Form FEMA Form 080-0-4b FEMA Form 080-0-4b Staffing for Adequate Fire and Emergency Response Recrui

Staffing for Adequate Fire and Emergency Response (SAFER) Grants

FEMA FORM 080-0-0-4b

Staffing for Adequate Fire and Emergency Response Recruitment and Retention of Volunteer Firefighters Application (Questions and Narrative)

OMB: 1660-0135

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DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency

Staffing for Adequate Fire and Emergency Response
Recruitment and Retention of Volunteer Firefighters Application
(Questions and Narrative)

OMB No.: 1660‐0135
Expiration Date: August 31 2017
PAPERWORK BURDEN DISCLOSURE NOTICE
Public reporting burden for this data collection is estimated to average up to 7.5 hours per response for FEMA Form 080-0-4b
“Staffing for Adequate Fire and Emergency Response Recruitment and Retention of Volunteer Firefighters Application (Questions
and Narrative).” The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and submitting this form. This collection of information is required to obtain or retain
benefits. You are not required to respond to this collection of information unless a valid OMB control number is displayed on this
form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information
Collections Management, Department of Homeland Security, Federal Emergency Management Agency, 500 C Street, SW.,
Washington, DC 20472-3100, Paperwork Reduction Project (1660-0135) NOTE: Do not send your completed form to this address.

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1. Applicant's Acknowledgements

Request Details

2. Overview
3. Contact Information

4. Applicant Information

5. Applicant Characteristics m
6. Applicant Characteristics (Ill
7. Department Call Volume
8. Req uest Details
9. Budget
10. Narrative Statement
11. Assurances and Certifications
12. Review Application
13. Submit Application
Print Application
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Please answer the questions below and then click Add Recruitment and Retention Activity to begin.
You must answer all of the project specific questions and specify at least one budget item. Once you have added your project, the list of the budgeted line items and the costs for each line item will be listed in the table below. You can come back
and modify this area at any point before you submit your application to FEMA .
You may update or delete the information by clicking the appropriate link under the Action column.
W hen y ou have fi nished, press the Return to Summary button below.

• In cases of demonstrated economic hardship, and upon the request of the grant recipient, the FEMA Ad ministrator
may waive or reduce a SAFER Recruitment and Retention (R&R) minimum budget requirement. Is it y our d epartment's
intent to apply for an economic hardship waiver, if awarded ?

0 Yes @ No

• Is there a grant-writing fee assoc iated with the preparation of this req uest? (if yes, you must add the cost as a budget
item below in order to be reimbursed with grant fu nds)

0 Yes 0 No

Activity

I
No line items are currently specified for this activity.

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1. Applicant's Acknowledgements

Recruitment and Retention of Volunteer Firefighters Activity

2. Overview
3. Contact Information

4. Applicant Information

Please provide the following additional information that pertains to your fire department.
As a reminder, the purpose of these grants is to assist fire departments with the rec ru itment and retention of v olunteer firefi ghters who are inv o lved w ith, o r trained in, t he operatio ns of firefig hting and emergency response. The grants
are intended to create a net increase in the number of trained, certified, and competent firefighters capable of safely responding to emergencies within the grantee's geographic response area.
Career fire departments are not eli gib le for t his activity.
Not e: Fields marked with an asterisk (' ) are required.
Recruitment and Retention of Volunteer Firefighters

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• 1. What is the id eal n umber of act ive vol unteer fi refi ghters needed by your department to adeq uately c om ply with NFPA 17 10 (Sec tion
5.2.4.1 - Single-Family Dwelling Initial Full Alarm Assignment Capability) or NFPA 1720 (Sec tion 4.3 - Staffing and Deployment)? (Note Include
only o perati onal volunteer firefighters; administrative or EMS only members should not be included)

I(Whole Numbers only)

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I

I(Whole Numbers only)
I(Whole Numbers only)
I(Whole Numbers only)

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• 2. What is the total number of current active v o lu nt eer firefig ht ers in your department? (Note: Include only o perati onal volunteer
firefighters; administrative or EMS only members should not be included)

Disclaimers

• 3. How many active vol unteer operati onal fi refi ghters j oin ed your department over the last three years?
• 4. How many active vol unteer operati onal fi refi ghters left your department over the last three years?

