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HomeMy WebLinkAboutItem #06c Approval of Fire-Based EMS Transport Services - Approval of Third Amendment to Transport Agreement with AMRContact Name. -
Contact Number:
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Ocoee
florido
AGENDA ITEM COVER SHEET
Meeting Date: June 19, 2018
Item # 60,
Reviewed By:
Fire Chief John Miller Department Director:
407-905-3140
City Manager:
Subject: Fire -Based EMS Transport Services:
c) Approval of Third Amendment to Transport Agreement with AMR
Background Summary:
Currently, the Ocoee Fire Department (OFD) is part of a two -tiered system for handling EMS patient care and
transports. The City of Ocoee has a contract with American Medical Response (AMR) to transport patients and
bill them for conveyance to the hospital. Over the last several years, the City has evaluated the feasibility of
providing Fire -Based EMS transport, in the interest of Ocoee's citizens and for continuity of patient care. Upon
a) adoption of a Rate Resolution, and b) approval to piggyback the Medical Billing Services Agreement between
Intermedix and the City of Tamarac, Florida, OFD intends to begin EMS transport in January.
The Agreement for Emergency Ambulance Transportation Services between AMR and the City of Ocoee is set
to expire on September 30, 2018. AMR has agreed to a Third Amendment to the Agreement, extending the
contract by three months (October 1, 2018 through January 1, 2019), which will cover the gap between the
current Agreement and OFD commencing Fire -Based EMS transport.
Issue:
Should the Honorable Mayor and City Commission approve the Third Amendment to Agreement for Emergency
Ambulance Transportation Services, extending the current agreement with AMR by three months?
Recommendations:
Staff recommends approval of the Third Amendment to Agreement for Emergency Ambulance Transportation
Services, extending the current agreement with AMR by three months.
Attachments:
Third Amendment to Agreement for Emergency Ambulance Transportation Services
Original Agreement for Emergency Ambulance Transportation Services ,
Type of Item: (please mark with an °x )
Public Hearing
For Clefk's Dept Use:
Ordinance First Reading
Consent Agenda
Ordinance Second Reading
Public Hearing
Resolution
Regular Agenda
X Commission Approval
Discussion & Direction
Original Document/Contract Attached for Execution by City Clerk
Original Document/Contract Held by Department for Execution
Reviewed by City Attorney
N/A
Reviewed by Finance Dept.
N/A
Reviewed by Q
N/A
2
THIRD AMENDMENT TO AGREEMENT FOR
EMERGENCY AMBULANCE TRANSPORTATION
SERVICES
THIS THIRD AMENDMENT TO AGREEMENT FOR EMERGENCY AMBULANCE
TRANSPORTATION SERVICES (the "Third Amendment") is entered into on the _ day of ,
2018, by and between the CITY OF OCOEE, a Florida municipal corporation, hereinafter called
"Ocoee", and RURAL/METRO CORPORATION OF FLORIDA, a Florida corporation, d/b/a American
Medical Response, hereinafter called "AMR".
RECITALS
A. Whereas, Ocoee and AMR entered into an AGREEMENT FOR EMERGENCY AMBULANCE
TRANSPORTATION SERVICES (the "Agreement") effective September 1, 2012, for
emergency ambulance transportation services.
B. Whereas, the Agreement was extended for twelve (12) months by mutual agreement dated June
25, 2015.
C. Whereas, the Agreement was extended for a twelve (12) month period and amended by the First
Amendment thereto on August 16, 2016.
D. Whereas, the Agreement was extended for a thirteen (13) month period and amended by the
Second Amendment thereto on August 15, 2017. (For purposes of this Third Amendment,
references to the Agreement include the Agreement, as extended and as amended by the First and
Second Amendment thereto.)
E. Whereas, Ocoee and AMR desire to extend the Agreement for an additional three (3) month term
subject to the terms and conditions set forth in the Agreement and this Third Amendment.
AGREEMENT
NOW, THEREFORE, for and in consideration of the foregoing, the mutual promises, covenants,
and agreements contained herein, and other good and valuable consideration, the receipt and sufficiency
of which are hereby acknowledged, the parties hereto agree as follows:
l . Term of Agreement and Renewal Provisions. The term of the extension to Agreement,
by this Third Amendment, will be from October 1, 2018 through January 1, 2019; provided, however,
that the either party may terminate this Agreement by providing thirty (30) days written notice to the
other party.
2. Effective Date of Third Amendment. This Third Amendment shall become effective on
October 1, 2018. All of the terms, covenants, conditions, and provisions of the Agreement and First and
Second Amendments thereto, unless modified by this Third Amendment, are hereby reinstated and
remain in full force and effect.
IN WITNESS WHEREOF the parties hereto have caused this Third Amendment to be executed
by their authorized representatives on the day and year first above written.
RURALIMETRO CORPORATION
OF FLORIDA
By:_
Title:
Signature:
CITY OF OCOEE
Rusty Johnson, Mayor
ATTEST:
Melanie Sibbitt, City Clerk
(SEAL)
APPROVED BY THE CITY OF OCOEE
COMMISSION IN A MEETING HELD ON
, 2018
UNDER AGENDA ITEM NO.
FOR USE AND RELIANCE ONLY BY
THE CITY OF OCOEE, FLORIDA;
APPROVED AS TO FORM AND
LEGALITY this day of
, 2018.
SHUFFIELD, LOWMAN & WILSON, P.A.
By:
City Attorney
AGREEMENT FOR EMERGENCY AMBULANCE
TRANSPORTATION SERVICES
THIS AGREEMENT FOR EMERGENCY AMBULANCE TRANSPORTATION
SERVICES (the "Contract") is made and entered into by and between Rural/Metro Corporation
of Florida dlbla Rural/Metro Ambulance, a Florida corporation ("Contractor"), and the City of
Ocoee, a Florida municipal corporation ("City"), effective September 1, 2012 (the "Effective
Date").
RECITALS:
A. Contractor is a provider of certain emergency ambulance transportation and related
services.
B. City desires to contract with Contractor to provide emergency ambulance transportation
and related services to its citizens.
C. Contractor desires to provide City with such services and has the necessary equipment,
training, expertise, professional certifications and licenses to do so.
NOW THEREFORE, in consideration of the mutual covenants and promises hereinafter
set forth, and other good and valuable consideration, the receipt and sufficiency of which is
hereby acknowledged, the parties agree as follows:
Provision of Services. Contractor agrees to provide City emergency ambulance
transportation services consistent with the scope of services detailed in Exhibit A
attached to this Contract (the "Services") and Exhibit D (Contractor's Response to
RFP #12-005 Emergency Ambulance Services). These Services shall be rendered by
Contractor to all areas located inside the Service Area which is the geographic area
depicted by the service area map attached hereto as Exhibit B.
2. Compensation. The City is not responsible for any compensation or reimbursement of
expenses to the Contractor for any services provided under or arising from this
Agreement, except as stated in Exhibit A.
3. Insurance. Contractor shall maintain at all applicable times, at its own expense, the
insurance coverage set forth in Exhibit C.
4. Ownership of Records & Confidential Information. In addition to protected health
information, as defined in 45 CFR § 164.504, or individually identifiable health
information, as defined in 42 U.S.C. § 1320d ("Protected Health Information"), during
the course of performing this Contract, each party may from time to time receive
confidential information about the other including but not limited to information about the
party's customers, patients, practices, procedures, strategies, organization, financial
and other related information. Neither party shall use or disclose any such confidential
information for any purpose other than the limited purpose of performing its obligations
under this Contract, without the prior express written permission of the supplying party.
All documents and records prepared, maintained, handled or otherwise related to
Contractor's performance of services hereunder are and shall be the property of
Contractor. Contractor's copyrighted materials and procedures shall be and remain the
Contract —Emergency —Ambulance —Services
sole property of Contractor. If a party is served with a public records request, subpoena
or other legal process concerning confidential information of the other party, that party
shall immediately (not more than 48 hours after the receipt) notify the supplying party
and shall, at no cost to City, cooperate with it in any lawful effort to contest the legal
validity of such process the supplying party may wish to pursue. Nothing herein shall
be construed to preclude City and Contractor from complying with the requirements of
Chapter 119, Florida Statutes, the "Public Records Act." Contractor acknowledges and
agrees that the City is a public entity that is subject to the Public Records Act and as
such, public records in Contractor's control and possession relating to any services
performed under this Contract shall, at no cost to City, be secured, maintained,
preserved, and retained in the manner specified pursuant to the Public Records Act and
available for inspection and copying pursuant to the Public Records Act unless
otherwise exempt or excepted by applicable law.
5. Availability of Information. During the term of this Contract and pursuant to any
record retention law or regulation the parties are subject to, each party shall make
available upon written request of the other, to the Secretary of the Department of Health
and Human Services, or to the Comptroller General of the United States, or of any duly
authorized representatives of any government agency, this Contract and the books,
documents and records of the party that are necessary to certify the nature and extent
of the costs of this Contract and/or compliance with the law.
6. Warranties & Representations.
a) Contractor warrants and represents (i) that it shall perform its services in
accordance with industry standards; (ii) that to the best of its knowledge all
goods and services reflected in its billing have been furnished to such patient;
and, (iii) it shall perform all its obligations and maintain all records and
patient information used for the performance of services under this Contract in
compliance with all applicable law including but not limited to the Fair Debt
Collection Practices Act, 15 U.S.C. §§ 1601 et seq., as amended, any applicable
state Consumer Protection laws, as amended, the Bankruptcy Code, 11 U.S.C.
§§ 101 et. seq., as amended, and the Health Insurance Portability and
Accountability Act of 1996, 42 U.S.C. §§ 1320d through d-8, as amended
("HIPAA") and the Health Information Technology for Economic and Clinical
Health Act of 2009, 45 CFR Parts 142, 160, 162 and 164 (the "HITECH Act").
b) Each party represents and warrants to the other that (i) it has the right to enter into
this Contract, to grant the rights granted in this Contract and to perform fully all of
the services and obligations contemplated by this Contract; (ii) all necessary
laws, consents, resolutions, and corporate/political actions have duly authorized
the execution and performance of this Contract, and this Contract constitutes
a valid and enforceable obligation of each of the parties; (iii) the person
entering into this Contract is authorized to sign this Contract on behalf of the
party; and (iv) the parties have reviewed this Contract with their respective legal
counsel to the party's satisfaction or voluntarily waived their right to do so. The
parties acknowledge that HIPAA and the HITECH Act, and the regulations
promulgated thereunder apply to the activities described in this Contract, and that
both parties are "covered entities" as that term is used in HIPAA and the
HITECH Act. In that regard, the parties acknowledge and warrant to each other
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Contract —Emergency —Ambulance —Services
that their respective activities undertaken pursuant to this Contract shall
conform to HIPAA and the HITECH Act no later than the effective date of each
such requirement.
c) City warrants and represents that (i) to the best of its knowledge, all
information supplied to and all representations made to Contractor shall be
true, accurate and complete and in the event such information or
representation(s) made herein become inaccurate or incomplete, City will
promptly notify Contractor in writing of such occurrence; (ii) it shall perform all
its obligations and maintain all records and patient information used for the
performance of services under this Contract in compliance with all applicable law
including but not limited to the Fair Debt Collection Practices Act, 15 U.S.C. §§
1601 et seq., as amended, any applicable state Consumer Protection laws, as
amended, the Bankruptcy Code, 11 U.S.C. §§ 101 et. seq., as amended, and
HIPAA and the HITECH Act.
7. Response Time Performance. During City declared emergencies, the Fire Chief may
suspend time -based performance requirements. Response times are a combination of
dispatch operations and field operations. Because this Contract is performance based,
the City will not limit the Contractor's flexibility in the methods of providing EMS service
other than the requirements described herein. However, the City reserves the right to
review and approve Contractor's deployment plans and encourages a strong and on-
going working relationship between City staff, the City of Ocoee Fire Rescue
Department, and the Contractor. This Contract is based on the Contractor's
commitment to perform within the response time standards. Appropriate response time
performance is the result of a coordinated effort of the Contractor's total operation. This
system will be based on the Contractors' processing requests for service, and then
dispatching resources in accordance with the Contractor's deployment plan. Response
time shall be measured in minutes and integer seconds, and shall be "time stamped" by
the Contractor provided ambulance CAD system.
8. Response Time Requirements.
a) Emergency Request. The contractor shall produce an ambulance
response time of ten minutes, zero seconds (10:00 minutes) or less for at
least 90% of all incoming emergency request calls from fire/police dispatch
or the public as determined by the dispatcher in strict accordance with
approved telephone protocols. The contractor shall provide a summary
performance report within (10) days of the end of each month.
b) Use of Mutual Aid Providers. The contractor may arrange and utilize
mutual aid agreements with the neighboring EMS providers, and may utilize
services furnished by such neighboring AILS providers toward the
contractor's response time requirements. The contractor must supply a
detailed report within (10) days of the end of each month with the reason for
each instance of utilization of mutual aid.
c) Severe or Chronic Non -Compliance. If contractor fails to comply with
monthly response time requirements more than or per quarter, for two or
more quarters, during any contract year, such failure shall be considered
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Contract—Emergency_Ambulance_Services
"severe or chronic" non-compliance of the Contract and the City shall have
the right to terminate this Contract.
9. Response Time Measurement Methodology. The response time measurement
methodology employed can significantly influence operational requirements for EMS
systems. The following are applicable:
a) Response times are measured from the time the call is received by the
Contractor until the Contractor's first arriving AILS unit is on scene.
b) For the purpose of this Contract, the Contractor's emergency response
times shall be measured from the time the Contractor is notified by radio,
telephone, data link, or other means that its services are required at a
particular location until unit arrival at the incident location by the Contractor's
first arriving ALS unit.
c) Arrival at the incident location means the moment a crew notifies that it is
fully stopped at the location where the ALS unit shall be parked while the
crew exits to approach the patient. In situations where the ALS unit has
responded to a location other than the scene (e.g., staging areas for
hazardous materials, violent crimes incidents, or non -secured scenes)
arrival at scene shall be the time the unit arrives at the designated staging
location.
d) Each Incident a Separate Response: Each incident will be counted as a
single response regardless of the number of units that are utilized. The
response time of the first arriving contractor ALS transport unit will be used
to compute the response time for the incident.
10. Reporting) Requirements. The ability of the City to monitor and evaluate the
effectiveness of its EMS delivery system is greatly dependent upon the availability of
valid data and statistical analysis that measures system performance including both
clinical and financial outcomes. Contractor shall provide detailed and periodic reporting
as follows:
a) Operational Reporting Requirements. Contractor shall provide within ten
(10) days after the first of each month, reports dealing with its performance
during the preceding month as it relates to clinical and operational
performance as specified herein. The Contractor will rely on its ambulance
CAD data in generating its response time reports. At a minimum the
Contractor will include the following in its operational monthly reports:
• Total responses
• Total emergency (911 generated) transports
• Total patients transported
• Total responses and transport activity by ambulance unit
• Total cancelled calls (prior to arrival)
• Total patient refusals (treatment and transport)
• Distribution of responses by time of day and day of week
• Distribution of incidents by location (ambulance service zones)
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Contract —Emergency —Ambulance —Services
• Description of incidents by call type
• Summary of patient complaints (by situation found)
• Response time summary for all responses
• Response time summary by ambulance service zones
• Response time summary by ambulance unit
b) Financial Reports. The Contractor shall organize and report its financial
records in a manner to facilitate the direct comparisons between dispatch
incident numbers and patient account records. The financial records, if
requested by the City, should be provided to the City on a quarterly basis
and organized to capture the following:
• Total expenses and revenues
Total average charge per patient
• Total average patient charge for mileage
• 30, 60, and 90 day Accounts Receivable
• Distribution of payments by all payment groups (Medicare,
Medicaid, private insurance, direct payment, non-collectables/bad
debt)
• Quarterly collection rate (percentage) for all ambulance billings
• Total of uncollected accounts with 180 days of aging
c) Miscellaneous Recordkeeping. If requested by the City, the Contractor
shall complete, maintain, and provide copies of records including:
• Continuing education and certification records documenting
training compliance
• Annual inventory report of capital assets
• Deployment planning reports
• Vehicle maintenance records
d) Electronic Patient Care Reporting (E-PCR). The Contractor will, within
three (3) months of beginning service, institute and maintain an electronic
patient care reporting system which is compatible with Florida Bureau of
EMS EMSTARS project.
