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Home My WebLink AboutFD04-253 - Amendment - #5 - Seattle KC Dept of Public Health - Basic Life Support Services (EMS Levy) - 01/01/2007 R P r"fl rtA C &A .a n- 0 hN%Z KENT ! . - �J Document WASHINGTON 3 CONTRACT COVER SHEET This is to be completed by the Contract Manager prior to submission to City Clerks Office. All portions are to be completed, if you have questions, please contact City Clerks Office. Vendor Name: i r t' OD -.�/�/ Vendor Number: JD Edwards Number Contract Number: FDog- .25.3 This is assigned by Deputy City Clerk Description: Detail: 000 ( �'�Y/"C�� Project Name: 2�L Contract Effective Date: ZIII-012 Termination Date: Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: rOlyel Q/rZ,4 Department: Abstract: S Publlc\RecordsManagement\Forms\ContractCover\ADCL7832 07/02 RECEIVED r• Public Health BAN 2 2 Zoa� Seattle 8c King County KENT FIRE DEPARTMENT HEALTHY PEOPLE. HEALTHY COMMUNITIES. Dorothy F.Teeter,MHA,Interim Director and Health Officer January 8, 2007 Greg Markley Kent Fire Department 24611 116th Ave SE Kent, WA 98030 RE: D33049D — Basic Life Support Services (Amendment #5) Dear Greg Markley: Enclosed is your fully signed copy of the referenced amendment. We have retained a copy of the amendment for our records. If you have any questions about the program, budget or reporting requirements, please contact your Program Monitor Felisa Az itarte at 206 296-4554. If you have an other r r ( ) Y Y questions, please call me at (206) 296-4898. Sincerely, I 1 Jeffry rown Contract Specialist II Grant & Contract Services JB: er Enclosure: D33049D — Basic Life Support Services (Amendment #5) cc: Felisa Azpitarte Grant and Contract Services—Finance&Administrative Services Division 999 Third Avenue,Suite 600• Seattle,WA 98104-4039 oty of seattle O King county u� T(206)296-4614 F(206)205-0947• www metrokc gov/health creyy, Wkels M'Ji of Ron<ims Fxrn,rrve D33oq�� OERGENCY MEDICAL SERVICES FUNDS( ) 2007 PROPOSED BUDGET FORM - BASIC LIFE SUPPORT SERVICES Applicant Agency City of Kent/King County Fire Prot. Dist. #37 Agency service Area(S) East Kent City Limits. North border is SE 192, East Border is 188th Ave SE and the City of Covington City Limits. south border is SE 288, Kent WA Contact Person Greg Markley Title Battalion Chief/EMS Officer Address 24611 116 Ave SE Kent WA 98030 Phone 253.856.4300 Amount Requested Budget Category in 2007* A. Personnel 1. Salaries & Benefits ** $725.000 2. Per shift Payments (list rate per shift) 3. Per Call Payments (list rate per call) B. Supplies (itemized on separate sheet) 30. 525 C. Equipment (itemized on separate sheet) S 19, 53 D. support Service (itemized on separate sheet) E. Total EMS Funds Allocated by King County EMS in 2007 (Please refer to the attached funding allocation) 775,056 *Please list only total amount of requested funds by category on this page. Attach itemized list of proposed expenditures if you are requesting funds for supplies, equipment, or support services. **Attach explanation of how requested funds for salary and benefits were Calculated and how they wi11 be used in accordance with the expenditure guidelines. An agency may request BLS funding for that portion of salaries and benefits that can be attributed to EMS (% aid calls out of total fire and aid calls) up to the BLS allocation for that agency. show Ws and total salary/benefit budget used to derive BLS request. 0 EXHIBIT 1 0 2007 PROGRAM PLAN AND PROPOSED BUDGET 1. Identification information A. Name and number of Fire Protection District or Fire Department: _City_of Kent/King County Fire Prot. District #37 B. Name of chief: jim Schneider Mailing Address: 24611 116 Ave S Kent WA 98030 C. Name of EMS coordinator (and Training coordinator if different) : ,Greg Markley Telephone No. 253.856.4300 Tom Shepard Telephone No. 253.856.4331 D. Location: manned or unmanned status of all fire stations in our department of district; location of aid vehicles. include the address of each station (use other side if necessary). Defib No. EMS Response No. & Type Fire Address unyt Status Vehicles at Location vehicles at Location 1. Station #71_ �C— Full Time_&_ 1 Ambulance 1 Enoine/Aid Part Time/ 504 W Crow St Vol 1 - Rescue Boat _Kent WA 98032 2. Station # 72_ --,X,_ Full Timed_ _1 Engine/Aid Part Time/ 25620 140 Ave SE Vol _1 Tender Kent WA 98042 1 - Engine/Aid (reserve) 3. Station #_73 _X Full Time-X _ lAmbulance _1 Engine/Aid— Part Time/ 26512 Military Rd. so. Vol _1 Mobile command (reserve) Kent WA 98032 1 - Engine/Aid (reserve) 4. Station 4_74 --X-- Full Timed 1 Ambulance 1 En ine "Aid Part Time/ 1 Ladder _24611 116 Ave SE Vol _1 command vehicle 1 command vehic e(reser) Kent WA 98030 1 Mobil Air Vehicle *Include aid units as well