202 KAR 7:520. Allocation of block grant funding assistance for emergency medical services.

KENTUCKY COMMUNITY AND TECHNICAL COLLEGE SYSTEM

Kentucky Board of Emergency Medical Services

(Amendment)

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.055, 311A.060, 311A.155(3), 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) Nothing in this administrative regulation shall 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, and each request shall be acted upon within forty-five (45) days of the office’s receipt of the request for reconsideration the time limits established in this administrative regulation.

(4)(a) If the office of the board denies changing an 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) County Application, Kentucky Ambulance Grant, KBEMS G-1, for block grant funds that designates for receipt of funds an agency that is currently undergoing or is the subject of proposed sanctions pursuant to KRS 311A shall be voted on by the board for approval or disapproval.

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 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, 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;

(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

(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;

(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

(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;

(b) "Ambulance Grant Substitute Item Form", KBEMS-G3, 1/2013; and

(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.[~~Application for Funding Assistance. (1) An applicant may apply to the board for funding assistance for the purchase of a vehicle or equipment in accordance with KRS 311A.155.~~

~~(2) An application shall be made on a Block Grant Funding Application, incorporated by reference.~~

~~(3) An entity is eligible to apply for funding if the entity is:~~

~~(a) Licensed as a Class I ground ambulance service; and~~

~~(b) Not subject to pending or proposed disciplinary action by the board in the current fiscal year.~~

~~(4) An applicant who has been awarded a grant shall execute a memorandum of agreement with the board.~~

~~Section 2. Allocation of Funds. (1) Funds may be expended for the purchase or lease of one or more of the following:~~

~~(a) A new or used vehicle that meets the requirements of 202 KAR 7:580, 202 KAR 7:582, and 202 KAR 7:584, if the provider demonstrates the need for a replacement vehicle because an existing vehicle:~~

~~1. Is totally inoperable; or~~

~~2. Is at least five (5) years old and:~~

~~a. Has been driven in excess of 70,000 miles, if it has a gasoline engine and is in poor condition; or~~

~~b. Has been driven in excess of 100,000 miles, if it has a diesel engine and is in poor condition;~~

~~(b) A monitor/defibrillator or automatic external defibrillator;~~

~~(c) An ambulance cot or stretcher costing more than $250 per unit;~~

~~(d) An item of nondisposable equipment required by administrative regulation for a ground ambulance service, that exceeds $250 per unit; or~~

~~(e) A training mannequin or dysrhythmia generator that exceeds $250 per unit.~~

~~(2) A vehicle purchased with grant funds shall not:~~

~~(a) Be more than three (3) model years older than the most current model year vehicle; and~~

~~(b) Have an odometer reading in excess of 40,000 miles.~~

~~(3) Grant funds may be used for personnel training, education, and related expenses.~~

Section 3. Verification of Expenditures. (1) The applicant shall provide documentation on an annual basis, or more frequently, as requested by a representative of the board, to verify that grant funds have been expended:

~~(a) As stipulated by the memorandum of agreement allocating the block grant funds; and~~

~~(b) Within the designated time frame.~~

~~(2) The board shall not approve or provide additional funding until the applicant provides documentation required in satisfaction of subsection (1) of this section.~~

Section 4. Title, Use, and Disposition of Vehicles and Equipment. (1) Legal title to a vehicle or equipment purchased pursuant to this administrative regulation shall vest in the applicant and not in any organization contracting with the applicant.

~~(2) The applicant shall maintain a record for each vehicle and item of equipment purchased with EMS block grant funds.~~

(3) An applicant shall not dispose of a vehicle or item of equipment purchased with EMS block grant funds within three (3) years of the date of purchase, unless the applicant seeks, and the board provides, prior written approval to dispose of the item.

Section 5. Fund Management and Scheduling - Block Grant Funds. (1) An application for consideration shall be postmarked by December 31. Failure to meet the postmark deadline shall render the applicant ineligible for that funding cycle.

~~(2) If funds are available from the Commonwealth, the board shall notify the grantees by March 1.~~

Section 6. Emergency Funding of Vehicles and Equipment. (1) A request for emergency funding of a vehicle, equipment, or both, may be made to the board at any time using the Application for Emergency Funding, incorporated by reference.