11. Fair Market Value. This Contract has been negotiated at arms length and in good faith
by the parties. Nothing contained in this Contract, including any compensation paid or
payable, is intended or shall be construed: (i) to require, influence or otherwise induce
or solicit either party regarding referrals of business or patients, or the recommending
the ordering of any items or services of any kind whatsoever to the other party or any of
its affiliates, or to any other person, or otherwise generate business between the parties
to be reimbursed in whole or in part by any Federal Health Care Program, or (ii) to
interfere with a patient's right to choose his or her own health care provider.
12. Policy Acknowledgement. City acknowledges that it has received copies of
Rural/Metro's Code of Ethics and Business Conduct and Rural/Metro's Anti -Kickback
Policy.
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Contract -Emergency -Ambulance -Services
13. Indemnification. Each party, for itself and its officers, directors, and employees
("Indemnitor") shall indemnify and hold harmless the other party, their officers,
directors, and employees ("Indemnitee") for, from and against all costs, claims, losses,
liabilities, penalties, fines, citations, expenses, forfeitures or other damages, including
but not limited to settlements, defense costs, judgments, court costs, expert(s) fees and
reasonable fees of attorneys, incident to, and which it may incur, become responsible
for, or pay out as a result of death or bodily injury to any person, destruction or damage
to any property, contamination of or adverse effects on the environment, or any
violation of applicable law, to the extent that such damage was caused by, in whole or
in part, incident to or arose out of this Contract and the Indemnitor's: (i) breach of this
Contract; or (ii) negligent or willful act(s) or omission(s); or (iii) violation of applicable
law; or (iv) any employment, workers' compensation or other related claim by
Indemnitor's employees, agents or subcontractors. Nothing in this section shall limit
any right to contribution or other allocation of fault between the parties as determined by
a court of competent jurisdiction and as permitted by all Applicable Law. The indemnity
provided by City under this paragraph 23 is limited to and capped by the recovery limits
established under Section 768.28(5), Florida Statutes.
14. Term of Contract. This Contract shall be for a period of three (3) years beginning
September 1, 2012. The City may offer, at its sole option, and based in part upon the
Contractor's superior performance, two (2) twelve (12) month renewals. The offer of
extension shall be for one 12-month extension after the completion of the initial three
(3)-year contract period and then a second 12-month extension at the completion of the
first 12-month extension period. Each extension will be considered independent of the
other and will be offered at the sole option of the City. If the City determines that an
extension of this Contract is warranted, such offer shall be made at least six (6) months
prior to the scheduled end of the term of the Contract or previously granted extension.
15. Termination Upon Mutual Consent. Notwithstanding any other provision in this
Contract, this Contract may be terminated upon mutual written consent of the parties.
16. Default. If conditions or circumstances, constituting a default as set forth in this section
exists, the City shall have all rights and remedies available at law and in equity,
specifically including the right to terminate this Contract, the right to pursue the
Contractor for damages and the right of emergency takeover of the services to be
provided by Contractor hereunder. All the City's remedies shall be non -cumulative and
shall be in addition to any other remedy available to the City. Conditions and
circumstances, which constitute default of this Contract, shall include the following:
a) Failure of the Contractor to operate the EMS system in a manner which
enables the City and the Contractor to remain in compliance with federal
state or City laws, rules, or regulations, medical control policies and/or
related rules and regulations adopted pursuant thereto;
b) Failure of the Contractor to meet system standards of care;
c) Breach of any of the warranties or representations contained in this
Contract;
d} Falsification of information supplied by the Contractor during or subsequent
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Contract —Emergency —Ambulance —Services
to this procurement process;
e) Failure of the Contractor to provide data or falsification of data supplied
during the course of operations, including by way of example but not by way
of exclusion, dispatch data, patient report data, response time data,
performance measurements, financial data or falsification of any other data
under the Contract;
f) Failure of the Contractor to maintain equipment in accordance with the
manufacturer recommended maintenance practices;
g) Failure of the Contractor's employees to conduct themselves in a
professional and courteous manner and to present a professional
appearance;
h) Failure of the Contractor to comply with the approved rate regulation, billing
or collection provisions of this Contract;
i} Contractor makes an assignment for the benefit of creditors, files a petition
of bankruptcy, is adjudicated insolvent or bankrupt, petitions to apply for any
custodian, receiver or trustee for a substantial part of its property,
commences and proceeding relating to it under bankruptcy, reorganization,
arrangement, readjustment of debt, dissolution or liquidation law or statute
of any jurisdiction;
j) Failure of Contractor to cooperate with and assist the City after a default has
been declared as provided for herein, even if it is later determined that such
breach never occurred or that the cause of such breach was beyond
Contractor's reasonable control;
k) Acceptance or payment by Contractor or any of Contractor's employees of
any bribe, kick -back or consideration of any kind in exchange for any
consideration whatsoever, when such consideration or action on the part of
Contractor or Contractor's employees could reasonably be construed as a
violation of federal, state or local law;
1) Failure of Contractor to maintain insurance in accordance with this Contract;
m) Chronic failure of Contractor to consistently meet response time
requirements as set forth in this Contract;
n) Failure to timely submit audited financial statements prepared by a certified
public accountant or public accounting firm;
o) Any other failure of performance, clinical or other system standards of care
as required in this Contract and which is determined by the Ocoee City
Commission to constitute a default or endangerment to public health and
safety;
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Contract -Emergency -Ambulance -Services
p} Restriction, suspension, or revocation of operating licenses or certifications
imposed by the City of Ocoee or the State of Florida;
q) Contractor debarment by Centers for Medicare and Medicaid Services
(CMS); or
r) Failure to comply with the "lame duck" provisions of this Contract.
17. Provisions for Curing Default. The Contractor is required to meet with the Fire Chief
to remedy any violations. In the event of a default, the City shall give the Contractor
written notice to the Contractor setting forth with reasonable specificity the nature of the
default. Contractor shall have the right to cure such default within five (5) calendar days
of receipt of such notice. Within 24 hours of receipt of such notice, Contractor shall
deliver to City, in writing, a plan of action to cure such default. If the Contractor fails to
cure such default within the period allowed for cure (with such failure to be determined
in the sole and absolute discretion of City) or Contractor fails to timely deliver the cure
plan to the City, City may assign Contractor's operations to a third party o may perform
the services itself. Contractor shall cooperate completely and immediately with City to
affect a prompt and orderly transfer of all responsibilities.
18. Rights and Remedies Not Waived. Contractor covenants that the provision of
services to be performed by the Contractor under this Contract shall be completed
without further compensation than that provided for in this Contract. The acceptance of
work under this Contract and the payment therefore shall not be held to prevent
maintenance of an action for failure to perform work in accordance with this Contract.
In no event shall payment of consideration by City constitute or be construed to be a
waiver by City of any default or covenant or any default by Contractor. City's payment
shall in no way impair or prejudice any right or remedy available to the City with respect
to such default.
19. "Lame Duck" Provisions. Should Contractor fail to prevail in a future procurement
cycle, Contractor shall agree to continue to provide all services required in and under
this Contract until the new contractor assumes service responsibilities. Under these
circumstances Contractor will, for a period of several months, serve as a "lame duck"
contractor. To ensure continued performance fully consistent with the requirements of
this Contract through any such period, the following provisions shall apply:
a) Contractor shall continue all operations and support services at the same
level of effort and performance as were in effect prior to the award of the
subsequent agreement to a competing organization;
b) Contractor shall make no changes in methods of operation which could
reasonably be considered to be aimed at cutting Contractor service and
operating cost to maximum profits during the final stages of the Contract;
c) City recognizes that if a competing organization should prevail in a future
procurement cycle, Contractor may reasonably begin to prepare for
transition of service to the new contractor. City shall not unreasonably
withhold its approval of Contractor 's request to begin an orderly transition
process, including reasonable plans to relocate staff, scale down certain
Contract —Emergency —Ambulance —Services
inventory items, etc., as long as such transition activity does not impair
Contractor's performance during this period;
d) During the process of a subsequent competition conducted by City,
Contractor shall permit its non -management personnel reasonable
opportunities to discuss with competing organizations the issues related to
employment with such organizations in the event Contractor is not the
successful Respondent. Contractor may, however, require that its non-
management personnel refrain from providing information to a competing
organization regarding Contractor's current operations, and Contractor may
also prohibit its management level personnel from communicating with
representatives of competing organizations during the competition.
However, once City has made its decision regarding award, and in the event
Contractor is not the winner, Contractor shall permit free discussion between
any City -based Contractor employees and the winning proposer without
restriction, and without adverse consequence to any City -based employee.
20. Regulatory Changes. Contractor reserves the right to seek modification of this
Contract, upon thirty (30) days notice to City in the event any applicable law,
government policy or program change is passed or adopted affecting Contractor's
rates, provisions of services and/or obligations, and in such event the parties shall work
in good faith to modify this Contract accordingly.
21. Permits and Licenses. Contractor shall be responsible for and shall hold any and all
required federal, state, or local permits or licenses required to perform its obligations
under this Contract. In addition, Contractor shall make all necessary payments for
licenses and permits for the services and for issuances of state permits for all
ambulance vehicles used. It shall be entirely the responsibility of the Contractor to
schedule and coordinate all such applications and application renewals as necessary to
ensure that the Contractor is in complete compliance with federal, state, and local
requirements for permits and licenses as necessary to provide the services. The
Contractor shall be responsible for ensuring that its employees' state and local
certifications and licenses as necessary to provide the services, if applicable, are valid
as of the Effective Date and are valid and current at all times throughout this Contract.
22. Compliance with Anti -Kickback Statute. Each party shall comply with the Federal
Health Care Programs' Anti -Kickback Statute (42 U.S.C. § 1320a-7b) and any
applicable regulations promulgated thereunder. The parties further recognize that this
Contract shall be subject to the amendments of the Anti -Kickback Statute or any of its
applicable regulations. In the event any applicable provisions of the Anti -Kickback
Statute or its regulations invalidate, or are otherwise inconsistent with the terms of this
Contract, or would cause one or both of the parties to be in violation of the law, the
parties shall exercise their best efforts to accommodate the terms and intent of this
Contract to the greatest extent possible consistent with the requirements of the Statute
and its applicable regulations.
23. Compliance with Applicable Law. The parties agree to be in full compliance with all
applicable law and shall immediately notify the non -breaching party in the event it has
failed to comply with this Section. In such an event, the non -breaching party may
immediately terminate this Contract.
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Contract—Emergency_Ambulance_Services
24. Exclusion of Certain Damages. NOTWITHSTANDING ANY PROVISION IN THIS
CONTRACT TO THE CONTRARY, IN NO EVENT SHALL ANY PARTY AND ITS
AFFILIATES OR ANY OF THEIR RESPECTIVE DIRECTORS, OFFICERS,
MEMBERS, SHAREHOLDERS, EMPLOYEES, AGENTS OR SUBCONTRACTORS BE
LIABLE TO THE OTHER PARTY OR ANY THIRD PARTY FOR LOST PROFITS,
SPECIAL, CONSEQUENTIAL, INCIDENTAL, OR PUNITIVE DAMAGES,
REGARDLESS OF THE BASIS OF THE CLAIM, WHETHER IN CONTRACT, TORT,
STRICT LIABILITY OR OTHER LEGAL OR EQUITABLE THEORY, WHETHER OR
NOT THE PARTY HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES.
25. Independent Contractor. Contractor is an independent contractor and nothing in this
Contract shall be construed as creating an employment relationship, agency,
partnership, or joint venture between the parties. Each party shall control and direct the
methods by which it performs its responsibilities hereunder. Except as provided herein,
neither party is authorized to act on behalf of the other in any other matter whatsoever.
In the event of medical necessity, City personnel may be requested to assist Contractor
in the continued medical care medically necessary for the care of the patient by
accompanying the patient during Contractor transportation. Under no circumstances
shall City's employees be considered an employee of Contractor.
26, Waivers. The failure by either party to insist on strict performance by the other party of
any provision of this Contract shall not be a waiver of any subsequent breach or default
of any provision of this Contract.
27. Governing Law. This Contract shall be subject to and governed according to the laws
of the State of Florida, regardless of whether either party is or may become a resident
of another state. The parties agree that the venue and jurisdiction shall be exclusively
in the state and federal courts located in the County of Orange in the State of Florida.
28. Binding Effect. This Contract shall be binding upon and shall inure to the benefit of
the parties hereto, their respective successors, assigns or other legal representatives.
29. Assignment. Contractor shall not assign any portion of this Contract without written
consent first obtained from the City and any assignment made contrary to the
provisions of this section may be deemed a default of this Contract and, at the option of
the City shall not convey any rights to the assignee. Any change in Contractor's
ownership shall, for purposes of this Contract, be considered a form of assignment. The
City shall not unreasonably withhold its approval of a requested change in ownership,
so long as the transferee is of known financial and business integrity for the
undertaking.
30. Severability. If any portion or portions of this Contract shall be for any reason invalid
or unenforceable, the remaining portion(s) shall be valid and enforceable and carried
into effect unless to do so would clearly violate the present legal and valid intention of
the parties hereto.
31. Headings. The headings used in this Contract are for convenience only and do not
limit the contents of this Contract.
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Contract —Emergency —Ambulance —Services
32. Variations of Pronouns. All pronouns and variations thereof will be deemed to refer to
the masculine, feminine, or neuter, singular or plural, as the identity of a person,
persons, or entity may require.
33. Survival. Any provisions of this Contract creating obligations extending beyond the
term of this Contract shall survive the expiration or termination of this Contract,
regardless of the reason for such termination.
34. Authorization for Contract. All necessary laws, resolutions, and corporate actions
have duly authorized the execution and performance of this Contract and this Contract
constitutes the valid and enforceable obligations of the parties in accordance with its
terms.
35. Force Maieure. Either party shall be excused for failures and delays in performance of
its respective obligations under this Contract due to any cause beyond its control and
without fault, including without limitation, any act of God, war, riot or insurrection, law or
regulation, strike, flood, fire, terrorism, explosion or inability due to any of the
aforementioned causes to obtain labor, materials, roadways or facilities. In addition to
the above, Contractor shall be excused for failures and delays in performance of its
obligations under this Contract due to adverse weather conditions, natural physical
barriers, such as mountains, hills or washes, natural disasters and/or other limitations
of access to the person requiring Services. Such conditions may impede or effect or
block Contractor's efforts to provide Services and/or ability to utilize some or all of its
Services' equipment. Nevertheless, each party shall use its best efforts to avoid or
remove such causes and to continue performance whenever such causes are removed,
and shall notify the other party of the problem.
36. Notices. Any notice required or permitted to be given pursuant to any provisions of this
Contract shall be given in writing, and deposited with the United States Postal Service,
postage pre -paid, registered or certified mail, return receipt requested, or by a nationally
recognized overnight courier service, addressed as follows:
To Contractor: Rural/Metro Corporation
9221 E. Via de Ventura
Scottsdale, Arizona 85258
Attn: General Counsel
With a copy to: Rural/Metro Corporation of Florida
4728 Old Winter Garden Rd.
Orlando, Florida 32811
Attn: Division General Manager
To City: City of Ocoee
Attn: City Manager
150 N. Lakeshore Dr.
Ocoee, Florida 34761
With a copy to: City of Ocoee
Attn: Finance Dept.
11
Contract_Emergency_Am bulance_Services
150 N. Lakeshore Dr.
Ocoee, Florida 34761
Any party may change the notification addresses listed above with proper written notice.
37. Entire Contract. This Contract constitutes the entire agreement and understanding
between the parties with respect to the subject matter hereof and supersedes any
previous agreements or understandings, whether oral or written.
38. Amendments. Any amendments to this Contract shall be effective only if in writing and
signed by authorized representatives of both parties.
39. Execution by Facsimile; Delivery of Oric linal Si ned Contract. This Contract may
be executed by facsimile, and shall be deemed effectively executed upon the receipt by
both parties of the last page of this Contract duly executed by the other party. Each
party to this Contract agrees to deliver two original, inked and signed Contracts within
two days of faxing the executed last page hereof.
40. Legal Fees. In the event either party brings any action for any relief, declaratory or
otherwise, arising out of this Contract, or on account of any breach or default hereof, or
to enforce the Dispute Resolution section, the prevailing party shall be entitled to
receive from the other party reasonable attorneys' fees, costs, and expenses.
