky;
(b) Acknowledges, understands, and agrees
to comply with the requirements and duties of KRS 311A.155 and this
administrative regulation;
(c) Has not made a false statement or
misrepresentation on the application and that falsely certifying shall subject
the agency to reimbursement of funds to KBEMS and sanctions pursuant to KRS
311A.060; and
(d) Shall not misuse funds and that doing
so shall require the agency to reimburse those funds to KBEMS and shall subject
the agency to sanctions pursuant to KRS 311A.060.
(7) An applicant county or merged
government shall submit the County Application, Kentucky Ambulance Grant, KBEMS
G-1, with the county judge executive’s signature or an agent duly authorized by
the applicant. A duly authorized agent may include, for example, a chief administrative
officer for the applicant, but shall not include a person unable to legally
bind the applicant.
(8) An applicant shall certify on the County
Application, Kentucky Ambulance Grant, KBEMS G-1 that the county or merged
government:
(a) Acknowledges, understands, and agrees
to comply with the requirements and duties of KRS 311A.155 and this
administrative regulation;
(b) Has not made a false statement or
misrepresentation on the County Application, Kentucky Ambulance Grant, KBEMS
G-1, and that falsely certifying shall subject the applicant to reimbursement
of funds to KBEMS and sanctions pursuant to KRS 311A.060;
(c) Shall not misuse funds and that doing
so shall subject the applicant to reimbursement of those funds to KBEMS and sanctions
pursuant to KRS 311A.155(5) and 311A.050; and
(d) Shall be jointly responsible for ensuring
that all purchases and expenditures of block grant funds are authorized and
allowable pursuant to KRS 311A.155 and this administrative regulation.
(9) The board shall vote to approve or
disapprove the County Application, Kentucky Ambulance Grant, KBEMS G-1, for
block grant funds if the application designates for receipt of funds an agency
that is currently undergoing or is the subject of proposed sanctions pursuant
to KRS Chapter 311A.
Section 4. Application for Change of Items.
(1) An applicant wishing to spend awarded funds on items not approved in the agency
application shall submit the Ambulance Grant Substitute Item Form, KBEMS-G3, to
remove the approved items and substitute different items for purchase.
(2) A substituted item
purchased without notification to and approval from KBEMS shall be misuse of
grant funds and shall subject the applicant to sanctions pursuant to KRS 311A.060.
(3) Authorization for substitute items
shall not be approved retroactively. An approval for a substitution shall be
sought prior to purchase.
(4) The County Application, Kentucky
Ambulance Grant, KBEMS G-1, for approval shall contain signatures of the agency
to which the funds were dispersed as well as the applicant’s authorized agent.
Section 5. Funds Management. (1) Upon
award of block grant funds, the applicant, the receiving agencies, and KBEMS
shall execute a grant agreement that outlines the relevant statutory and regulatory
requirements, duties, and obligations of all parties.
(2) Every grant agreement
shall bear the signatures of the applicant’s authorized agent, the service
director or ambulance board chair of each agency receiving the funds from the
applicant, and the executive director of KBEMS.
(3) Funds shall not be dispersed until
the grant agreement is signed and dated by the parties required in this section
of this administrative regulation.
(4) The grant agreement shall require
that the applicant and the receiving agency authorize KBEMS to conduct an audit
of records relevant to use of the awarded funds.
Section 6. Allowable Expenditures. (1) Awarded
funds shall only be spent on authorized purchases.
(2) Authorized purchases
shall be determined by the tier for which the receiving agencies are eligible.
