City of La Palma Agenda Item No. 7

Transcription

1 City of La Palma Agenda Item No. 7 MEETING DATE: April 15, 2014 TO: FROM: SUBMITTED BY: CITY COUNCIL CITY MANAGER Ellen Volmert, City Manager AGENDA TITLE: Letter of Support for Orange County Ambulance RFP Extension PURPOSE: Present information to the City Council relative to Orange County s current process for Ambulance RFP and recommend a one year extension to the current contracts. BACKGROUND: As you are aware, the Orange County Fire Authority (OCFA) has managed ambulance contracts for the County of Orange (OC) and many OC cities (including La Palma) for many years, including Ambulance RFP processes and selection. Most recently, the State has made it clear that this is not a function which counties are able to assign to others but rather as the emergency medical services lead agency, must conduct those processes themselves. This has created a difficult situation for Orange County in that contracts are set to expire by September. In an effort to meet this very tight timeline, the County had provided little in terms of public input for the process and appeared to have largely excluded city input into the RFP and selection processes, until their most recent meeting on April 8, On April 8, 2014, the Board of Supervisors publicly recognized these issues and indicated that they will be submitting a request for an extension of current ambulance contracts and anti-trust protection to the State. This should allow for the time necessary to complete an orderly and smooth process. The Board additionally made significant changes to the RFP as outlined in the attached Ambulance RFP Process Update from the OCFA. The attached draft letter (Attachment 1) supports the Board s request. 14 of the 19 impacted cities have already sent letters to the State in support of the extension, as well as 2 others which are in process like La Palma. This represents strong city support for the State extension. Agenda Item 7 Page 1

2 SUMMARY: The City of La Palma delegates to the County (previously OCFA) authority relative to ambulance provider selection and is part of the overall Orange County ambulance territories. Under State law, the County is able to designate one provider for a specific region with anti-trust protection. It is in the City s interest that the selection process for ambulance provider is conducted in a thoughtful, fair, and inclusive manner and this was undermined by the revision in responsible agency so late in the current process. The attached draft letter supports the request which is forthcoming from the Orange County Board of Supervisors to the State allowing for a one-year extension to alleviate this time constraint and allow for a more methodical and inclusive process. Since La Palma not only has residents and businesses which rely upon efficient and reliable ambulance service, but is also home to a hospital which receives ambulance patients, this is an important concern. Issues raised to date in addition to the time constraints include the reduction in service areas, inadequate contract term, public and city input processes, minimum qualifications, criteria and performance measurement, and provider ramp up time. The draft letter reiterates many of the same points made by other cities. Hopefully, the strong support of the majority of cities for the County s request will be persuasive. ALTERNATIVES: The City is not mandated to take any action. It could therefore not write a letter or it could take some other action or direction. The draft letter is consistent with the recommendations from the OCFA City Manager Technical Advisory Committee and with the concerns expressed in prior letters to the County and the State from fellow Orange County cities. FISCAL IMPACT: There is no financial impact to sending correspondence on this issue and no known financial impact to an extension of current ambulance contracts. If contracts are not extended and an RFP process is not concluded by the deadline, the County risks a lapse in their anti-trust protection. Conducting a thorough and well-informed RFP process has a better opportunity of being not only more cost effective, but more effective in providing services as well. RECOMMENDED ACTION: It is recommended that the City Council authorize the Mayor to communicate with Orange County and State officials the City s support for a one year extension to current ambulance contracts as the best way to ensure a continuation of effective and efficient ambulance services. APPROVED: City Manager Agenda Item 7 Page 2

3 Attachment(s): 1. Proposed Letter 2. Summary information re: Ambulance RFP Process 3. OCFA Board Advisory dated April 10, 2014 Agenda Item 7 Page 3

