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HomeMy WebLinkAbout07 REQUEST FOR PROPOSAL (DRAFT)County of Orange Health Care Agency 04� J OGv Re it :for Proposals 9 -1- ergency Ambulance ans p ortation Services A� �O Released April 25, 2014 TABLE OF CONTENTS SECTION I. Introduction A. Proposal Focus and Background ...................... .................................. I................. B. Eligibility to Submit Proposals ............................................. ............................... C. Contract Term and Funding Availability .............................. ............................... D. Evaluation of Proposals and Selection of Providers ............. ............................... E. County's Rights .................................................................. ............................... F. Protest Process .............................................................. ............................... G. Timeline .................................................................... ............................... ILConfidentiality .......................................................... ............................... ........ I. Addendums ........................................................ ............................... .......... J. Contract Terns and Conditions ..................................... .............Ik................ K. Insurance Requirements ............................................... .........,..................... H. Description of Services A. Target Population .......... ............................... B. Functional Responsibilities .......................... C. Operations ..................... ............................... D. Emergency Response Communication Syst E. Facilities, Supplies and Equipment.......... F. Vehicles and Maintenance ................ 1111.. .... G. Personnel ......... ............................... I H. Data Management .................... I. EMS System and Communrt J. Administrative Provisior}s� ................ III. Proposal Preparatio 41tru ctions ................. IV. Agency Descr' tto "Information .................... eco ............ ... ............................... ....... .. ......................... I........ ........................ I..................... .......... . ............ ...... I.................... ..................... ............................... PAGE ...........5 lV J......12 ..........13 ......14 ..........14 ..........14 ..........15 ..........15 .......:.........18 .................18 .................19 .................21 .................36 .................39 .................40 .................42 .................44 .................45 ..53 .55 Attache Attac I — Contracting Requirements /Attestation A ent II — Forms A -D N TE: Forms and attachments in PDF and /or Excel format are posted on BidSync as separate attachments to this solicitation. Request for Proposals 4 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs INTRODUCTION SECTION I A. PROPOSAL FOCUS AND BACKGROUND The County of Orange (County) Health Care Agency (HCA) is seeking proposals from qualified ambulance service providers to provide 9 -1 -1 Emergency Ambulance Transportation Services within an Orange County Exclusive Operating Area (EOA). The primary goal of these services is to provide high quality Basic Life Support (BLS) medical care and ambulance transportation services to Orange County (OC) residents. Enacted by the legislature in 19 80, the Emergency Medical Services System (EMSS) d1 re- hospital Emergency Medical Care Personnel Act (EMS Act) created a comprehe tatutory system governing pre - hospital emergency medical services for the purpose of ac statewide coordination and integration of pre - hospital emergency medical services. The EMS Act accomplishes this integration through a two- tiered sys f state and county regulation. At the state level the Emergency Medical Services Au rt �( MSA) is responsible for functions relating to the coordination of EMS throughout th . At the county level, a designated local EMS agency ( LEMSA) is responsible for � it of emergency medical services and required to have a Medical Director th ribes the medical management of the EMS system. In OC, the designated LEMSA is tl C_o ty's Emergency Medical Services ( OCEMS) program. 7 Health and Safety Code §1797.224 authorizes (5C MS to create Exclusive Operating Areas (EOA), provided a competitive process is utilize ' t select providers of the services pursuant to the local EMS Plan. EOAs may be changed, adj>te , or redrawn by OCEMS at any time during the contract period. Unincorporated service are subject to annexation or incorporation at any time as determined by the OC Local Agp4yTormation Commission (LAFCO). OCEMS has reconfigured the fern (19) individual EOAs (Table 1) into five (5) regional EOAs. The five (5) region e created to assure state sanctioned anti -trust protection and provide uniform, reliable ncy ambulance services. The five (5) regional EOAs (Table 2) are medically feasible, fit Tally viable, and allow for efficient resource utilization to maximize response times The information ' able 1 and Table 2 below is based on data at the time of release of this solicitation le information is provided for general purposes only and does not constitute any commitme t the County, nor does it guarantee any annual utilization of services. The tLome of this solicitation will be the selection of one (1) bidder for each designated EOA re ' with whom the County will negotiate an exclusive, performance -based contract with for rovision of the required services. Request for Proposals 5 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs INTRODUCTION SECTION I TABLE 1: Individual EOAs EOA Ci Associated Unincorporated Areas 5 Cypress (City + Associated Unincorporated Areas in Tkbl) 10 Irvine John Wayne Airport QWA), Irvine Sphere Of Influence 13 La Palma Volume 14 Los Alamitos Rossmoor 17 Placentia Brea Unincorporated, Tonner Canyon 19 San Juan Capistrano Ortega Highway 21 Seal Beach Bolsa Chica 22 Stanton Midway City 23 Tustin Cowan, Lemon Heights 24 Villa Park Silverado Canyon, Orange/Olive Area 26 Yorba Linda Chino Hills State Park 28 Laguna Hills 29 Rancho Santa Margarita Trabuco, O'Neill Park, Las Flores, Q o e Caza 30 Laguna Hills 32 Aliso Viejo Aliso Woods, Aliso Canyon 35 Laguna Woods Newport Coast, Unincorpo aguna Wilderness, Emerald Bay 38 Mission Viejo 39 Dana Point 42 Lake Forrest Mod'eska, Upper, uco /Cooks TABLE 2: OC Regional EOAs - Call Volurri+(9/1/12 through 8/31/13) REGION A ' Annual ALS ALS BLS (City + Associated Unincorporated Areas in Tkbl) Call Assessment Transport Transports 614 Volume La Palma 658 135 17 Placntia e 2,369 294 662 524 26 1 Yorba Linda 2,817 350 724 686 RE B (City +Associate S §pko. led Areas in Table l) Annual Call Volume ALS Assessment ALS Transport BLS Transports 5 Oypress 2,084 275 583 614 13 yk, La Palma 658 135 234 152 14 Los Alamitos 1,385 153 447 492 Seal Beach 3,011 523 787 915 Stanton 3,405 442 1 681 1 929 Request for Proposals 6 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs INTRODUCTION SECTION I I REGION C (City +Associated Unincorporated Areas in Table 1) Annual Call Volume ALS Assessment ALS Transport BLS Transports 10 Irvine 9,594 1,326 2,803 2,324 23 Tustin 4,992 698 1,455 1,384 24 Villa Park 254 51 179 9 _' a To be eligible to submit sal for these services, the bidder must have attended the mandatory Bidders' Conference; i e licdensed by the California Highway Patrol (CHP) and OCEMS by the s�s}� time the proposal ib rtted. NZ As part of thii ' ility process, and in order to proceed to the proposal evaluation stage, HCA will be con g an inspection of the bidder's proposed equipment, personnel, and facility to ensure the$ e capable of independently operating in each proposed EOA region, and that they meet of the requirements of the solicitation. If the inspection concludes that the bidder's j re es are not capable of independently operating in any proposed EOA region, or does not 11 of the solicitation requirements, the bidder's proposal, in its entirety, will be deemed non- Psive and will not proceed to the proposal evaluation stage. Therefore, it is the sole responsibility of each bidder to ensure that their proposed equipment, personnel, and facility are capable of independently operating in each proposed EOA region. Bidders may submit a proposal for one (1) or more of the five (5) EOA regions, which may result in a bidder being awarded a contract for one (1) or multiple EOA regions. If proposing multiple EOA regions, and the bidder is selected to provide services in multiple regions, if during contract Request for Proposals 7 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs REGION D Annual ALS ALS j LS (City+ Associated Unincorporated Arens in Table 1) Call Assessment Transport A ransports Volume 28 Laguna Hills 2,198 287 781 641 30 Laguna Niguel 2,840 340 788 807 32 Aliso Viejo 1,737 287 51) 446 35 Laguna Woods 4,339 702 8 1,475 39 Dana Point 2,416 334 i V 698 600 a To be eligible to submit sal for these services, the bidder must have attended the mandatory Bidders' Conference; i e licdensed by the California Highway Patrol (CHP) and OCEMS by the s�s}� time the proposal ib rtted. NZ As part of thii ' ility process, and in order to proceed to the proposal evaluation stage, HCA will be con g an inspection of the bidder's proposed equipment, personnel, and facility to ensure the$ e capable of independently operating in each proposed EOA region, and that they meet of the requirements of the solicitation. If the inspection concludes that the bidder's j re es are not capable of independently operating in any proposed EOA region, or does not 11 of the solicitation requirements, the bidder's proposal, in its entirety, will be deemed non- Psive and will not proceed to the proposal evaluation stage. Therefore, it is the sole responsibility of each bidder to ensure that their proposed equipment, personnel, and facility are capable of independently operating in each proposed EOA region. Bidders may submit a proposal for one (1) or more of the five (5) EOA regions, which may result in a bidder being awarded a contract for one (1) or multiple EOA regions. If proposing multiple EOA regions, and the bidder is selected to provide services in multiple regions, if during contract Request for Proposals 7 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs REGION E Annual ALS BLS (City+Associated Unincorporated Areas in Table 1) Call sment Transport Transports Volume 19 San Juan Capistrano 2,3 MIN ' 274 769 644 29 Rancho Santa Margarita 64 341 788 606 38 Mission Viejo 9 1,064 1,680 1,424 42 Lake Forest ,670 514 1,176 956 a To be eligible to submit sal for these services, the bidder must have attended the mandatory Bidders' Conference; i e licdensed by the California Highway Patrol (CHP) and OCEMS by the s�s}� time the proposal ib rtted. NZ As part of thii ' ility process, and in order to proceed to the proposal evaluation stage, HCA will be con g an inspection of the bidder's proposed equipment, personnel, and facility to ensure the$ e capable of independently operating in each proposed EOA region, and that they meet of the requirements of the solicitation. If the inspection concludes that the bidder's j re es are not capable of independently operating in any proposed EOA region, or does not 11 of the solicitation requirements, the bidder's proposal, in its entirety, will be deemed non- Psive and will not proceed to the proposal evaluation stage. Therefore, it is the sole responsibility of each bidder to ensure that their proposed equipment, personnel, and facility are capable of independently operating in each proposed EOA region. Bidders may submit a proposal for one (1) or more of the five (5) EOA regions, which may result in a bidder being awarded a contract for one (1) or multiple EOA regions. If proposing multiple EOA regions, and the bidder is selected to provide services in multiple regions, if during contract Request for Proposals 7 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs INTRODUCTION SECTION I negotiations it is determined the selected bidder is not capable of providing services in any of the proposed multiple EOA regions, HCA in its sole, absolute and unfettered discretion has the right to negotiate and award a contract to the next highest scoring bidder, who is detennined to be willing and capable of providing services for the affected region. To be eligible to contract with the County an individual or entity must not be listed on the current Cumulative Sanction List of the Office of the Inspector General (U.S. Department of Heal Human Services) or the General Services Administration's list of parties excluded fro eeral programs, or the California Medi -Cal Suspended and Ineligible Provider List. Hill not review a proposal submitted by an individual or entity found to be on either list HCA plans to use the following linIcs to identify individuals and entities that are not e ' ' 41e-o contract with the County of Orange: http : / /exclusions.oig.hhs.g vv, https: / /www.sam.govinorta blic /SAM(, and Medi -Cal Suspension Search Database. Each bidder should verify that it�,on any list prior to preparing a proposal to submit in response to this solicitation. Corre torof any errors found on either sanction list is the sole responsibility of the bidder and mu ade prior to the day the proposal is submitted. HCA requires all potential individuals and /or contract entitiesi self- disclose any pending charges or convictions for violation of criminal law and /or an} s tction or disciplinary action by any federal or state law enforcement, regulatory or lice agency or licensing body, including exclusion from Medicare and Medicaid programs. C During the term of the contract between th ' lected bidder(s) and the County, and in accordance with its existing provisions, if a selected bi r and /or an individual becomes an Ineligible Person, the selected bidder and/or individual sig T b removed from any responsibility and /or involvement with County contracted obligations to any direct and /or indirect federal or state health care programs and any other federal tate finds. An Ineligible Person is defined as any individual or entity who is currently ex , suspended, debarred or otherwise ineligible to participate in the federal health care ; s; or has been convicted of a criminal offense related to the provision of health care or services and has not been reinstated into the federal health care programs after a period lusion, suspension, debarment, or ineligibility. The County does equire, and neither encourages or discourages, the use of lobbyists or other consultants fp t( purpose of securing business. HCA serves the right to disqualify any bidder on the basis of any real or apparent conflict of inte to at is disclosed by the proposal submitted or any other information available to HCA. isqualification is at the sole discretion of HCA. Any bidder submitting a proposal herein ves any right to object to RCA's exercise of this right, now or at any future time, before ybody or agency including, but not limited to, the County Board of Supervisors or any court of competent jurisdiction. By submitting a Proposal, the Bidder agrees to waive any claim it has or may have against the County of Orange, its officers, employees, and agents, arising out of or in connection with the administration, evaluation, or recommendation of any Proposal, the waiver or any requirements under the RFP, the acceptance or rejection of any Proposal, and/or the award of the Contract. Request for Proposals 8 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs INTRODUCTION SECTION I 4� Request for Proposals 9 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs INTRODUCTION SECTION I Causes for Disqualification HCA is conducting a competitive solicitation process for required services, which must be free from improper influence or lobbying. Bidders, by submitting a proposal, are agreeing to adhere to the directions for asking questions related to this solicitation, and to refrain from attempting to influence any part of this process, which for purposes of this solicitation is from the date the solicitation is posted on BidSync through the date the Board of Supervisors approves le recommended contract award(s). Bidders directly, or indirectly through others, agr 8 t to attempt to influence, in any manner, the decision making process, including but not( rrted to, contacting or lobbying the Board of Supervisors or County Executive Office, or atte " $ to fmd out who the evaluation panel members are and contacting them. Violation of thi ive will be considered a violation of the procurement process, and may subject the bides roposal to be rejected from the process. HCA in its sole, absolute and unfettered discretion will determin vher or not a bidder is qualified and responsive. This determination may be based on one ore of the following: • Evidence of collusion amongst proposals. t N/ • Lack of business skills or financial resources ne to operate this business successfully, as revealed by either financial statemegi, :ay xperience statement. • Lack of responsibility as shown by past work, 0e graces, or other factors. • Bidder is in arrears or in default to County oAQAy debt or agreement or defaults upon any obligation to County, or has failed to fai frilly perform any previous agreement with County at HCA's sole determination. • Submission of a proposal that i�J, incomplete, conditional, ambiguous, obscure, or which deviates from the spec c�12ns in this solicitation, or has irregularities of any kind. • Other causes as HCA d appropriate. RCA's deterininatio, as t whether a bidder is qualified and responsive will be based on the information f imi ey the bidder in this solicitation, interview(s) with the bidder (if applicable), as well as fr )v sources determined to be valid by HCA. Award will not be made until after such invest' i ns, as are deemed necessary, are made by HCA regarding the experience and financial re`s onsibility of the bidder, which each bidder agrees to permit by submitting its must be valid for a minimum of 120 days from the due date of this solicitation. The County plans to contract with one (1) ambulance service provider for each designated EOA region to provide the subject services, which may result in an ambulance service provider being awarded multiple EOA regions. At the discretion of HCA, the initial term of the agreement resulting from this solicitation can be up to five (5) years and may be renewed for an additional term or terms so long as the aggregate of all terms do not exceed ten (10) years in duration without Request for Proposals 10 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs INTRODUCTION SECTION I La a competitive bid process. Any renewal is contingent upon available funding, performance, need for services, and HCA policies. The contracts awarded through this solicitation are anticipated to be performance- based, and each selected bidder will be part of a Master Agreement, which will require the selected bidder(s) to achieve and maintain high levels of performance and reliability. The demonstration of effort, even diligent and well- intended effort, will not suffice to meet the requirements of this solicitation respect to prescribed performance requirements. In submitting a proposal, the bidder is a i to employ whatever level of effort is necessary to achieve the clinical, response tim c tomer satisfaction, quality improvement and other performance results required. Fai o meet specified service standards will result in financial penalties and may lead to te m ion of the selected bidder's contract. HCA reserves the right to revise the contract , stated in this solicitation. Start -up funds are not available for these services. 4 An evaluation committee will be established consisting of re e- Natives of the County and /or members of the community having direct job knowledge and.�� ise of the services described in this solicitation. The evaluation will consist of a thorou hr6iew of the bidders' proposals and may include interviews and/or site visits with the bidders a evaluation committee may request a bidder to provide additional information or doc tion regarding its proposal, and such requests must be fulfilled by the bidder or its propoealll be rejected. As part of the evaluation process, the Co has the right to conduct a review and audit all business records and related documents and all bidders (including an affiliated or parent company), to determine financial sta ri' y, the adequacy, fairness, and reasonableness of the proposal; and to contact any and all 'e references. Selection of a bidder for eac X region will be based solely on the highest proposal score as determined by the evalua 'ep mmittee. Following the review of proposals by the evaluation committee, the HCA D r or Designee, with concrurence of the OCEMS Medical Director, will approve a recomm`�ration regarding the selection of a bidder(s). Award of a contract will not be effective unl ,arid until it is authorized by the County of Orange Board of Supervisors. Criteria The fo owing guidelines will be used in analyzing and evaluating proposals received in response to tlUlicitation. Members of the evaluation committee, in accordance with the following will evaluate all responsive proposals. Review of Financial /Organization Stability. 2. Experience and Qualifications. 3. Performance Objectives. 4. Continuous Quality Improvement Processes. 5. Proposed Facility/Equipment. Request for Proposals I I of 56 9 -1 -1 Emergency Ambulance Transportation Svcs INTRODUCTION SECTION I 6. Proposed Timeline. 7. Proposed Services. 8. Proposed Data Management 9. Proposed EMS Enhancements. Each proposal should be complete and present a thorough understanding of the needs County in regard to its desire to provide the required services. The successful bigdl demonstrate in their proposal: _ C i 1. Commitment to the delivery of compassionate, timely, professional and Tent out -of- hospital medical care. 2. Continuous effort to detect and correct service level performance e ** cies, as determined by OCEMS, and to continuously upgrade the performance and rility of the EMS system within their designated EOA. 3. Reliable clinical and response time performance, with equirt failure and human error held to an absolute minimum through constant attentio 'rerfornance, protocol, procedure, performance auditing, proper management oversi loyee training, continuing education, and prompt and definitive service level correcfiv ns plans. The adequacy and experience of the bidde 's personnel is critical to the success of the program, and HCA will closely evaluate onnel assigned to the program. HCA may check the references provided by the bidder for of validating claims made in each proposal. Award INj ° HCA expressly reserves the rig �Q egotiate contract terns with a selected bidder prior to award, or negotiate with several b' S simultaneously, and thereafter, to award a contract to the bidder(s) offering the moist* table terms to HCA. HCA also expressly reserves the right to award a contract on the basis of initial offers received, without discussiT'herefore, each initial offer should contain the bidder's best terms from a programmaticmpensation standpoint. E. COUNTY'S IUGHTS T e'unty reserves the right to: odify this solicitation. Cancel this solicitation at any time, in whole or in part. • Accept any proposal as offered. • Reject any or all proposals. • Disqualify a bidder, or terminate a contract for false information submitted in response to this solicitation. Request for Proposals 12 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs INTRODUCTION SECTION I • Contract for all or some of the stated services. • Based on the County's needs at the time of selection or during contract negotiations, modify the scope of service described herein. • Waive, at its sole discretion, any procedural irregularity, immaterial defect, or other impropriety deemed reasonably correctable or not warranting rejection of the proposal. • Ask bidders for additional documentation and /or information to further dete financial /organization stability. F. PROTEST PROCESS In the event a bidder believes that this solicitation is unfairly restrictive, bus or contains conflicting provisions, the bidder may submit a grievance or protest. t� Protest of Bid/Proposal Specifications All protests related to a bid or proposal specifications mu ubmitted to HCA Contract Development and Management (CDM) no later than five (5) ess days prior to the close of the bid or proposal. Protests received after the five (5) busin } deadline will not be considered by the County. In the event the protest of specifications i dd and the protester wishes to continue in the solicitation process, it must still submit 4.15 "rior to the close of the solicitation in accordance with the bid /proposal submittal proce ;provided in the bid /proposal. Protest of Award of Contract In protests related to the award of a cotd<raa the protest must be submitted no later than five (5) business days after the "Notice of I cr Award Contract" is provided by HCA CDM. Protests relating to a proposed contract a v hich are received after the five (5) business day deadline will not be considered by the Cq Procedure All protests shall be ty rider the protester's letterhead and submitted in accordance with the provisions stated. A&r tests shall include at a minimum the following information: 1. The name,,kddlos, and telephone number of the protester. 2. The sigti t e of the protester or the protester's authorized representative. 3. Th naihe of the solicitation or number of the RFP. 4. iled statement of the legal and /or factual grounds for the protest. e form of relief requested. Written protests must be sent to: County of Orange /Health Care Agency Contract Development and Management 405 W. 5th Street, Suite 600 Santa Ana, CA 92701 -4637 Attn: Interim Division Manager FAX: (714) 834 -4450 Request for Proposals 13 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs INTRODUCTION SECTION I G. TIMELINE H. uum tur.iv t L--Li t Y Timeline dates are approximations only, and do not constitute any commitment or guarantee by the County. Pursuant to California law, all information contained in a bidder's reVn to this solicitation may be public record subject to disclosure to any member of the pu o requests it through the California Public Records Act. If it is necessary to include pro /trade secret information in a bid response, the County recommends that the bidder y and prominently mark the information they believe falls within this category. HCA will attempt to notify the bidder if disclos s requested of information that has been identified as proprietary /trade secret information ' r r to give the bidder an opportunity to seek a court order prohibiting disclosure of such ' o 'on. However, due to statutory time limits the County has in response to request for publi ords, County will be able to give the bidder only a short period of time in which to seek suc urt order before County will be required to disclose the requested information. Furthe t is entirely the bidder's responsibility to assert that information the bidder believes iis etary /trade secret information should not be disclosed. County will not make such a cl ' r the bidder but will obey a valid court order obtained by the bidder prohibiting disclosure information. If a bidder believes thtt�s�ecific section of its proposal is confidential, bidder will isolate the pages marked coV�1� t m a specific and clearly labeled section of its proposal response. Bidder will include a statement as to the basis for considering the marked pages confidential including the a harm or prejudice if disclosed and HCA will review the material, bidder's concerns ank"e an independent determination. I. ADD D'JMS eserves the sole right to interpret or change any provision of the solicitation at any time to the proposal submission date. Any and all interpretations or changes will be in the form of written addendum, which will be furnished to all bidders through the BidSync System. All addendums issued will become part of the solicitation and resultant agreement. Bidders hereby acknowledge their receipt of any addendum by being registered in the BidSync System and acknowledge it is the bidder's responsibility to check for, and read all addendums posted in the BidSync System. Request for Proposals 14 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs INTRODUCTION SECTION I Should such addendum require information not previously requested, HCA at its sole discretion, may determine that a time extension is required for the submission of proposals, in which case an addendum will indicate the new proposal submission date. J. CONTRACT TERMS AND CONDITIONS The successful bidder(s) may be required to attend a post -award meeting with HCA for discu en of the terms and conditions of the contract. HCA staff will coordinate any such meeting ) A reserves the right to clarify any contractual teens with the concurrence of bidder; h v e�r, any substantial non - conformity in the proposal as determined by HCA, will be deemed �sponsive and the proposal rejected. Any contract resulting from this solicitation will n the entire contract between HCA and the bidder relating to this requirement and will pre r any and all previous contracts, proposals, negotiations, purchase orders, or master agreqmen of any form. K. INSURANCE REQUIREMENTS Insurance coverage and limits for the awarded contracts wi11 based upon the identified services and will be determined during contract negotiations. aseline amounts are as follows: COVERAGE MINIMUM LIMITS Comprehensive General Liability with broad form Property dama e and contractual liabilt ,000,000 combined single limit per occurrence. $5,000,000 aggregate. Automobile Liability, including coverage Owned, non -owned and hired vehicles $3,000,000 per occurrence. $5,000,000 aggregate. Workers' Compensation Statutory Employer's Liability $1,000,000 per occurrence Professional Liability $3,000,000 per occurrence. $5,000,000 aggregate. Sexual Misconduct Liabili $1,000,000 per occurrence Performance Securi B9JR $1,250,000 1. The Cotmmerci &�ral Liability coverage shall be written on Insurance Services Office (ISO) forte C 01, or a substitute form providing liability coverage at least as broad. 2. The Cokticial General Liability policy shall contain the following endorsements, which shall accompany the Certificate of Insurance: r Additional Insured endorsement using ISO form CG2010 or CG 2033 or a form at least as broad naming the County of Orange, its elected and appointed officials, officers, employees, and agents as Additional Insureds. b) A primary non- contributing endorsement evidencing that the contractor's insurance is primary and any insurance or self - insurance maintained by the County of Orange shall be excess and non - contributing. 3. The business Auto Liability coverage shall be written on ISO form CA 0001, CA 0005, CA 0012, CA 0020, or a substitute form providing coverage at least as broad. Coverage for owned, non - owned, and hired vehicles must be indicated on Certificate of Insurance. Request for Proposals 15 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs INTRODUCTION SECTION I 4. The Workers' Compensation policy must include a waiver of subrogation endorsement waiving all rights of subrogation against the County of Orange, and members of the Board of Supervisors, its elected and appointed officials, officers, agents and employees. 5. The insurance company providing coverage must have and maintain at minimum the following ratings based on the most current edition of the Best's Key Rating Guide/Pro Casualty/United States (ambest.com): a) A- (Secure A.M. Best's Rating). b) VIII (Financial Size Category). 6. The policy or policies of insurance must be issued by an insurer licensdv too business in the state of California (California Admitted C verifiable at: (http: // interactive. web. insurance. ca.gov /webuser /idb_co_Iist$.st4� 7. Self - Insured Retentions (SIRS) and deductibles shall be stated on the Certificate of Insurance. If no SIRS or deductibles apply, indicate iii on the Certificate of Insurance with a 0 by the appropriate line of coverage. CD 8. All insurance policies required by the agreemee Acalendar give the County thirty (30) calendar days' notice in the event of cancellation and to days' notice for non - payment of premium. This shall be evidenced by polcp ovisions or an endorsement separate from the Certificate of Insurance. 9. The performance bond requireen j ay be secured by one of the following methods, or a combination there of. a) Performance Bond is y an admitted surety licensed in the State of California and acceptable to the n , provided that the language of such bond shall recognize and accept the con _ requirement for immediate release of funds to the County upon determinati bthe County, that the bidder is in breach of the contract or County ordinanc that the nature of the breach is such that the public health and safety are endan a and recognizing that any legal dispute by the bidder or the bonding company shallQi i itiated and resolved only after release of the performance security funds to the Cotjntty�, or b� Irrevocable Letter of Credit, issued by a bank or other financial institution acceptable to the County, on a form acceptable to the County, which shall recognize and accept the contract requirement for immediate payment of funds to the County upon determination by the County that the bidder is in breach of the contract or County ordinance, and that the nature of the breach is such that the public health and safety are endangered, and recognizing that any legal dispute by the bidder or the creditor shall be initiated and resolved only after release of the performance security funds to the County. Real property may be used by a bank to provide the financial resources for credit required under this section. Request for Proposals 16 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs INTRODUCTION SECTION I The performance bond or irrevocable letter of credit furnished by the bidder in fulfillment of this requirement shall provide that such bond or letter of credit shall not be canceled for any reason except upon thirty (30) calendar days' written notice to the County of the intention to cancel said bond or letter of credit. The bidder shall, not later than twenty (20) business days following the commencement of the 30 -day notice period, provide the County with replacement security in a form acceptable to the County. In the event that the guarantor /surety is placed into liquidation or conservatorship proceedings, the bidder shall provide replacent security acceptable to the County within twenty (20) business days of such occurrence Failure of the bidder to meet these requirements after the bidder has been selected prior to the contract start date, shall result in forfeiture of the bidder's contract award. Prior to the provision of services, the successful bidder(s) will be re uir to purchase all insurance at the above minimum standards at bidder's expense, and to grit with the County Certificates of Insurance including all endorsements necessary to sattid) e provisions identified above. If Self- Insured, the successful bidder(s) will be required to p o �a Certificate of Self - Insurance that meets at minimum, the requirements identified above. Request for Proposals 17 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II A. TARGET POPULATION 9 -1 -1 Emergency Ambulance Transportation Services shall be provided to all persons requiring emergency medical treatment and ambulance transport within designated County EOA regions, including areas requiring mutual aid response. B. FUNCTIONAL RESPONSIBILITY Selected bidder(s) shall provide the required services, in accordance with California & and Safety Code Sections 1797 et seq., Orange County Ordinances, and all regulatio mulgated there under including any amendments or revisions thereof. All costs associated a services referenced herein, shall be the sole responsibility of the selected bidder, unlessce ise stated. In performing the required services, selected bidder(s) shall work coo ely with OCEMS, which shall include the OCEMS Medical Director and /or any o ier CEMS employee or designee. Selected bidder(s) are expected to perform 9 -1 -1 Emergencyy ulance Transportation Services to the complete satisfaction of OCEMS, which shall inclluuc]c bpi not be limited to: 1. Basic Services a) Provide services continuously aro d -thy -clock and without interruption throughout the term of the contract. b) Provide services without re any illegally discriminatory classification, including without limitation, the paUqu race, color, national origin, religious affiliation, sexual orientation, age, sex, or r 'ty to pay. c) The Contractor's r, al will be retained and incorporated into the contract by reference, except in the ca any conflicting provisions, the provisions contained in the contract shall prevail d> 2. Seryace.Description rovide all management, personnel, facilities, equipment, training, materials, fuel and supplies necessary to provide the required services in each awarded EOA region at the 9 -1- 1 BLS level, twenty -four (24) hours per day, seven (7) days a week. b) Provide the required services in each EOA region, as the sole ground ambulance service provider, as authorized by contract with the County. . Request for Proposals 18 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II C. MEDICAL ADMINISTRATION 1. Medical Oversight The medical direction and management of the selected bidder's EMSS shall be under the medical control of the OCEMS Medical Director, and shall be maintained in accordance with minimum standards for medical control established and implemented by the authority. The OCEMS Medical Director provides medical control and management of the grgency Medical Services system through ongoing planning, design, development, nation and direction of system wide Emergency Medical Services. Participate in pilot or research studies that OCEMS may authorize. Se�vitandards may be waived in the event conflicting standards are established for the pilot bgtam. Any such pilot program must be approved by OCEMS. Participation in the Ylotprogram(s) shall be in addition to the other services described in this solicitation. 2. Continuous Quality Improvement (CQI) Plan Selected bidder(s) shall be required to develop and bw ement a CQI Plan that includes and assures, but is not limited to: ( h a) Compliance with the terms of the contra riftimum performance standards, and rules and regulations. b) Compliance with process meas its and process improvements that integrate with the OCEMS CQI Plan. c) Compliance with effecti edministration and management of clinical performance (patient care activities), resp me performance, driver performance, dispatch performance, and for all other BL ice levels, and regular evaluation thereof, to include operational, administrative al rocedural activities of the system; accurate determination of training needs of in id als and the system as a whole; and identification and reporting of significant nt care issues to the base hospital and/or the OCEMS Medical Director. d) Inc1QI indicators, which shall be measured by all system participants, and may be developed in collaboration with the base hospitals, 9 -1 -1 ALS providers, and OCEMS. yiicators shall be based on current California EMSA Core Measures, EMS data analysis, esearch, and call demand. e) Participate in and comply with the OCEMS CQI committees and audit processes. Request for Proposals 19 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II 3. Minimum Clinical Levels and Staffing Requirements a) Ambulance Staffing Requirements (1) Ambulance service providers rendering the required services shall be staffed at a minimum, with two (2) California certified and OC accredited EMTs equipped to render 9 -1 -1 emergency ambulance level care and transport. (2) Ambulance personnel rendering the required services, shall throughout the t tf the contract, be licensed, accredited and credentialed as appropriate to prWE )OC, and shall maintain evidence of current/valid licenses and/or certifica OCEMS certification/licensure requirements may be downloaded from t S website. (www.healthdisasteroc.org/erns) b) Training Requirements At a minimum, ensure ambulance service perso B�eive the following training and /or certifications, which shall be in addition to =,g defined in State and OCEMS polices:: (1) Organization and EMS System Orientatigi0h1'On -Going Preparedness Provide proper orientation to all fieersonnel before assigning them to respond to emergency medical requests. Sue, orientation shall include, at a minimum, ambulance service provider policies and edures; EMS system overview; EMS policies and procedures; radio communi a o s with and between the ambulance service provider, base hospital, receiving s�tals, and County communication centers; map reading skills including ke marks, routes to hospitals and other major receiving facilities within the Comity surrounding areas; and ambulance and equipment utilization and maintenanc ddition, all frontline personnel must receive continual orientation to customer Wtce expectations, performance improvement and the billing and (2) Prepay Yfor Multi - casualty Incident Pvi e training to all ambulance personnel and supervisory staff in their respective g roles and responsibilities under OCEMS policy, and prepare them to function in the medial portion of Incident Command System. The specific roles of these individuals and other public safety personnel shall be defined by relevant plans and command structure. (3) Driver Training Develop and maintain an on -going driver training program for ambulance personnel. The program, the number of instruction hours, and the system for integration into ambulance operations (e.g., accident review boards, impact of accidents on employee performance reviews and compensation, etc.) shall be reviewed and approved by Request for Proposals 20 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II OCEMS, initially and on an annual basis thereafter. Training and skill proficiency is required at initial employment with annual training refresher and skill confirmation. (4) Infection Control Create a culture focused on infection prevention that focuses on aggressive hygiene practices and proactive personal protective equipment donning (e.g., eye prote 'on, gloves etc.). Develop and strictly enforce policies for infection contro ss contamination and soiled materials disposal to decrease the chance of con &u cable disease exposure. D. OPERATIONS Selected bidder(s) shall be required to meet the following operatio'hip expectations, core requirements, and activities: 1. Service Operations Selected bidder(s) shall have exclusive rights to originating in their awarded EOA region(s); EOA regions where the nearest 9 -1 -1 emerl jurisdiction. In the interest of obtaining the approve the use of these closer 9 -1 -1 emergq satisfactory Instant Aid /Mutual Aid 9Ort responding from the neighboring EOAQ 2. Dispatch Operations p,I -1 emergency ambulance calls re are areas on the periphery of the �� b%lances may be located in an adjacent ambulance to the patient, OCEMS may ilances, contingent upon the execution of with the ambulance service provider a) Establish a dispatch , which shall be approved by OCEMS, to provide backup dispatch services i be necessary, for disaster incidents or other circumstances that impair the opera of the primary 9 -1 -1 dispatch center. Y b) Ensure 2 �eration of the EMS dispatch system utilizing qualified personnel and supervsiRn. 3. Resgonie � i.•m1e Performance Requirement Acessful performance of the required services shall in part be based on a commitment to orm to the Response Time Standards set forth herein. Response Times are a combination of dispatch, operations, and field operations; therefore, an error in one phase of operations (e.g. ambulance dispatch, system deployment plan, ambulance maintenance, etc.) shall not be the basis for an exception to performance in another phase of operations (e.g. clinical performance or response time performance). Appropriate Response Time performance is the result of a coordinated effort of total operations, and therefore, is solely the responsibility of the selected bidder(s). Request for Proposals 21 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II Response Times shall be measured in minutes and integer seconds, and shall be "time stamped" by the selected bidder's computer aided dispatch system. The standards include two (2) code priorities and three (3) geographical zones that will be used for Response Time monitoring, reporting, and compliance purposes. Response Times originating from within an EOA region shall meet specific performance standards, of which, a monthly compliance rate of ninety percent (90 %) in each code priority and geographical zone is required (Table 3). a) Call Classifications r{ (1) Code 2 - emergency ambulance vehicles responding to an emergency for service expeditiously without red lights and sirens on. (2) Code 3 - emergency ambulance vehicles responding to an emerge scene or request for service with red lights and sirens on. b) Geographical Zones (1) Metro/Urban zones are areas with a population deng reater than one hundred (100) persons per square mile. (2) Suburban/Rural zones are areas with a po 0 n density of seven (7) to one hundred (100) persons per square mile. These enerally include the roads and contiguous canyon areas of the local mountain r s including Brea Canyon, Tonner Canyon, Carbon Canyon, Modjeska Cany�4n, ilverado Canyon, Trabuco Canyon, Santiago Canyon Road between Jambo acid Live Oak Canyon Road, and Ortega Highway 4a en (Highway 74) between La PJaue and the OC line. (3) Wilderness zones are a s *ith a population density of less than seven (7) persons per square mile. ThePe enerally the areas of the Cleveland National Forest within the ders County bor, exception of incidents on or immediately adjacent to Highway 74. Request for Proposals 22 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II TABLE 3: Response Time Compliance Requirements Metro/Urban Code 3 90% < 10:00 Metro/Urban Code 2 90% <_ 15:00 Suburban/Rural I Code 3 1 90% 1 _< 20: Wilderness I Code 3 1 90% 1 `i� )30:00 Wilderness Code 2 90 % \J" S 40:00 4. Response Time Measurement Methodology Response Times shall be calculated on a mon � to determine compliance with the standards set forth in Table 3. The Response easurement methodology employed can significantly influence operational requir for the EMS system. The following measurements are applicable: 1 a) Call Receipt Time ` "Response Time" begins At\Ull Receipt ", which is when the dispatch center receives adequate information toAn—tify the location and priority level of the call, or sixty (60) seconds after the call ' vered, whichever is less. b) At Scene Time "At Seen means the moment the first 9 -1 -1 emergency ambulance arrives and stops at the t ocation where the ambulance shall be parked while the crew exits to approach the p�t and notifies dispatch that it is fully stopped. Only the arrival of a transport gap�bl emergency ambulance shall constitute "At Scene ". This does not include t&Rervisory or other non - transport capable units. In situations where the ambulance has responded to a location other than the scene (e.g. staging areas for hazardous materials, ,C � violent crime incidents, non - secured scenes, gated communities /complexes, wilderness �~ locations), arrival "At Scene" shall be the time the ambulance arrives at the designated staging location or nearest public road access point to the patient's location. Request for Proposals 23 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II c) Response Time "Response Time" is the interval, in exact minutes and seconds, between the "Call Receipt' time and "At Scene" arrival time, or is cancelled by an OCEMS recognized public safety agency. d) Failure to Report "At Scene" Time In instances when ambulance crews fail to report "At Scene ", the time a next communication between dispatch and the ambulance crew shall be used as dscene" time. However, the actual arrival time through another means (e.g. First der, AVL, communications tapes /logs, etc.) may be documented if an auditable p of any edits is produced. e) Calculating Upgrades, Downgrades, Turn - around and Cancell-e��6ponses From time to time special circumstances may cause ch n call priority classification. Response Time calculations for determination of con e with standards and liquidated damages for non - compliance shall be as follows: (1) Upgrades If an assignment is upgraded prior tt a ival on scene (e.g. Code 2 priority to Code 3 priority), compliance and liquidatedamages shall be calculated based on the shorter of (a) Time elapsed from dl to time of upgrade plus the higher priority Response Time Standard; o (b) The lower Time Standard For exam leN�&call is initially dispatched as Code 2 and is upgraded to Code 3. The applic esponse Time requirement shall be the shorter of the Code 2 Response Tim e sum of the elapsed time from Call Receipt to the time of the upgrade plus tele 3 Response Time. Downgrades If a call is downgraded prior to arrival on scene (e.g. Code 3 priority to Code 2 priority), compliance and liquidated damages shall be determined by: (a) If the time of the downgrade occurs after the higher priority Response Time Standard has been exceeded, the more stringent, higher priority standard shall apply; or (b) If the time of the downgrade occurs before the higher priority Response Time Standard has been exceeded, the less stringent, lower priority shall apply. In all Request for Proposals 24 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION 11 such cases, documentation must be presented for validation of the reason why the priority status was downgraded. If the downgrade was justified, in the sole discretion of OCEMS, the longer standard shall apply. (c) Reassignment En Route If an emergency ambulance is reassigned en route or turned around prior to at 1 on the scene (e.g. to respond to a higher priority request), compliance and 1' i ed damages shall be calculated based on the Response Time Standard apple 1p to the assigned priority of the initial response. The Response Time cloc )not stop until the arrival of an emergency ambulance on the scene which the ambulance was diverted. (d) Canceled Calls If an assignment is canceled prior to arrival on the s liance and liquidated damages will be calculated on the elapsed time dispatch to the time the call was canceled. f) Response Times Outside Primary Service Areas , Selected bidder(s) shall not be held acco tae for Response Time compliance for any assignment originating outside the Coin esponses to request for service outside the County shall not be counted in the to umber of calls used to determine compliance. g) Each Incident/Separate Respons Each incident shall be c s a single response regardless of the number of units that are utilized. The Res p ime of the first arriving emergency ambulance shall be used to compute the Responirie for that incident., h) Response Tii�'- mpliance for Individual Emergency Response Zones Respon ie requirements for the three (3) geographical zones shall be reported and utili compliance purposes. Specifically, all responses in the County, in all three (3) geogrhical zones, are included in the calculation of non - compliance liquidated damages for detergency responses. quity in Response Times (1) OCEMS recognizes that equity in Response Times is largely based upon call and population densities within the EOA regions. In developing Response Time Standards, OCEMS uses the three (3) geographical zones for Response Time compliance measurement. (2) OCEMS may evaluate the call density and zone structure to address changes occurring within each zone. Should the call density of any significant contiguous area within the Request for Proposals 25 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION 11 Suburban/Rural or Wilderness zones become equal to or greater than the call density to the adjacent Metro/Urban zone, then that area shall be considered for reclassification for Response Time compliance. (3) Selected bidder(s) shall report to OCEMS each month, its response time performance in the existing ambulance zones. Chronically poor response time performance in any of the zones will result in the selected bidder being required to modify its deplo t plans to achieve consistent performance. Chronically poor performance is d n as failure to meet response time performance in any (3) three consecutive mom or any four (4) out of twelve (14) consecutive months. Failure to achi nsistent performance in any of these areas may result in these areas being use ompliance measurement and application of liquidated damages, rather a countywide performance measure described previously. OCEMS reserves he i t to look at any area of the County to identify if there are pockets of poor Res7o@ Time performance and refer such findings to the selected bidder for mitigation 5. Response Time Exceptions and Exception Requests Selected bidder(s) shall maintain mechanisms for capacity to increase production should a temporar� that from time to time unusual factors beyond a of specified Response Times Standards. In determine compliance with the Response Stu It public safety agency originating from wiCounty a) Multi- casualty Disaster I. ack`trp capacity, or reserve production fas m overload persist. It is understood ble control may affect the achievement 'monthly calculation of performance to mdards, every request from a recognized shall be included, except as follows: Response Time requirern ay be suspended at the sole discretion of OCEMS during a declared multi - casual dent, medical advisory or disaster in OC, or during a declared disaster in a neighb jurisdiction to which ambulance assistance is being provided as requested by OCE . b) Good Caucq` } b (1) S4 may allow exceptions to the Response Time Standards for good cause, as ermined at their sole discretion. At a minimum, the asserted justification for Exception must have been a substantial factor in producing a particular excess Response Time, and there must have been a demonstration of a good faith effort to respond to the call(s). Good cause for an exception may include, but is not limited to, unusual system overload; incorrect or inaccurate dispatch information received from the public safety agency or calling party; disrupted voice or data radio transmission (not due to equipment or infrastructure); material change in dispatched location; unavoidable telephone communications failure; inability to locate address due to non - existent address; inability to locate patient due to patient departing the scene; delays caused by traffic secondary to the incident; unavoidable delays caused by extreme inclement weather (e.g., fog); when units are providing County authorized mutual aid; and remote Request for Proposals 26 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION 11 calls (patients' location is greater than ten (10) road miles from the nearest boundary of the wilderness zone) or off -road locations. (2) Unusual system overload is defined as 200% of the countywide average demand for the day of the week and hour of day. The average demand for each day and hour is to be calculated on an annual basis using the prior calendar year's actual run volume. (3) Extended delays at hospitals for transferring patients to receiving facility s el shall not be a criterion for potential good cause exceptions. Equipment f '1 traffic congestion not caused by the incident, ambulance failure, lost ambul�, rews, or other causes deemed to be within the selected bidder's control or aw a shall not be grounds to grant an exception to compliance with the Response Ti dard. c) Exception Request Procedure (1) It is the selected bidder's responsibility to apply to S for an exception to a required Response Time. If it is felt that any respond roup of responses should be excluded from the calculation of Response Tim Hance due to unusual factors beyond a reasonable control, detailed documen ton for each actual response in question shall be provided to OCEMS wa request to exclude the runs from calculations and liquidated damages. An ub request must be in writing and received by OCEMS within twenty (20) business l daof the end of the month of occurrence. (2) A request for an exception receid after the twenty (20) business days will not be considered. OCEMS compli d review committee will review each exception request and make a decisiot• approval or denial. Any appeal of the decision must be submitted, in writing, toy CEMS Medical Director within ten (10) business days after the committee's ion. All decisions by the OCEMS Medical Director shall be considered frnal. (3) At the sole dise on of OCEMS, calls with extended Chute Times (time interval from dispatch to aulance en route) of more than two (2) minutes may be excluded from consid as exceptions. 6. Respons"t e Performance Reporting Procedures and Penalty Provisions a) ``es0onse Time Performance Reporting Requirements `(` 1) Documentation of Incident Response Time Intervals Selected bidder(s) shall document all times necessary to determine total ambulance Response Time, including but not limited to, time call received by the dispatch center, time location verified, time ambulance crew assigned, time en route to scene, arrival at scene time, total on -scene time, time en route to hospital, total time to transport to hospital, and arrival at hospital time. Request for Proposals 27 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II OCEMS will use the CAD database for the analysis and determination of response times. Selected bidder(s) may not make changes to times entered into CAD after the event; only OCEMS may make adjustments to reported CAD times. The selected bidder may request changes from OCEMS when errors or omissions are discovered. OCEMS has sole discretion whether changes to times are acceptable. Other times may be required to document specific activities such as arrival at t side, administration of treatments and other instances deemed important fo cal care monitoring and research activities. All times shall be recorded on the dthim Care Report (PCR) and in CAD system. (2) Response Time Performance Report OCEMS shall analyze and evaluate CAD data within twen (25) business days following the end of each month, for the determinati Response Time non- compliance; and monitor Response Time data on going basis to evaluate performance. Selected bidder(s) shall self - monitor e Time Data as follows: (a) Use Response Time data in an < compliance with Response Time Response Time performance levels. (b) Identify the cause(s) of p problems on an on -going ier to evaluate performance and an effort to continually improve and document efforts to eliminate the (c) Provide an explanatio r every call exceeding the required Response Time interval and describ aken to reduce extended responses in the future. b) Liquidated Damages ?P ons Isolated instances individual deviations of Response Time compliance shall be treated as instances i f nit, non - compliance. Severe or chronic deviations of Response Time complian constitute a breach of performance standards, which may be subject to the followi id damage penalties. (1) r uidated Damages for Failure to Comply with Response Time Requirements Z Selected bidder(s) shall pay OCEMS liquidated damages each month when they fail to comply with the Response Time requirements. Response Times shall be assessed for each call in each zone and within each code of response that exceeds the Response Time requirements. Liquidated damages for late responses increase according to the number of minutes the emergency ambulance is delayed past the mandated response, which shall accrue for all calls each month with no maximum penalty (Table 4). In the event the selected bidder fails to report any or all times necessary to calculate Response Time, and when Response Time is not verifiable by other reliable means, the Request for Proposals 28 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II selected bidder shall pay OCEMS a liquidated damages assessment of $250 for each occurrence. TABLE 4: Per Call Response Time Liquidated Damages 0.01 -1 minute 1 $5 1.01 — 2 min 1 $10 1— 3.01 — 4 min 1 $50 4.01— 5 min $70 5.01 — 6 min $90 6.01 -7 min 1$110 8.01— 9 min 9.01 —10 min 10.01 —15 mi. 15.01 —20 mi 20.01 — 30 mid 1 1 $300 1 �Y 1 failure to Respond 1 In the event the selected bidder does not respond with an ambulance to an emergency medical call, the liquidated damages assessed shall begin at $10,000 per incident. Failure to respond is be defined as any call request made for 9 -1 -1 emergency ambulance transport for which the selected bidder fails to dispatch and/or no ambulance responds within one (1) hour of call receipt. Prior to imposition of liquidated damages, OCEMS shall conduct an investigation of the incident. Disruption in service due to failure of ambulance maintenance shall be considered a breach and may be cause for immediate contract cancellation. Request for Proposals 29 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II (3) Performance Credits For each designated EOA region in which the Response Time Standard exceeds ninety percent (90 %) in each calendar month, performance credits shall be applied against the total liquidated damages for Per Call Late Arrival Assessments, as referenced in Liquidated Damages for Failure to Comply with Response Time Requirements. For the purpose of performance credits, Response Time compliance for each calendar nQah shall be based on the overall average of all Response Times for all code pno geographical zones for that month. Performance credits shall be allocated e� endar month (Table 5). �r TABLE 5: Performan ce Credits <) 91 -92% 10% ti 92.01 -93% 20% 93.01 -94% 30% 94.01 -95% 50% 95.01 -96% 65% (4) Zone Non - Compliance 11)`k v Selected bidders) is exp c to meet overall Response Time compliance of ninety percent (909 o ) m each Ithin each code of response, for each month. Failure to meet this requiremer>,Y a 1 be deemed in breach of contract: (a) In the sarp�ee onse zone for any two (2) reporting periods in any six (6) consecuk'Vee oonths;and/or (b) In a Ame response code category for any two (2) reporting periods within any l�cutive six (6) month period. l 'addition to the per call response time liquidated damages for late responses, �XN' liquidated damages shall be assessed on an escalating scale when response time compliance falls below ninety percent (90 %) for any zone or response code within a given month (Table 6). Failure to meet response time requirements for at least ninety percent (90 %) of responses each month for three (3) consecutive months, or four (4) months in any contract year shall be considered a breach and may result in removal of the selected bidder and forfeiture of performance bond.. Request for Proposals 30 of 56 9 -I -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II All Zone Non - Compliance liquidated damage amounts shall be paid each month by the selected bidder within thirty (30) business days of receipt of invoice from OCEMS unless otherwise stipulated. TABLE 6: Liquidated Damages for Zone Non - Compliance 89% $2,000 0� 88% $4,000 t `� 87% $6,000 86% $8,000 85% and less $10,000 (5) Excessive use of Instant Aid/Mutual Aid � I Selected bidder(s) may utilize Instant Aid/Mutual Aid rt from approved OCEMS emergency ambulance providers from adjacent in order to ensure timely emergency medical services are rendered to pe need of such services within those areas. C. Instant Aid/Mutual Aid support shall no pended on regularly to cover designated EOA regions. In the event the select eij fler utilizes Instant Aid/Mutual Aid support from a specific agency more than dq ° of the Instant Aid/Mutual Aid support that it provides the specific agency, tf�cted bidder shall pay OCEMS $250 per response over the 200% threshold. Sel bidder may also be subject to liquidated damages based on Response Ti e n- compliance and uncollected amounts due to the emergency ambulance providing the Instant Aid/Mutual Aid support (Table 7). Y� Request for Proposals 31 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION 11 TABLE 7: Liquidated Damages for Contractor Excessive Instant Aid/Mutual Aid Use of other ambulance $250 per occurrence when County: EMS Trust Fund