(3) Authorized purchases for the tiers are
as follows:
(a) Tier I services shall be authorized
to spend awarded funds on items, equipment, and training for personnel only if
those purchases are necessary for the agencies to meet the minimum requirements
of 202 KAR 7:501;
(b) Tier II services shall be authorized
to spend awarded funds on any items, equipment, or training for personnel that
fall under Tier I. In addition, Tier II eligible services shall be authorized
to spend awarded funds on pre-approved educational tools and items;
(c) Tier III services shall be authorized
to spend awarded funds on an item from Tier I or II, plus outside EMS related
class registrations, items appearing on the Federal Emergency Management Agency
Approved Equipment List, www.fema.gov, and additional items if applied
for and approved by the board based on current applicability to EMS standards
of medical practice and promotion of public health and safety; or
(d) Tier IV services may organize as a cooperative
of agencies consisting of services that qualify for Tier III. Cooperative agencies
shall be allowed to pool awarded funds for the purchase of items beneficial to
multiple counties within the cooperative.
(4) If seeking reimbursement for the
conduct of authorized educational courses, only expenses directly related to
courses or training shall be authorized. Block grant funds shall not be used
for reimbursement of participants’ travel, food, gas, lodging, or incidental
expenses related to EMS classes.
Section 7. Cooperative of Agencies. (1) A
cooperative of agencies shall consist of a minimum of two (2) agencies.
(2) Each agency within a
cooperative shall have on file current mutual aid agreements that existed prior
to and extend past the current grant award period. An agency that does not have
a current and ongoing relationship shall not be allowed to enter into a
cooperative agreement.
(3) Items or equipment purchased with the
grant funds awarded to an agency within a cooperative shall benefit each member
agency of that cooperative.
(4) Each applicant shall agree that the
agencies to which they disperse money may enter into the cooperative of
agencies for the benefit of the inhabitants within the county or area of the
merged government.
(5) Each agency included in a cooperative
of agencies shall enter into and submit to KBEMS a cooperative agreement approved
by the board that includes, at a minimum:
(a) Where ownership of the equipment shall
reside;
(b) Who shall maintain and repair the
equipment;
(c) Certification that all parties to the
cooperative of agencies shall have access to the equipment;
(d) An agreed and approved protocol for
the possession, access, use, and replenishment of items or equipment obtained
with grant funds;
(e) A narrative justification for the purchase
of the equipment;
(f) A process for discarding the
equipment if it becomes obsolete;
(g) An agreed statement of liability
distribution; and
(h) The signatures and certifications of
truthfulness of each party to the cooperative of agencies, the applicant
counties or merged governments, and the chair of KBEMS.
(6) In addition to the agency application,
representatives of the cooperative of agencies and the applicant counties or
merged governments shall appear at a regular meeting of the board to present an
explanation of and justification for the use of combined funds.
(7) Tier IV cooperatives shall not be
authorized without affirmative vote of the board.
Section 8. Accountability. (1) Each
applicant that receives funds and each agency to which the applicants disperse
funds shall be jointly accountable for use of the money.
(2) Each applicant and agency shall submit
a Grant Accountability of Funds, KBEMS-G4, that includes at a minimum:
(a) Itemization of all purchases;
(b) Attached receipts for all purchases;
and
(c) Included packing slips or invoices.
(3) If an applicant or agency maintains carry-over
funds in accordance with KRS 311A.155(5), the applicant or agency shall submit
proof of the continued availability of those funds. Proof may include, for
example, a bank statement, a letter from the designated county or government
official, a budgetary line-item, or other evidence sufficient to account for
the unused, carry-over funds.
(4) Failure to submit documents
accounting for grant funds by the deadline established in Section 9 of this
administrative regulation shall subject the applicant or agency to being ineligible
for further award of block grant funds.
(5) The board may request documentation
of purchases and expenditures during the grant cycle. Failure to comply with
this request shall make an applicant or agency ineligible for further award of
grant funds.
(6) An agency that fails to comply with
subsections (4) or (5) of this section shall also be subject to discipline pursuant
to KRS 311A.060.
Section 9. Time limits and Deadlines for Block
Grant Funds Awards. (1) Agency application for block grant funds shall be postmarked
or received by January 31 of each year.
(2) Accounting required pursuant to Section
8 of this administrative regulation shall be postmarked or received by March 15
of each calendar year.
(3) The office of the board shall supply
notification to the applicants and agencies of their grant award no later than April
30 of each calendar year.
