77 Ill. Adm. Code 547.500
Application Requirements
Section 547
Section 547.500 Application
Requirements
a) Applications shall be submitted to the Department at the
following address:
Regional
Ambulance Services Grant Project
Illinois
Department of Public Health
Division of
Emergency Medical Services
525 W.
Jefferson St., 3
rd
Floor
Springfield,
Illinois 62761
b) Applications shall include the following:
1) The officer or agency designated by the regional ambulance
service to be responsible for administering grant funds;
2) The results of the needs assessment conducted pursuant to
Section 547.400;
3) The organization and responsibilities of the Board;
4) The operations budget of the regional ambulance service,
including projections on how and when the regional ambulance service will
become self-sufficient, and a description of local financial support or in-kind
service;
5) A staffing plan for the regional ambulance service;
6) An agreement by the applicant to ensure that the requirements
of the Emergency Medical Services Systems Act will be met;
7) A description of the proposed interaction between any existing
ambulance services and the regional ambulance service;
8) A description of the support of the local medical communities
for the regional ambulance service;
9) A plan for quality management, including an evaluation of the
project to be submitted to the Department after the first six months of
operation, that indicates:
A) the amount of grant funds expended and a description of
expenditures;
B) changes that have occurred in service provided as a result of
the grant project; and
C) an evaluation of the effectiveness of the officer or agency
designated by the regional ambulance service to be responsible for
administering grant funds;
10) A description of a plan for the provision of education for
ambulance service personnel and a plan for public education by the regional
ambulance service;
11) A description of the responsibilities of service providers,
including maintenance of vehicles and equipment;
12) A description of the communications system that will be used
by the regional ambulance service; and
13) The name, address, and telephone number of the person to whom
questions and information concerning the application and the grant project are
to be directed.