41. Counterparts. This Contract may be executed in several counterparts, each of which
shall be an original, but all of which shall constitute one and the same instrument.
42. Omnibus Provision. Contractor understands and agrees that for four years following
the conclusion of the Contract it may be required to make available upon written
request to the secretary of the U.S. Department of Health and Human Services, or any
other fully authorized representatives, the specifications and subsequent agreements,
and any such books, documents, and records that are necessary to certify the nature
and extent of the reasonable costs of services.
43. No Third Party Beneficiary. No party intends in any manner whatsoever to create an
interest or beneficiary in a third party.
44. Warranty Regarding Consideration and Procurement. Contractor warrants that it
has not employed or retained any company or person other than a bona fide employee
working solely for the Contractor to procure or solicit this Contract, and that it has not
paid or agreed to pay any company or person, other than a bona fide employee working
solely for the Contractor, any fee, commission, percentage, brokerage fee, gifts, or
other consideration contingent upon or resulting from this procurement. Further,
Contractor represents that its pricing has been independently arrived at without
collusion.
45. Exhibits. All Exhibits referenced herein are incorporated into this Contract in their
entirety. Contract when used throughout this Contract shall include all referenced
Exhibits.
46. Publicity Provision. Neither party shall use any trademarks, service marks, visual
product representations, trade names, logos or other commercial or product
12
Contract —Emergency —Ambulance —Services
designations of the other party, or disclose such without said party's express prior
written consent. In particular, neither party shall identify or make reference to the other
party in any advertising or other promotional modality regardless of its form without
explicit prior written consent from said party.
47. Product endorsemenVadvertising. Contractor shall not use the name of the City or
the City's fire agencies for the endorsement of any commercial products or services
without the expressed written permission of the City.
48. IP Provision. Nothing in this Contract is intended to grant a license or any rights of any
nature whatsoever to Contractor's intellectual property which may include but is not
limited to its any of its patents, mask work rights, trademarks, trade names, service
marks, logos, copyrights, derivatives, software or any other intellectual property rights of
Contractor.
49. FCC Compliance. Contractor acknowledges that the FCC license is held by City and
that any shared transmitter use under this Contract and pursuant to Section 90.179 of
the FCC's Rules shall be subject to City' control.
50. End -term Provisions. Contractor shall have 90 days after termination of this Contract
in which to supply the required audited financial statements and other such
documentation necessary to facilitate the close out of the Contract at the end of the
term.
51. Notice of Litigation. Contractor agrees to notify City within 24 hours of any litigation or
significant potential for litigation of which Contractor is aware. Further, Contractor is
required to warrant that it will disclose in writing to the City all litigation involving the
Contractor, Contractor's related organizations, owners, and key personnel.
52. Dispute Resolution. In the event of a dispute, the parties will consider the use of
mediation to resolve the dispute prior to the commencement of litigation.
53. Sovereign Immunity. Nothing contained in this Contract shall be considered or
deemed a waiver of City's sovereign immunity protections or a waiver of any other
defense or immunities to lawsuits.
(Remainder of page left blank intentionally)
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Contract —Emergency —Ambulance —Services
IN WITNESS WHEREOF, the parties hereto have caused this Contract to be executed
by their authorized representatives on the day and year first above written.
Signed and delivered in the presence of: CONTRACTOR:
Print N me: Ann to io
Print Name: Stella V. Weeks
ATTEST:
RURAL/METRO CORPORATION OF FLORIDA
dlbla RURAL/METRO AMBULANCE
By:
Z§# �"
Print Name: Michael P. DiMino
Title: President
Reviewer Legal Dept.
CITY:
CITY OF OCOEE, FLORIDA
1
By:�
Eikenberry, City Clerk S. Scott Vandergrift, Mayor
(SEAL)
APPROVED BY THE OCOEE CITY
COMMISSION AT A MEETING
HELD ON June 19, 2012
UNDER AGENDA ITEM NO. 10. B.
FOR USE AND RELIANCE ONLY BY
THE CITY OF OCOEE, FLORIDA;
APPROVED AS TO FORM AND
LEGALITY this '.� day of
cx42z;.� , 20I?%
SHUFFIELD, LOWMAN & WILSON, P.A.
By:
14
Contract_Emergency_Ambulance_Services
EXHIBIT A
SCOPE OF SERVICES
KEY TERMS
Throughout the document, we use key terms that we will define for reader clarity.
Advanced Life Support (ALS) — Advanced services or skills that include the use of
techniques including intravenous (IV) therapy, ECG monitoring, medications, advanced airway
management and similar treatments.
Ambulance — A vehicle that meets State of Florida standards and Federal specifications to
provide medical transportation for sick and injured patients.
Ambulance Service Zone — A geographic area designated by the City to identify specific
EMS response areas.
Basic Life Support (BLS) — Basic EMS skills that include CPR, automated or assisted
defibrillation, bleeding control, spinal immobilization, splinting, and similar treatments.
Billing System — The system used by the contractor to collect accounts receivable from the
provision of EMS by the contractor. The contractor may subcontract this to a third -party agency
provided that all sections of the contract are met.
Computer Aided Dispatch (CAD) — A computer assisted telecommunications system that
provides voice and data communications for emergency service systems.
Ambulance CAD -- The CAD system operated by the contractor for the communication and
dispatch needs of its units.
Default — A situation(s) that occurs where the contractor can no longer meet the performance
requirement set within the contract.
Electronic Patient Care Report (E-PCR) — A computer device that allows EMS and fire
service providers to enter call and patient data into a reporting system.
Emergency Response — Response to those calls which fall into the Echo, Delta, Charlie and
Bravo level call categories as identified by the NAEMD protocols.
Emergency Transport — The transportation of a patient resulting from a request generated
through the 911 emergency communications center, or from some other form of notification
indicating the need for emergency care. Does not include inter -facility transfers.
Fire Chief — The City representative that will oversee the ambulance service contract.
EMT-B — Any person certified by the State of Florida and credentialed by the local medical
director to provide basic life support services.
Evaluation Committee — A committee appointed by the City Manager to qualify and/or rank
proposals and to forward to the City Commission.
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Contract —Emergency —Ambulance —Services
Federal Specifications for Ambulances (Triple K) — Federal specification #KKK-A-1822 is
the US General Services Division's specifications for ambulances.
Medical Director — The Office of the Medical Director Orange County, Florida EMS System.
Medical Oversight — The process of providing on-line and off-line medical oversight of the
EMS system.
Medical Priority Dispatch System (MPDS) — An advanced emergency dispatch system that
provides protocols for EMS dispatch, and protocol -driven pre -arrival patient care instructions.
National Academies of Emergency Medical Dispatch (NAEMD) — The NASD is a non-profit
standard -setting organization promoting safe and effective emergency dispatch services world-
wide. The NAED supports first -responder related research, unified protocol application,
legislation for emergency call center regulation, and strengthening the emergency dispatch
community through education, certification, and accreditation.
Paramedic — Any person licensed by the State of Florida and credentialed by the local
medical director to provide advanced life support services.
Proposal — A response from vendors wishing to bid on the exclusive contract to provide
emergency ambulance service for the City.
Public Safety Answering (or Access) Point (PSAP) — The City's appropriate call center
responsible for answering calls to an emergency telephone number for police, fire, and
ambulance services.
Request for Proposal (RFP) — A document released by the City that requests proposals from
vendors to provide emergency ambulance service to the City.
Response Time — The time that begins when the contractor's dispatch center receives
notification of the alarm and ends when contractor's unit(s) arrive at the scene,
Response Time Summary — A summary of the specific times indicated, provided at the 90%
fractile percentages.
1. SYSTEM DESIGN SUMMARY
A. Overview
The City of Ocoee, Florida ("City") is soliciting proposals for the provision of Advanced
Life Support (ALS) ambulance transport response for 911 emergency calls. The City
intends to award a contract for all EMS Services for the entire City or a portion of the
City as selected by the City, except City Fire Department First Response services. The
successful contractor will be the City's primary provider of the Emergency Transport
Certificate of Public Convenience and Need within the City.
The purpose of this procurement process is to provide a fully integrated, high
performance EMS delivery system. The contractor, utilizing an approved medical
priority dispatch system, will provide emergency dispatching services for contractor's
units.
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Contract —Emergency —Ambulance —Services
The proposal is to include comprehensive medical direction including both on-line and
off-line medical oversight. The medical director shall oversee the training requirements
for all contractor's personnel, oversight of emergency medical dispatching including pre -
arrival medical instruction, recertification guidelines, the development of emergency
medical protocols and standing orders, and a fully functional quality assurance process
including quality control is a primary deliverable of this process.
The selected contractor will be required to fully integrate into the region's and the City's
various medical receiving facilities for pre -hospital emergency medical care.
The City will monitor service delivery and contractual compliance through a series of
independent performance measurements. The successful vendor will base its delivery
model on clearly defined outcome measures and not a Level of Effort criterion.
It is the City's desire to have an EMS system that ensures high quality clinical care,
provides efficient and reliable EMS services at a reasonable cost to consumers, and
provides the community with an operationally and financially viable system.
B. City's Responsibilities
The City, in procuring an ambulance contractor, represents the interests of its taxpayers
and the general public as consumers of emergency services within its boundaries.
In this performance -based approach it is the City's responsibility to:
• Monitor contractor compliance and enforce contractual terms;
• Provide ALSIBLS first response utilizing City of Ocoee Fire Rescue
Department personnel and equipment;
• Provide the contractor with information that will allow completion of
contract requirements in a timely manner.
C. Contractor's Responsibilities
The contractor is responsible for responding to all requests for emergency ambulance
service in the designated service area. The requirements for all operations are
delineated throughout these specifications and will become the basis of the
performance based contract between the City and the contractor.
The contractor shall be responsible for the following:
• Furnishing and managing all personnel required in the delivery of ALS
emergency ambulance transport operations;
• Providing and operating an ambulance CAD system or dispatch and
radio system.
• Providing local office space, within Orange County, for customer
assistance, billing activities, and administrative oversight;
Employing or contracting for medical direction through the Office of the
Medical Director for Orange County EMS System;
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Contract_Emergency_Ambulance_Services
• Supplying all medical supplies, medications and disposable equipment
for the contractor and the City's first response fire service agencies;
• Providing all necessary vehicles and vehicle maintenance for vehicles
operated by the contractor;
• Providing in-service training, quality assurance, and improvement
monitoring for contractors personnel;
• Providing notification and access of contractor's EMS training to
personnel from City's first response fire agencies;
• Developing and issuing standing orders and medical protocols that
integrate with City's existing first response fire agencies' medical
protocols through the Office of the Medical Director for Orange County
EMS System;
• Providing the required insurance coverage for all employees and
response personnel operating under the oversight of the contractor's
medical director;
• Providing EMS stand-by at special events, as requested;
• Providing mutual aid and disaster response services, and other
associated support functions in coordination with the City and the
Orange County Office of Emergency Management;
• The contractor is responsible for providing all billing services. Billing and
collection services shall be conducted according to the professional
guidelines outlined in the contract;
• The contractor shall provide detailed and comprehensive monthly
reporting on response activities, patient treatments, billing and collection
reports, customer and citizen complaints, accidents, and equipment
malfunctions;
• The contractor is expected to comply with all applicable City, state, and
federal guidelines in the delivery of pre -hospital medical care and to
obtain the necessary State of Florida and the City licensing and or
permits required to provide emergency transport services.
• The contractor will apprise the City fully of any changes or modification in
its deployment practices or anticipated deployment practices that could
alter service delivery.
• The contractor business office shall maintain reasonable business hours
and be located within Orange County. The contractor shall establish and
maintain a published telephone number for customer contacts and an
updated and interactive web -page for customer service, including the
posting of up to date transport fee schedules and the disclosure of
corporate contact information.
2. BACKGROUND AND SERVICE AREA SUMMARY
The City is interested in contracting the EMS delivery system within its jurisdictional
boundaries. There is significant concern to improve transparency and provide an adequate
level of accountability for the EMS assets assigned to and or paid for by City. The City is
designing this proposal to create greater interaction between City government, the fire
departments, the EMS contractor, and medical direction. The City is also seeking the
development of a performance based delivery model that utilizes comprehensive reporting and
monitoring techniques to insure the highest level of patient care and cost accounting.
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Contra ct_Emerge ncy_AmbuIance_Services
A. Description of Service Area
The transport area is within the City of Ocoee city limits, excluding County enclaves.
Please reference Exhibit B of the contract for the proposed service area map (subject to
change as set forth in this RFP).
B. Historic Service Volume
As reported by the current service provider, the area generated 4,214 emergency and
non -emergency incidents in FY 2010-2011 that generated ambulance responses. Of
these responses, 3,442 resulted in a patient transport.
3. PROGRAM RESPONSIBILITIES
A. Scope of Services
The contractor shall furnish all personnel necessary in the delivery and oversight of
emergency ambulance transport service for the entire population of the City. The
contractor is also responsible for providing medical direction and clinical oversight for
their personnel, for all aspects of EMS delivery. Additionally, the contractor shall furnish
stand-by coverage for City sponsored events as required, EMS transportation for
incidents involving transfer to and from aero medical EMS units, reasonable mutual aid
services, and comprehensive reporting, as specified in this proposal.
The scope of services will be agreed to between the Contractor and the City and
included in the contract. The contractor shall be the City's primary emergency
ambulance contractor within the specified service area per Attachment A - Service
Area. The City reserves the right to reduce the size of the service area and negotiate
with the selected firm.
A. Vehicles, Vehicle Maintenance and Equipment Repairs
It is the contractor's responsibility to provide ambulances capable of transporting
patients receiving ALS care that meet the federal Triple K specifications, and State of
Florida minimum standards. The contractor shall also provide all medical and technical
hardware and software needed to properly equip each ambulance.
It is the contractor's responsibility to maintain and equip each ambulance in accordance
with State of Florida guidelines for ALS transport vehicles. The contractor and its
medical director may choose to stock each vehicle with additional equipment, tools, and
protective clothing beyond that which is required by state guidelines; such equipment
shall be compatible with the City's fire service agencies' equipment.
Vehicle maintenance shall be the responsibility of the contractor in accordance with the
warranty maintenance specifications of the vehicle manufacturer. Records shall be kept
for all maintenance and repair work and shall be made available to the City upon
request. The City expects all ambulances and equipment used in the performance of
the project will be maintained in an excellent manner. Any ambulance, support vehicle,
and/or piece of equipment with any deficiency that compromises its function must be
immediately removed from service. All maintenance costs shall be the responsibility of
the contractor. Any vehicle repairs, parts replacements, or general up -keep shall be the
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Contract_Emerg ency_Ambulance_Services
responsibility of the contractor. Vehicles are to be kept clean and fully stocked. The
contractor shall maintain, store, and dispose of all bio-medical equipment and
byproducts in accordance with the appropriate state and OSHA guidelines.
Equipment Requirements
Each ambulance unit shall be equipped with the required medical supplies,
medications, bandages, splints, airway and suction equipment, oxygen and
other supplies and disposable goods as required by State of Florida guidelines.
It is the responsibility of the contractor to maintain sufficient quantities of goods
and supplies to adequately stock and re -stock vehicles without interruption of
services. The contractor is expected to have additional supplies and equipment
in a secure location within the City of Ocoee or general area, to allow the re-
stocking of first line vehicles 24 hours per day, 7 days per week throughout the
contract period.
2. Replacement of Medications and Medical Supplies for City of Ocoee
Fire Rescue
The contractor shall develop written guidelines, subject to approval by the City
Manager, for the replacement of or payment for applicable medications, medical
supplies, disposable splinting materials, and other disposable supplies utilized
by City of Ocoee Fire Rescue Department in the delivery of patient care. All
such supplies, equipment, and medications shall be replaced on a no cost basis
to the City of Ocoee Fire Rescue Department or the Contractor may reimburse
the City for said medications and supplies. In addition, the contractor must also
develop a controlled substance storage, distribution, usage, and documentation
policy that satisfies any applicable laws and the policies of the respective
Medical Director.
B. Coverage and Availability
These specifications are for a performance contract. The City neither accepts nor
rejects the contractor's level of effort estimates, rather the City accepts the contractor's
financially guaranteed commitment to employ whatever level of effort is necessary to
achieve response time and performance results required by the terms of the contract as
outlined in these specifications.