• 5. Will y our department period ically evaluate your proposed program's impact?

0 Yes O No

Help

5a. If Yes, please provide an explanation of how the evaluation will be conducted (800 characters) .
800 characters left

• 6. Do you currently have a Recruitment and Retention Coord inator or Prog ram Manager position?

0
0
0
0

• 7. Do you currently have a marketing plan as part of your recruitment and/or retention program?

0 Yes
0 No, but will be developing one as part of this grant
0 No

• 8 . Does your department currently offer worker's com pensation/accidental death and dismem berment (A D&D) insurance for active volunteer
firefighters?

Yes
No, but will appoint one outside of the grant
Included in this request
No

0 Yes
0 Included in this request

Help

0 No

• 9. Will your grant have a reg ional andl or local impact beyond your fire department?

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0 Yes, the ac tivities requested will be shared d irectly with other
departments
0 Yes, other departments will benefit ind irectly from the recruitment or
retention activities
O N
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1. Applicant's Acknowledgements

2. Overview
3. Contact Information

0 Yes
0 No, but will be developing one as part of this grant
0 No

• 7. Do you currently have a marketing plan as part of your recruitment and/or retention program?

4. Applicant Information

• 8. Does your department currently offer worker's com pensation/accidental death and dismem berment (AD&D) insurance for active volunteer
firefighters?

0 No
0 Yes, the ac tivities requested will be shared d irectly with other
departments
0 Yes, other departments will benefit ind irectly from the recruitment or
retention activities
0 No, other departments will not benefit
0 N/A (Requesting assistance to retain current members only)

• 9. Will your grant have a reg ional and/or local impact beyond your fire department?
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0 Yes
0 Included in this request

9a. If Yes, please list the departments and describe how they will benefit from this application. (Note: If awa rded , you may be required to provide
documentation of the fire department's consent to participate in the application).
If additional space is needed for your response, please include it in the Project Description section of the application Narrative (1000 characters) .

1000 characters left

9b. If Yes, do you certify that you will ensure that the fire departments benefiting from this application have not received grants for similar
items/activities?

0 Yes
0 No

* 10. If awarded a grant, will you provide the new recruits with entry-level physicals in accordance with NFPA 1582, Standard on Com prehensive
Occupational Medical Program for Fire Departments 2003 Edition, Chapter 6?

0 Yes, NFPA 1582 com pliant
0 No, but will provide other physicals not to NFPA 1582 spec ifications
0 No

• 11. Do you currently provide annual medical/physical exams in ac cordance with NFPA 1582, Standard on Com prehensive Occupational
Med ical Program for Fire Departments 2003 Edition, Chapter 6?

0 Yes, NFPA 1582 com pliant
0 No, but will provide other physicals not to NFPA 1582 spec ifications
0 No
0
0
O
O
O

• 12. What is the minimum level of training and certification standard required by your locality/state?

None
First responder
FF I
FF I/EMT
FF 11

O FF II/EMT

• 13. Will the personnel rec ru ited meet the minimum local or State fire and EMS training and certification requirements for firefighters within 24
months of appointment?

0 Yes
0 No
0 N/A - (Requesting assistance to retain current members only)

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1. Applicant's Acknowledgements

Add Budget Item

2. Overview
3. Contact Information
4. Applicant Information
5 . Applicant Characteristics

6. Applicant Characteristics (Ill
7. Department Call Volume

Please provide the following information. You may request additional line items by clicking on the "Add Budget Item " link.
NOTE: The cost figures you provide do not have to be firm quotes from your vendors, but they should be est imated based on research of current prices (i.e ., check with at least two vendors for your estimates) before you submit your estimated
costs. If you do not have these estimates, you can come back and modify this area at any point before you submit your application to FEMA. Only whole dollar amounts should be provided (no cents please).

8. Req uest Details
9. Budget
10. Narrative Statement

Fields marked with an asterisk(•) are required.

