ContraCostaEmergencyAmbulanceRequestforProposal

DevelopmentWorkshopSeptember17,2014

   

  Patricia Frost EMS Director Contra Costa Emergency Medical Services 10/14/2014 

 

County of Contra Costa

EMERGENCY MEDICAL SERVICES Memorandum DATE: August 15, 2014 TO: Contra Costa EMS Stakeholders FROM: Pat Frost, EMS Director SUBJECT: Save the Date: September 17, 2014 Day Long EMS Ambulance

Request for Proposal Development Workshop

Contra Costa Emergency Medical Services EMS Ambulance Request for Proposal (RFP) Development Workshop

Date: September 17, 2014 Time: 8:30 am - 4:30 pm Location: Contra Costa County Schools Insurance Group at 550 Ellinwood Way, Pleasant Hill, CA To Register: Call Contra Costa EMS at (925) 646-4690 or email Leticia.Andreas@hsd.cccounty.us

Full Day Emergency Ambulance RFP Development Workshop You are invited by the Contra Costa EMS Agency and the Contra Costa Board of Supervisors to participate in a consultant facilitated Emergency Ambulance RFP development workshop designed to capture local knowledge and expertise for the next emergency ambulance procurement. Workshop participants will assist the Fitch and Associates consultant(s) in specifying “what” will be accomplished, in the upcoming emergency ambulance procurement associated with Emergency Response Areas I, II and V and currently served by American Medical Response. Goal of RFP Preparation: To attract multiple qualified bidders to submit proposals for emergency ambulance service to the County using a transparent, fair and objective competitive process. Workshop Invitees: Workshop invitees/participants will include potential bidders, union representatives, hospital and Contra Costa health system representatives, medical community representatives, patient advocates and other local jurisdictional staff. All participants must be prepared to attend the entire day. Lunch will be provided for workshop participants. Emergency Ambulance RFP Workshop Concepts to be covered:

1. Safety net provisions 2. Performance requirements 3. General legal provisions 4. Procurement evaluation process 5. Request for Proposal Timeline

2

The workshop is limited to approximately 50 participants. Each invited group is encouraged to select representatives to participate. Workshop participants must be available for the entire day and confirm they will be attending with Contra Costa EMS by September 11, 2014. County Fire Executive Chiefs representing East , Central and West County (up to 3)

EMS and Fire Union representative (1 from each union, up to 3)

City Manager representation from East , Central and West County communities (up to 3)

Local Law Enforcement representing East, Central and West County (up to 3)

Non-Emergency Ambulance and Air Ambulance Provider representatives (up to 3)

Dispatch Centers (1 representative from Sheriffs Communications , Richmond, San Ramon and Contra Costa Fire) (up to 4)

Potential emergency ambulance bidders (1 representative from each) (Anticipate up to 6)

Aging and Advisory Committee representative (up to 2)

EMS Medical Director and Staff (up to 3)

Hospital Council representative (1)

ACCMA representative (1)

EMCC representatives (up to 3)

Community Hospital Health care representatives (1from each health system partner) (up to 5)

Behavioral Health Care and Mental Health advocacy (up to 2)

LAFCO representatives (1)

Representative from HICAP (1)

American Heart/ Stroke Association Representative (1) California Emergency Physician Representative (1)

Public Meeting and Comment:

This workshop will be noticed as a public meeting with the agenda and all materials posted in compliance with the Brown Act. Members of the public will be able to observe the workshop and offer public comment at the end of the workshop (2 minutes each). The public is also invited to submit written public comment and recommendations for the upcoming ambulance procurement in the following ways: Via

Email: Patricia Frost, EMS Director: Patricia.Frost@hsd.cccounty.us or directly to Fitch & Associates, LLC: cccems@fitchassoc.com. Via Mail: Contra Costa EMS Attn: Fitch Study Public Comment, 1340 Arnold Drive, Suite 126, Martinez, CA 94553 or Via Fax: 925-646-4379 All workshop invitees should prepare for the workshop by reviewing the following materials and are encouraged to bring specific recommendations for discussion.