Initial Ambulance Coverage Plan: Notwithstanding the above, the
proposals must include descriptions of Respondent's initial ambulance
coverage plans for the City of Ocoee service area, the number of
ambulance and reserve ambulance units required, supervisory units,
personnel and other components that it will utilize to meet the
performance standards required herein. Acceptance by the City of the
Respondent's offer shall not be construed as acceptance of the
Respondent's performance.
2. Ambulance Service Zones: The contractor shall establish a series of
ambulance service zones to analyze alarm activities throughout the City
of Ocoee service area. These zones shall coincide with the fire
department response areas. Numbering of the service zones shall be
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Contract —Emergency —Ambulance —Services
consistent with City of Ocoee Fire Rescue Department station response
areas.
3. 2417 Coverage: It is the intent of this proposal to ultimately enter into an
agreement with the contractor that ensures the prescribed services will
be available on a 24-hour a day basis, seven days a week, and 365 days
per year. It is further understood by the contractor that there will be
certain periods of time during the year that service demand will exceed
the normal daily call volume. During these heightened periods of
demand (City cultural. and celebration events, man-made or natural
disasters, hurricanes, mass casualty incidents, and transportation
accidents) the contractor will rapidly increase its staffing and available
ambulances in response to these peak demand periods. The contractor
is required to provide emergency contact information and maintain the
accuracy of this information, in order to contact key personnel during a
critical emergency or during disaster situations.
C. Integration of the City of Ocoee Fire Departments as First Responders
Currently City of Ocoee Fire Rescue provides ALS service from its responding units. On
all incidents, the senior City of Ocoee Fire Rescue Department officer will be
responsible for incident command as espoused by the National Incident Management
System (NIMS). The incident commander may, when appropriate, designate the
contractor's EMS supervisor or lead paramedic as the medical group supervisor based
on NIMS procedures. Primary patient care will be the responsibility of the agency that
arrives on scene first and initiates patient care. When initiated by fire service personnel,
primary patient care may be turned over to the contactor's paramedic for continuance of
care and transportation. Fire personnel will support the care provided by the contractor
on -scene, and when the situation warrants, will accompany ambulance personnel in the
ambulance by providing care enroute to the hospital.
D. Risk Management and Loss Control Provisions
The City believes that education and aggressive prevention of conditions in which
losses occur, is the best mechanism to avoid injuries to the contractor staff; City
personnel and patients. Therefore, the City requires the contractor, at a minimum, to
employ the following risk management processes. Pre-screening of potential
employees (including drug testing), initial and ongoing driver training using a curriculum
equivalent to EVOC, significant event investigations (e.g., motor vehicle accident with
injuries or any vehicle accident which requires the towing of the ambulance from the
scene of the accident), lifting technique training, hazard reduction training and other
training or policy guidelines that are directed towards injury prevention and accident
avoidance. If requested by the City, the contractor will provide the City an annual report
of their risk management activities and adverse events.
Note: The pre-screening of employees must begin at the initiation of the contract.
E. Deployment Planning and Disaster Response
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Contract_Emerg ency_Am bulance_Services
The contractor shall be actively involved in planning for and responding to any declared
or undeclared disaster in the City. Disaster coordination is to be facilitated through City
of Ocoee Fire Rescue, the City, and Orange County Office of Emergency Management.
Planning Documents: The contractor is expected to develop, within 90
days of the start of this service contract, a mass casualty incident plan
and an emergency disaster plan following the NIMS incident command
system guidelines. This plan will be submitted to the City's emergency
manager and the fire chiefs for review and incorporation into the City's
Emergency Management Plan.
2. Supervisory Training and Participation in Drills and Exercises: The
contractor's supervisory personnel will be required to complete incident
command training and hazardous material training as required by the
City. Contractor involvement shall include participation in training, drills
and exercise without additional charge to the City. The contractor may
be considered for eligible grant funding when applicable, for the above
described drills and exercises. Within 30 days of contract
implementation, all EMS providers will be certified in IS-700 and ICS-
100. In addition, all supervisory personnel or those designated to act as
supervisors will also be certified in IS-800 and ICS-200.
3. Evacuation Planning: The contractor is expected to work directly with
all local medical facilities, the Fire Chief and the City of Ocoee Office of
Emergency Management in developing a medical facility evacuation plan
for City of Ocoee. This plan is to be developed within 180 days from the
start of the service contract and presented to the City's emergency
manager for review and inclusion into the City's Emergency
Management Plan.
4. Performance Criteria During Disaster Situations: In the event of a
disaster within the City of Ocoee or the contractor responds to a disaster
in a neighboring jurisdiction, normal operations shall be suspended and
the contractor shall respond in accordance with the respective disaster
planning document. The contractor shall use the best efforts to maintain
primary emergency services in the City. During the period of a declared
disaster or MCI, the City will not impose performance requirements for
response times and other performance criteria.
F. Service Inquiries and Managing Complaints
The contractor shall log all inquiries and service complaints, including complaints
involving billing and collection issues. The contractor shall provide prompt response and
follow-up to such inquiries and complaints. Such responses shall be subject to the
limitation imposed by patient confidentiality restrictions and HIPAA privacy rules.
The contractor shall on a monthly basis submit to the City a list of all complaints
received and their appropriate disposition/resolution. Copies of any inquiries and
resolutions of a clinical nature shall also be referred to the contractor's Medical Director
within (24) hours.
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Contract_Emergency_Ambulance_Services
It is the desire of the City that the contractor notify the Fire Chief regarding the most
egregious or criminal actions that could reflect negatively on the City or its employees.
In these situations it is essential that this notification be made as soon as possible and
apart from the monthly reporting process.
G. Prohibition of Contract Transfer without Prior Approval
The contractor agrees that they will not transfer or assign any provisions of the contract to
another entity or service provider without prior written approval of the City.
4. EMPLOYMENT PRACTICES
A. Personnel Qualifications and Staffing
All Ambulances rendering services under the contract shall be staffed and equipped to
render ALS level care. The paramedic shall be the primary caregiver for all emergency
patients and shall accompany all patients in the back of the ambulance during any
patient transportation except as otherwise permitted under Orange County protocols.
Minimum Staffing: The contractor is required to staff a minimum of one
(1) EMT-P and one (1) EMT-13. At the contractor's option the requirement
for EMT staffing levels on any units may be enhanced to higher levels of
training without obligation to the City.
2. Qualifications: Personnel will be appropriately certified or licensed by
the State of Florida and their functional privileges will be specifically
authorized by the Orange County Medical Director in accordance with
medical oversight policies.
3. Professionalism: The City expects and requires professional and
courteous control and appearance at all times from the contractor's
ambulance personnel, supervisors, middle managers and top
executives. The contractor shall address and correct any occasional
departure from this standard of conduct.
4. Employment Practices and Background Checks: All persons
employed by the contractor shall undergo a criminal record check
conducted by the contractor. It is the City's intent in requiring a criminal
record check that the contractor is aware of any felony or misdemeanor
convictions that could be a factor related to an individual's performance
in an EMS system. This should include, at a minimum convictions related
to driving under the influence, drug related offenses, and sexual offenses
including rape, child abuse, and spousal abuse. The contractor must
independently judge the employability and potential liability associated
with employing any individual with a past history of such offenses. The
contractor shall provide the City with its specific policies concerning
sexual harassment. In addition, the contractor shall provide as part of
this proposal its employment polices relating to the hiring of employees
with felony and misdemeanor convictions. The contractor shall not
employ or retain any employee whose Florida drivers' license is revoked
or currently suspended.
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Contract_Emerg ency_Ambulance—Services
5. Key Personnel: The City will, in part, base the award of the contract
upon the qualifications of the organization and upon the qualifications of
its key personnel. The contractor will be expected to furnish the
personnel identified in the proposal submitted and throughout the term of
the contract. The contractor is expected to furnish the same personnel
or replacement personnel with equal or superior qualifications. It is the
specific intent of this provision to prevent "bait and switch" bidding
practice whether intended or not.
6. Experience: The City will, in part, base its award on the experience of
the provider and key staff personnel in administering, managing, and
operating a 911 emergency transport system.
B. OSHA and Other Regulatory Compliance
It is the City's expectation that the contractor will adopt procedures specifically for the
City of Ocoee contract that will meet or exceed the regulatory requirements for
occupational safety and health including but not limited to infection control, blood borne
pathogens and Tuberculosis. These precautions shall be designed for both the safety of
ambulance personnel and City of Ocoee Fire Rescue Department first responders.
Additionally, such measures would include, but not be limited to written procedures and
directives, universal precautions, periodic training and safety alerts, annual medical
screenings and the wearing of personal protection equipment. The Contractor shall
insure adherence to all Health Insurance Portability and Accountability Act (HIPAA)
guidelines.
C. Discrimination Prohibited
Throughout the performance of the contract, the contractor agrees that it will comply
with all applicable provisions of federal, state and local laws and regulations prohibiting
discrimination. Specifically, the contractor warrants that it will fully comply with Title VI
and VI of the Civil Rights Act of 1964, as amended, the Americans with Disabilities Act
(ADA), and all other regulations promulgated hereunder. The contractor will not
discriminate against any employee or applicant for employment because of race,
religion, color, disability, national origin, sex, sexual orientation or age.
D. Establish a Drug -Free Workplace
The contractor agrees, in accordance with Florida laws, to establish a Drug -Free
workplace within its City of Ocoee operations. These guidelines will include, but not be
limited to:
A published statement notifying employee that the unlawful manufacture,
distribution, dispensing, possession, or use of a controlled substance is
prohibited in the workplace and specifying the actions that will be taken
against employees for violations of such prohibition.
2. Inform the employee about the dangers of drug abuse in the workplace,
the company's policy of maintaining a drug -free workplace, any available
drug counseling, rehabilitation, employee assistance programs and the
24
Contract_Emergency_Ambulance_Services
penalties that may be imposed upon the employees for drug abuse
violations.
3. Give each employee a copy of the statement specified in Paragraph 1.
4. Impose a sanction on, or require satisfactory participation in a drug
assistance or rehabilitation program, by any employee convicted of a
drug related crime or determined to be in violation of the contractors'
drug and alcohol control policy.
5. At the beginning of the contract period have a drug -testing program in
effect that addresses both pre -employment drug screening and the
periodic testing of employees.
5. FINANCIAL AND ADMINISTRATIVE PROVISIONS
A. Term of Contract and Renewal Provisions
The initial term of the contract ultimately executed by the contractor shall be for a period
of three (3) years beginning September 1, 2012. The City may offer, at its sole option,
and based in part upon the contractor's superior performance, two (2) twelve (12)
month renewals. The offer of extension shall be for one 12-month extension after the
completion of the initial three (3)-year contract period and then a second 12-month
extension at the completion of the first 12-month extension period. Each extension will
be considered independent of the other and will be offered at the sole option of the City.
If the City determines that an extension of the contract is warranted, such offer shall be
made at least six months prior to the scheduled end of the term of the contract or
previously granted extension.
B. Methods and Form of Compensation
The contractor receives a variety of compensation for providing services. The following
are the specific types of compensation available to the contractor in this procurement:
Market Rights: The City, except as otherwise outlined in these
specifications, shall utilize the contractor as the primary provider of
emergency response and ambulance transport services within the
defined service area boundaries.
2. User Fees: The primary financial compensation for the contractor for the
services rendered under this RFP will be from funds received for fee -for -
service billings and collections and contractual arrangements with
insurance organizations and other payers.
3. Local Subsidy: The City desires a no subsidy contract; however, the
Ocoee City Commission may include into the contract a final
subsidyluser fee mix if deemed appropriate. Any contractor fee subsidy
must include a rate and fee structure as well as any inflationary rate and
fee plan of said fee structure.
25
Contract -Emergency -Ambulance -Services
4. First Responder Assistance: The contractor shall have the benefit of
BLS and ALS level first responder services throughout the entire service
area.
5. Term of Offer: The term of the Respondent's offer shall be in effect for
at least 120 days from the closing date of this request for proposals.
C. Ambulance Fees and Guidelines for Rate Increases
The contractor shall be entitled to charge patients for the services rendered according
to the patient fee schedules included and proposed by the contractor as part of this
procurement process. The proposed rate schedule shall be in effect for the initial 12
months of operations and shall not be increased during this timeframe. All emergency
transport rates shall be based on the patient condition or the services rendered. There
is no intent on the City's part to require ALS care on every situation found.
The contractor shall provide as part of their proposal a comprehensive rate schedule for
all services, materials, medications, and other actions or items that may be billed to a
patient in the course of their treatment and transport. The contents and description of
the "Proposed Rate Schedule" shall include, but not be limited to the following:
• Whether a "bundled or unbundled" rate structure is being proposed.
• Single Base Rate Charge and what items are included and excluded
from the base charge.
• If "unbundled", a complete schedule of charges for medical supplies,
equipment, procedures or other services that may be charged to the
patient.
• Oxygen charge
• Mileage charge
• Emergency stand-by charge at special events
Disclosure of Fee Schedule: It is the City's desire to provide complete disclosure of all
charges and fees associated with the delivery of ambulance services. As such the
contractor shall establish as part of this proposal its full and complete rate schedule for
all services and charges. These charges shall be posted at the contractor's business
office, be made available as a handout to all patients and/or family members, and be
posted on the contractor's web page. The contractor may not deviate or alter the
established fee schedule without prior written authorization by the Ocoee City
Commission.
Rate Increases: The contractor may request a rate increase after the initial 12 months
of operations and base this requests on market factors, collection rates, and inflationary
impacts in the City of Ocoee area. Request for rate increases are to be made in writing
to City's Fire Chief. The Fire Chief shall investigate the situation and make a
recommendation to the Ocoee City Commission. All changes to ambulance rates are
made by the City Commission. Any contract rate structure increase shall be in effect for
a minimum of 12 months. In no instance may the contractor request more than one rate
increase within any consecutive 12 month period.
26
Contract_Emergency_Ambulance_Services
The Contractor agrees that City of Ocoee employees and family members who are
covered by current City of Ocoee health care benefits may be transported by the Ocoee
Fire Department.
In the event that patient transports are performed by the City of Ocoee Fire Department
in order to satisfy the requirements of the Orange County Medical Director's protocols
or for any other valid reason as determined by the City, and subject to the City acquiring
the Medicare and Medicaid numbers as described below, the City shall provide
necessary patient and billing information to the Contractor and Contractor shall act as
the City's billing agency for such claims. Contractor shall remit all funds received to the
City, minus an administrative fee of Twenty Dollars ($20.00) per claim. Both the City
and the Contractor agree that the aforementioned Contractor billing for transports
performed by the City of Ocoee Fire Department will not commence until after the City
obtains both Medicare and Medicaid numbers for their agency. Any necessary
transports performed by the City prior to that time will not be subject to billing.
D. Billing System and Access to Information
The contractor shall conduct all billing and collection functions for the EMS system in a
professional and courteous manner. The City's goal is for the contractor to collect the
maximum amount available from patients and third party payers, without unduly
pressuring those who legitimately cannot pay.
The Respondent must fully outline its billing and collection policies and procedures in its
proposal. This should include samples of invoices, reminders, telephone collection
methods, and handling accounts turned over to collection. Policies about acceptance of
assignment and write-off should be specifically addressed.
Local Access: A specified local phone number for inquiries from
patients and third party payers shall be provided by the contractor for
patient's use.
2. Web Page Access: The contractor shall provide billing and payment
information in a web based format. Patients shall have the opportunity to
make inquiries, access service fees and locate company contact
information.
3. On -scene Collection Prohibited: For services provided within the City
of Ocoee service area, the contractor shall not engage in on -scene
collection for local services at scene, enroute, or upon delivery of the
patient at the receiving medical facility.
4. Third -Party Billing and Collection: The contractor may engage, at its
sole expense, a third -party agent to provide EMS billing and collection
services.
5. Audits and Inspections: If requested by the City, the contractor shall
provide the City with an annual audited consolidated financial statement
prepared by an independent public accounting firm in accordance with
27
Contract_Emergency_Ambulance_Services
generally accepted accounting principles consistently applied.
Statements shall be available within 150 days of the close of each fiscal
year.
At any time during normal business hours and as often as may be reasonably deemed
necessary, City representatives may observe the contractor's office operations, and the
contractor shall make available to the City for its examination any and all business
records, including incident reports, patient records, and financial records of the
contractor pertaining to the contract. The City may audit, request a subsequent audit or
a special audit, copy, make transcripts, or otherwise reproduce such records including
but not limited to contracts, payroll, accounts receivable, inventory, personnel, and
other records, daily logs, employment agreements, and other documentation for the
City to fulfill its oversight role.
A City representative may ride as a "third -person" on any of the contractor's ambulance
units at any time, provided, that in exercising this right to inspection and observation,
City representatives shall conduct themselves in a professional and courteous manner,
shall not interfere with the contractor's employees' duties, and shall at all times be
respectful of the contractor's employer/employee relationship.
E. Federal Employer Identification Number and Corporate Identification
The contractor shall provide all vital and accurate information relating corporate
information as registered with State of Florida, the Florida Department of Business and
Professional Regulations, and the federal government. Such information shall include at
a minimum but not limited to the following:
• Name of corporation
• Type of corporation
• Authorization to transact business in Florida
• Registration of any fictitious names
• Names of officers
• Corporate address
• Federal identification number
• Contact person for company
• Name and title of person authorized to sign legal documents on behalf of
the company
F. Demonstration Depth and Stability of Financial
Respondents may be required to provide evidence of financial stability, which clearly
documents the financial history of the organizations and demonstrates that the
Respondent has:
The financial capacity to Dandle the expansion (including implementation
and start-up costs) necessitated by the award of the contract.
Respondents shall include copies of its financial statements for the most
recent two-year period. Audited financial records are preferable. If
audited financial records are unavailable, Respondent must provide un-
audited financial statements supported by federal tax returns. In cases
28
Contract —Emergency —Ambulance —Services
where the Respondent is forming a new entity, the financial records of
the parent company shall be available for review.
• Has expertise in billing Medicare -Part B and other 3rd party payers of
ambulance services (or contracts with a third -party agency with
necessary expertise).
• Respondent shall provide information, which demonstrates a clear and
convincing capability to implement and manage a billing and collection
system. The Respondent should include information about what steps,
policies, procedures, training, equipment and management techniques
would be utilized on award of the contract.
• Has the ability to secure insurance coverage's required under this
procurement. Any existing self-insurance plan used for the purpose of
qualification must substantially meet the requirements set forth in the
RFP.
• Respondent shall detail any and all notifications of pending insurance
(separate listing for auto and professional liability) claims, investigations,
and settlements including both status and resolution.
(Remainder of page left blank intentionally)
29
Contract —Emergency —Ambulance —Services
EXHIBIT C
Insurance
The Contractor shall maintain insurance coverage reflecting the minimum amounts and
conditions required by the City.
The Contractor shall not commence any work in connection with the contract until all of the
following types of insurance have been obtained and such insurance has been approved by the
City, nor shall the Contractor allow any subcontractor to commence work on a subcontract until
all similar insurance required of the subcontractor has been so obtained and approved.
Policies other than Workers' Compensation shall be issued only by companies authorized by
subsisting certificates of authority issued to the companies by the Department of Insurance of
Florida which maintain a Best's Rating of "A" or better and a Financial Size Category of "VII" or
better according to the A.M. Best Company. Policies for Workers' Compensation may be
issued by companies authorized as a group self -insurer by F.S. 440.57, Florida Statutes.
a) Loss Deductible Clause: The City shall be exempt from, and in no way liable for, any
sums of money which may represent a deductible in any insurance policy. The
payment of such deductible shall be the sole responsibility of the Contractor and/or
subcontractor providing such insurance.
b) Workers' Compensation Insurance: The Contractor shall obtain during the life of the
contract, Worker's Compensation Insurance with Employer's Liability Limits of
$500,000/$500,000/$500,000 for all the Contractor's employees connected with the
work of this project and, in the event any work is sublet, the Contractor shall require the
subcontractor similarly to provide Workers' Compensation Insurance for all of the
latter's employees unless such employees are covered by the protection afforded by
the Contractor. Such insurance shall comply fully with the Florida Workers'
Compensation Law. In case any class of employees engaged in hazardous work under
the contract for the City is not protected under the Workers' Compensation statute, the
Contractor shall provide, and cause each subcontractor to provide adequate insurance,
satisfactory to the City, for the protection of the Contractor's employees not otherwise
protected. The policy shall include a Waiver of Subrogation in favor of the City.
c) Contractor's Public Liability and Property Damage Insurance. The Contractor shall
obtain during the life of this Contract COMMERCIAL AUTOMOBILE COVERAGE, this
policy should name the City of Ocoee as an additional insured, and shall protect the
Contractor and the City from claims for damage for personal injury, including accidental
death, as well as claims for property damages which may arise from operations under
this Contract whether such operations be by the Contractor or by anyone directly or
indirectly employed by the Contractor, and the amounts of such insurance shall be the
minimum limits as follows:
1) Automobile Bodily Inmury Liability & Property Damage Liability
■ $1,000,000 Combined single limit per occurrence (each person, each
accident)
■ All covered automobile will be covered via symbol 1
■ Liability coverage will include hired & non -owned automobile liability
• Include Waiver of Subrogation in favor of the City
3J
Contract —Emergency —Ambulance —Services
2) Comprehensive General Liability (Claims Made From) - this policy should name
the City as an additional insured and should indicate that the insurance of the
Contractor is primary and non-contributory. When coverage is written on a
claims made basis, any change in carriers requires that the retroactive date will
include the previous terms and Contractor shall provide City thirty (30) days
advance notice of such change. if there is a change in the coverage form, tail
coverage will be secured for a period of not less than two (2) years.
■ $2,000,000 GENERAL AGGREGATE
■ $2,000,000 PRODUCTS -COMPLETED OPERATIONS AGGREGATE
■ $1,000,000 PER OCCURRENCE
■ $1,000,000 PERSONAL & ADVERTISING INJURY
• Include Waiver of Subrogation in favor of the City
3) Subcontractor's Comprehensive General Liability, Automobile Liability and
Worker's Compensation Insurance: The Contractor shall require each
subcontractor to procure and maintain during the life of this subcontract,
insurance of the type specified above or insure the activities of these
subcontractors in the Contractor's policy, as specified above.
4) City's Protective Liability Insurance: NIA.
5) Contractual Liability: If the project is not bonded, the Contractor's insurance
shall also include contractual liability coverage to insure the fulfillment of the
contract. NOTE: FOR PUBLIC LIABILITY INSURANCE AND AUTOMOBILE
LIABILITY INSURANCE, THE CITY SHALL BE NAMED AS ADDITIONAL
INSURED.
$1,000,000 PER OCCURRENCE
$2,000,000 AGGREGATE
6) Commercial Umbrella:
$1,000,000 PER OCCURRENCE
$2,000,000 Aggregate
Including Employer's Liability and Contractual Liability
7) Builders Risk: NIA
8) Certificates of Insurance: Certificate of Insurance Form (see sample below),
naming the City as an additional insured will be furnished by the Contractor
upon notice of award. These shall be completed by the authorized Resident
Agent and returned to the office of the Purchasing Agent. This certificate shall
be dated and show:
i) The name of the insured Contractor, the specific job by name and job
number, the name of the insurer, the number of the policy, its effective
date, its termination date.
if) Statement that the insurer shall mail notice to the City at least thirty (30)
days prior to any material changes in provisions or cancellation of the
32
Contract_Emergency_Ambulance_Services
policy, except ten (10) days written notice of cancellation for non-
payment of premium.
�t pP� CERTIFICATE OF LIABILITY INSURANCE oP to ° °"`°"aY0"""L'
0ISDRERa ALFOROIRO COWMWE rim Y
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COVERAGES
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aeucrrLar WOIeNATgxaIEOCAIOWIYFIICL[a1EM9l¢naWIi e1 erWrelraCll PROMLIOx!
-bell
The ertil L3nevrane:e Ovideuded by this eOate - shell pema tLa e■rti Eieate
holder■ ee an additional ineuvad on the Oeueral Liability a pwbralla
Liability. Wdrkere' Cr®Llan.ation, Mayers' Llehility a 0■eera1 Liability
shell contain a Weivar o! H¢brogetion in favOc of the c■rti Eldatw kolder.
Lcata holder 1e added s■ a 1®d ...'d for Bd cb� fb$L,
The certil
CERTIFICATE ""UM - ---- -
OCaHt01 axoLanPKy oP rPeAeoveoPecaeeormwaee wcuua eeraleTxewwTgx
arETxwa.rxeeauxo wlLmeaxeL EanuuoLl rd xaL 10 eArsnxn'IUL
xoTrero txc crmaLEATe nrmEa xueeororxaurr, IIII PxaVae ro w w! WiL
City 0! 0cdea _EHepnx Ie "Luse W xM X" MR THE R IAMUR--am
150 W. Lakeshore Drive avaewLralnnA.
Oeoea !L 14761-2155 nrneeaeoevIWFA e
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33
Contract —Emergency —Ambulance —Services
EXHIBIT D
Contractor's Response to City of Ocoee's RFP ##12-005
34
Contract_Emergency_Ambulance_Services
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
A "" CERTIFICATE OF LIABILITY INSURANCE
�oaEcata of ca 1 Lrr7�
Q- DE=
"Flual r
DATE(NII, —M)
11 ov:017
THIS CERTIFICATE 13 19SUEU AE, A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVEiLY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERjS), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER,
IMPORTANT: It the eeHlRaale holder Is an ADD T O L INS RED, the poIlaNles) must 6e eadors B ROGATION IS WAIVED, eB eat to
the lemlt and oondHlont al Iho pollcy, codaln pollclet may require an emdorsenunl, A statenlanl oR this cerflBeate does no( confer rights to ilia
cart,froato holder In How of suoh endoisemant1Q,
PRODUCER
Aan Risk Insurance Servlce5 west, Inc.
Phoenix AI Office
,jp. F.1 (006) 263-7122 Ib C6T2) 013•5790
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75Ss Last ramelbAck Rd,
sus to 700
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14SUAEa A: ACE American Insurance Cowpony
22667
Rural/Metro Corp. and all Subsidiaries
Affiliates, and Other Business Assoc.
owned operated of controlled by
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INSURER 0; 1-01109ton I115urallce company
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THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BE OW NAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. 140IWITKSTANOING ANY REQUIRELLENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RE8PEOT TO WHICH THIS
CERTIrwATE NAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS 9UDKOT TO ALL THE TERMS.
EXCLUSION& ANDCONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAR)CLAWS. Llmhs shown era as lagtlested
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SIR applies Per policy ter
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PFCgRIPUOa PF PAb1ATIDN9 rLOr:ATlDit9 rVEIefLES IA}beh ACORP lei, AXY21oru1 Renvhs 5<hnlWr, irnvFspx, 6regWrtel
City or Ocoee is included RE Addi LlodAl Insured as IV uired by written contract, but lilli Led to tba pellati.ol of the Insured
under said contract per the applicable ando—Oiint with ovspect to Wv Cunural LiabiliLy tool AutOO-bile Liability policies.
The Oeueral Liability coveragpe e0denited herein is Pr'inary RIW Nan-eagtrOutory to other insurance availahle to the
certificate Rolder but only CO the aktent regained 4y wrlccen contract with the Insured, A waiver of subroyati on is granted
in favor or certificate Bolder as required by written contract but limited to the operations of the Insured under said
contract, with rasped to the Genar,t Liabill ty, AUTomobile Liability and h'orkers' compensation policies.
CFRTIFICATF HOLDER CANCELLATION Tr.I
INOOLP NIV OF 711E ABOVE DESCRIDED FOUMS BE CAjxnLED BEFORW THs
EAPIRAIgII DATE TION&OF. NOTICE WALL Be DELIVERED IN AOC B.Ce WIN 111E
AOLicy FROYi510115
. -
city of vcvte AUrHaAIIEPREP0EIEI1TA1rK
ISO N. Lakeshore Drive FA
OCBCC FL 34761-2ZS8 USA all
,-kAA.�fit .
4DJOSS-2010 ACORO CORPORATION, All rights roservad.
ACORD 26(201010S) The ACORD name eml logo are regletolcd mooki of ACORD
RFA# 12-005 Rriral/MEfro, Page 165
Rural/Metro
ambulance
City of Ocoee Finance Department/Purchasing
Joyce Tolbert, Purchasing Agent
150 N. Lakeshore Drive
Ocoee, FL 34761-2258 ACCR$DITE'D
Ms. Tolbert & Selection Committee:
It is my pleasure to submit Rural/Metro of Central Florida's response to the City of Ocoee's
Request for Proposals (RFP) #12-005 for Emergency Ambulance Services. In submitting this
proposal, we affirm our understanding of and ability to meet the Program Responsibilities
delineated in the RFP and its Addendum.
Rural/Metro has been a reliable partner in the City of Ocoee's EMS system since last fall, when
we acquired Health Central Paramedic Services. We were fortunate to retain Health Central's
dedicated EMS professionals, who have decades of combined experience serving the City and
have deep roots in West Orange County. This team was instrumental in ensuring a smooth
transition, and they remain committed to meeting Ocoee's emergency 911 response needs.
As the first ambulance service provider in the State of Florida to achieve accreditation by the
Commission on Accreditation of Ambulance Services (CAAS), Rural/Metro of Central Florida can
provide the City's residents and visitors with cutting -edge patient care and medical
transportation services that meet the industry's highest standards of excellence. In addition,
the Ocoee operation is backed by substantial regional and national resources that provide an
unparalleled safety net in the event of a major disaster in Ocoee.
We welcome the opportunity to strengthen our current partnership with the City and Ocoee
Fire Rescue under a new contract. Please feel free to contact me directly with any questions
regarding Rural/Metro's proposal.
Warmest regards,
Chris Blach
Division General Manager
Christopher.Blach@rmetro.com
(407) 578-3601
t
Rur81/MM17'
ambulance
Table of Contents
ExecutiveSummary......................................................................................................................... 1
I. Introduction................................................................................................................................. 2
A. Description of the Proposed Organizational Structure.......................................................... 2
B. Deployment Plan.................................................................................................................... 7
C. Characteristics of a High Performance EMS Model.............................................................. 20
II. Clinical Performance................................................................................................................. 24
A. Medical Director Credentials/Experience............................................................................ 24
B. Suggested Medical Protocol Compliance Process................................................................24
C. Clinical Credentials of Field Personnel.................................................................................. 26
D. Medical Equipment and Supplies.......................................................... ............. 27
..................
E. Financial Reserve for Clinical Upgrades................................................................................ 29
F. Quality Improvement Program Processes............................................................................ 30
G. In -Service Training................................................................................................................ 34
H. Employee Recruitment, Screening and Orientation............................................................ 37
I. Incorporation of Area Hospitals In Service Delivery Model ................................................... 45
III. Human Resources.................................................................................................................... 46
A. Employee Work Schedules...................................................................................................46
B. Health and Safety Programs................................................................................................. 46
C. Re -Employment of Current Workforce................................................................................. 50
IV. Customer Service Monitoring and Development.................................................................... 52
A. Program Development......................................................................................................... 52
B. Mechanisms, Record Keeping and Time Frames for Resolution of Customer Service
Inquiries(Non-Billing).............................................................................................................. 52
V. Fleet and Equipment Issues...................................................................................................... 60
A. Number of Vehicles Needed................................................................................................. 60
B. Ambulance and Equipment Maintenance Practices............................................................. 60
C. Equipment Replacement...................................................................................................... 65
� m Rural/Meir�e°
Ambulance
VI. Billing and Collection............................................................................................................... 68
A. Billing Processes to Maximize 3rd Party Payments............................................................... 68
B. Mechanisms, Record Keeping and Time Frames for Resolution of Customer Service
Inquiries(Billing) ...................................................................................................................... 78
C. Examples of Transport Collection Audits.............................................................................. 79
VII. Organizational Experience and Key Personnel....................................................................... 81
A. Experience Providing Similar Service.................................................................................... 81
B. On -Site and Off -Site Personnel............................................................................................. 87
Vill. Administrative/Financial........................................................................................................ 95
A. Transition Plan/Schedule...................................................................................................... 95
B. Provision of Insurance.......................................................................................................... 97
C. Method of Providing Required Reporting for Performance Measurements ..................... 103
D. Delineation of Ambulance Service Zones........................................................................... 105
E. User Fee Information.......................................................................................................... 107
F. Term of Offer....................................................................................................................... 109
G. Proposed Design of Company Web Page........................................................................... 116
IX. Other Required Content........................................................................................................ 117
A. Forms Listed on Table of Contents..................................................................................... 117
�Conclusion................................................................................................................................... 124
Attachments................................................................................................................................ 125
Attachment 1: Disaster Response Shelter Information & Agreement ................................... 125
Attachment 2: ZOLL RescueNet ePCR Information................................................................ 128
Attachment 3: Harassment & Background Screening Policies ............................................... 133
Attachment 5: Supervisor Training Program Outline............................................................. 141
Attachment 5: Drug & Alcohol Use Policy.............................................................................. 144
Attachment 6: Transport Collection Audit Policy................................................................... 153
Attachment 7: Letters of Recommendation........................................................................... 160
Attachment 8 Certificate of Insurance................................................................................... 164
Attachment 9: DriveCam Information Sheet.......................................................................... 166
Attachment 10: Local Ad & Media Coverage Featuring Rural/Metro.................................... 168
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
Executive Summary
Rural/Metro of Central Florida is a
leading private provider of
emergency and non -emergency
medical transportation services
within the State of Florida. We bring
more than 27 years of medical
transportation experience to the
City of Ocoee, where we serve as
the current 911 provider. Our local
service team has decades of hands-
on experience in Ocoee, as the
majority of employees who worked
in the City's EMS system as
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quality 911 medical response in partnership with
the City and Ocoee Fire Rescue Department.
employees of Health Central Paramedic Services transitioned to Rural/Metro last fall following
our acquisition of the hospital's ambulance service. These dedicated EMS professionals enjoy
strong personal and professional ties to the community, and we are thrilled to have them on
the Rural/Metro team.