4 April 16, 2014 Howard Backer, Director California Emergency Medical Services Authority Gold Center Drive, Suite 400 Rancho Cordova, CA Dear Director Backer: On behalf of the City of La Palma, I am writing to express concerns on behalf of our citizens and elected officials on the proposed draft Request for Proposals (RFP) Emergency Ambulance Transportation Services under preparation by the County of Orange, Health Care Agency. I am requesting that you support an extension of one year for the current Exclusive Operating Areas (EOAs) set to expire August 31, 2014, allowing the EOAs to maintain State sanctioned anti-trust protection while the County completes a thorough and methodical RFP process. Without an extension, public input and the potential transition to new ambulance providers resulting from the RFP is unlikely to occur in a smooth and seamless manner. We are particularly concerned that the proposed timeline of completing the RFP is unrealistic and impractical. The process to date has provided very limited opportunity for public comment to the draft RFP. Although County staff conducted three public outreach sessions, those public sessions involved no details of the RFP, were conducted prior to when the draft RFP was issued and there was no public discussion of minimum qualifications for service providers, response time standards or other quality control and performance measures that will be used to determine contract compliance. The draft RFP was made public on March 27, 2014, after the three previous public forums. The current expedited process as designed is understandable due to the very late start provided by the change to an Orange County rather than Orange County Fire Authority process as originally initiated. The lack of review and input opportunities are designed to meet the established goal of submitting the RFP for your review by April 10, While it is understandable that it would be very difficult for County staff to analyze and incorporate substantive comments in a manner of days, this further illustrates the difficulties associated with the proposed timeline for this procurement. Since the release of the draft RFP, we have also noted that it is very difficult to determine from the document whether or how cities as major stakeholders will be involved in the evaluation of responses should the current process continue. Ambulance providers are expected to bid and serve the newly formed jumbo EOAs, which have not even been approved, in an extremely compressed timeline. As you are well aware, transitioning to new service providers can involve a number of critical steps for providers, city and county staff, and our fire/emergency services provider, the Orange County Fire Authority PHONE Walker Street FAX La Palma, CA

5 (OCFA). This can include hiring staff, purchasing additional ambulances, and working with OCFA and others to ensure dispatch information can be relayed to the provider s compatible radio and computer equipment. The proposed timeline by County staff to make contract awards in late July or August is not adequate time for a new provider to begin operation on September 1, We have been informed that in some cases a review by California EMSA of a proposed RFP can take several months. We recognize the County of Orange, especially the Health Care Agency staff, were placed in this position in large part not of their choosing. The determination by California EMSA, per the interpretation of the Butte Decision, that the OCFA could no longer be designated by the County to conduct this process has forced county staff to react in a timeline not of their choosing. We therefore add La Palma s voice to the great majority of Orange County communities requesting that an extension be approved and supported by the California EMSA to allow all parties to work together and design a practical and fair process. Sincerely, Steve Shanahan Mayor cc: Board of Supervisors, County of Orange Holly Veale, County of Orange Health Care Agency Dr. Samuel Stratton, County of Orange Health Care Agency Tammie McConnell, County of Orange Health Care Agency Board of Directors, Orange County Fire Authority Lori Zeller, Assistant Chief/Business Services, Orange County Fire Authority

6 Top Emergency Ambulance RFP Comparisons Number Topic 1. Total Number of EOA s OCFA (Based on Draft RFP s) OCEMS RFP Proposal OCEMS March 27 th RFP Version Page Reference 19 EOA s. Five EOA s. Page 5 Proposal Focus and Background Comments This still requires State EMSA approval. OCFA proposed this "regional EOA concept in 2006, and also reviewed options other than 5 EOA's The proposed timeline does not allow adequate time for input from the cities or citizens. 2. Contract Term Five years plus additional five. Up to three years plus optional renewal(s) not to exceed a total of 5 years in aggregate Page 9 Contract Term The current maximum allowable period is ten years; why incur the additional startup and RFP administration process in any shorter period of time? Ambulance providers typically amortize their vehicle, communications and equipment startup cost over five years. Page 1

7 Number Topic 3. Number of EOA s a Bidder May be Awarded OCFA (Based on Draft RFP s) All 19 EOA s Experience Minimum of five years experience within last ten years in a comparable system or CAAS Accreditation and three consecutive years of 911 experience in a comparable system. OCEMS RFP Proposal Provider cannot be awarded more than three of the five EOA s. Management team, at a minimum, shall include senior members having no less than five (5) year's experience supervising a 911 transportation service, in a primary or backup capacity, of similar size and population to the EOA region(s). OCEMS March 27 th RFP Version Page Reference Page 10 Evaluation of Proposal and Selection of Provider. Page 37 Personnel Comments Inconsistent with contract award goes to highest bidder. 911 Transportation service requires specific equipment, unique infrastructure, and familiarity of working in emergency situations that are response time dependent. 5. ALS Pass- Through Ambulance provider required to reimburse OCFA for ALS services and medical supplies. Ambulance provider required to reimburse OCFA for ALS services and medical supplies. Page 43 Administrative Provisions Same language that OCFA proposed. 6. Administrative Fee OCFA included in the ALS pass through (above) the cost of EMS staff required to administer the contract, training and equipment. Current cost recovery rate is approximately 60%. New rates will be adjusted appropriately but will still remain below full cost recovery. Providers are required to reimburse OCEMS $13.33 per transport (Approximately $550,000 annually). Successful bidder also required to reimburse OCEMS a pro rata share of the $50,000 RFP preparation cost. These will be a new fee that the provider may eventually have to pass on to patients. Is it equitable only to charge OCFA private Ambulance providers? Page 2

