Rural Ambulance Service Grants Frequently Asked Questions

The county judge must apply on behalf of the qualified county, as defined in Section 130.914(a)(3) of the Local Government Code.

Section 130.914(a)(3) of the Local Government Code defines a qualified county as a county with a population of fewer than 68,750.

Yes. The Comptroller’s office awards grants based on the county’s ability to provide adequate ground ambulance services based on the formula set out in Texas Administrative Code (TAC) Rules 16.502(c) and 16.502(e).

Yes.

No. Eligibility is limited to qualified rural county governments.

Counties can submit two ambulance service providers for consideration because a provider is only allowed to receive one grant per fiscal year. If a county’s preferred provider was awarded under another county’s application, the Comptroller may consider the second provider named in the county’s application.

The Comptroller’s office evaluates applications and awards grants pursuant to the statutory requirement to consider the county’s ability to provide adequate ground ambulance services, including, specifically, the county’s average (1) per capita taxable property value, (2) per capita income, and (3) unemployment rate. The Comptroller uses a formula to measure a county’s average per capita taxable property value, average per capita income, and average unemployment rate, and further considers additional factors set out in TAC Rule 16.502(e). The Comptroller awards the counties most in need of grant funding in consideration of all these factors and as funding allows.

The Department of State Health Services issues EMS provider licenses to private safety entities or public agencies that are qualified to provide emergency medical services within certain counties, as defined by Section 772.001 of the Health and Safety Code.

The county is responsible for preparation of all required compliance reports. The county may not delegate preparation of the compliance report to its approved qualified service provider. TAC Rule 16.505(e) requires an official of the grant recipient (county) who is authorized to bind the grant recipient to electronically sign the compliance report and certify that all information in the report is true and correct.

Yes. Funds can be spent on allowable costs under the rules, grant agreement and grant management standards. All grant funds must be expended during the five-year term. Unexpended funds must be returned upon expiration of the grant agreement.

Yes, provided the cost satisfies the requirements of the rules, grant agreement and grant management standards, including the requirement that costs are necessary and reasonable. If these requirements are met, accessories and modifications are further allowable only in connection with (1) the purchase of an ambulance or (2) the refurbishing of an ambulance that the qualified currently possesses. Refurbishing costs described in (2) (TAC Rule 16.504(b)(2)) are only allowable when remounting an existing ambulance.

Yes, provided the costs satisfy the requirements of the rules, grant agreement and grant management standards, including the requirement that costs are necessary and reasonable. If these requirements are met, accessories and modifications are allowable in connection with (1) the purchase of an ambulance or (2) the refurbishing of an ambulance that the county currently possesses.”. Refurbishing costs described in TAC Rule 16.504(b)(2) are only allowable in connection with remounting an existing ambulance.

Counties may purchase multiples of the same item provided the costs are otherwise allowable under the rules, grant agreement and grant management standards, including the requirement that costs are necessary and reasonable. Accessories are defined in TAC Rule 16.500(1) as “Equipment required for emergency medical service vehicles to provide treatment and transportation of adult, pediatric and neonatal patients as described in 25 TAC Chapter 157, Subchapter B, Emergency Medical Services Provider Licenses.” If these requirements are met, accessories and modifications are further allowable only in connection with (1) the purchase of an ambulance or (2) the refurbishing of an ambulance that the qualified county currently possesses (i.e., when remounting an existing ambulance).

No. Items purchased solely for the purpose of entertainment do not meet the definition of “accessories” under TAC Rule 16.500(1) and are therefore not allowable costs.

The grantee may only use funds to cover costs incurred after the effective date of the grant agreement unless the Comptroller specifically approves otherwise in writing. Therefore, if an ambulance is purchased or any other cost is incurred before the effective date of the grant agreement, it is not reimbursable under the grant and the grantee incurs the cost voluntarily, at its own credit and expense. However, if the grantee incurs an allowable cost after the effective date of the grant agreement but before its receipt of grant funds and all other grant requirements are met, that cost is reimbursable under the grant.