On a national level, Rural/Metro is backed by one of the industry's finest medical transportation
companies. Rural/Metro Corporation has 64 years of experience, and serves more than 425
communities throughout the country. Our corporate leadership team provides a depth of
resources and expertise that few medical transportation companies can match.
Rural/Metro of Central Florida was the first ambulance provider in the state to achieve the
gold -standard of accreditation by the Commission on Accreditation of Ambulance Services
(CAAS, www.caas.org). We remain only one of nine companies in Florida with this distinction.
CAAS provides third -party verification that Rural/Metro meets or exceeds the industry's most
rigorous standards. Importantly, it communicates to Ocoee's residents that their EMS provider
is qualified to deliver the care they or their loved ones need during an emergency.
Our proposal offers an in-depth look into Rural/Metro's operations, and explains how we are
and will continue to be a steadfast partner to Ocoee Fire Rescue and the City. Rural/Metro
remains absolutely committed to ensuring the delivery of world -class emergency medical
services. Our EMS program offers multiple value-added services. Program highlights include
unparalleled fleet and staff surge capacity, state-of-the-art communications and reporting
tools, and aggressive operations -wide quality improvement processes.
RFP# 12-005 0 Nurellffletra Page 1
RmBulanee
���cnlcf o! Cm�rf L,y,�
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES QC�
FOR THE CITY OF OCOEE __
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I. Introduction
A. Description of the Proposed Organizational Structure
RFP: The contractor shall be responsible for furnishing and managing all personnel required in
the delivery of ALS emergency ambulance transport operations. (C. Contractor's Responsibilities,
p 19)
Rural/Metro Corporation is a leading provider of emergency and non -emergency medical
transportation services in approximately 425 communities throughout the United States.
Providing the highest levels of patient care and transportation is our No. 1 priority.
With more than 60 years of experience, Rural/Metro has established integrated partnerships
that ensure superior customer service and continuous quality improvement. Our success stems
from unparalleled system transparency, seamless integration with fire agencies, and dedicated
cooperation with local government and community leaders. As the City of Ocoee's ALS
ambulance transportation provider, Rural/Metro will apply each of these core principles to
create a model EMS system in the State of Florida.
Rural/Metro Corporation of Florida's
knowledgeable management team has decades
of combined experience in emergency medical
services and public safety, and is ready to
continue providing seamless service to the City
of Ocoee. Our local leadership has the proven
experience to sustain the type of integrated
EMS system Ocoee seeks in its RFP.
Rural/Metro leads the industry in creating collaborative EMS systems, breaking down barriers
to develop close and cohesive relationships with our partners in public safety, public health and
health care. We view ourselves as a small but critical piece of the larger continuum of patient
care, and we look for opportunities to collaborate with other stakeholders to create efficiencies
and opportunities that others often miss.
We will continue to work !land -in -hand with the City and Ocoee Fire Department to ensure
patients throughout the service area receive the same excellent care at the lowest possible
cost. Our proposal envisions a fully integrated system in which training, clinical quality
assurance and improvement, and patient data management are consistent between the first
responders and Rural/Metro. This consistency will lay the groundwork for broader City
initiatives, such as participation in clinical studies, public health initiatives and national EMS
research activities.
RFP# 12-005 11irAwatp° Page 2
AMMANoce
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
tft
To achieve this level of integration, Rural/Metro proposes the formation of an Ocoee EMS
Advisory Board, depicted below, with representation from stakeholders throughout the system.
The System Advisory Board will ensure that our strategic initiatives are on the right course, that
we meet our objectives, gain stakeholder insight and maintain system transparency.
OCOEE EMS SYSTEm ADVISORY BOARD
Members Duties
Ocoee Fire Department — 2
Meet quarterly
City EMS System Administrator-1
Set strategic initiatives
Rural/Metro — 2
Review financial data
HospitaD/Trauma Center-1
Ensure contract compliance
Community Stakeholders — 2
Within the Rural/Metro
organization, we will have a full-
time, on -site Manager who
reports to Rural/Metro of
Florida's Division General
Manager. An organizational
chart for the team who will be
responsible for our on -going
success in the City of Ocoee is
provided on the following page.
providing uninterrupted service to the City of
Ocoee.
RFP# 12-005 JIMBu�eiro Page 3
ambulance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
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RFP# 12-005 IJIR'al/Me�ry Page 4
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
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RFP# 12-005 Rural/Metro' Page 5
RMaulonce
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
Federal Employer Identification Number and Corporate Identification
RFP: The contractor shall provide all vital and accurate information relating to corporate
information as registered with State of Florida, the Florida Department of Business and
Professional Regulations, and the federal government. Such information shall include at a
minimum but not limited to the following: (F. Federal Employer Identification Number and
Corporate Identification, p. 30)
• Name of Corporation: Rural/Metro Corporation of Florida
• Type of Corporation: Florida Profit Corporation
• Authorization to Transact Business in Florida: Licensed in the State of Florida by the
Department of Health — Division of Emergency Medical Service to operate in the
Counties of Seminole, Orange, Osceola and Sumter
• Registration of any Fictitious Names: Rural/Metro Ambulance
• Names of Officers:
Michael DiMino
Chris Kevane
Kevin Moore
Yvonne Martinez
Jeffrey Perry
Jorge Perez
• Corporate Address:
Nural/Metro
AmbWance
Rural/Metro Corporation of Florida
Rural/Metro Corporation (parent company)
4728 Old Winter Garden Road
Orlando, FL 32811
9221 E Via De Ventura
Scottsdale, AZ 85258
• Federal Identification Number: 590934668
• Contact Person for Company: Division General Manager Chris Blach, (408) 578-3601;
christopher.blach@rmetro.com
• Name and Title of Persons Authorized to Sign Legal Documents on Behalf of the
Company: Michael DiMino, CEO, or Chris Kevane, Senior VP and General Counsel
Local Office Space
RFP: The contractor shall be responsible for providing local office space, within Orange County,
for customer assistance, billing activities, and administrative oversight.
RFP# 12-005 0 RrmaUllfetr0 Page 6
AMAWBW
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
RFP: The contractor business office shall maintain reasonable business hours and be located
within Orange County. The contractor shall establish and maintain a published telephone
number for customer contacts and an updated and interactive web -page for customer service,
including posting up to date transport fee schedules and the disclosure of corporate contact
information. (Contractor's Responsibilities, p. 20)
Rural/Metro will continue to provide local office space, within Orange County, for customer
assistance, billing activities, and administrative oversight. Our supply facility is located at 2700
Old Winter Garden Road in Ocoee, and our headquarters for West Orange County is just down
the road in Orlando at 4728 Old Winter Garden Road. This facility includes supervisor offices,
administration, fleet services and dispatch. We are committed to maintaining facilities within
Orange County throughout the term of the contract. We will continue to publish customer
service contact numbers on our local, interactive website. A customized page will be
established for Ocoee that includes the rate schedule and disclosure of customer service and
other desired information.
B. Deployment Plan
Coverage and Availability
RFP: These specifications are for a performance contract. The City neither accepts nor rejects the
contractor's level of effort estimates, rather the City accepts the contractor's financially
guaranteed commitment to employ whatever level of effort is necessary to achieve response
time and performance results required by the terms of the contract as outlined in these
specifications, (Coverage and Availability, p. 22)
Rural/Metro understands and agrees that this is a performance -based contract. We will
financially guarantee commitment to employ the level of effort necessary to achieve the
response time and performance results required by the contract terms.
Initial Ambulance Coverage Plan
RFP: Notwithstanding the above, the proposals must include descriptions of Respondent's initial
ambulance coverage plans for the City of Ocoee service area, the number of ambulance and
reserve ambulance units required, supervisory units, personnel and other components that it will
utilize to meet the performance standards required herein. Acceptance by the City of the
Respondent's offer shall not be construed as acceptance of the Respondent's performance. (C.1.
Initial Ambulance Coverage Plan, p. 22)
RFP# 12-005 Rural a ro Page 7
Rmu7alance
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
As the current provider, Rural/Metro has the experience and historical data to develop a
deployment plan which specifically meets the current and future needs of the City of Ocoee.
We also have a rich history of using and developing cutting edge advanced deployment
processes and tools used to create these types of plans in all of our 911 markets across the
Country.
Rural/Metro currently runs a deployment system which fully integrates the communities of
Ocoee, Windermere and Winter Garden. By integrating these communities in our deployment
plan, Rural/Metro is capable of achieving efficiencies and utilizing vast more resources for
coverage then would be capable from serving the City of Ocoee on its own.
The initial deployment plan proposed is identical to the one deployed today. We do so because
this plan is currently working and at this point requires no adjustments. This plan deploys 5
units during peak periods of the week and more than fully covers the demand patterns
throughout the week. The following graph contrasts the current demand of the system against
our proposed schedule:
Q Current Demand �Cunerll8 Proposed Sth6d�fe
0
S&ffi��&,igAgP;aVE�GrA92
RFP# 12-005 Page 8
ambUMM
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
As one can easily see, our staffing patterns are both consistent with the demands of the current
system and in many cases exceed the demand of the system during important potential high
demand periods of the week.
To supplement our current dedicated units assigned to these communities, Rural/Metro also
has the ability to access 60 ambulances from our local operations for back up during unusual
periods of high demand or during disaster response situations from our operation in the City of
Orlando. No other provider can even come close to the backup surge coverage Rural/Metro can
provide, given our size and presence in Orange County.
Rural/Metro will initially deploy 692 unit hours per week. The hours Rural/Metro will deploy by
hour of day and day of week are included in the table below:
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Rural/Metro also has one Field Supervisor available 24/7 to respond to large emergency
responses or for times when a liaison is necessary to handle administrative inquires. We will
also staff a Supervisor 24/7 on one of the ambulances deployed in the system.
RFP# 12-005 Row
Page 9
Rmb�►lance
Rural/Metro also has one Field Supervisor available 24/7 to respond to large emergency
responses or for times when a liaison is necessary to handle administrative inquires. We will
also staff a Supervisor 24/7 on one of the ambulances deployed in the system.
RFP# 12-005 Row
Page 9
Rmb�►lance
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PROPOSAL TOPROVIDEEMERGENCYAMBULANCESERVICESFOR THE CITY OF OCOEE
Our priority posting locations are provided in the map on the following page. The map also
shows the coverage from these locations with an 8-minute drive contrasted against historic
emergency call locations.
historical call demand data to ensure equitable response times throughout the
service area.
R F P4# 12-005 40 Rural/Metro' Page 10
aMArrlance
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
Ambulance Service Zones
RFP: The contractor shall establish a series of ambulance service zones to analyze alarm
activities throughout the City of Ocoee service area. These zones shall coincide with the fire
department response areas. Numbering of the service zones shall be consistent with City of
Ocoee Fire Rescue Department station response areas. (C.2. Ambulance Service Zones, pp. 22-
23)
Rural/Metro will establish ambulance service zones to analyze alarm activities. These zones will
coincide with the fire department response areas, and the number of the service zones will be
consistent with the City of Ocoee Fire Rescue Department station responses, as depicted below.
�ha Cenl'.���
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Legend
,.0 Strategic Post Locations
Ocoee Reporling Districts
® OE2501
- OE2502
- OE2503
OE2504
OE2601
- OE2602
_ OE2r,03
- OE2604
r� OE3901
r - OE3902
- OF3903
_ Ocoee
in Windermere
�L 1 WinlerGarden
RFP# 12-005 Rrn'8I/Melro Page 12
Ambulance
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
24/7 Coverage
RFP: it is the intent of this RFP to ultimately enter into an agreement with the contractor that
ensures the prescribed services will be available on a 24-hour a day basis, seven days a week,
and 365 days a year. It is further understood by the contractor that there will be certain periods
of time during the year that service demand will exceed the normal daily call volume. During
these heightened periods of demand (City cultural and celebration events, man-made or natural
disasters, hurricanes, mass casualty events, and transportation accidents) the contractor will
rapidly increase its staffing and available ambulances in response to these peak demand
periods, The contractor is required to provide emergency contact information and maintain the
accuracy of this information, in order to contact key personnel during a critical emergency or
during disaster situations. (C.3, 2417 Coverage, p. 23)
Rural/Metro understands that the City, through the RFP, intends to enter into an agreement
with a contractor to ensure the prescribed services on a 24-hour-a-day basis, seven days a
week, and 365 days a year. We understand that there will be certain periods of time during the
year that service demand will exceed the normal daily call volume. During these heightened
periods of demand (City cultural and celebration events, man-made or natural disasters,
hurricanes, mass casualty events, and transportation accidents) Rural/Metro will rapidly
increase staffing and available ambulances in response to these peak demand periods. In
addition to our five dedicated units, Rural/Metro has a local fleet of 60 additional vehicles that
can be placed into service as necessary to meet unusual demand.
The On -Duty Crew Chief and Market General Manager Tom Daniels and Division General
Manager Chris Blach will be available to the City on a 24/7 basis. Emergency contact
information will be provided to the City and updated as necessary to ensure access to the
leadership team during a critical emergency or disaster situation.
Computer Aided Dispatch (CAD) System & Radio System
RFP: The contractor shall be responsible for providing and operating an ambulance CAD system
or dispatch and radio system. (C. Contractor's Responsibilities, p. 19)
Rural/Metro utilizes ZOLL's RescueNet Computer Aided Dispatch (CAD) system for dispatch
services. RescueNet Dispatch is a user-friendly, state-of-the-art EMS CAD solution that helps
streamline call -taking and dispatch while reducing response times. It utilizes intuitive modules
that collect important trip information so future calls can be more efficient. A RescueNet Web
Viewer allows for the easy monitoring of vehicle status. The system fully integrates with both
the RescueNet ePCR system and Rural/Metro's billing system, allowing for the efficient
RFP# 12-005 ib p l �� p Page 13
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
RescueNet'
collection of patient care data from the time of the call for help through delivery of the patient
to the hospital.
Radio System
Rural/Metro owns and maintains a UHF radio system. All Rural/Metro vehicles and base
stations in Central Florida are fully capable of communicating with each other via this system.
Three separate frequency pairs are licensed to Rural/Metro exclusively for ambulance
operations. Each frequency pair is broadcast via its own repeater. To ensure redundant back-up
and overlapping coverage, these repeaters transmit from three geographically separate tower
sites; two in Orange County and one in Sumter County. To provide yet another layer of
redundancy, all state required EMS frequencies are included in the programming matrix of
every Rural/Metro UHF ambulance radios.
EMS physician via an 800MHz radio.
In addition to Rural/Metro's own UHF
system, all ambulances and dispatch
centers are equipped with radios that can
operate on the state's 800MHz mutual aid
channels as well as all emergency
departments covered by the Orange
County radio system. Should crews need
immediate guidance from the on-line EMS
physician, all 800MHz radios are
programmed with the Orange County EMS
Medical Control talk -group. Ambulances
dedicated to the Ocoee response area
have the additional capability of
communicating via P25 digital talk -groups
authorized by the controlling agency
RFP# 12-005 40 �m ONO ° Page 14
�CertLCY of G� L!P
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FORTH E CITY OF OCOEE
Pla�ldf
._Changes to Deployment Plans
RFP: The contractor will apprise the City fully of any changes or modification in its deployment
practices or anticipated deployment practices that could alter service delivery. (C. Contractor's
responsibilities, p. 20)
Rural/Metro continually monitors deployment to ensure adequate coverage throughout the
service area. We will keep the City apprised of any changes or modifications in deployment
practices or anticipated deployment practices that could alter service delivery.
EMS Standby at Special Events
RFP: The contractor sholl be responsible for providing EMS Standby at special events as
requested. (C. Contractor's Responsibilities, p. 20)
Rural/Metro will provide EMS standby at special events as requested.
Integration of the City of Ocoee Fire Departments as First Responders
RFP: Currently, City of Ocoee Fire Rescue provides ALS service from its responding units. On oil
incidents, the senior City of Ocoee Fire Rescue Department officer will be responsible for incident
command as espoused by the National Incident Management System (NiMS). The incident
commander may, when appropriate, designated the contractor's EMS supervisor or lead
paramedic as the medical group supervisor based on NiMS procedures. Primary patient care will
be the responsibility of the agency that arrives on scene first and initiates patient care, When
initiated by fire service personnel, primary patient care may be turned
over to the contractor's paramedic for continuance of care and
transportation. Fire personnel will support the care provided by the
contractor on -scene, and when the situation warrants, will accompany
ambulance in the ambulance by providing care enroute to the hospital.
(D. Integration of the City of Ocoee Fire Departments as First
Responders, p, 23)
As the current ambulance service provider, Rural/Metro's field personnel work cooperatively
with the Ocoee first responders. We remain committed to strengthening these relationships to
promote cohesive relations between the organizations and to provide seamless patient care.
We understand and agree that the City of Ocoee Fire Rescue paramedics will continue to
provide ALS service from their responding units. On all incidents, the senior City of Ocoee Fire
Rescue Department officer will be responsible for incident command, as espoused by the
National Incident Management System (NIMS). We further understand that the incident
RFP# 12-005 Rmanee a Page 15
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
commander may, when appropriate, designate the Rural/Metro EMS supervisor or lead
paramedic as the medical group supervisor based on NIMS procedures. Our staff is trained to
comply with the NIMS system.
Rural/Metro also understands and agrees that primary patient care will be the responsibility of
the agency that arrives on scene first and initiates patient care. When initiated by fire service
personnel, primary patient care may be turned over to the Rural/Metro paramedic for
continuance of care and transportation. We understand and agree that fire department
personnel will support the care provided by the contractor on -scene, and when the situation
warrants, will accompany the patient in the ambulance by providing care en route to the
hospital.
In addition to honoring and respecting Ocoee Fire Rescue's role in the EMS system, including
adherence to NIMS and the first responders' role in patient care, we propose to enhance
integration between the two organizations through several avenues, including:
• Continuing Education: All Rural/Metro continuing education courses will be open to the
first responders at no cost to the City. These joint training opportunities promote
seamless patient care and can be tailored, in coordination with the Medical Director, to
address specific system issues.
• Grand Rounds: We propose to conduct one "Grand Rounds" program per month. These
special educational programs would include 1 hour of case review and one hour of
coordinated continuing education with the Fire Department.
• ePCR Compatibility: Rural/Metro's ZOLL RescueNet ePCR system provides the
opportunity for the two organizations to potentially integrate patient reporting, should
the City decide to choose the ZOLL program. Rural/Metro has more experience
deploying the ZOLL system than any other provider, and will lend technical guidance to
the City to promote the smooth transition from paper to electronic records. In addition,
we will share our staff ePCR training materials and protocols with the City to serve as
templates.
• Monitor Compatibility: Rural/Metro has deployed brand-new LifePak 15
monitor/defibrillators in Ocoee —the same monitors used by the first responders.
• Billing Support: Rural/Metro proposes to establish the City as a "subcontractor" for the
purposes of billing and collections. Designating the City as a Rural/Metro subcontractor
will allow us to legally bill for and remit payments for the City for transports provided by
the Fire Department.
RFP## 12-005 j 1?ural�Metrn Page 16
A'NAWWnce
���Gtler of G�fL,p�
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
FlarSda
• Coordinated Community Education & Outreach: Rural/Metro will gladly participate in
Fire Department -sponsored educational events and open houses, and will support
coordinated campaigns to address specific health and safety concerns in Ocoee,
• Staffing of Ambulance Units with Fire Personnel: Rural/Metro will provide
opportunities for Fire Department paramedics to staff ambulances to help support their
recertification requirements.
• Firefighter Rehab Services: Rural/Metro will
provide specialized Firefighter Rehabilitation
services to the City of Ocoee at the scene of
working fires. Our call out for rehab will occur
on all Second Alarm or higher fires, fires where
people are trapped and anytime upon the
request of the on -scene Incident Commander.
Rehab services will include monitoring the
firefighters' vital signs, ensuring proper
hydration, and providing a comfortable shelter
on cold or hot days.
We look forward to strengthening our already solid relationship with Ocoee Fire Rescue
through these programs, and will seek out opportunities to further integrate our services
wherever desired and practical.
Disaster Response
RFP: The contractor shall be actively involved in planning for and responding to any declared or
undeclared disaster in the City. Disaster coordination is to be facilitated through City of Ocoee
Fire Rescue, the City, and Orange County Office of Emergency Management. (F. Deployment
Planning and Disaster Response, p. 24)
RFP: The contractor shall be responsible for providing mutual aid and disaster response services,
and other associated support functions in coordination with the City and the Orange County
Office of Emergency Management. (C. Contractor's Responsibilities, p. 20)
Rural/Metro will be actively involved in planning for and responding to any declared or
undeclared disaster in the City. We understand and agree that disaster coordination will be
facilitated through City of Ocoee Fire Rescue, the City, and Orange County Office of Emergency
Management.
RFP# 12-005 �ural/Mel�o Pa a 17
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
Due to Rural/Metro's large operations base in Central Florida, we can offer the City
unparalleled response capabilities with a fleet of more than 60 ambulances in the immediate
area. To supplement our dedicated response units, staffed ambulances could be quickly
deployed to Ocoee in the event of a natural disaster or other catastrophic mass -casualty event.
Beyond vehicles, Rural/Metro's state-of-the-art dispatch and communications centers in
Sumter and Orlando are capable of providing backup communications for the City's
communications center in the event of a disaster.
To further demonstrate our commitment to Ocoee's disaster response efforts, Rural/Metro will
sign a Memorandum of Understanding with OK's Cascade Company for the fast deployment of
a temporary shelter/operations center should the need arise. Please see Attachment 1 a copy
of the draft MOU and more information the company's disaster response resources.
1. Planning Documents
RFP: The contractor is expected to develop, within 90 days of the start of this service
contract, a mass casualty incident plan and an emergency disaster plan following the
NIMS incident command system guidelines. This plan will be submitted to the City's
emergency manager and the fire chiefs for review and incorporation into the City's
Emergency Management Plan.
Rural/Metro will develop, within 90 days of the start of this service contract, a mass
casualty incident plan and an emergency disaster plan following the NIMS incident
command system guidelines. This plan will be submitted to the City's Emergency
Manager and the Fire Chief for review and incorporation into the City's Emergency
Management Plan. Rural/Metro currently participates in the Orange County Office of
the Medical Director's Disaster Response Plan.
2. Supervisory Training and Participation in Drills and Exercises
RFP: The contractor's supervisory personnel will be required to complete incident
command training and hazardous material training as required by the City. Contractor
involvement shall include participation in training, drill and exercises without additional
charge to the City. The contractor may be considered far eligible grant funding when
applicable, for the above described drills and exercises. Within 30 days of contract
implementation, all EMS providers will be certified in IS-700 and ICS-100. in addition, all
supervisory personnel or those designated to act as supervisors will also be certified in IS-
800 and ICS--200.
Rural/Metro provides training in the incident CBRN=
Command System and hazardous materials, the
RFP# 12-005 4$ R�'8t�° Page 18
Rmaulamce
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PROPOSAL TO PROVIDEEMERGENcyAMBULANCESERVICESFOR THE CITY OF OCOEE
National incident Management System and the Standardized Emergency Management
System. Specialized training in chemical, biologic, radiological, nuclear and explosive
terrorism incidents is also provided for staff. This training follows Department of
Homeland Security and Florida State EMS Authority recommendations.
Rural/Metro's supervisory personnel will complete incident command training and
hazardous material training as required by the City. Rural/Metro staff will also
participate in training, drill and exercises without additional charge to the City. Within
30 days of contract implementation, all EMS providers will be certified in IS-700 and ICS-
100. In addition, all supervisory personnel or those designated to act as supervisors will
also be certified in IS-800 and ICS-200.
3. Evacuation Planning
RFP: The contractor is expected to work directly with all local medical facilities, the Fire
Chief and the City of Ocoee Office of Emergency Management in developing a medical
facility evacuation pion for the City of Ocoee. The plan is to be developed within 180 days
from the start of the service contract and presented to the City's emergency manager for
review and inclusion into the City's Emergency Management Plan.
Rural/Metro will work directly with all local medical facilities, the Fire Chief and the City
of Ocoee Office of Emergency Management in developing a medical facility evacuation
plan for the City of Ocoee. The plan will be developed within 180 days from the start of
the service contract and presented to the City's emergency manager for review and
inclusion into the City's Emergency Management Plan.
4. Performance Criteria During Disaster Situations
RFP: In the event of a disaster within the City of Ocoee or the contractor responds to a
disaster in a neighboring jurisdiction, normal operations shall be suspended and the
contractor shall respond in accordance with the respective disaster planning document.
The contractor shall use the best efforts to maintain primary emergency services in the
City. During the period of a declared disaster or MCI, the City will not impose
performance requirements for response times and other performance criteria.
Rural/Metro understands and agrees that, in the event Rural/Metro responds to a
disaster in Ocoee or a neighboring jurisdiction, normal operations will be suspended and
Rural/Metro will respond in accordance with the established disaster plan. We will use
best efforts to maintain primary emergency services in the City; however, we
understand and appreciate that the City will not impose performance requirements for
response times and other performance criteria during disaster responses.
R F P# 12-005 Mural/Metro' Page 19
Ambulance g
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
To demonstrate our commitment to effective
disaster response, Rural/Metro will also sign an
MOU with OK's Cascade Company for the
provision of a temporary shelter/operations
center in the event of a major disaster. Please see
Attachment 1 for more information on the
disaster resources this company offers.
C. Characteristics of a High Performance EMS
Model
Rural/Metro is committed to working in partnership with
the City of Ocoee and Ocoee Fire Department to provide
a fully integrated, high-performance EMS delivery
system. In this two -tiered system, the fire agencies would
,��Eniel of Goq{il��
'S
CCf
Florida
Cascade Company will
provide for a temporary
shelter or operations center
during a major disaster in
Ocoee.
act as ALS/BLS first responders utilizing City of Ocoee Fire Department personnel and
equipment, with Rural/Metro ambulance personnel seamlessly bridging patient care and
providing AILS transport to the hospital.
Rural/Metro is experienced at operating high-performance EMS systems in collaboration with
cities and counties throughout the nation, including many communities similar in size and 9-1-1
call volume to that of Ocoee. Our partnership with the City and fire first responders will ensure
the provision of clinically sophisticated, efficient and reliable emergency medical services within
a transparent system that's operationally and financially sustainable. We will seek to align our
operational and financial incentives with those of the City of Ocoee Fire Department.
Opinions vary on what, exactly, constitutes a "high-performance EMS system." The National
Association of EMS Physicians (NAEMSP) published in 2002 its third edition of "Prehospital
Systems and Medical oversight."' This report provides perhaps the best description of what
characterizes a successful high-performance EMS system. According to NAEMSP, a high-
performance EMS system includes:
• A sole provider: Market rights are granted to a single provider.
The RFP provides for a single provider.
• Control center operations: The ambulance provider controls dispatch to allow for fluid
deployment and redeployment of resources to meet changing demand. Patient care
1 Kuehl, A.E. (Ed.). (2002). Prehospital Systems and Medical Oversight. (31d ed).National Association of EMS
Physicians.
RFP# 12-005 alull/Metre Page 20
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PROPOSAL TO PROVIDEEMERGENCyAMBULANCESERVICESFOR THE CITY OF OCOEE
begins with the call to 911. Calls are properly triaged and dispatched, and pre -arrival
instructions are provided.
Rural/Metro will provide an ambulance ZOLL RescueNet CAD system and will properly
dispatch calls per National Academies of Emergency Dispatch protocols.
• Accountability: The ambulance provider is legally and/or contractually obligated to
meet specific performance requirements, and failure to meet these requirements
results in financial penalties or loss of the contract.
The RFP provides response -time requirements and penalties for non-compliance.
• Revenue maximization: To either minimize or eliminate a public subsidy, the ambulance
provider must be capable of maximizing revenue through fee -for -service billings to
Medicaid, Medicare and other third -party payers.
Rural/Metro is highly experienced at billing Medicare and other third -party payers and
will provide a completely integrated information system that allows for the collection
and automatic transfer of patient billing data from the field to our billing system,
ensuring all charges are accurately captured.
• Flexible production strategy: The ambulance provider operates a fleet of advanced life
support (ALS) units capable of handling all requests for service. Advanced deployment
techniques are used to ensure that all patients, no matter how initially dispatched,
receive the highest -level of care.
Rural/Metro will provide an all ALS system, ensuring that all patients have equal access
to advanced prehospital medical care while providing maximum flexibility in
deployment.
• System status management: The ambulance provider analyzes temporal and
geographic patterns of demand to ensure resources are always available to meet both
emergency and non -emergency response demand within the required response times.
Shift schedules are designed to match production with demand while distributing
workload equally, thereby preventing crew fatigue.
Rural/Metro will utilize advanced deployment techniques to best match system demand
with supply according to hour of day, day of week.
We believe that each of these characteristics is essential to ensuring EMS system success in the
City of Ocoee. We also believe in absolute system transparency, ensuring that the City and
Ocoee Fire Department are aware on a daily basis of our performance in each of these areas.
In addition to the proposed formation of an Ocoee EMS System Advisory Board as previously
described (p. 3), Rural/Metro utilizes the Fleet Eyes Automatic Vehicle Location (AVL) system,
described below, which helps ensure that we achieve the high-performance EMS model
envisioned by both the City and Rural/Metro.
RFP# 12-005 4D A PullM� o Page 21
M
PROPOSAL TO PROVIDEEMERGENCyAMBULANCESERVICESFOR THE CITY OF OCOEE
FleetEyes AVL System
Rural/Metro will utilize the FleetEyes automated vehicle location (AVL) system to ensure the
most efficient deployment of ALS resources in the City on a daily basis. The system provides
real-time web views of the fleet's location and will integrate with our ambulance CAD system.
FleetEyes creates a Common Operating Picture for one or multiple agencies.
Features include:
• Compliance with Medicare's new fractional mileage requirements,
• Vehicle tracking on a feature -rich Google map;
• Integration with the ambulance CAD system;
• Display of vehicle position, speed, heading and status;
• A patent -pending hospital interface;
• Map icons at specified locations (incidents, hospitals, landing zones, etc.);
• Map zoom and pan capabilities;
• Satellite, hybrid, terrain and weather layers;
• Valuable inputs (speed,
vehicle performance,
emergency lighting);
• Ability to replay the activity
of the entire fleet from
user -defined dates and .,
times;` _
• Connections to multiple =_"
servers simultaneous)
• Display of incident location
and status;
• Two-way messaging; and
• Advanced Geo Fences
FleetEyes provides a real-time view of the fleet's
(perimeter for a geographic location to optimize deployment of resources.
area) and Smart Alerts.
Our experience with FleetEyes shows that the system helps shorten response times, reduces
unnecessary miles driven, reduces liability, lowers vehicle operating expenses and provides an
auditable trail of en route and arrival times.
RFP# 12-005 Ilra��Metro Page 22
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCESERVICESFOR THE CITY OF OCOEE
Throughout this Section, we have discussed our proposed organizational structure and
deployment plan for the City of Ocoee, as well as our vision of what it means to be a high-
performance EMS system. The remainder of our proposal offers detailed information on the
individual departments that will support this high-performance system.