service (public or exceeds 200% of Instant net thirty (30) business private) for 9 -1 -1 Aid/Mutual Aid support that it days from occurrence emergency ambulance provides the specific agency and completed within response. time y Applicable response time fines County: EMS and to a specified EOA when net thirty (3 6&ss incurred by Instant days fro�ence Failure to ensure Aid/Mutual Aid ambulance $1,000 per incident which a equipment and service's response. l� supplies on board $250 per occurrence if patient 9 mergency or emergency is uninsured or does not pay a bulance Service used. ambulance "reasonable and customary" trect payment by bill for service issued b selected bidder. responding 9 -1 -1 emer ambulance provider six 6 months of rvice (6) Additional Liquidated Damages C O OCEMS may impose financial es for other breaches, and may impose a fine of up to $500 per incident for an ch not specifically addressed in Table 8. TABLE 8: Additional ted Damages Failure to pro timely opera Le orts Operational and Response Time reports due on specific date after close of month $50 per report, per day, received after specified due date FPRe,iAithin Accurately complete ePCR $50 per instance when patient a ely complete for each patient care care records are not accurate interaction within specified and completed within tpecified time time established time. $100 per day for every ePCR not completed within 24 hours of patient delivery Failure to ensure All emergency calls shall be $1,000 per incident which a equipment and responded to by a 9 -1 -1 9 -1 -1 emergency ambulance supplies on board emergency ambulances responds and is not prepared or emergency stocked with equipment and with equipment and supplies ambulance supplies required for patient care Request for Proposals 32 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II Failure to provide Quality improvement, clinical $50 per report or data timely quality data and reports due on submission, per day, received improvement data specific date after close of after specified due date and reports month Failure to provide Unusual occurrence reports $100 per report, per day, timely unusual due within specific time from received after specified ti occurrence reports date of the occurrence frame Failure to respond Respond to all official Minimum $10,000 f e h to an emergency requests for a response from failure to respond request for a County public safety agencies official call response from a County public safety agency Improper Staffing an ambulance with $ 5 i'r call responded to by certification improperly certified personnel , operly certified employee (7) Penalty Disputes Selected bidder(s) may appeal to OCEMS, in Pake*� ng, within twenty (20) business days of receipt of notification of the imposi ' y penalty or penalty calculation. OCEMS shall review all such appealEitted i a decision to eliminate, modify, or maintain the appealed penalty. Shou selected bidder desire to appeal the OCEMS decision, a written request must s to the OCEMS Medical Director within ten (10) business days. All i§ions by the OCEMS Medical Director shall be considered final. c) Fleet Requirements Selected bidder(s) provide all appropriate vehicles, fuel, oil, maintenance and any other necessities a« intain an ambulance fleet in a manner that meets OCEMS and California ambi i equipment standards. (1) Enter Ambulance Vehicles (,,yPhovide Modular (type III) dual real wheeled ambulances for the provision of the ® required services. Each vehicle used shall have no more than 100,000 miles at the start of contract. (b) Develop and maintain policies regarding fleet size and standardization, as well as a fleet maintenance program that addresses how ambulance maintenance is tracked, improved, and how vehicle failures are minimized. (2) Quantity of Vehicles (a) Selected bidder(s) may be required by OCEMS to expand the total number of ambulances available for use within the EOA region(s) and /or the total number of Request for Proposals 33 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II ambulances regionally available for use within the EOA region(s), if response time requirements are not consistently being met or if the EOA region(s) experience a significant call volume increase. (b) On an ongoing basis, maintain the number of 9 -1 -1 emergency ambulances equipped and fully staffed and operational that represent at least 130% of the peak staffing level. For example, if the peak number of ambulances is five (5), a fleet of at least seven ambulances (5 x 130% = 6.5 rounded to 7) u be maintained. If a fraction is derived when multiplying the peak nutnber is by 130 %, the number shall be rounded up to the next whole integer. (e.g would be rounded to 7). (3) Inspection , (a) OCEMS shall conduct scheduled and unscheduled 'ns #ec ons of ambulances, maintenance facilities, and maintenance recor anufacturer suggested maintenance programs and /or ambulance parch a /acquisition documentation shall be made available to OCEMS during ins s. (b) Develop and maintain an automated or al maintenance program and record keeping system. Maintenance record site available to OCEMS for analysis and inspection, and shall be maintaii r two (2) years. (4) Daily Maintenance (a) Maintain daily mainten f ambulance vehicles, which shall include, but not be limited to, the checki4� 9Y tire pressure and condition, coolant, oil, fuel levels, and electrical system tion. (b) At the begins f each shift, all ambulances shall have sufficient 9 -1 -1 emergency ambulanc q pment and supplies to prevent stock levels in the ambulance from fallin bw minimum requirements under normal circumstances, which includes nor restocking during the shift. (5) 9keig Maintenance (a) Maintain all vehicles and equipment in excellent condition. Comply with or exceed the maintenance standard outlined in the Accreditation of Ambulance Services Standards published by the Commission on Accreditation of Ambulance Services. Failure to service and maintain all ambulances and equipment pursuant to the manufacturer's suggested maintenance program shall be deemed a breach of contract and cause for immediate contract termination. (b) Ensure the availability of all fuel, lubricants, repairs, initial supply inventory and all supplies necessary to fulfill obligations pursuant to the standards set forth herein. Sufficient supplies and equipment (excluding fuel, lubricants and repair items) Request for Proposals 34 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II needed to sustain local operations for a minimum of fifteen (15) days at its main operation location or its materials and supplies distribution center is required. (c) Replace, immediately, any vehicle or equipment that becomes unreliable due to mechanical failure with a vehicle or equipment that meets the standards described herein. (d) Provide OCEMS with the name and location of the vehicle maintenanc i ity (contracted or owned), and the name of person knowledgeable of the taenance records; and the name and location of the electronic repair or service fly (radio, cellular, vehicle locator system, and other communication system the name of the person knowledgeable of the maintenance records., (6) Supervisor Vehicles At a minimum, one (1) staffed field supervisor vehicle e in service in each EOA region at all times. The vehicle type and markings s e approved by OCEMS, and shall meet all applicable policy mandates related ntory standards for a BLS first response resource. Vehicles shall be capa towing 24 -foot trailers with an estimated GVW of 10,000. OC 1 t Request for Proposals 35 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II Q (7) Automatic Vehicle Locator Provide, install, and maintain an automatic vehicle locator system in the ambulance dispatch center and in emergency vehicles. Such system shall be integrated with the CAD System. Existing computer interfaces for such integration may be utilized if all equipment is compatible. d) Coverage and Dedicated Ambulances, Use of Stations/Posts These specifications are for a performance based approach rather than a effort undertaking involving defined locations. OCEMS neither accepts nor 61�s�sfelected bidder's level of effort estimates; rather OCEMS accepts the co nt to employ whatever level of effort is necessary to achieve the Response Time g �an er performance results required to meet the requirements of this solicitation. Ambu 6e resources shall be deployed in a manner consistent with this goal. C C1 1. Compliance with Laws PA a) Prior to the contract start date, install, prgv ire, `operate, and maintain an ambulance dispatch center, telephone service, inclu ring -down line, 800 MHz mobile radio system, mobile data computer /radio systijg personal computer, and a secondary dispatch response system, hereinafter referredas Emergency Response Communications System (FRCS), according to the terms, coi ns, and requirements contained herein. b) ERCS must comply with al al, state, and local laws, rules, statutes, and regulations, including licensing rVqui=s, oncerning th e broadcast of public safety and emergency communications oveved Federal Communications Commission (FCC) frequencies at all times during tl f the contract. c) All 800MHz node and C.C.C.S. radios must meet 9 -1 -1 ALS Provider, OCC, ECC, 800 MHz C. rStandard Operating Procedures, and OCEMS specifications and requireike as applicable. Requirements E:Ilntenance y with the following requirements concerning the installation, use, operation, and of their Emergency Response Communications System: a) Prior to the contract start date, have any and all FCC licenses and authorizations required for the engineering, assembling, installation, use, operation, and maintenance of the EROS, which is necessary to provide the required services. b) Provide documentation describing in detail the operational design for the FRCS and methods proposed for dispatching ambulances. Request for Proposals 36 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II c) FRCS must be operated and maintained twenty -four (24) hours per day, seven (7) days per week. d) Dispatch centers must be equipped with a secondary, emergency back -up electrical system to insure uninterrupted twenty -four (24) service. e) Provide and maintain a dedicated point -to -point telephone ring -down line between I ALS Provider Emergency Communications Center and the ambulance dispatch cent r 3. 800 MHz County -wide Coordinated Communications System (800 MHz C.C.C. The OC Sheriff - Coroner Department and OC Communications Division ( lurrently serve as the central coordination point for the OC Emergency Response C 'cations System. As such, OCC operates, maintains, administers, and overseesiexisting 800 MHz countywide Coordinated Communications System, which is theii'sting communications network that is responsible for providing emergency res o system communications throughout OC, thereby, effectively linking emergency re calls for law enforcement, fire, public works, lifeguards, and public utilities within a shared 800 MHz backbone County -wide Coordinated Communications System MHz C.C.C.S.. "). 9 -1 -1 ALS Providers are one of many participating and subs rt agencies to the 800 MHz C.C.C.S. Selected bidder's ERCS must be fully compatibl e 800 MHz C.C.C.S. 4. CAD Interface Establish and maintain a Computer Vea Dispatch (CAD) interface, or other equivalent electronic data system, that is corn a le with the 9 -1 -1 ALS Provider Emergency Command Center (ECC), which may e, but is not limited to, hardware; software; and telecommunications lines th t 9 -1 -1 ALS Provider specifications. 5, System Upgrades Upgrade the EFunty Irt "h comparable and compatible technology to upgrades made to 9 -1 -1 ALS Provider FRCS. 6. Vehicle �`ounications 800 MHz Mobile Radio Allmdrgency ambulance vehicles licensed in OC must comply with OCEMS policies and d�� c��ggyyes related to communication requirements. These include, but are not limited to: 800 MHz Mobile Radio Install and maintain an OCEMS approved 800MHz mobile radio in the front passenger area (with a remote head in the rear patient area) of each ambulance that will be used to provide the required services. Request for Proposals 37 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION Il b) Obtain all necessary licenses, permits, and /or approvals from OCC (and any other applicable licensing or permitting agency) to operate and maintain 800 MHz mobile radios in conjunction with the 800 MHz C.C.C.S. c) Comply with all federal, state, and local laws, rules, statutes, and regulations governing the operation of 800 MHz mobile radios, including compliance with 800 MHz C.C.C.S. Standard Operating Procedures. d) Ensure 800 MHz mobile radios are pre - assigned to a vehicle with a pre -ide radio identifier, and are configured to send status and message data compatible 1 -1 ALS Provider SmartNet Information Management Systems (SIMS) or sim' stems, and includes a 9 -1 -1 ALS Provider approved and issued Motorol box with 8 status/message keys to transmit unit status (e.g., en route, on sce e, available status functions). Collaborate with 9 -1 -1 ALS Provider in configuratiothe SIMS system to enable the feature on all radios enabled on the 800 MHz e) 800MHz mobile radios must meet 9 -1 -1 ALS Provider, ECC, 800 MHz C.C.C.S., and OCEMS specifications and requirements. 7. Mobile Data Computer System Install and maintain an OCEMS and 9 -1 -1 ,&Swvider approved and issued mobile data radio and necessary equipment and softwart support the mobile data radio at the dispatch center, for purposes of sending and r . 'ving electronic emergency dispatch information, instructions, and call status. 8. UHF Med Radio Install and maintain a de UHF Med Radio capable of continuous operation on Med 9, for purposes of comet ng current field information to appropriate County staff during multi - casualties, dae response, hazardous materials incidents and other unusual occurrences. } 9. Web Based Qunications Application Install a �teb -based communication application at the dispatch center for hospital status, regl#�red assessments and messages, and MCI coordination (e.g. ReddiNet or other systems that er licate ReddiNet). C Medical Emergency Data System (OC -MEDS) Utilize the OC -MEDS electronic patient care record (ePCR) software for documenting patient care, and ensure inter - operability with 9 -1 -1 ALS providers, emergency receiving hospitals, and other applicable providers. Request for Proposals 38 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II a) Service Administrator Requirements (1) Designate at least one OC -MEDS Service Administrator. OCEMS also recommends designating two (2) additional individuals to serve as alternates. (2) The OC -MEDS Service Administrator shall manage the day to day operational needs as it pertains to OC -MEDS, and shall be the primary point of contact for OCEMS foy OC -MEDS related issues. t b) Technical Requirements (1) Establish and maintain CAD integration with OC -MEDS, which �Ynclude a one- way data push from the CAD system to OC -MEDS with real lime dates upon each status change. N} (2) Supply and maintain computer hardware required to z ePCR documentation within OC -MEDS. � (3) Establish and maintain continuous mobile terhet connectivity in each response vehicle. Mobile Internet connectivity (aka M td Hot Spot) shall be available for use by EMS first responders, 9 -1 -1 ALS prow' d other public safety entities. c) ePCR Compliance and Training C (1) Accurately complete an ePCR every patient to include all information required by OCEMS and established in 1 2, Division 9, Chapter 4, Article 8, Section 100700. (2) Ensure the ePCR i ted to OC -MEDS upon completion of each call and is distributed pursu tablished OCEMS Policies and Procedures. (3) Provide an el is or hard copy ePCR to the emergency receiving center for each patient. �. (4) ProSill rtial and continuing OC -MEDS ePCR education and training for employees yle documenting in OC -MEDS. 7� F. FACI ATItS. SUPPLIES AND EQUIPMENT Pro all facilities, equipment, material, and supplies, as well as any other resources deems ssary to provide the required services; maintain a neat, clean, and professional appearance of quiprnent and facilities; ensure all equipment and supplies are readily available and accessible from the interior portions of the patient transportation compartment; and shall use the same or compatible patient care equipment as standardized 9 -1 -1 ALS provider agency equipment. Request for Proposals 39 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II G. 1. Standard Inventory a) Equipment and supplies shall be available in quantities sufficient to meet patient care needs without interruption of the required services to designated EOA service areas. b) In addition to OCEMS standard ground ambulance equipment ( OCEMS Policy 720.00 Section 300), an automated external defibrillator shall be carried and stocked at all tim each ambulance providing services. 