Contra Costa EMS Website at www.cccems.org EMS System Review and Ambulance RFP website at http://cchealth.org/ems/system-

review.php#simpleContained1 EMS Modernization Project Report at http://cchealth.org/ems/pdf/2014-EMS-System-

Modernization-Study.pdf EMS Modernization Project Report Public Comment Document:

http://cchealth.org/ems/pdf/2014-EMS-System-Modernization-Study-Public-Comments.pdf EMS System Annual Report at http://cchealth.org/ems/annual-reports.php Current AMR Contract: http://cchealth.org/ems/contract-ambulance.php Contra Costa EMS Quality Improvement Program: http://cchealth.org/ems/quality.php Contra Costa 2013 Quality and Utilization Report: http://cchealth.org/ems/pdf/QI-2013-Annual-

Report.pdf Contra Costa EMS System Plan 2012: http://cchealth.org/ems/pdf/sysplanupd12.pdf

EMS Ambulance Request for Emergency Ambulance Proposal (RFP) Workshop September 17, 2014 Attendees

Name: Organization/Agency: 1

Ruth Atkin Contra Costa HICAP 2

Betty Blandino Kaiser Permanente 3

Dan Colbath Contra Costa Firefighters Local 1230 4

Marcy Dixon John Muir Health - Walnut Creek Campus 5

Pat Frost EMS 6

David Goldstein Contra Costa Regional Medical Center 7

Jeff Haislet Paramedics Plus 8

Kacey Hansen John Muir Health - Walnut Creek Campus 9

Alan Hartford Contra Costa Fire Protection District 10

Hugh Henderson East Contra Costa Fire Protection District 11

Jan Howe, RN Advisory Council on Aging 12

Pete Howes Falck Northern California 13

Matt Huffaker City of Walnut Creek 14

Kody Kerwin Contra Costa Fire Protection District 15

Richard Kimbrel Kaiser Walnut Creek 16

Art Lathrop EMS 17

Ellen Leng John Muir Health - Walnut Creek Campus 18

Lance Maples El Cerrito/Kensington Fire 19

Paige Meyer San Ramon Valley Fire Protection District 20

Mike Mohun IAFF Local 3546 SRVFPD 21

Denise Pangelinan San Ramon Valley Fire Protection District Dispatch 22

Dan Pratt San Ramon Police Department 23 Erik Rhode AMR 24

John Rinaudo Advisory Council on Aging 25

Rebecca Rozen Hospital Council of Northern & Central CA 26

David Seidner CC Behavioral Health 27

Josh Sheridan Sutter Delta Medical Center 28

Thomas Sugarman Alameda-Contra Costa Medical Association 29

Lou Ann Texeira Contra Costa LAFCO 30

Melinda Trost REACH

31 Vince Wells Contra Costa Firefighters Local 1230

32

Jennifer Williams Contra Costa County Office of the Sheriff 33

David Zenker Rural/Metro Ambulance 34

Douglas Dunn NAMI Contra Costa 35

Andy Swartzell San Ramon Fire 36

Stephen Smith ECCFPD Board of Directors 37

David Akin San Ramon Fire Fighters 38

Paul Comaroto Rural/Metro Ambulance 39

Brad Deutser AMR 40

Dave Gibson El Cerrito Fire 41

Joseph Greaves Alameda-Contra Costa Medical Association 42

Krystal Hinojosa District IV, Mitchoff 43

Johan Klehs Paramedics Plus/Johan Klehs & Company Inc. 44

Derek Krause San Ramon Valley Fire Protection District 45

Michael Lambton Richmond Police Department 46

Jill Ray Supervisor Candace Andersen 47

Miguel Mendoca AFSCME

Additional comments Post workshop phone interviews

Vince Wells: Richmond double medic ambulance staffing important to retain. Support making improvements in dispatch where all assets fire and ambulance can be deployed. Zone changes may make sense. Response time extensions need to be based on first responder capability.

David Seidel: Workshop clear and comprehensive. Very informative and glad to attend and recommend getting more behavioral health senior leadership input. Want RFP candidates to offer solutions for behavioral health medical transportation options.

Betty Blandino: Moderator did a good job. Support consolidation of dispatch but complex issue. Shared goal getting the right patient to the right hospital the first time. Hospitals are slammed, First responder budgets worrisome but exciting times and change is needed but very hard.

Jan Howe: Very helpful, clear, still torn between experts different views. Believed it was very important to have consumer input. Support having a judge or a member of the faith community who would understand finance to be on the RFP review panel.

Dave Gibson: Interesting day very educational. Brought things together, the EMS study and the RFP. If consider increasing response times then more important to have first responder ALS. Dispatch single point ordering interesting. Concern about the changes suggested in Richmond due to fire fighter safety with longer response time suggested in the study.

Hugh Henderson: Not what he expected thought more RFP specifications would be discussed. Need to have ambulance provider in Fire-EMS dispatch if single point deployment. Raised concern on recommendation for neural outside reviewers who do not understand the community requirements adding that there is a need to have representation that has institutional knowledge.

Joseph Graeves: ACCMA interested in longer term support for clinical and quality issues. Response time and dispatch recommendations of the EMS study not a concern. Recommendation to have ACCMA involved in clinical advisory committee to address EMS system design changes.

Rebecca Rozen: Learned about the process. Informational about what the RFP would be but if did again would recommend that more discussion in small groups and report out to increase engagement.

William B. Walker, M.D. HEALTH SERVICES DIRECTOR Pat Frost EMS DIRECTOR Joseph Barger, M.D. MEDICAL DIRECTOR

Contra Costa Health Services

Emergency Medical Services

1340 Arnold Drive, Suite 126 Martinez, CA 94553-1631

Ph (925) 646-4690 Fax (925) 646-4379

9/19/2014

Dear Contra Costa RFP Workshop Participant,

On behalf of the Contra Costa EMS Agency and emergency ambulance procurement consultants Fitch and Associates, I would like to thank you for your active participation and candid comments during the September 17, 2014 Emergency Ambulance RFP Development Workshop. We hope you found the day informative. The RFP workshop PowerPoint presentation is now available on our website at http://cchealth.org/ems/pdf/RFP-Workshop-2014-0917.pdf.

If there are additional comments that you would like to contribute, please submit them by September 29th so they can be included in the written report on the workshop to the Board of Supervisors on October 21st. Comments may be submitted in the following ways.

Via Email: Patricia Frost - Patricia.Frost@hsd.cccounty.us Fitch & Associates, LLC - cccems@fitchassoc.com

Via Mail: Contra Costa EMS Attn: Fitch Study Public Comment 1340 Arnold Drive, Suite 126 Martinez, CA 94553

Via Fax: 925-646-4379

Again, thank you for your participation in the Contra Costa Emergency Ambulance RFP Development Workshop.

Regards,

Patricia Frost

Received on 10/9/2014

Fire Executive Chiefs Workshop Feedback: Three Executive Fire Chiefs attended and participated in the RFP development workshop on September 17th. Post workshop the representative chiefs shared that they were disappointed in the workshop format and content. They had anticipated it would be more discussion focused with facilitated time for the group to explore alternative models and impacts of the consultant EMS study recommendations. They characterized the workshop as projecting that the county had to make concessions when in their opinion those decisions should be made when necessary. The EMS study trends and analysis was believed to be accurate but the projections that those trends would continue were questionable given the many unknowns and the dynamic nature of present day events. The Fire Chiefs do not feel that it was likely that a change would be required and it is not possible to predict this would be necessary. In addition the Fire Chiefs expressed concerns in the following key areas:

• There was a general consensus among the Chiefs that the workshop discussion was focused on concerns of what may happen while it was known there was no immediate need to make changes at this time.

• That the current RFP approach created unnecessary anxiety for first responder agencies who have been already deeply affected by cutbacks.

• A modified approach of making changes through the term of the emergency ambulance contract and addressing issues on a situational basis was desired.

• The Chiefs wanted to first see what prospective bidders would bring to the table to enhance the system and not to assume a subsidy would be required.

• There was consensus that if bidders did not show up or were disqualified then that would be evidence to change the RFP specs in line with the EMS study recommendations would need to be more seriously considered.

• There was support for the recommended third party review fiscal analysis of bidders to protect the county from bidder misrepresentations of service capabilities.

• Operationally there was a deep concern that changes in longer ambulance response times, reductions in paramedic ambulance staffing in Richmond, removal of QRVs and merging of ambulance response zones would create a lower level of service, resulting in more time on task for fire first responders affecting Fire first response capability to respond to next call.

• There was concern that the RFP would create increased requirements for Fire first responder paramedics or fire personnel to accompany the patient in the ambulance more often using BLS ambulances.

• The Chiefs strongly believed that fire ALS first responder capability was being characterized in the EMS study as no longer needed and saw any reduction of Fire ALS as degrading the level of service within the EMS System.

• Support was expressed for high quality accredited single EMS dispatch with an understanding that the complexities of the current EMS dispatch environment were part of a larger discussion to appropriately address both political and financial impacts of dispatch consolidation..

• Fire Chiefs unanimously expressed the desire to strengthen their first responder ALS QI and expressed an interest in having a dedicated fire medical director to help them focus on those efforts.

• Improving the electronic Patient Care record (ePCR) data management platforms and data systems effectively supporting health care exchange, improvement of patient outcome and future partnerships with the health care system was of interest as part of the RFP process provided it supported efficiencies in the quality and patient care oversight required of Fire first responders.

Overall the fire executive chiefs believed that the EMS study recommendations associated with the RFP diminished the present EMS System at a time when the county has lost 20% of their fire stations and had suffered reductions of 10-20% in fire first responder workforce.

1 Attachment

Ms. Frost,

On behalf of the members of AFSCME Local 4911 members, that work for AMR in Contra Costa County, I'd thank you for including us in the RFP process. We truly appreciate the opportunity to participate in the RFP process in Contra Costa.

Per the request of Fitch and Associates, I have attached incumbent workforce language we'd like to see included in the RFP. We are also submitting this to the entire CCC BOS. We truly believe this will give our members the protection that they deserve during the entire RFP process.

Thank you for your time on this matter and we look forward to hearing from you. Please feel free to contact me via email or at 925-457-4742, if you have any further questions.

Sincerely,Brandon BigosAssistant Chief Steward & CLC DelegateUnited EMS Workers, AFSCME Local 4911

Incumbent Workforce Language for EMS RFPBrandon Bigos to:Patricia Frost09/23/2014 05:03 PMCc:cccems, "jason.brollini@uemsw.org", Aimee Skaggs, "miguel9162573751@yahoo.com"Hide Details From: Brandon Bigos <babigos@gmail.com>To: Patricia Frost <Patricia.Frost@hsd.cccounty.us>, Cc: cccems@fitchassoc.com, "jason.brollini@uemsw.org" <jason.brollini@uemsw.org>, Aimee Skaggs <skaggzs5@gmail.com>, "miguel9162573751@yahoo.com" <miguel9162573751@yahoo.com>History: This message has been replied to.

CoCo RFP Incumbent Workforce Language Request - PF.pdf

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United  EMS  Workers  AFSCME  Local  4911  www.uemsw.org    www.emsmemorialfoundation.org  

P.  O.  Box  203  Oakley,  Ca  94561  Office:  408-­‐772-­‐5175  Fax:  617-­‐367-­‐1328  

   

 

To: Patricia Frost September 23, 2014 Contra Costa EMS 1340 Arnold Drive, Suite 126 Suite 126 Martinez, CA 94553

Re: Incumbent Workforce language for Contra Costa Ambulance RFP

Dear Ms. Frost,

As the designated labor organization representing the Emergency Medical Technicians, Paramedics, Vehicle Service Technicians and Schedulers that diligently serve the residents of Contra Costa, we hereby respectfully request that “Incumbent Personnel Solicitation” language be added to the RFP.