~~(2) The board shall award emergency grant funds based upon:~~

~~(a) Review of the application; and~~

~~(b) Availability of funds.~~

~~Section 7. Discretion of the Board. (1) The board may reduce, but not increase, the amount of funding requested by an applicant.~~

(2) Except as provided by Section 6 of this administrative regulation, the awarding, reduction, or denial of a grant application under KRS 311.155 and this administrative regulation is within the sole discretion of the board.

~~Section 8. Incorporation by Reference. (1) The following forms are incorporated by reference:~~

~~(a) Block Grant Funding Application (2002); and~~

~~(b) Application for Emergency Funding (2002).~~

(2) This material may be inspected, obtained, or copied, subject to applicable copyright law, at the Office of the Kentucky Board of Emergency Medical Services, 275 East Main Street, Frankfort, Kentucky 40621, Monday through Friday, 8 a.m. to 4:30 p.m.]

MIKE POYNTER, Executive Director

APPROVED BY AGENCY: March 15, 2013

FILED WITH LRC: March 15, 2013 at 10 a.m.

PUBLIC HEARING AND PUBLIC COMMENT PERIOD: A public hearing on this administrative regulation shall be held on April 23, 2013 a.m. Eastern Time at the Kentucky Community and Technical College System, 300 North Main Street, Versailles, Kentucky 40383. Individuals interested in being heard at this hearing shall notify the Kentucky Board of Emergency Medical Services in writing by five (5) workdays prior to the hearing of their intent to attend. If no notification of intent to attend the hearing is received by that date, the hearing may be canceled. This hearing is open to the public. Any person who wishes to be heard will be given an opportunity to comment on the proposed administrative regulation. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to be heard at the public hearing, you may submit written comments on the proposed administrative regulation. Written comments shall be accepted until April 30, 2013. Send written notification of intent to be heard at the public hearing or written comments on the proposed administrative regulation to the contact person.

CONTACT PERSON: Steve Amato or Anne-Tyler Morgan, Legal Counsel, McBrayer, McGinnis, Leslie and Kirkland, PLLC, 201 East Main Street, Suite 1000, Lexington, Kentucky 40507, phone (859) 231-8780, fax (859) 231-6518.

REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT

Contact Person: Steve Amato or Anne-Tyler Morgan

(1) Provide a brief summary of:

(a) What this administrative regulation does: 202 KAR 7:520 establishes the requirements for the Emergency Services Block grant funds Program. The regulation sets the conditions for eligibility and the authorized expenditures.

(b) The necessity of this administrative regulation: This regulation is mandated by KRS 311A.155 which creates the program for distribution of state grant funds to fiscal courts and the EMS agencies that operate for emergency response in the counties involved.

(c) How this administrative regulation conforms to the content of the authorizing statutes: This regulation conforms with KRS 311A.155 which establishes a grant fund for the promotion and assistance of EMS in Kentucky and creates a partnership between county governments and the ambulance services that operate for 911 calls within the county’s geographic area.

(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes: KRS 311A.155 requires the Kentucky Board of EMS to set eligibility requirements for the legislatively approved block grant funds. Additionally, the statute requires a management and oversight plan for those funds. This regulation assists the Board by ensuring a consistent mechanism for application, review, and oversight exists in dispersing and using public funds.

(2) If this is an amendment to an existing administrative regulation, provide a brief summary of:

(a) How the amendment will change this existing administrative regulation: The current amendment is a revision that is necessary due to the long lapse in intervening revisions. Because this regulation has not been amended in years, the eligibility requirements for services and the types and costs of equipment have drastically changed. This regulation attempts to create a more current mechanism for managing the grant program.

(b) The necessity of the amendment to this administrative regulation: Without this amendment, the current regulation will continue to restrict the appropriate expenditure of monies earmarked by the legislature for assistance to counties in obtaining the most responsive and highest quality EMS care possible.

(c) How the amendment conforms to the content of the authorizing statutes: The authorizing statute – KRS 311A – grants power to KBEMS to administer the block grant funds distributed to KBEMS for award to county ambulance services in Kentucky.