2. Facilities AE Provide at least one (1) facility with a physical location of appropriate si -1ch designated EOA for crew comfort, vehicle re- supply and cleaning, personnel anagement and communications. Facilities are subject to inspection by OCEMS at anw'e without notice. 1. Management Team a) Management team, at a minimum, shall i (5) years' experience supervising a 9 -1 -1 capacity, of similar size and population to ator members having no less than five ion service, in a primary or back -up region(s). b) Changes in executive, operations, d clinical management/leadership staff shall be communicated to OCEMS, in writiliowithin ten (10) business days of the effective date of the change. 2. EMS Liaison Designate an EMS Pr Liaison, who may also be the operations manager, division manager or similar. pit n. The EMS Program Liaison shall have an overall grasp of the entire operation, be ponsible for overall day -to -day operations, perform information review and gathering report generation and analysis. Responsibilities shall include, but not be limited to:�i' a) Liais`o3abetween OCEMS, 9 -1 -1 ALS provider agencies, and other applicable EMS and /or ,�ubfic safety agencies within the EOA. articipate in EMS System Stakeholder Committees and task force groups. At a minimum, provide representation at applicable base hospital meetings, quality assurance forums and other ancillary meetings required by OCEMS (e.g., REAC, County Paramedic Agency Committee). 3. Field Supervision OCEMS recognizes the need to ensure adequate supervision of personnel and delegation of authority to address day -to -day operational needs, and desires that these personnel and Request for Proposals 40 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION 11 operational supervisory responsibilities do not displace the provision of direct clinical supervision of the caregivers. Minimum requirements and duties for this position are: a) Provide 24 hours a day, on -duty supervisory coverage within the designated EOA region(s). An on -duty field supervisor must be authorized and capable to act on behalf of the organization in all operational matters. b) Ensure the individual has the ability to monitor, evaluate, and improve clini e provided by their personnel, and ensure that on -duty employees are open m a professional and competent manner. c) Individual shall not be assigned to a 9 -1 -1 emergency ambulance unit. d) Individual shall have a minimum of one (1) year experience in prodg 9 -1 -1 emergency ambulance transport, and shall have successfully completed 0, 200, 300 & 400, NIMS 700 & 800. 4. Personal Safety Equipment . ��1 a) Provide personal safety equipment for all emplo accordance with applicable federal and state laws and standards. Policies and p 01 res should clearly describe the routine use of PPE on all patient encount( rs. b) Personal safety equipment shall cqt pwith State EMSA Guideline 216 regarding recommended PPE for Ambulanc s el (OSHA's General Description and Discussion of the levels of Personal Prote ear, 29CFR 1926.65, App. B, Part IV, Level D) for each ambulance dedicated toy emergency transportation, including: (1) Full- length blue (B )packet with reflective stripes. (NFPA 1999, EMS Standards) (2) Hard hat, Wor4CITvlmet Blue. (3) Leather 5. Internal and Safety Program a iplement multiple programs to enhance the safety and health of the work force, which hall include driver - training, safety, and risk management training. Develop and maintain an employee alcohol and drug program that includes at a minimum, an alcohol and drug free workplace policy, and an employee alcohol /drug- testing program that complies with the U.S. Department of Transportation requirements to the extent allowed by law, including pre - employment drug screening.and random alcohol and drug testing. Any employee found working under the influence of alcohol or drugs must be immediately removed from performing services under this solicitation. Request for Proposals 41 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II 6. Evolving OSHA and Other Regulatory Requirements a) It is anticipated, during the term of the contract that certain regulatory requirements, for occupational safety and health, including but not limited to, infection control, blood -borne pathogens and TB maybe increased. It is OCEMS' expectation that appropriate procedures shall be adopted that meets or exceeds the requirements for dealing with these matters. b) Make available at no cost to employees, all currently recommended including influenza vaccinations and TB skin test. 7. Staff Resources Ensure that all personnel have access to support references and resources, ich may include, but are not limited to: a) Employee Handbook that describes the organization's oper Ja:tpolicies and procedures (P &Ps). A copy of the handbook shall be made availablMS upon request. b) Access to and' adherence to OCEMS P &P ; and upon all revisions. (www.HealthDisasterOC.ora /EMS1. Z c) Incident reporting P &Ps that include steps in the performance work duties. Incident 1 a mechanism for reporting patient cargeu porting accidents and incidents that occur ng programs shall provide, at a minimum, service, and operational related incidents. d) P &P related to field supervisto p r i shall address, at a minimum, training and education and oversight plans and proc for the designated EOA region(s). e) P &P related to scene saf d personnel safety. H. DATA MANAGEMEN Selected bidde r(s) sl it rovide, maintain, and adhere to the following: 1. Data and a mg Requirements The ong -term success of any EMS system is predicated upon its ability to both measure and e its affairs. Therefore, OCEMS shall require detailed operational, clinical, and inistrative data in a manner that facilitates its retrospective analysis. a) Dispatch Computer The dispatch computer utilized shall include security features preventing unauthorized access or retrospective adjustment and full audit trail documentation. In conjunction with OCEMS, establish procedures to automate the monthly reporting requirements not collected within CAD data. Request for Proposals 42 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II b) Records Complete, maintain, and provide to OCEMS, upon request, adequate records and documentation to demonstrate its performance compliance and aid OCEMS in improving, modifying, and monitoring the EMS system. c) Monthly Reports (1) Provide to OCEMS, within twenty (20) business days after the first of e endar month, computer database data in an electronic format and reports ning to performance during the preceding month related to clinical, operatio d financial performance. (2) Document and report to OCEMS, monthly, in writing, an form approved or provided by OCEMS, Response Time compliance and cus mfr "complaint /resolutions. Reports other than Response Time compliance and cust omplaint/resolutions may be required less frequently than monthly. At the e each calendar year, no later than November 30 of the preceding year, OC all provide a list of required reports and their frequency and due dates. Rep rts all include, at a minimum: (a) Clinical y" • Continuing education complianc rJ orts • Summary of clinical /service iti 'Ties and resolutions • Summary of interrupted dldue to vehicle /equipment failures (b) Operational • A list of each rted by Emergency Response Zone, where there was a failure to pro ecord all times necessary to determine the Response Time • Ali of _ id responses to and from system (c) Respons T6 Compliance • s each emergency call dispatched for which the selected bidder did not i the Response Time standard for each Emergency Response Zone and an planation of why the response was late Canceled calls ® • Exception reports and resolution (d) Response Time Statistical Data Within twenty (20) business days following the last day of each month, ensure that any Response Time statistical data not available within CAD are available to OCEMS in a computer readable format approved by OCEMS, and are suitable for statistical analysis for all ambulance responses originating from requests within the County. Request for Proposals 43 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION I1 (e) Personnel Reports Ensure all licensed, certified, accredited and authorized staff is current and up -to- date in the OC -MEDS licensure system. Provide OCEMS a personnel list by January 31" of each year, which shall include names of all owners, executive leadership, management, and supervisors employed. The personnel list shall include, at a minimum, the name, address, telephone number of each person oe list. (f) Other Reports Provide other reports and records as may be required by OCEIVISy I. EMS SYSTEM AND COMMUNITY 1. Participation in EMS System Development OCEMS anticipates further development of its EMS sy d regional efforts to enhance disaster and mutual aid Response; therefore, selecte -bi er(s) shall be required to actively participate in service area and regional disaster p e on and response, including disaster drills and exercises, mutual and automatic aid a e ts, and training. 2. Accreditation Current CAAS Accreditation is pr a. If selected bidder(s) is not currently CAAS accredited, selected bidder(s) shall i twenty -four (24) months of the start of the contract, attain full accreditation as an (lice service through the Commission on Accreditation of Ambulance Services (CAAS) 11 maintain accreditation through the term of the contract. 3. Handling Service Inqui ' d Complaints Develop and mai tata�log for inquiries and service complaints, provide prompt response and follow -up to nqutrtes and complaints. Such responses shall be subject to limitations imposed b nt confidentiality restrictions. Submit to OCEMS each month, a list of all complain e eived and their appropriate disposition/resolution. Copies of any inquiries and resolution of a clinical nature shall be refereed to the OCEMS Medical Director within twenty %ur (24) hours of occurrence. 4. t�i� e`m Satisfaction Program Implement a coordinated Patient Satisfaction Program (PSP) that focuses on the services provided to patients in the OCEMS system, which shall be approved by OCEMS prior to implementation, and for all subsequent modifications and updates. The PSP may be developed and implemented in cooperation with the 9 -1 -1 ALS providers, and shall include, but not be limited to: Request for Proposals 44 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II a) Qualitative and quantitative assessments related to 9 -1 -1 ALS provider level care. b) Description of how the organization intends to share recognition with all components of the EMS system in public relations and education efforts. 5. Public Education Develop and implement public outreach/education programs to improve community -an d education programs that emphasize preventative health care, which s elude cardiopulmonary resuscitation and AED training initiatives semi - annuall y. itionally, develop an annual training plan that includes a list of programs and associate ctives to be offered in the calendar year. J. ADMINISTRATIVE PROVISIONS 1. Payments for Procurement Costs, County Compliance Monito ' ontract Management and Regulatory Activities a) Selected bidder(s) shall reimburse OCEMS for ion of its expenses related to conducting this procurement, monitoring and m g the contracts, provision of medical direction, and conducting periodic procurem A one -time payment shall be due upon execution of the contract, which shall re r se a portion of the estimated actual costs to OCEMS for conducting this RFP and ft bring the contracting process. The one -time payment totals $50,000, and is pror' to each designated EOA region based on current transport volumes. (Table 7) b) Selected bidder(s) shall originating from the 9 -1 call volumes for each thirty (30) busin will be invoiced occurring from t y ` S the amount of $13.33 per patient transport from calls tem. A quarterly amount shall be assessed based on actual �er of a calendar year. The quarterly fee shall be paid within ter invoice from the County. The first payment for this contract fourth quarter of calendar year 2014 and will include all calls icement of the contract Request for Proposals 45 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRPTION OF PROPOSED SERVICES SECTION II Table 7 One Time Contractor Payment a) Invoicing and Payment for Services $4,500 $9,000 $12,500 �O $11,500 $12,500 OCEMS shall render its invoice for any liq ' ~damages to the selected bidder within thirty (30) business days of OCEMS' recei o e monthly performance reports, and after approval of the penalties determined. selected bidder(s) shall pay OCEMS on or before the 30th day after receipt of�ke invoice. Any disputes of the invoiced amounts should be resolved in this thirty ay period. If a dispute has not been resolved to OCEMS or the selected bidt(��atisfaction, the invoice shall be paid in full and subsequent invoices shall be ovVed to reflect the resolution of disputed amounts. b) Audits and Inspections-,,0 (1) Maintain sepa>�t &ancial records for services provided through this solicitation, in accordance generally accepted accounting principles. With reasonable notification and d Jrmal business hours, OCEMS shall have the right to review any and all busing cords including financial records pertaining to the required services. All r shall be made available to OCEMS at the selected bidder's OC office or other Xtn`�jually agreeable location. OCEMS may audit, copy, make transcripts, or otherwise teproduce such records, including but not limited to contracts, payroll, inventory, personnel and other records, daily logs and employment contracts. (2) On an annual basis, provide OCEMS with audited financial statements by certified public accountants for ambulance operations in OC and/or separate business records of financial accounting of any other businesses that share overhead with the ambulance service operation. (3) Selected bidder(s) may be required by OCEMS to provide periodic reports in a format specified by OCEMS, to demonstrate billing compliance with relevant rules and regulations and adherence with approved and specified rates. Request for Proposals 46 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II 3. County License OCEMS oversees ambulance services within the County. Pursuant to OCEMS policies, an ambulance company must obtain the appropriate ambulance service and vehicle permits and licenses. OCEMS Policies and ambulance service applications can be found on the Orange website at www.healthdisasteroc.org/ems 4. Annual Performance Evaluation OCEMS shall evaluate the performance on an annual basis, which may ' e, but not be limited t: a) Response Time performance standards assessed with r (er ce to the minimum requirements in the Contract. b) Clinical performance standards assessed with referenc inimum contract requirements. c) Initiation of innovative programs to improve sy!teAn d) Compliance with information reporting re 'ret eennts. 5. Service Rates Ak Selected bidder(s) shall adhere to ice Rates below: a) Maximum BLS Service No more than the in OC Board of Supervisors approved BLS Service Rate may be charged to patiento the provision of the required services. b) Maximut Service Rate ThelWimum ALS Service Rate may be charged for OC Fire Authority (OCFA), provided hate emergency ALS services to patients transported either ALS or BLS were vided. For service calls in which ALS services are provided by OCFA to patients that e transported either ALS or BLS, the selected bidder(s) shall be responsible for charging and collecting the ALS Service Rate. , No more than the maximurn OC Board of Supervisors approved ALS Service Rate may be charged. The ALS Service Rate is subject to the same annual percentage adjustment increase as the County's emergency BLS base rate increase, if any. As of July 1, 2013, the approved maximum ALS Service Rate is $387.35 per transport. Request for Proposals 47 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II c) ALS Reimbursement Rate for Medicare Patients The ALS Reimbursement Rate for Medicare patients, including patients covered under Medi -Medi or Medicare +Choice plans (e.g., Secure Horizons), that use Medicare rates as a basis for payment in full, shall be based on the Medicare allowed amounts. (1) ALS -1 Emergency Services The ALS Reimbursement Rate for ALS -1 emergency transports and ALS- 1r3Sgrgency assessments with BLS transports for Medicare patients, including p covered under Medi -Medi or Medicare +Choice plans that use Medicare ra a basis for payment in full, is the ALS Increment. The ALS Increment is deft e the difference between the Medicare allowed amount for a given ALS service (i.e., S -1 or ALS -2) and the Medicare allowed amount for BLS emergency sery j eprior to the twenty percent (20 %) co- payment deduction. (2) ALS -2 Services The ALS Reimbursement Rate for ALS -2 sewic`bs shall be the ALS Increment, as defined above. (3) Annual Adjustments The ALS Reimbursement Rateall be reviewed annually by OCFA. The ALS Reimbursement Rate reimburstto OCFA by selected bidder's for all ALS services provided to patients, ex clu t edicare patients and patients covered under Medi - Medi or Medicare + Ch 6 ans (e.g., Secure Horizons) that use Medicare rates as a basis for payment in s subject to the same annual percentage adjustment increase as the County's ency BLS base rate increase, if any. The current ALS Reimbursement s of as of July 1, 2013 is as follows: (a) ALS eiir�bursement Rate is $274.38 per transport with ALS services. (b) Lehnbursement Rate for Medicare patients and patients with Medi -Medi or dicare +Choice plans is ALS -1 or ALS -2 Increment. d) Medical Supply Flat Reimbursement Rate elected bidder(s) shall reimburse OCFA for each BLS /ALS transport to cover OCFA's costs for providing expendable medical supplies. The Medical Supply Reimbursement Rate is a flat fee rate per transport, reviewed annually by OCFA, and is subject to the same annual percentage adjustment increase as the County's emergency BLS base rate increase, if any. As of July 1, 2013, the Medical Supply Reimbursement Rate is $30.65 per BLS /ALS transport. Request for Proposals 48 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II e) Zero -Pay Patients OCFA shall not require selected bidder(s) to pay the established ALS Reimbursement Rate or Medical Supply Reimbursement Rate, nor any portion thereof, for zero -pay patients. Zero -pay patients are calls for service to patients whose only method of healthcare coverage or insurance is provided by a state or local subsidized health care program (e.g., Medi -Cal, CalOptima, California Child Services, Medical Services Network). Sel d bidder(s) may seek relief from making the required reimbursement payments to A by applying for a Zero -Pay Patient Exemption as provided below. t (1) Risk of Non-Payment Except as provided otherwise herein, assume the entire risk of n n- ent for any and all of the services rendered and the charges incurred in cone ilgit with performance, including all BLS and ALS charges incurred, as well as alt V, reimbursements and medical supply reimbursements. O� NI (2) Medicare Patients Selected bidder(s) may not charge Medicare: is more than the maximum Medicare rate. f) Billing, Audit, and Access to Records,� �l (1) Selected bidder(s) shall only O services according to the approved service rates and schedules set forth s authorized by OCEMS, with no additional fees or charges imposed unless Yp�g ed in writing and in advance by OCEMS. (2) Prior to the start ices, selected bidder(s) shall establish an auditable billing system approve CEMS, which shall be available for review by OCEMS on a periodic basis. patient billing /records system shall be organized so that search and retrieval Qf illing records can readily be made by OCEMS according to the • Sp • Patient Name • Chief compliant (billed) • Response location including zip code • BLS Transport • ALS Assessment /BLS Transport • ALS Escort • 9 -1 -1 Responses without transport • Day /Month/Year /Time • Patient care record number Request for Proposals 49 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II g) Accounting Maintain accurate and complete records of all patient accounting in accordance with generally accepted accounting principles and practices consistently applied. Provide, at no cost to OCEMS, access to such records and information upon seventy -two (72) hours advanced written notice at all times during normal business hours, and a proper facility for inspection, audit, review, evaluation, and duplication of such information. Records 1 include but not limited to: ",� • Patient invoices • All service charges • All reimbursements 4'3 • All payments made to other provider • Invoices, payments, and correspond health care programs, responsible thi h) Submission of Claims Submit timely and accurate claims for s used for this purpose and must meet the federal or state ag agent may be i) Monthly Payments to OCFA All ALS reimbursements and medr supply reimbursements, as required in this Section, (hereinafter referred to as "M n Payments ") must be promptly paid by Selected Bidder to OCFA beginning Hint } days from September 1, 2014, and such payments shall continue to be promptl Bitted by Selected Bidder to OCFA thereafter within ninety (90) days after the first I f each month throughout the contract term. Zero Pay Patient Exemptions ma r uested by Selected Bidder for each qualifying call by following the procedures b locA penalty of $500 may be imposed for each late payment. Selected Bidder w onthly payments are sixty (60) days late (or more) may be assessed a 1' /2% late fer each month that payments are not made. Failure to make timely Monthly Pav may be deemed breach of contract. r 1 o Pay Patient Exemption Requests elected Bidder must submit to OCFA for approval all Zero Pay Patient Exemption requests and all documentation justifying each request. Zero Pay Patient Exemption requests must be submitted by Selected Bidder with their monthly ALS reimbursement and medical supply reimbursement payments for the month in which the exemption is requested and must be reflected as a credit on the current Monthly Payment remittance. Requests for exemptions outside the current monthly payment period will not be considered, except as provided herein. Each Zero Pay Patient Exemption will be evaluated and either granted or denied at the sole discretion of the OCFA EMS Section Battalion Request for Proposals 50 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II Chief. Selected Bidder will be notified in writing by the OCFA EMS Section Battalion Chief if any exemption request will be denied within thirty (30) days of receipt of the request. The decision may be appealed by the Selected Bidder to the OCFA Fire Chief, whose decision shall be final. In the event a Zero Pay Patient Exemption request is denied, the requesting Selected Bidder shall adjust its next Monthly Payment remittance for the amount of the credit denied. Exemption requests for "Retro Credits" should be made n the month the Selected Bidder receives notification of the retroactive enrollri; it a qualified zero pay patient program. 6. Contract Breach Affecting Health and Safety , a) In the event OCEMS determines that a breach, actual or threatened, hor will occur, or that a labor dispute has prevented performance, and if the n f the breach is in OCEMS' opinion such that public health and safety are end_ d, the matter shall be presented to the OCEMS Medical Director. If the OCEM cal Director concurs that a breach has occurred or may occur, and that public heal safety would be endangered by allowing operations to continue, the selected bidd r cooperate fully with OCEMS to affect a transition to allow OCEMS pre -ide iL1 1 alternate emergency ambulance service provider to take over the provision of tho ed services. b) In the event of determination by OCEMtlahf the selected bidder is in breach of the contract or County Ordinance, and that t nature of the breach is such that the public health and safety are endangered, � er ormance secuity shall be subject to immediate release of funds to the County. 7. Alternate Emergency Ambulanc ice Provider Upon contract award of d ted EOA regions, OCEMS reserves the right, and shall realize that right, to recognize ect the second highest scoring bidder in each EOA region as the back -up service provr in the event the selected bidder is unable to fulfill the terms of the contract at any time 8. Transition Plai- Competitive Bid Requirement Selected der(s) acknowledge that OCEMS intends to conduct a competitive procurement pro s-for the provision of the required services within OCEMS' EOA regions prior to the t IS ation of the contracts that result from this solicitation. Selected bidder(s) acknowledge meagree that OCEMS may select a different ambulance service provider to provide exclusive rgency ambulance services following said competitive procurement process, and to reasonably extend its obligations hereunder if such extensions are necessary to complete such process, including but not limited to, any reasonable decisions to cancel and restart such processes. Request for Proposals 51 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs DESCRIPTION OF PROPOSED SERVICES SECTION II 9. General Provisions a) Permits and Licenses Obtain and maintain any and all required federal, state, or local permits or licenses required to perform the required services, and make all necessary payments for licenses and permits for the required services and for issuance of state permits for all ambulance vehicles It shall be entirely the responsibility of the selected bidder(s) to schedule and coor a all such applications and application renewals as necessary to ensure compliance ederal, state, and local requirements for permits and licenses as necessary to provi A& required services. Selected bidder(s) shall also be responsible for ensuring that its l yee's state and local certifications necessary to provide the required services, as ble, are valid and current at all times. b) Compliance with Laws and Regulations All services provided trader this solicitation shall be req,Qe in full compliance with all applicable federal, state, and local laws, ordinances, d regulations, which shall be the selected bidder's sole responsibility to determiriettch, and be fully familiar with, all laws, rules, and regulations that apply to the req�e�_, services, and to maintain compliance with those applicable standards at all times. C) Observation and Inspections (1) OCEMS may, at any time, and bout notification, directly observe operations of the dispatch center, maintenan c1 ity, or any ambulance post location; and may ride as "third person" on any vehf� t any time. (2) At any time durin al business hours, and as often as may be reasonably deemed necessary by 0 OCEMS may observe office operations, and selected bidder(s) shall make a la le to OCEMS for its examination, any and all business records, including in t�nt reports, and patient records pertaining to the required services. OCE y audit, copy, make transcripts, or otherwise reproduce such records for OCFN fulfill its oversight role. d) NotiOW Litigation or Investigations eIr lected bidder(s) shall agree to notify OCEMS within twenty -four (24) hours of any litigation, federal or state investigation or significant potential for litigation, 'federal or state investigations of which they are aware. Request for Proposals 52 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs PROPOSAL PREPARATION INSTRUCTIONS SECTION III Bidder's proposal must clearly meet all of the requirements of this solicitation. Bidders should review all requirements and instructions to ensure that each requirement is clearly addressed in the proposal. HCA shall not be responsible for any oral instructions given by any employees of HCA in regard to the proposal instructions, specifications, or proposal documents described in this solicitation. Bidders may submit a proposal for up to two (2) County EOA ambulance regions, which may result in a bidder being selected to provide services in one (1) or both regions. A. Proposals should be carefully proofread and include the following: 1. Table of Contents with page numbers, for each unloaded file. j 2. Reference(s) to any appendices. 4 1 Y 3. Placement of required forms immediately after the text they support in the 6sal. 4. Numbered pages. 5. Single -sided text, at least one and one -half (11/2) line - spaced. 6. Times Roman 12 point font. 7. Each section is to be separated by a titled cover page (s' espo to a tab in a binder), and each question as it appears in the solicitation is to precede it o nding response. 8. All requested information is to be in the sequence rmat specified in the solicitation. B. Use the Proposal Preparation Checklist (Form attachment II) to plan and monitor proposal preparation, as well as to verify completion of �1 terials before submission. C. Follow instructions about the order f e�nting information, narrative text, and information requested on the forms. D. Proposals and requested docum must be electronically uploaded in PDF format, via BidSync. Hard copy proposals will no cepted. 1. Section IV is to be ded in one (1) file labeled "[RFP Name] - [Bidder Name]- Agency Description ". 2. Section V is t loaded in one (1) file labeled "[RFP Name]- [Bidder Name]- Proposal. 3. Allow su c n time to upload all required files. After the 4:00 P.M. PST proposal deadline, BidSyn not allow any uploads, e.g., if file #1 uploaded successfully at 3:58:23pm and file #2 is inyprogress of being uploaded at 4:OO:Olpm, file #2 will not upload successfully. If all rr'ovide accurate, honest, and verifiable information. Reviewers tend to respond more favorably to a candid account of problems and a realistic plan to address them, than a glossing over of an apparent problematic situation. Information that is deliberately inaccurate may prompt an investigative review and will affect the evaluation of the proposal. F. Ensure that information provided on the forms is consistent with the narrative and the information provided on other forms. Request for Proposals 53 of 56 9 -1 -1 Emergency Ambulance Transportation Svcs PROPOSAL PREPARATION INSTRUCTIONS SECTION III G. If you omit any required information or data, explain why. H. Prepare the proposal with the reviewer in mind; do not assume reviewers know your program. Proposal must be detailed and completely self - explanatory. I. Provide documentation where necessary, including items such as forms, etc. J. Do not use appendices for information that is required in the body of the proposal. Use a "�',Onldks to provide documentation or examples of activities mentioned in the proposal. f . Request for Proposals 54 of 56 9 -1 -I Emergency Ambulance Transportation Svcs PROPOSAL FOR EMERGENCY AMBULANCE SERVICES SECTION V Provide the information requested below in one (1) file per Section III instructions. Failure to provide and /or disclose requested information and/or documents may result in disqualification of your bid. A. Complete the Agency Description (Form B - Attachment II). Ensure Form B is signed prior to scanning and uploading it into BidSync. B. Complete the Board of Directors (Form C - Attachment II). C. Provide copies of the documents below. Include an index of all the documents inclit d an explanation for any document requested but not provided. 