Rural Ambulance Service Grants Applications and Reporting

How to Apply

For the Rural Ambulance Service Grant Program, the county judge must apply for the grant. The grant application requires the following information:

• Name of the county
• Name and contact information for the county judge applying for the grant
• Address for county office
• Texas Identification Number (TIN) for county
• Mail code for county
• Ambulance Service Provider(s) Information
  • Name of ambulance service provider(s)
  • Ambulance service provider DBA name
  • Main address for ambulance service provider(s)
  • Phone number for ambulance service provider(s)
  • Tax Identification number for ambulance service provider(s)
  • DSHS Service provider number(s)

The application allows counties to input up to two qualified service providers in the application. The service provider must be licensed by DSHS to be considered a qualified service provider under the grant program. The service provider listed first in the application should be the county’s primary choice for the award.

Application Deadlines

A qualified county must apply for the grant starting 60 days prior to the beginning of the entity’s fiscal year and not later than 30 days after the first day of its fiscal year.

By law, failure to file during the 90-day application period would require a qualified county to wait until its next fiscal year to apply.

Application Periods

Fiscal Year Start	Opening Date	Closing Date
Oct. 1	Aug. 2	Oct. 31
Jan. 1	Nov. 2	Jan. 31

Annual Compliance Report

Counties that receive a grant must submit a compliance report at the end of their fiscal year. The compliance report will be electronic and will include information to help the Comptroller’s office determine whether the funds were spent on authorized expenses.

Any additional information requested by the Comptroller’s office must be submitted by the grant recipient within 14 calendar days of the request.

Reporting Periods

Fiscal Year Start	Opening Date	Closing Date
Oct. 1	Oct. 1	Dec. 1
Jan. 1	Jan. 1	March 1

The compliance report will include:

• Information about the Qualified Service Provider awarded through grant
  • Service Provider Name
  • Service Provider DBA, if applicable
  • Service Provider Contact Name
  • Service Provider Contact Email
  • Service Provider Contact Phone Number
  • Service Provider Tax ID#
  • DSHS Provider License #
  • Service Provider License Effective Date
  • Service Provider License Expiration Date
  • Level of service for provider/Vehicle Authorization
  • Information on any leasing agreement between county and service provider
• Ambulance Purchase Information
  • Date county ordered ambulance
  • Vendor Name
  • (Estimated) Delivery date
  • Estimated Cost of ambulance
  • Total Grant Funds used for ambulance purchase
  • Information regarding any other grant funding for purchase of the ambulance
• Accessories/Modifications Purchases
  (Each item purchased must be reported individually.)
  • Date of invoice
  • Accessory or modification name
  • Item description and use
  • Cost of item
  • Total Grant funds used for item
• Registration Fees and Interest
  • Type of registration
  • Vendor name
  • Cost of registration
  • Grant funds used for registration
  • Interest earned on grant funds for the reporting year.
• Required Documentation
  • Purchase order for ambulance
  • Invoice for any items that have been paid for
  • Proof of payment for ambulance
  • Proof of payment for accessories or modifications
  • List of all medical equipment, supplies, medical devices, parenteral solutions, and pharmaceuticals to be carried on ambulance
  • Current agreement/letter of contract with the approved qualified service provider, if applicable
  • Subagreement with Comptroller-approved service provider, if applicable
  • Copy of lease agreement for ambulance with service provider and proof of payment from service provider, if applicable
  • County budget for fiscal year that corresponds with current report

Contact us with questions about the Rural Ambulance Service Grant Program.

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Need Help?

For additional information, contact the Data Analysis and Transparency Division.