8 Number Topic 7. Other Liquidated Damages Excessive Use of Mutual Aid Provider/ Failure to Provide Timely Reports/ Maintain Equipment/ Improper Certification OCFA (Based on Draft RFP s) Not providing quarterly response time compliance data resulted in a potential corrective action plan. OCEMS RFP Proposal Fines range from $50.00 per late electronic patient care report (epcr) report to $1, per incident for responding without required equipment and supplies. OCEMS March 27 th RFP Version Page Reference Page 27, 29, 32 Operations Comments With implementation of epcr in the early stages, perhaps a phase in would be more appropriate. Also how would this apply to non OCFA contracts? 8. Response Time Compliance Penalty/ Liquidated Damages Penalty per Month per EOA >90% $ % $1, $2,000 <79% $3,000 Liquidated Damages per Month per EOA 89% $2,000 88% $4,000 87% $6,000 86% $8,000 <85% $10,000 Page Response Time Performance OCFA contract emphasized compliance not penalties. 9. Response Time Compliance Response time compliance is the same as proposed by the OCEMS. OCFA did not propose a per call penalty, but rather assessed a penalty if overall compliance fell below 90% per month. Second draft of phase 2 RFP to include a maximum allowable response time per call. Liquidated damages for every call that is late. Damages range from $5.00 for a call that is.01-1 minute late with a graduating table up to $10,000 for a call greater than 60 minutes late. These will be offset with credits if response time compliance exceeds 90% for the month. Page Response Time Performance Appears to contradict the 90% overall response time criteria. Page 3

9 Number Topic 10. Insurance s 11. Financial Statements OCFA (Based on Draft RFP s) Commercial General Liability, Business Automobile, Ambulance Medical Malpractice set at 3M/5M or higher depending on city requirements (some have $5M/10). Audited Financial Statements. OCEMS RFP Proposal Sets the limits at 3M/5M as the limit and adds requirements, also requires a $1.2M performance bond. Statements prepared by a Certified Public Accountant (CPA). Page 4 OCEMS March 27 th RFP Version Page Reference Page Insurance s Page 44 Administrative Provisions Comments Need to resolve the issue of varying insurance requirement at the city level and within EOA s. Does the insurance requirement default to the highest level of the cities that compromise the EOA? Additionally, need to ensure that OCFA and cities are included on Additional Insured Endorsements and Waiver of Subrogation. With audited Financial Statements, CPA s are required to look for Going concern issues (Financial analysis and audit procedures attesting to the company being able to operate for another year) and financial footnote disclosures/ warning about pending litigation and or liabilities. Statements prepared by a CPA may not render such an opinion and are not required to provide this level of assurance.

10 Number Topic OCFA (Based on Draft RFP s) 12. Scoring RFP disclosed the scoring process including maximum points by section. OCEMS RFP Proposal Provides high level/general proposal evaluation criteria maximum points by section are not disclosed. OCEMS March 27 th RFP Version Page Reference N/A Comments The OCEMS proposal is inconsistent with State comments recently received on the draft Garden Grove RFP, which required that the scoring criteria and grading methodology must be disclosed as part of the RFP. 13. Grading Panel RFP outlined the specific position and experience of the evaluation panel including member city participation. OCFA & OCEMS staff will observe but not participate. Panel will consist of representatives of the county and community having knowledge and expertise in service described. Page 9 Evaluation of Proposals and Selection of Providers The OCEMS proposal is inconsistent with State comments on the draft Garden Grove RFP, which required that the composition of the evaluation panel be disclosed as part of the RFP. It appears the cities, as key stakeholders seeking to represent their citizens, and OCFA, which has the public/private partnership with the ambulance providers interacting with them on every 911 EMS call (over 75,000 responses annually), are not significantly involved in the evaluation process. Page 5

11 Number Topic 14. Public Bidding Statute OCFA (Based on Draft RFP s) Not bound by lowest bid and city/ocfa may award contract to any prequalified bidder. OCEMS RFP Proposal Contract must be awarded to highest point bidder. OCEMS March 27 th RFP Version Page Reference Page 10 Evaluation of Proposals and Selection of Providers Comments Consistent with Eel River decision requiring the selection of number one ranked bidder. Problematic if Bidder submits proposal for all five EOA s and is number one in all EOA s, but restricted to only three. 15. Protest / Appeal Allows ten days for appeals to be submitted. Allows five days for appeals to be submitted. Page 12 Protest process Five days is inconsistent with State EMSA comments on the draft Garden Grove 911 RFP. Page 6

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