1. If incorporated: a. Articles of Incorporation executed by the Secretary of state, including alendments. b. By -laws, including all amendments. �✓ c. Board of Directors resolution empowering a Corporate Of ither by title or individual name, to act on behalf of the organization by his/her sign alone. 2. If not incorporated: Documentation empowering iliorized Representative to act on behalf of the organization by his /her signature alon 3. Fictitious Business Name statement filed wi eS.!6unty Clerk and proof of publication. 4. Partnership papers and /or joint venture ments. 5. Evidence of federal /state tax statu 6. IRS W -9 Form: Request for 64 ayer Identification Number and Certification. 7. CHP License /CAAS ation/OCEMS License. 8. Conflict of Interest s went. 9. Recent fin�ci statement prepared by an independent Certified Public Accounting (CPA) firm. �} 10. A audits, reviews, or inspection reports completed by a CPA firm, regulatory agency (e.g., (cu ational Safety and Health Administration), or other government agency within the last ve (12) months. Corporate organizational chart that includes all programs, identifies the relationship of the proposed program to the overall organization, and identifies the reporting relationship of each proposed staff position. Request for Proposals 55 of 56 PROPOSAL FOR EMERGENCY AMBULANCE SERVICES SECTION V 12. Data Universal Number System (DUNS): A unique 9 -digit identification number required by the federal government as part of their financial request and reporting process, which can be obtained free of charge from Dun and Bradstreet's website (www.dnb.com) or by calling (866) 705 -5711. Every bidder is required to provide a DUNS number regardless of the funding source of this solicitation. D. Acknowledgement that you will submit a copy of your organization's insurance certificat d endorsements to the County prior to the services start date, and that the limits will, at a ny i meet the minimum limits referenced in Section I.K. of this solicitation. N E. Describe any pending audits, pending litigation, and/or investigation involving ization. Limit your response to one -half (1 /2) page of text. F. Provide three (3) professional references from an organization who knowledge of your performance within the last year, will corroborate that your per , ce as an emergency ambulance transportation services provider meets the requirement s solicitation. References must be submitted on the organization's letterhead and sign d an individual that has the authority to submit the reference on behalf of the named organnii . G. Describe any performance issues and /or audit or revi , f any contractual documents (e.g., invoices, units of service reports, etc.) within the Ist (2) years that resulted in a corrective action plan, reimbursement of money to fonder, in st Ition, and/or termination of any contract(s) between your organization and the County, oth r eminent entity, and /or private organization. Limit your response to one (1) page of text. F r each performance issue include: 1. The type of contract, contract tetra: a es), funding amount and services provided. 2. The issues and circumstances 3. How and when the 4. Your plans to ensure he issues will not recur in future contracts. H. Complete and sign ahec(lked station Form (Attachment I - Contracting Requirements). Ensure the applicable sectio and the form is signed prior to scanning and uploading it into BidSync. UpjbVNhe signed Attestation Form only; do not upload the pages containing the Request for Proposals 1 56 of 56 AMBULANCE RFP FREQUENTLY ASKED QUESTIONS (FAQ) Background • The Emergency Medical Services System and Prehospital Emergency Medical Care Personnel Act ( "EMS Act ") (Cal H &S Code § 1797 et seq.) authorizes the Local EMS Agency to create exclusive operating areas ( "EOAs ") wherein contracts are awarded for the provision of emergency ambulance services. In Orange County, the County Health Care Agency is the designated Local EMS agency ( "OCEMS "). • In 2004, the County delegated to OCFA its authority to conduct the competitive process for the selection and award of emergency ambulance service contracts for 19 EOAs within OCFA's jurisdictional areas. (Resolution 04 -120) That year, OCFA released an RFP and awarded emergency ambulance service contracts to 19 EOAs (Aliso Viejo, Cypress, Dana Point, Irvine, La Palma, Laguna Hills, Laguna Niguel, Laguna Woods, Lake Forest, Los Alamitos, Mission Viejo, Placentia, Rancho Santa Margarita, San Juan Capistrano, Seal Beach, Stanton, Tustin, Villa Park, and Yorba Linda). • In 2008, OCFA released an RFP and awarded emergency ambulance service contracts to 10 EOAs (Cypress, La Palma, Laguna Niguel, Lake Forest, Los Alamitos, San Juan Capistrano, Seal Beach, Stanton, Tustin, Villa Park) and 9 EOAs renewed contracts (Aliso Viejo, Dana Point, Irvine, Laguna Hills, Laguna Woods, Mission Viejo, Placentia, Rancho Santa Margarita, and Yorba Linda). The renewed 2004 and 2008 EOA contracts will expire August 31, 2014, • In 2010, the California Appellate Court issued the County of Butte decision (187 Cal.App.4`h) limiting the ability of Local EMS Agencies to delegate their statutory duties and powers under the EMS Act. • In 2011, OCFA assisted the City of Westminster in releasing an RFP and awarding its emergency ambulance service contract. • In 2012, OCFA assisted the City of Santa Ana in releasing an RFP and awarding its emergency ambulance service contract. • In February of 2014, the California Emergency Medical Services Authority ( "State EMSA ") determined that the delegation of the emergency ambulance services RFP processes to OCFA conflicts with the EMS Act and the County of Butte decision. OCEMS must conduct and administer RFPs and contracts for the 19 EOAs located within OCFA's jurisdictional areas. • Although it is unclear when the State EMSA's determination concerning the delegation of authority to local jurisdictions will impact non -OCFA cities, it is applicable to all cities and counties statewide. 1 992942.1 FA Os 1) Q: Is the County consolidating the 19 existing EOAs? A: Yes. OCEMS proposes to consolidate the current 19 OCFA EOAs to five regional EOAs. This proposal still requires the Board of Supervisors approval. 2) Q: Will the RFP be released in multiple phases? A: No. Unlike years past where the RFP was issued in two phases (Phase 1 Prequalification & Phase 2 Proposal Evaluation), OCEMS is preparing a single - phase RFP. 3) Q: Will cities be able to provide input on the RFP before its release? A: Yes. The Draft RFP will be made available to the public on Wednesday, March 26, 2014. It will be posted as part of the agenda materials for the April 1, 2014 Regular Meeting of the Orange County Board of Supervisors. If commenters want their comments to be part of the April 8, 2014 Board agenda item, those comments need to be received by Friday, April 4, 2014. OCEMS will continue to receive comments on the Draft RFP until April 8, 2014. Please direct comments to: Samuel J. Stratton, MD, MPH Medical Director Orange County EMS Agency 405 W. 50' Street, Suite 301A Santa Ana, CA 92701 Dr. Stratton will take all comments under advisement prior to seeking final approval of the RFP from the State EMSA. 4) Q: Will city representatives be able to participate in the evaluation of RFP proposals covering their jurisdictions? A: OCEMS proposes that each EOA have a three- member evaluation panel reviewing the proposals which meet minimum criteria. Panel Members will consist of representatives of the County and /or members of the community having direct job knowledge and expertise in the delivery of emergency services without any conflict of interest. These panels could include representatives with the appropriate experience from cities and base hospitals. Representatives of HCA Contracts and OCEMS will serve as ad hoc (i.e. non - voting) members and technical advisors. 992942.1 5) Q: Will OCFA representatives be able to participate in the evaluation and grading of RFP proposals? A: It is possible that OCFA representatives with the appropriate field level experience could participate in the evaluation process. 6) Q: Will cities be able to retain authority to approve ambulance service contracts? A: No. The County Board of Supervisors will award all five regional contracts. 7) Q: How will the contracts be awarded? A: Historically, OCFA has conducted a two -step process in conducting the RFP. Phase 1 consisted of a prequalification phase to verify that prospective bidders met minimum requirements (e.g., 911 experience, ability to obtain the insurance coverage, communications and technology requirement). The pre - qualified firms continued on to Phase 2 — the proposal evaluation phase. Cities retained discretion to award contracts to any of the prequalified firms that completed Phase 2, and were not required to select the bidder with the highest score. The State EMSA has now mandated that contracts must be awarded to the highest scoring bidder. 8) Q: On what grounds may the County reject the highest scoring bid? A: The County may only reject the highest scoring bid if there has been a material error in the evaluation panel's ranking of proposals. 9) Q: Could a single ambulance service provider bid be awarded contracts for all five EOAs? A: No. County OCEMS proposes to limit the number of EOAs for which a single bidder may submit a proposal. 10) Q: What is the value to a city to have the County conduct the RFP process? A: The County of Butte decision states that a Local EMS agency cannot delegate some of its duties and powers under the EMSA Act (e.g., the authority to conduct the RFP process and administer ambulance service contracts) while retaining other powers and duties granted by the EMSA Act. The State EMSA has directed OCEMS to conduct and administer RFPs and contracts for OCFA's jurisdictional areas in order to comply with the EMSA Act and the holding in the County of Butte. Compliance with the EMSA Act ensures that the cities located within an EOA are afforded anti -trust protection. Without this protection, 911 ambulance providers could petition a city /County to be rotated into the 911 transportation for the specific EOA and the city /County would be required to honor the request. 992942.1 11) Q: Can the cities conduct the RFP themselves? A: No. EMSA has stated that OCEMS must conduct the RFP and administer the contracts for these areas. 12) Q: Has the County asked the State for an extension to the existing contracts? A: Yes, but it was denied. The current requirement states that the RFP will be issued on a periodic basis. While the statute and regulation has not changed the recent interpretation is 10 years. Nine of the 19 OCFA contracts will be at the 10 -year mark this year. 13) Q: What about the other cities that awarded contracts in 2009? Could they renew their existing contracts for five years? A: No. EMSA has stated that OCEMS must conduct the RFP and administer the contracts for these areas. 14) Q: Will the ALS pass- through provision be included in the RFP? A: At this time, the Board of Supervisors is discussing that policy decision. Medicare regulations state that only the transporting entity can bill the patient. Without a provision in the RFP requiring the private ambulance providers to bill for ALS services rendered by OCFA, these services cannot be billed to Medicare. OCFA would need to bill the patient directly and Medicare would not consider this a covered benefit. If this pass - through provision is not included in the OCEMS RFP, the impact to OCFA would be $4.5 million annually. Because the RFP will be used as a future model for all of Orange County, this decision could drastically impact a significant revenue source for all cities in the region. County's Proiected Timeline Release Draft RPF Publicly March 26 — April 1, 2014 Accept Comments on RFP Aril 8, 2014 Submit Draft RFP to State EMSA for Approval Mid A ril Formal Release of RFP Mid April Responses Due June 2014 Evaluation of Proposals July 2014 Consideration of Protests Contract Award (by County I August 2014 El 992942.1 Draft Orange County 911 Emergency Ambulance RFP Highlights Request All interested cities need to request the state Emergency Medical Services Authority (EMSA) to grant a one -year extension for Exclusive Operating Area (EOA) contracts currently scheduled to expire on August 31, 2014 Rationale • OCEMS's current timeline to have five new 911 emergency ambulance contracts in place by September 1, 2014 is unrealistic and places impractical hardship on the existing public health Emergency Medical System to meet an unattainable deadline. As proposed: o The RFP leaves very little (if any) time for public input and concerns to be submitted, heard and resolved. • OCEMS did host three outreach sessions, but little was discussed regarding the actual RFP content as it was not available for distribution and review by interested parties including citizens and cities impacted by the change (attached is the OCEMS PowerPoint). o Providers would have little time to staff up appropriately (jumbo EOA's), purchase vehicles and communication /technology equipment. • Extending the current EOA's: o Allows the existing EOA's to maintain the anti -trust protection for one more year so that OCEMS can undertake a more thorough and more realistic RFP process. o Provides more time for OCEMS to seek input from impacted citizens, public, hospitals and ambulance providers on the five EOA- concepts. • Permits time for a smooth transition from an existing provider to a new provider for the EOA (if applicable). • Provides ample opportunity for a provider to recruit the necessary staff, acquire the communications equipment and technology needed after being notified of the awarded EOA (or EOAs). • Allows more time for the formation of proposal evaluation panel(s) (As proposed, panels cannot be formed until the bidders for a particular EOA are known due to potential conflicts). • Provides ample time for protest on the selection process and grading criteria. • Allows a more realistic timeframe for EMSA to review OCEM's proposed RFP. • OCEMS's timeline assumes EMSA will review and approve the RFP in 13 working days (April 9 -25). Historically it has taken 4 -6 weeks (without significant changes). • The City of Garden Grove is trying to finalize an RFP and has been awaiting State approval of its draft RFP for 8 months now OCEMS's Proposed RFP • Moves from the current 19 EOAs to five. • Current annual call volume for each of the 19 EOA's ranges from 350-9,500 annually depending on the EOA. • The call volume for the five new EOA's would range from 5,100- 14,800 calls, depending on the EOA. • This concept was originally proposed by OCFA in 2006 (see attached staff report) and was REJECTED as not feasible for the following reasons: • Reduction of competition • Logistically difficult o Imbalance of call volume • Imbalance of payor mix • Loss of individual /local control OCEM Proposed Timeline • Composition of the five new EOA's still in early proposal stages • Requires approval by the Board of Supervisors and State EMSA. • Input and feedback from cities and citizens is still timely. • Timeline • RFP released March 26, 2014. Comments are due back April 4`h for inclusion into the April 8 County Agenda item. Comments received between April 5 -8 will be accepted but not incorporated into the agenda. No comments accepted after the 8'h • Anticipate that RFP will be sent (potentially hand delivered) to State EMSA on April 10/11. • Officially release the RFP April 25,2014 • Mandatory Bidder conference May 6 • Proposals due back May 23 • Proposal evaluation May -July • Services Commence September 1 History • For the past10 years, OCFA has administered the ambulance EOA process and contracts. 0 10 OCFA cities delegated to the OCFA Board of Directors 0 9 retain the contract award authority with the city • Traditionally, the process has taken about a year (without the significant changes in OCEMS's current proposal) by OCFA fully staffed and with experience conducting the ambulance RFP process. • Because of a recent court decision, the county can no longer delegate this authority to the OCFA. So, OCEMS is scrambling to award new EOAs via this process before the current EOAs expire on August 31, 2014.