To: Board of Supervisors of Sonoma County
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Barbie Robinson, 565-7876
Vote Requirement: Majority
Supervisorial District(s): Countywide
Title:
Title
Emergency Ground Ambulance Services Competitive Procurement Consultant
End
Recommended Action:
Recommended action
Authorize the Director of Health Services to execute an agreement with Endpoint EMS Consulting, LLC for subject matter expertise and support in developing a request for proposals for an exclusive provider of emergency ground ambulance services in an amount not-to-exceed $161,000 through December 31, 2021.
end
Executive Summary:
The Coastal Valleys Emergency Medical Services Agency (Coastal Valleys), organized under the Department of Health Services, serves as the local emergency medical services agency for Sonoma and Mendocino counties. State law provides that counties, at the recommendation of the local emergency medical services agency, may establish one or more exclusive operating areas for the provision of emergency medical services within the county. The cities of Santa Rosa, Sebastopol, Rohnert Park, and the Town of Windsor (along with unincorporated adjacent communities) have been served by the current vendor under a contract awarded in 2009 and most recently amended in 2019 to remain in effect through June 30, 2022.
State law requires that a competitive process is performed at periodic intervals for providers of exclusive operating area emergency medical services. Coastal Valleys must review the current emergency medical services system, develop a request for proposals for a competitive process, administer that competitive process, and bring a recommended contract to the Sonoma County Board of Supervisors prior to January 31, 2022 to allow sufficient time for the transition to a new contract. To better facilitate an impartial, transparent procurement process, the Department has determined that the services of an experienced consulting firm to administer the competitive procurement process in partnership with County staff is required.
Discussion:
The coordinated provision of emergency medical services is of paramount importance to the health and well-being of Sonoma County residents and visitors. Individuals suffering illness or injury rely on the County’s emergency medical services system to provide assistance through the publicly-administered 911 system. Callers are unable to exercise consumer choice in emergency situations and must accept the medical response sent through that system. Key concerns are quality of care provided, efficiency and timeliness of response, and the cost to the consumers that are billed for the medical care provided.
For the last 30 years Sonoma County has safeguarded the interests of the public through the authority granted by California Health and Safety Code section 1797.224 by selecting a vendor for the provision of emergency ambulance services via a competitive process. In order to incentivize a high level of commitment from vendors, the resulting exclusive contracts have been typically at least five years in length with extensions available for superior performance. Because the needs of the community change over time, and California Health and Safety Code requires repetition of competitive process at periodic intervals, the process of developing a request for proposals must include an examination of the current system and consideration of any needed improvement or changes in geographic scope identified by the local emergency medical services agency and the system stakeholders.
In order to provide a fair, transparent process with the best possible outcome, the Department engaged with EMS system stakeholders to receive input regarding the current EOA and the effect of that structure on the communities and service providers within Sonoma County. In order to complete a process of additional system assessment, development of recommendations and management of any RFP process informed by those recommendations, the Department desires to hire an emergency medical services consulting firm with significant experience in the provision and regulation of emergency medical services systems served by Exclusive Operating Areas. To that end, the Department requests approval to enter into an agreement with EndPoint EMS Consulting of San Francisco, California. California’s complex system of state and local regulation and the tools used in that structure to design, release, and evaluate responses related to an emergency medical services system exclusive operating area are unique to our state. The Department desires staff to work in partnership with an experienced consulting firm to administer the competitive procurement process.
EndPoint EMS Consulting has 30 years of experience in California’s emergency medical services system. The firm’s principals have direct experience in emergency medical services system service delivery and system oversight. EndPoint’s leadership team members have led other county local emergency medical services agencies charged with oversight of performance-based emergency medical services system contracts and ambulance services acting as contractors in such systems. EndPoint was successful in Stanislaus County in completing a competitive advanced life support ambulance request for proposals and subsequent provider contract that lowered ambulance rates for consumers and increased funding for fire first-responder services. Following this achievement endpoint was secured to provide consulting services for Calaveras County to include an emergency medical services assessment, ambulance request for proposals for three exclusive operating areas, and develop and negotiate provider contracts.
EndPoint staff have managed or regulated public/private partnership models serving urban/suburban and rural response areas. This level of expertise and familiarity with the challenges faced by counties and the emergency medical services providers that serve those counties is not available through other vendors. The unique combination of regulator and provider-level knowledge specific to California’s emergency medical services system is not available from other firms in the emergency medical services consulting marketplace that is dominated by large nationally-focused organizations. The Purchasing Agent approved a single-source waiver request for EndPoint EMS Consulting on September 26, 2019.
Through the proposed agreement, EndPoint EMS Consulting will provide the following services
- Develop an emergency 911 ambulance request for proposals that will implement a fully evidence‐based emergency medical services system to include advanced life support ground ambulance transport operations, data collection, high-quality clinical care, and process improvement methods to ensure future opportunities for system growth, flexibility, and clinical innovation.
- Conduct a fiscal analysis of the current exclusive operating area ambulance provider. Review, research, and provide recommendations related to health care system needs and their unique relationship to Sonoma County’s ground ambulance and fire first-responder services.
- Consider the existing EMS system and provide recommendations and options for any Exclusive Operating Area changes.
- Solicit qualified proposers for the provision of 911 emergency ambulance services and non-emergency services if recommended and work with County Purchasing to ensure procurement processes are followed.
- Provide evaluation, financial review, and compliance with request for proposals requirements prior to forwarding to the proposal review committee for scoring review.
- Assist with orientation and oversight of the proposal review committee and management of its review and recommendation process.
Assist the County in negotiating the exclusive operating area contract with the awardee and transitioning to the new contract terms.
Prior Board Actions:
None
Fiscal Summary
|
Expenditures |
FY 19-20 Adopted |
FY 20-21 Projected |
FY 21-22 Projected |
|
Budgeted Expenses |
30,000 |
103,000 |
28,000 |
|
Additional Appropriation Requested |
|
|
|
|
Total Expenditures |
30,000 |
103,000 |
28,000 |
|
Funding Sources |
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General Fund/WA GF |
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State/Federal |
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Fees/Other |
30,000 |
103,000 |
28,000 |
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Use of Fund Balance |
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Contingencies |
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Total Sources |
30,000 |
103,000 |
28,000 |
Narrative Explanation of Fiscal Impacts:
Appropriations of $30,000 for the agreement with EndPoint EMS Consulting are included in the FY 19-20 budget. The agreement is funded through the Emergency Medical Services Fund. Appropriations of $103,000 for FY 20-21 and $28,000 for FY 21-22 will be included in the appropriate year budgets.
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Staffing Impacts: |
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Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
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Narrative Explanation of Staffing Impacts (If Required):
N/A
Attachments:
Services agreement with EndPoint EMS Consulting, LLC
Related Items “On File” with the Clerk of the Board:
None