11. Assurances and Certifications
12. Review Application

• Category

13. Submit Application

If you selected Other, above, please spec ify:

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• Sub-Category

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If you selected Other, above, please spec ify:

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• Select Object Class:

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I

ISelect Object Class vi

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If you selected Other, above, please spec ify:

First 12-Month Period of Your Grant

*Cost

Second 12-Month Period of Your Grant

At least one box must have a value greater than zero .

Third 12-Month Period of Your Grant

Fo u rth 12-Month Period of Your Grant

• Description
Use the space to the right to provide specific details on the items/activities requested
under this budget line item and how costs were determi ned. Provide a simple, yet
descriptive explanation of the costs. Some examples are provided below:
• If requesting turnout gear/personal protective equipment, you should identify the
number of new rec ruits that will receive gear under this award, a list of each item
being req uested (and assoc iated cost per item), and the total cost of one full set of
gear for eac h new recru it;
• If requesting salary costs for a recruitment coordinator, you should identify
whether the position is part-time or full-time, the number of hours that will be worked
per week, and the tasks that the individual will perform as part of the award;
2000 characters left
• If requesting funds for member awards or incentives, you shou ld include the type
of award or incentive, the amou nt requested for eac h, and how the members will
qualify to receive the incentive;
• If requesting station duty uniforms for new members, you shou ld identify the
number of new rec ruits that will receive uniforms under this award, a list of each item
being req uested, and the cost of eac h item .

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1. Applicant's Acknowledgements

2. Overview
3. Contact Information

Budget

4. Applicant Information
5. Applicant Characteristics
6. Applicant Characteristics (Ill
7. Department Call Volume
8. Req uest Details
9. Budget
10. Narrative Statement
11. Assurances and Certifications
12. Review Application
13. Submit Application

Application 70% complete
Recru itment and Retention of Volunteer Fi refighters :
There is no local match requirement for this activity and there are no maximum Federal share limits. Therefo re, any items requested under Recruitment and Retention will be 100% Federally funded.
Please review the budget information below. If you need to change any of the budget amounts on the matrix, you will need to change the budget information on the previous Request Details screen.
Using the information you entered for your item's please enter and review the budget information below. Include totals in the right hand column and bottom row.
First
12-Month Period

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Second
12-Month Period

Third
12-Month Period

Fourth
12-Month Period

Total

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Personnel

Privacy Statement

Fringe Benefits

10,000

40,000

Disclaimers

Travel

Eg ui12ment

SUQQlies

Contractual

Other

Indirect Charges

Federal Share

10,000

40,000

Applicant Share

Total:

10,000

40,000

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1. Applicant's Acknowledgements

Narrative Statement for Volunteer Recruitment and Retention Activ ity

2. Overview
3. Contact Information

4. Applicant Information

Application 80% com plete

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The narrative statements must provide all the information necessary for you to justify your needs and for FEMA to make an award decision. A panel of peer reviewers will perform the second phase of the applications' evaluations by using the
narrative statements below, along with the answers to the general and the activity-specific application questi ons, to determine the worthiness of the request for an award.
Please ensure that your narrative clearly addresses each of the following evaluation criteria elements to the best of your ability, with detailed but concise information. Eac h element will be evaluated independently by the peer review panelists.
The relative weight of the evaluation criteria in the determination of the grant award is listed below.
You may either type your narrative elements in the spaces provided below; or create the text in your word proc essing system and then copy it into the appropriate spaces provided below. Please note the narrative block does not allow for
formatting. Do not type your narrative using only capital letters. Additionally, do not include tables, special fo nts (i.e., quotation marks, bullets, etc .), or graphs.
Not e: Fields marked with an asterisk (' ) are required. Eac h element must have a minimum of 200 characters and each element will have a character limit; th e limit varies based on the questions being asked. The character count will be listed
below each text box.