(4) The office of the board shall make
payment of grant funds to applicants no later than August 31 of each calendar
year.
Section 10. Review of Grant Applications.
(1) A grant application shall be subject to review by the office of the board
and other entities relevant to the award process.
(2) Review of applications shall include:
(a) Level One Review, which shall
determine completeness of the application. An incomplete application shall be
rejected, and if still within the deadline for application, the incomplete
areas may be cured and resubmitted. If outside the application deadline, resubmission
shall not be accepted; and
(b) Level Two Review, which shall
determine regulatory compliance and appropriateness of expenditures.
(3) Approval authority for grant
applications and purchase authorization shall be the:
(a) Executive director for Tier I and II
applicants;
(b) Executive director for Tier III
applicants who request purchases or expenditures at the Tier I or II level;
(c) Board for Tier III applicants with
request for purchases or expenditures at the Tier III level; and
(d) Board for Tier III applicants that
fall within the Tier IV Cooperative of Agencies level.
(4) All Tier I or II purchases shall be
consistent with Section 6(3)(c) of this administrative regulation and approved
prior to purchase. Exemption from or waiver of pre-approval shall not be permitted.
(5) Tier III and IV applications and
purchase authorizations may be recommended for:
(a) Full approval;
(b) Approval with modifications; or
(c) Denial.
(6) Tier III and IV applicants may
request reconsideration of approval with modifications by submitting new
evidence of justification for their request at the next regular board meeting
or at a meeting specially called by the chair of the board.
(7) Tier III and IV applicants may
request reconsideration of denial by submitting new evidence of justification
for their request at the next regular board meeting or at a specially called
meeting.
(8) New proposals,
if applicable, shall be considered during a request
for reconsideration.
(9) A second denial of a Tier III or IV
application or authorization for purchases shall be final and shall result in a
default to Tier I or II purchases or expenditures that shall meet all
requirements of this administrative regulation.
Section 11. Grant Program Management. (1)
Implementation and management of the grant program may include employment of an
individual with primary responsibility of managing the block grant fund program.
(2) Other
responsibilities shall include:
(a) Research of and application for
additional EMS grant sources and funding streams that benefit KBEMS’ regulatory
obligations to licensed and certified agencies; and
(b) Assistance to licensed EMS agencies
in their efforts to locate and obtain other EMS grants.
(3) Employment of the grant management
employee shall be dependent upon the availability of budgetary funds.
Section 12. Statewide Initiatives. (1) The
board shall reserve a portion of the block grant funds appropriated to it by
the legislature if a unanimous vote of the board determines:
(a) That a statewide
initiative is necessary to further one (1) or more of the statutory functions
of the board in KRS 311A.035; or
(b) A portion of the funds shall be
distributed to assist agencies in meeting a federal or state mandate relevant
to EMS.
(2) KBEMS shall not reserve funds for
statewide initiatives in consecutive years.
(3) Notification of reservation of funds
shall be sent to all eligible applicants and agencies by September 1 of the
calendar year prior to the grant cycle.
Section 13. Incorporation by Reference.
(1) The following material is incorporated by reference:
(a) "County Application, Kentucky
Ambulance Grant", KBEMS-G1, 1/2013;
(b) "Agency Application, Kentucky
Ambulance Grant", KBEMS-G2, 1/2013;
(c) "Ambulance Grant Substitute Item
Form", KBEMS-G3, 1/2013; and
(d) "Grant Accountability of Funds",
KBEMS-G4, 1/2013.
(2) This material may be inspected,
copied, or obtained, subject to applicable copyright law, at the Kentucky Board
of Emergency Medical Services, 300 North Main Street, Versailles, Kentucky
40383, Monday through Friday, 8:30 a.m. to 4:30 p.m. (27 Ky.R. 3438; Am. 28
Ky.R. 594; eff. 9-10-2001; 29 Ky.R. 1311; 1763; eff. 1-15-2003; 39 Ky.R. 2056;
40 Ky.R. 278; eff. 8-21-2013.)