Yes, provided the software package costs satisfy the requirements of the rules, grant agreement and grant management standards, including the requirement that costs are necessary (per TAC Rule 16.500(1)) and reasonable. If these requirements are met, accessories and modifications are further allowable only in connection with (1) the purchase of an ambulance or (2) the refurbishing of an ambulance that the qualified county currently possesses (e.g., when remounting an existing ambulance).

No. These items do not meet the definition of “accessories” under TAC Rule 16.500(1) and are not allowable costs.

TAC Rule 16.504(b)(3) allows counties to pay for “necessary registration fees” with grant funds, which can include DSHS registration fees.

No. The grant funds must remain in the county’s possession.

The county must order and purchase the ambulance.

If the county does not perform EMS services (i.e., if any third party performs the services for the county), the county and service provider must enter into a written agreement that incorporates the material requirements of the county’s grant with the Comptroller (referred to as a “Subagreement” in the grant agreement between the county and Comptroller). Minimum requirements and mandatory clauses for the Subagreement are available upon request.

The county must own the ambulance for the duration of the State Interest period unless the Comptroller approves otherwise in writing. The Comptroller will consider alternative arrangements upon request. There is a State Interest in all equipment acquired or improved with grant funds, including any grant-funded ambulance, and the State Interest period is 10 years, starting upon acquisition or improvement of an ambulance and expiring 10 years later.

The county must own the ambulance for the duration of the 10-year State Interest period unless the Comptroller approves otherwise in writing. See the grant agreement for specific requirements that apply during the State Interest period.

Among other requirements, the county (or service provider, if applicable) may not sell or encumber a grant-funded ambulance during this period without the Comptroller’s written approval (and in the case of sale, disposition instructions), with the exception that the county (or service provider, if applicable) may sell a grant-funded ambulance if its fair market value is less than $10,000. In that case, the county must notify the Comptroller of any such disposition and provide documentation of the sale and fair market value, the sufficiency of which documentation shall be determined by the Comptroller.

Yes. The county may lease the ambulance to its service provider. Under the county’s grant from the Comptroller, the county and its provider are required to enter into a written agreement that incorporates all applicable requirements of the grant. Among those requirements, the county and provider must use and manage any grant-funded ambulance in accordance with the terms of the grant agreement, which includes requirements for both maintenance and insurance. The provider may assume the primary responsibilities associated with use and management, including obtaining required insurance and performing necessary repairs, but the county remains responsible for monitoring its provider and ensuring compliance with these and other requirements of the grant.

Any revenue generated from leasing the ambulance to the provider is considered program income and must be tracked and reported to the Comptroller. See the program income question below.

The Grantee may not substitute or replace the Comptroller-approved rural ambulance service provider under this Agreement without the Comptroller’s written preapproval. Requests will be reviewed on a case-by-case basis, but the Comptroller can only approve substitutions in limited circumstances. The grantee must also notify the Comptroller in writing of any termination or expiration of the Subagreement between the grantee and provider.

HB 3000 does not change the roles or authority of the county commissioners court, county auditor, county treasurer, or any other county officer as outlined by applicable law. Local Government Code, §130.914 does not create exceptions to the ordinary budget making process and does not create exceptions to a county commissioners court’s authority to set budgets or accept grants.

Whenever possible, grant funds must be deposited and maintained in insured, interest-bearing accounts. Interest earned on grant funds is not considered program income, and Grantee must use any accrued interest on allowable costs under the county’s grant agreement with the Comptroller. Unexpended funds must be returned to the Comptroller upon termination or expiration the grant.

The full definition of program income can be found in the Program Income Section of TxGMS (page 16 of version 2.1) and includes income from the use or rental of personal property acquired or improved with grant funds. Program income under this program is limited to fees that the grantee (county) charges for the service provider’s use of the grant-funded ambulance (e.g., if the county leases the ambulance to the provider). Income generated by the county or service providers via performance of the ground ambulance services is not program income under this grant program and does not need to be tracked or reported.

Program income generated under the grant may only be used on allowable costs under the grant agreement, and the county must return any unexpended program income to CPA upon termination or expiration of the grant. The county must track any program income and report it to the Comptroller’s office in its annual compliance report.