as fire apparatus, command cars, rescue units, etc. STATIONS PLANNNED for construction in 2007 Address _17820 SE 256, Kent 98042 Status _Full Time vehicles 1 Engine/Aid Exhibit 1 2007 Program Plan and ProposedQdget Page 2 Defib No. EMS Response No. & Type Fire Address Unit Status vehicles at Location Vehicles at Location 5. Station #75 --A. _ Full Time_ 1 Engine/Aid Part Time/ _15635 SE 272 Vol 1 Engine/Aid (reserve) Kent wA 98042 6. station # 76 _ Full Time_ 1 Engine/Aid— Part Time/ 1 Haz Mat Unit 20676 72 Ave SE Vol Engine/Aid (reserve)_ Kent wA 98032 7. Station # 77 �C_ Full Time,c_ 1 Engine/Aid_ Part Time/ 1 Ladder (reserve) 20717 132 Ave SE Vol _1 Engine/Aid (reserve) Kent wA 98031 NOTE: All of our engine/air vehicles, as well as one of our ladder units, are licensed as aid units by D.S.H.s. E. Agency Response Information Number of fire suppression responses in 2006 925 estimated Number of EMS aid responses in 2006 10,954 estimated Total number of responses in 2006 15.278 estimated Percent aid responses of total responses 71.7% estimated II. Relationships with other EMS Agencies A. specify location of transfer points with paramedic provider groups if applicable: N/A Exhibit 1 �j C 2007 Program Plan and Proposed`�dget Page 3 III. Personnel A. Number of full-time paid fire fighters _ .154 , of which 120 are EMT's and 8 are First Responders.* B. Number of volunteer fire fighters 0 of which are EMT's and are First Responders.* C. Number of personnel currently trained in defibrillation Automated External Defibrillator certified 19 Manual Defibrillator Certified 120 * certified as First Responders by state of Washington IV. EMT Defibrillation Program 13-Medronic Physio A.E.D A. Number and type of defibrillator units control Life Pak 12 _ Manual 1 - Heartstart FR2 B. Location of defibrillation equipment (address) All firstline apparatus carry a life Pa( including the Shift Commanders vehicle C. unit numbers of aid vehicle(s) usually carrying defibrillation equipment (use number(s) recorded when completing EMS Medical incident Reporting Form) . 57 V. Budget The EMS Division is seeking to collect information that documents total fire department expenditures for emergency medical services. we are also requesting each fire department to report its total operating budget for the year. In order that the information be consistent, please exclude from these totals major capital expenditures including vehicles and buildings, and monies earmarked for bond payments, etc. A. Estimated total EMS budget for 2007 S 1,837,323 .00 of which S 775,056.00 is provided by EMS funds. B. Total fire department or fire district S 21, 597,062.00 budget for 2007. • Exhibit 1 0 2007 Program Plan and proposedQdget Page 4 vi. Fees for services A. Does your department charge for providing emergency services? Yes No xx a. If yes, please provide a list of charges below. VII. Service Improvements/changes Please describe how EMS funds will be used by your department in 2006 to improve services to the citizens of King county. To supplement total Ems budget. To maintain quality and timely deliver of EMS in the face of increasing demand for services and budget reductions, with local funds we will cover the remaining costs of the total EMS budget. BLS Pro i _� Date Doroth Teeter, tin4 Director and Health officer Date Department of u is Health 4 ' ITEMIZED LIST OF PROPOSEPr"ENDITURES FOR SUPPLIES AND EQQENT 2007 BASIC LIFE SUPPORT LEVY CATEGORY ITEM COST EQUIPMENT BLANKETS $788.00 EQUIPMENT BP CUFFS $3427.00 EQUIPMENT DISP. BAG VALVE MASKS $1134 00 EQUIPMENT KENDRICK TRACTION DEVICE $1902.00 EQUIPMENT MEDICAL KITS $5137.00 EQUIPMENT OXYGEN CYLINDER REGULATORS $674 00 EQUIPMENT PATIENT TARPS/RESCUE SEATS $1016 00 EQUIPMENT PEDIATRIC MATTRESS-VACCUM $2383 00 EQUIPMENT PULSE OXIMETERS $1061 00 EQUIPMENT TEFLON SPINE BOARDS $761 00 EQUIPMENT VACUUM SPLINTS $616.00 EQUIPMENT ELECTRONIC THERMOMETERS $651 00 TOTAL EQUIPMENT $19,550 00 SUPPLY BAND-AIDS $24100 SUPPLY DISPOSABLE BLANKETS $497.00 SUPPLY TRAUMA DRESSINGS $197.00 SUPPLY BURN SHEETS $120.00 SUPPLY CANNULAS $99100 SUPPLY COLD/WARM PACKS $504.00 SUPPLY DEFIBRILLATION FAST PATCH $1726 00 SUPPLY ECG PRINTER PAPER $840 00 SUPPLY ELECTRODES $746.00 SUPPLY EPI PENS $1908 00 SUPPLY EXTRICATION COLLARS $4390 00 SUPPLY GAUZE $649 00 SUPPLY GAUZE PADS $244.00 SUPPLY GLUCOSE TEST STRIPS $1542 00 SUPPLY GLOVES $8516 00 SUPPLY HEAD IMMOBILIZERS $2811 00 SUPPLY HEPA FILTER MASKS $1816.00 SUPPLY OB KITS $75.00 SUPPLY PENLIGHTS $165 00 SUPPLY PILLOWS $8100 SUPPLY TER]TOWELS $878 00 SUPPLY THERMOMETERS $218 00 SUPPLY TRAUMA DRESSINGS $197 00 SUPPLY TRIANGULAR BANDAGES $218.00 SUPPLY SMOKE FLARES FOR LANDING ZONES $468.00 SUPPLY SPLASH GOWNS $132.00 SUPPLY WATERPROOF TAPE $581.00 TOTAL SUPPLIES $30,75100