(d) How the amendment will assist in the effective administration of the statutes: 202 KAR 7:520 provides the foundation for a block grant program that will carefully and more thoughtfully administer public funds in order to bolster EMS in Kentucky, particularly in rural areas where EMS can often lack the resources necessary to provide patient care.

(3) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation:

(a) All ground ambulance services in Kentucky who are licensed to provide Class I emergency care to individuals within their geographic service area;

(b) EMS personnel who will benefit from the use of funds to further their EMS education and training;

(d) All residents and citizens who receive EMS in Kentucky.

(4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including: EMS Personnel, EMS Ambulance Providers, and County and City Governments will all benefit from the amended regulation because it will update and expand the types of expenditures authorized and will allow for cooperative use of funds.

(a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment: The regulated entities – services, county and city governments, and personnel – shall meet applicable block grant requirements, including the need to follow application procedures, follow through with approval requirements, provide accounting of funds expended, and all other requirements necessary to obtain and appropriately use public funds provided pursuant to the block grant for EMS.

(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3): The cost of compliance will be no greater than it has been under the previous version of the regulation. The cost is simply whatever resources are used to apply for and manage the grant funds.

(c) As a result of compliance, what benefits will accrue to the entities identified in question (3): All entities will benefit because the regulation provides a much clearer and more organized management mechanism for the block grant funds. Additionally, counties and their citizens will benefit because the EMS agencies in their areas that provide services will be better equipped due to the expanded range of approved expenditures.

(5) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation: KBEMS will not incur any additional costs. However, the time that already employed staff members spend managing the new system may increase because the new requirements need closer review and have a potentially more detailed approval process.

(a) Initially: The above paragraph is accurate for initial costs.

(b) On a continuing basis: The continuing costs may decline as the system becomes more streamlined and most applications become electronically submitted.

(6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation: KBEMS is a state agency that receives its annual budget from the state government as well as the block grant funds that originated with SB 66.

(7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment: No increase in fees or funds will be necessary. The program already exists and there is currently, nor will there be in the future, any fee associated with the application for and approval of the block grant funds.

(8) State whether or not this administrative regulation established any fees or directly or indirectly increased any fees: This regulation did not establish any fees.

(9) TIERING: Is tiering applied? Tiering was used in this administrative regulation to encourage compliance with regulations by permitting expanded use of grant funds for those services that have obtained and maintained compliance. Additionally, the mechanism for awarding funds allows EMS providers to regionally pool grant money when an generalized area is in need of equipment or other life-saving tools that might not be available due to the expense. Each tier must meet compliance or exceed compliance to be eligible to purchase certain items.

FISCAL NOTE ON STATE OR LOCAL GOVERNMENT

1. What units, parts or divisions of state or local government (including cities, counties, fire departments, or school districts) will be impacted by this administrative regulation? The regulation will relate to any County or City owned ambulance service or any ambulance service operated on behalf of a City or County but only if those services are licensed as Class I agencies which means that they respond to E-911 calls within their designated area.

2. Identify each state or federal statute or federal regulation that requires or authorizes the action taken by the administrative regulation. KRS 311A.010, 311A.030(2), 311A.055, 311A.060, 311A.155(3), KRS 311A.155. No federal statutes necessitate this amendment.

3. Estimate the effect of this administrative regulation on the expenditures and revenues of a state or local government agency (including cities, counties, fire departments, or school districts) for the first full year the administrative regulation is to be in effect.

(a) The grant program is already in place, and the sums available will continue to be available to parties who meet the requirements and fulfill all statutory and regulatory obligations in the first year.

(b) The regulation will continue to supply revenue to the state or local government entities eligible for the block grant funds and could increase the amount that they are entitled to receive in subsequent years.

(c) In the first year, because this grant program is already in place with relatively little burden placed on the counties or merged governments involved, this administrative regulation will not impose any new need for expenditures or revenue outlay by the governmental entities involved.

(d) In subsequent years, the amendment will not cost any revenues above and beyond what is currently being expended to administer the block grant program.

Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.

Revenues (+/-)

Expenditures (+/-)

Other Explanation: