EMS not allowed on Fire Channels!! When it comes to the FCC there is no distinction. Are all the ambulances in OC private? Any FD operated EMS should be allowed on the FD dispatch and other channels as this sounds more like politics than a radio issue. For hospital comms that are now on the VHF band, they could be UHF, using the Med 1-10 channels. Even though most at least in Dutchess are now on cell phone.
This grant sounds like, "lets get some free money since every body else is". Instead of having a comprehensive county wide plan for all agencies, and using those monies for it. With narrow banding looming, now would be a great time to chuck all the bands and come up with one plan on one band for there should be a ton of channels made available, and if you don't get them when they first come available forget it. Most likely for a good county wide system would be UHF or you could go the UHF-T band route. Other agencies outside the 50mi limit have.
IMHO the police agencies using the 800 mhz operate there out of convience, one bill a month. A county wide radio system could be built, but that takes real planning and money, and using a commercial radio system is just a stopgap. God help all those agencies if for some reason or another NYCOMMCO ever goes belly up.