United EMS Workers Local 4911 has introduced the following language in multiple RFP’s, all of which have been approved by legal counsel, added to the EOA contracts and have ensured a smooth transition of services in the event of a provider change. Furthermore, retaining the experienced and dedicated providers of Contra Costa ensures that the residents continue to receive the quality medical care they deserve and have come to expect.

Therefore, on behalf of the Emergency Medical Services providers of Contra Costa County, I hereby request the RFP to include the following:

“Incumbent Personnel Solicitation. The successor provider will guarantee employment for all incumbent EMT, Paramedic, VST and Scheduling personnel within the county’s EOA who meet the minimum employment requirements. The successor provider shall ensure that all other incumbent employees who meet the minimum employment requirements will be afforded priority consideration of employment. All such incumbent personnel will receive compensation and benefits that equal and/or exceed their current employment compensation and benefits, as long as minimum employment requirements are met. The successor provider will recruit employees currently working in the system to assure a smooth transition and to encourage personnel longevity.”

United EMS Workers and its members stand committed to serving the citizens of Contra Costa County and look forward to assisting during this RFP in any way possible.

Your consideration on this request is greatly appreciated.

Sincerely,

Jason Brollini, MICP Political Director United EMS Workers Local 4911  

Pat­

Chief Henderson has passed on to me your request for my comments on the EMS RFP workshop. I found the last portion of the workshop—discussion of the bid evaluation process—highly interesting. My comments below are also informed by my own experience with the CONFIRE Dispatch Center, viewing of the Executive Chiefs Association presentation before the Board of Supervisors, and discussions with Chief Henderson and others. My specific comments follow:

1. The RFP must require completely addressing upgrades to the Dispatch function including a consolidation of Fire and Ambulance dispatching.

2. Measurement of response times must be broken down into separate measurements for each of the three zones (at the very least) rather than one Countywide number.

3. Very careful continued consideration must be given to any proposed removal of Paramedic capability from fire companies. If done, it should probably be on a station­by­station basis, removing Paramedics only where ambulance arrival times are consistently within the golden minutes.

4. A huge plus would be adoption of innovative ideas for transport of 5150 patients that does not tie up a full ALS ambulance and crew.

Steve Smith

Comments On EMS RFP WorkshopStephen F. Smith to:Pat Frost \(CCCHSD\)09/30/2014 04:23 PMCc:"Hugh Henderson \(ECCFPD\)"Hide Details From: "Stephen F. Smith" <stephenfsmith@sbcglobal.net>To: "Pat Frost \(CCCHSD\)" <Patricia.Frost@hsd.cccounty.us>, Cc: "Hugh Henderson \(ECCFPD\)" <HHenderson@eccfpd.org>Please respond to <stephenfsmith@sbcglobal.net>

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Thank you for holding the daylong session on the next RFP.I am emailing you both to make sure that the RFP includes the respondents’ ability to:

1. Gather data and report on the nature of the transports, including age and other characteristics of the people being transported, nature of the services provided (such as oxygen provided, etc.) and geographic distribution of the service calls, and

2. Demonstrate an appeals process in billing and claims for the rider and that sufficient time is allowed for denied claims to go through governmental and private insurers appeals timeframes before being sent to collections. In the case of Medicare billing, the first level of Medicare appeals is 120 days.

Thank you for including HICAP as a stakeholder in this critically important effort.

Ruth Atkin, MSW, LCSWContra Costa HICAP Program Manager(925) 602-4161Fax: (925) 677-3007ratkin@ehsd.cccounty.us

Ambulance RFPRuth Atkin to:cccems09/22/2014 09:24 AMCc:patricia.frostHide Details From: "Ruth Atkin" <RAtkin@ehsd.cccounty.us>To: <cccems@fitchassoc.com>, Cc: <patricia.frost@hsd.cccounty.us>History: This message has been replied to and forwarded.

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Hi Pat,

I rec’d a message from you regarding feedback on the workshop.