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• Element #1 - Project Description (30% ):
• 1a. What p roblems and/or issues is th e d epartment experiencing in recruiting new volu nt eer fi refig hters (i.e., why are you u nable to recruit members)? What are th e problems an d/or issues t he department is experiencin g in
retaini ng cu rrent members (i.e., why are the current vo lunteer firefight ers leaving)? (3000 characters)

3000 characters left

• 1b. What is t he department's implementation plan to direct ly address t he p roblems and/or issues discussed above? What are t he methods and specific steps t hat will be used to achieve this plan? (3000 characters)

3000 characters left

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1. Applicant's Acknowledgements

• 1c. How will t he recru itment o f new vol unteer firefight ers and/or retent ion of cu rrent volunteer firefighte rs impact the department's operational needs or capabil ities? (1500 cha racters)

2. Overview
3. Contact Information

4. Applicant Information

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1500 characters left

• 1d. What are the specific benefits the new volunteer firefighters and/or retention of current volunteer fi refi ghters w ill provide for the fire department(s) an d comm unity? (1000 characters)

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1000 characters left

• 1e. If your grant will have a regional impact, w hich activit ies are part of th e regional request and w hich activities are exclusive t o th e host applicant, if applicable. (2000 characters)

2000 characters left

*Element #2 - Impact on Daily Operations (30%)

• 2a. How are the community and the current vol unteer fi refighters in the department at ri sk without t he items/activities requested in this application? How will that ri sk be reduced if award ed? (2000 characters)

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1. Applicant's Acknowledgements

*Element #2 - Impact on Daily Operations (30%)

2. Overview
3. Contact Information

4. Applicant Information

5. Applicant Characteristics m

• 2a. How are the community and the current vol unteer fi refighters in the department at ri sk without t he items/activities requested in this appl ication? How will that ri sk be reduced if award ed? (2000 characters)

6. Applicant Characteristics (Ill
7. Department Call Volume
8. Req uest Details
9. Budget
10. Narrative Statement
11. Assurances and Certifications
12. Review Application
13. Submit Application
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2000 characters left

• 2b. How often does yo ur department cu rrent ly comp ly with th e applicable NFPA 1710 or NFPA 1720 standards? What impact will the recru itment of new volunt eer firefighte rs and/or the retention of current volunteer
fi refighters have on the departments NFPA compl iance, if awarded? (2000 characters)

2000 characters left

*Element #3 ·Financial Need (30%):

• 3a. Please provi de additional details on the department's current operati ng budget. Th is must incl ude an income verse expenses breakdown of the current annual budget indicated in t he Applicant Characteri stics secti on of
the application. If you were unable to provide the department 's operatin g budget for the 2001, 2002, and 2003 fiscal years, please provide details on why you were not able to provide th e information. (2000 characters)

2000 characters left
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1. Applicant's Acknowledgements

2. Overview
3. Contact Information

• 3b. Please describe th e department 's budget shortfalls and t he inabi lity to address t he financial needs w ithout federal assistance . Wh at other actions have you take n to obtai n fu nding elsewhere (i.e., state assi stance
prog rams, other grant programs, et c.)? How have similar project s been funded in t he past? (2000 cha racters)

4. Applicant Information

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• 3c. How are the critica l functions of your department affected wit hout th is funding? (1000 characters)

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1000 characters left

*Element #4 - Cost Benefit (10%):
• Please descri be the benefits (i.e., ant icipated savings, effi ciencies) t he department and commu nity will realize if award ed the items/activities request ed in t his application. (3000 characters)

3000 characters left

Element #5 - Additional Information : If you h ave any additional information you woul d l ike to include about the department an d/or this application in general, please provide below. (2000 characters)
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1. Applicant's Acknowledgements

• 3c. How are the critica l fu nctions of your department affected wit hout th is funding? (1000 characters)

2. Overview
3. Contact Information

4. Applicant Information

1000 characters left

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*Element #4 - Cost Benefit (10%):

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• Please describe the benefits (i.e., ant icipated savings, effi ciencies) t he department and commu nity will realize if awarded the items/activities request ed in t his application. (3000 characters)

Disclaimers

3000 characters left

Element #5 - Additional Information : If you h ave any additional information you woul d l ike to include about the department and/or t his application in general, please provide below. (2000 characters)

2000 characters left

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File Modified	2017-06-16
File Created	2017-03-27