I believe it was a well-run workshop that allowed all in attendance to freely share their opinions/concerns/suggestions. We have had no negative feedback since the workshop – so I would say it went well.

Thanks for checking in!JillRay,FieldRepresentativeSupervisorCandaceAndersenContraCostaCounty,District2309DiabloRoadDanville,CA94526(925)957­8860voice(925)820­3787faxLafayetteOffice3338Mt.DiabloBoulevardLafayette,CA94549(925)646­6067voice(925)646­6068faxhttp://www.cccounty.us/district2This message is being sent on a public e­mail system and may be subject to disclosure under the California Public Records Act.

MessageJill Ray to:Patricia Frost09/30/2014 03:42 PMHide Details From: Jill Ray <Jill.Ray@bos.cccounty.us>To: Patricia Frost <PFrost@hsd.cccounty.us>, History: This message has been replied to and forwarded.

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Pat, Leticia (as well as Dr. Barger & Fitch Consultants): It was a pleasure participating in the RFP Workshop Wed. Great information, lots of input...what a job ahead for all. It was well worth the time to be present. Things will be ready for our BOS when they address this RFP in the future. This new mechanism for EMS transport comes from assessment of past data and looks toward the future for Contra Costa despite all the unknowns we heard about during the workshop. The following is unsolicited input: Videotaping an educational piece for the public purposes isn't cheap. Once filmed, it's cheap to U-Tube stream it or burn discs for civic groups to hear, then discuss. This media option could be distributed to League of Women Voters - Diablo Valley and West County chapters, Cal State University - East Bay/ DVC/ Los Medanos. Contra Costa Community College, the Interfaith coalition of Contra Costa, all school district civics instruction faculty, chambers of commerce groups, AARP, CARA, SIRS, Toastmasters, Kiwanas, etc. to explain to the consuming/ voting/ taxpaying public why change must happen. How else does anyone outside EMS learn positive info about a new emergency transport contract process? It's their in interest. It's money well-spent pro-actively. Why wait till the county may need to pass a new funding measure to keep EMS alive? This model is employed by advocates for ballot measures or political candidates alike. Use tech, appealing social or film media to get a well-informed public. Partner with reputable community entities to "market it"/ explain it. A well informed public votes for parcel taxes, funding measures (ie. San Ramon School District passes every school parcel tax, funding measure with #'s greater than just a 2/3 majority. Doctors Medical Center lost out because their campaigns started too late x2 and their assumed funds allocated were inadequate.) If taxpayer advocates had been in the audience this Wed., they wouldn't be so inclined to parrot their only mantra which I heard @ the Sept. 9 BOS meeting regarding "wages, pensions, etc. = 40% of fire budgets." It would help if they understood the realities of running an emergency transport system & didn't just focus on one old issue beat to death in the press. Cheap staff may not be the right, the only, or "cheapest" option for a great EMS. That was then, this is now. Jan Howe county consumer/ senior from San Ramon

On Friday, September 19, 2014 9:12 AM, "Leticia.Andreas@hsd.cccounty.us" <Leticia.Andreas@hsd.cccounty.us> wrote:

Sent on behalf of Pat Frost and Fitch & Associates:

Leticia AndreasEMS SecretaryContra Costa Emergency Medical Services1340 Arnold Drive, Suite 126Martinez, CA 94553Direct: 925-313-9542Office: 925-646-4690Personal Fax: 925-313-8387

Re: Thank you for your participation in the RFP WorkshopRobert Howe to:Leticia.Andreas@hsd.cccounty.us, Pat.Frost@hsd.cccounty.us09/19/2014 10:59 AMCc:John RinaudoHide Details From: Robert Howe <bobhinsram@sbcglobal.net>To: "Leticia.Andreas@hsd.cccounty.us" <Leticia.Andreas@hsd.cccounty.us>, "Pat.Frost@hsd.cccounty.us" <Pat.Frost@hsd.cccounty.us>, Cc: John Rinaudo <jrin57@comcast.net>Please respond to Robert Howe <bobhinsram@sbcglobal.net>

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