RFP# 12-005fun �aw8 ° Page 23
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FORTHE CITY OF OCOEE
II. Clinical Performance
A. Medical Director Credentials/Experience
RFP: The contractor shall be responsible for employing or contracting for medical direction
through the Office of the Medical Director for the Orange County EMS System. (C. Contractor's
Responsibilities, p. 20)
Rural/Metro will contract with the designated Orange County 911 Medical Director, Dr. George
Ralls. We also employ Dr. Geeslin as our in-house Medical Director. Dr. Geeslin will be available
to help coordinate joint training ventures between Rural/Metro and our first responder
partners.
B. Suggested Medical Protocol Compliance Process
RFP: The contractor shall be responsible for developing and issuing standing orders and medical
protocols that integrate with the City's existing first response fire agencies' medical protocols
through the Office of the Medical Director for Orange County EMS System. (C. Contractor's
Responsibilities, p. 20)
Rural/Metro will be responsible for developing and issuing standing orders and medical
protocols that integrate with the City's existing fire agency medical protocols through the Office
of the Medical Director for Orange County EMS System. Adherence to required protocols are
monitoring through Rural/Metro's proven continuous quality improvement (CQI) process. This
comprehensive program is described in Section F. Quality Improvement Processes of this
proposal, provided later in this section.
HIPAA Compliance
RFP: The Contractorshall insure adherence to all
HIPAA guidelines. (B. OSHA and Other
Regulatory Compliance, p. 26)
Rural/Metro ensures adherence to all HIPAA
guidelines. HIPAA compliance training is
provided as part of the New Employee
Orientation Program, and refresher training is
required on an annual basis. Rural/Metro's
Corporate Compliance Department also
maintains standardized policies regarding
patient privacy.
performed into the ePCR, and the data
are tracked and trended as part of the
Continuous Quality Improvement (CQI)
process.
RFP# 12-005 Q 8 ° Page 24
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
Electronic Patient Care Records (ePCRs)
Rural/Metro currently uses the WILL RescueNet ePCR system for on -scene patient care
reporting in the City of Ocoee. The RescueNet ePCR program has the ability to monitor and
provide important data related to patient care. Field employees enter every field intervention
conducted, including but not limited to, vital signs, pulse oximetry readings, oxygen
allows for the convenient capture of
patient care data via mobile data
computers.
administration and spinal immobilization.
Rural/Metro uses these reports to establish
benchmarks and performance standards for
field personnel. The Clinical Manager, in
collaboration with the Medical Director, can
customize the report to track any one of the
interventions documented in the patient care
report. Additionally, reports can be generated
based on chief complaint or pertinent medical
history to monitor treatment modalities used
by the field providers. The system is designed
to tie directly into our billing system, ensuring
the fast and accurate capture of patient
charges. Crews are required to complete specified data fields before a record can be closed,
ensuring complete documentation.
The ZOLL RescueNet, system offers unique features to assist in measuring performance,
including:
• The ability to customize reports to view any aspect of our clinical performance,
including:
o Compliance with documentation standards;
o Individual skills proficiency;
• The ability to create color charts, graphs or other visual tools for the presentation of
data;
• The ability to view patient care reports as soon as they are completed; and
• The ability to give field personnel immediate feedback, flag cases for review, or make
clinical suggestions.
For more information on the WILL RescueNet ePCR system, please see Attachment 2.
RFP# 12-005 e ° Page 25
AMMMIC
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
C. CIinical Credentials of Field Personnel
RFP: All ambulances rendering services under the contract shall be staffed and equipped to
render ALS level care. The paramedic shall be the primary caregiver for all emergency patients
and shall accompany al/ patients in the back of the ambulance during any patient
transportation except as otherwise permitted under Orange County Protocols. (A. Personnel
Qualifications and Staffing, p. 25)
All ambulances rendering services under the contract will be staffed and equipped to render
ALS-level care. The paramedic will be the primary caregiver for all emergency patients and shall
accompany all patients in the back of the ambulance during any patient transportation, except
as otherwise permitted under Orange County protocols.
RFP: Personnel will be appropriately certified or licensed by the State of Florida and their
functional privileges will be specifically authorized by the Orange County Medical Director in
accordance with medical oversight policies. (A.2. Qualifications, p. 25)
Rural/Metro's Ocoee field personnel currently meet the Florida Department of Health's
credential requirements for EMTs and paramedics. Our in-house Medical Director personally
tests each Paramedic with a written, practical and oral exam. If satisfied with their
performance, they receive functional privileges in accordance with Rural/Metro's medical
oversight policies.
All ambulances will continue to be staffed with a
minimum of one EMT -Basic and one EMT -Paramedic
who meet the following clinical credentialing
requirements:
-AlT/11191?
• State of Florida EMT-B certification
• CPR certification
Paramedic & Field Supervisor
• State of Florida EMT-P certification
0 CPR certification
• Advanced cardiac life support (ACLS)
• Pediatric advanced life support (PALS)
with a minimum of one EMT
and one paramedic.
RFP# 12-005 ib it b Page 26
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
In addition, all field employees must: pass criminal and work background checks, a drug
screening and a physical capability test; have an acceptable driving record; and complete a 16-
hour Emergency Vehicle Operator (CEVO III) course before being assigned to work in the field.
D. Medical Equipment and Supplies
RFP: Each ambulance unit shall be equipped with the required medical supplies, medications,
bandages, splints, airway and suction equipment, oxygen and other supplies and disposable
goods as required by State of Florida guidelines. It is the responsibility of the contractor to
maintain sufficient quantities of goods and supplies to adequately stock and restock vehicles
without interruption of services. The contractor is expected to have additional supplies and
equipment in a secure location within the City of Ocoee or general area, to allow the restocking
of first line vehicles 24 hours per day, 7 days per week throughout the contract period.
(Equipment Requirements, p. 22)
Every ambulance will continue to be equipped with the
required medical supplies, medications, bandages, splints,
airway and suction equipment, oxygen and other supplies
and disposable goods as required by State of Florida
guidelines. Rural/Metro will also continue to be responsible
for maintaining sufficient quantities of goods and supplies to
adequately stock and restock vehicles without interruption
of services. We currently stock a minimum two -week supply
of consumables to ensure adequate supplies in the event of
a disaster, unexpected demand or supplier shortages.
Rural/Metro stores additional supplies and equipment at our
secure facility in the City of Ocoee on Old Winter Garden
Road to allow for the restocking of first line vehicles on a
24/7 basis.
Medical Equipment
Rural/Metro ambulances carry medical equipment that's
compatible with the fire department equipment, including
Physio-Control LIFEPAK 15 monitor/defibrillators. The
LIFEPAK 15 monitors Sp02, carbon monoxide and met
hemoglobin, and includes a metronome to guide CPR
compressions and ventilations. It's powered by a lithium -ion
battery and has a SunVue display screen, enabling crews to
Stryker's Power -PRO XT
helps reduce back injuries
due to strenuous patient
lifting.
Physio-Control's LIFEPAK 15
monitor/defibrillator has
Bluetooth capability for
transmitting ECGs to
receiving facilities.
RFP# 12-005 Rupal/Metpa' Pa a 27
40 Rmtrulance g
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
read the screen even in bright daylight. Data connectivity ensures the easy collection and
transmission of patient information for both the patient's prehospital and hospital record.
Each ambulance is equipped with the Stryker Power -PRO XT stretcher. These stretchers
dramatically reduce strenuous lifting and the associated risk of back injury. A battery -powered
hydraulic system raises and lowers patients up to 700 Ibs, and an automatic high-speed retract
feature reduces load and unload stresses.
Ambulances are also equipped with a continuous positive airway pressure (CPAP) delivery
system and an EZ 10 (intraosseous) driver and two penetrating needle devices.
Replacement of Medications/Supplies for Fire Rescue
RFP: The contractor shall be responsible for supplying all medical supplies, medications and
disposable equipment for the contractor and the City's first response first service agencies. (C.
Contractor's Responsibilities, p. 20)
RFP: The contractor shall develop written guidelines for the replacement of applicable
medications, medical supplies, disposable splinting materials, and other disposable supplies
utilized by City of Ocoee Fire Rescue Department in the delivery of patient core. All such supplies,
equipment and medications shall be replaced on a no -cost basis to the City of Ocoee Fire Rescue
Department. (p. 22)
In consultation with Ocoee Fire Department, Rural/Metro will develop written guidelines for
the replacement of applicable medications, consumable medical supplies, disposable splinting
consumable supplies used by the
first responders in patient care
on a one -for -one basis.
materials and other disposable supplies utilized by
the first responders in the delivery of patient care.
All such supplies and medications will be replaced on
a no -cost basis to the City. This plan will fully comply
with Medicare regulations.
Rural/Metro will manage the entire supply -chain of
all durable medical equipment and consumable
supplies required to operate the Ocoee's EMS
system, including purchasing, distribution, tracking
and field resupply. These support services are
available to the first responders 24 hours a day,
seven days a week.
Rural/Metro replaces the first responders' supplies
RFP# 12-005 0AWAVI n e ° Page 28
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
on a one -for -one basis on scene whenever possible. Specialty items are delivered the next
business day or at a time that's convenient for the Fire Department. The Fire Department staff
currently complete a supply usage form for these supplies. Forms and supplies are typically
collected and delivered on a weekly basis. The Rural/Metro Materials Manager can provide a
monthly summary report to the Fire Department and Rural/Metro's Division General'Manager
detailing supply usage.
Should the Fire Department desire another method for supply replenishment, Rural/Metro will
work cooperatively with the first responders to identify a process that works for everyone.
Rural/Metro currently orders consumable supplies on a weekly basis using the JD Edwards
EnterpriseOne Inventory Management System. Supplies are drop -shipped from the
manufacturer. The Supply Department maintains a minimum of two -week supply inventory in
our local warehouse to accommodate excessive demand in the system or a disaster situation.
Controlled Substance Policies
RFP; The contractor must also develop and controlled substance storage, distribution, usage and
documentation policy and satisfy any applicable laws and its medical director policies. (p. 22)
Rural/Metro has a comprehensive "Controlled Substances" policy and procedure in place to
assure controlled substances are secure and properly accounted for. All controlled substances
carried on emergency vehicles are monitored daily and tracked from the assigned unit to the
patient and receiving hospital when administered. Crew Chiefs are responsible for inspecting
and accounting for all controlled substances and Mark I auto injectors in their assigned vehicles.
Controlled substances are issued in a tamper -evident container and stored under double lock
and key while in the ambulance. Any unused portion of a controlled substance is discarded in
accordance with Title 21 of the Federal Code of Regulations.
E. Financial Reserve for Clinical Upgrades
Rural/Metro is committed to continual system development, including the provision of cutting -
edge clinical equipment and programs. To ensure that financial resources are available to fund
EMS system enhancements, Rural/Metro will maintain an annual reserve of $10,000 to be used
exclusively for clinical upgrades. Decisions regarding distribution of these funds will be made
collectively by the Ambulance Advisory Board for the improvement of clinical care in the City of
Ocoee.
RFP# 12-005 RIme1�11+letra' Page 29
Ambulance
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
F. Quality Improvement Program Processes
RFP: The contractor shall be responsible for providing in-service training, quality assurance, and
improvement monitoring for contractors personnel. (C. Contractor's Responsibilities, p. 20)
Quality improvement begins with leadership; therefore, Rural/Metro provides a personnel
structure that places clinical quality improvement (CQI) staff in leadership roles to ensure all
quality issues are quickly and appropriately managed. Rural/Metro's CQI program currently
complies with State of Florida clinical requirements and will be further refined in cooperation
with our City of Ocoee EMS partners. The ultimate goals of Rural/Metro's CQI program are to
ensure field crews comply with establish protocols, to quickly identify and resolve issues, and to
promote continual system improvement and excellence.
Internal and External QI Practices
Quality improvement issues may be identified via internal and/or external channels. One of the
hallmarks of a professional workforce is employees' ability to self -evaluate. Rural/Metro
strongly encourages individuals to continually evaluate their own performance for strengths
and weaknesses, and to report errors of omission or commission to the Crew Chief and/or
Quality Assurance Manager in a proactive manner. Self -evaluation and reporting allow quality
improvement to occur at the most basic level —with the provider.
Treatment provided in the field is audited
during the CQI process to identify issues with
patient care or deviations from protocols.
The routine audit of Rural/Metro's
electronic patient care records
(ePCR) database will be another
means of identifying internal quality
issues in the City. On a daily basis,
the Quality Assurance Manager
searches for calls such as cardiac
arrests, advanced airway utilization
and STEMIs to monitor these low-
frequency/high-risk patient
populations. In reviewing individual
patient records, the Quality
Assurance Manager identifies which
employees have performed well and
which need to improve. Issues may be as simple as documentation deficiencies or as serious as
an error in patient care.
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PROPOSAL TO PROVIDE EMERGENCyAMBULANCE SERVICES
FOR THE CITY OF OCOEE
Once an issue is identified, the Quality Assurance Manager logs it into a database for tracking
and monitoring of trends. The issue is then addressed at the individual or system -wide level,
depending upon the extent of the problem.
The Quality Assurance Manager reviews the call history, the ePCR data and cardiac monitor file,
as well as contacts involved outside agencies as necessary. Once sufficient information is
obtained, the QA Manager contacts the involved personnel to document their recollection of
the call. This contact provides an opportunity for the Quality Assurance Manager to reinforce
what the employee did well, as well as discuss the medical considerations and policy
implications for any areas needing improvement.
Once an issue is satisfactorily addressed, it is closed in the database. Later review may indicate
the presence of individual and/or systemic trends, and help in directing educational efforts to
correct the deficiency. If the deficiency is noted to be a violation of the Standard of Care, then
follow-up action may focus on individual attention. Policy violations may also result in discipline
in extreme circumstances.
External CQI Process
Quality improvement issues may also be identified via external channels, adding depth to the
CQI process. One method of external issue identification involves Rural/Metro's interaction
with fire department and base hospital staff as part of a team approach to patient care. As with
the internal CQI process, issues discovered as a result of external CQI activities may be as easy
to resolve as documentation deficiencies, or as serious as those involving actual patient care.
Another external reporting path involves the patient or customer themselves. An actual or
potential QI issue may be in question whenever a patient or a family member voices a concern
about the treatment provided. By conducting a thorough investigation, including gathering the
employee's perspective, Rural/Metro strives to ensure that patients receive appropriate care
and that any concerns they express are satisfactorily resolved.
As with the Internal CQI Process, the Quality Assurance Manager logs any issues into a database
for tracking and trending. Once again, the call history, ePCR and cardiac monitor file, as well as
contact with the involved outside agencies is reviewed as necessary. The QA Manager follows
up with the employee to document their perspective of the call as well as discuss what went
well or any medical considerations or policy implications for areas needing improvement.
Later review may indicate individual and/or systemic trends that require corrective action. Any
deficiencies determined to violate the Standard of Care are promptly addressed and may result
in discipline.
RFP# 12-005 40 Q l�e a Page 31
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
Nearly always, the patient's first contact with
any EMS agency is with Dispatch and
Communications. Therefore, it is imperative
that the dispatcher be not only
knowledgeable and efficient, but also
empathetic and compassionate.
All Rural/Metro Dispatchers are trained and
certified the National Academies of
Emergency Dispatch. They must comply with
Rural/Metro's CQI policies as well as the QA
program for Priority EMD.
Clinical Inquiry & Complaint Management
Process
tft
takers are not only knowledgeable
and efficient, but also compassionate.
Rural/Metro's Quality Assurance Manager maintains a comprehensive customer service inquiry
and unusual occurrence reporting system that tracks all inquiries via a database. These inquiries
are input via web interface and designated a priority for resolution, as listed below:
• Emergency: Paged out to the on -duty Crew Chiefs;
• Priority 1: Entered into the database and allotted 24 business hours for
resolution; or
• Priority 2: Entered into the database and allotted 72 business hours for
resolution.
Should an inquiry not be resolved in the required time, it will be automatically "escalated" to
the senior management level for prompt resolution. Serious patient care issues are promptly
reported to the Medical Director.
Dispatch & Communications CQI
It is imperative that the dispatcher be not only knowledgeable and efficient, but also
empathetic and compassionate. All Rural/Metro Dispatchers are trained and certified the
National Academies of Emergency Dispatch. They must comply with Rural/Metro's CQI policies
as well as the QA program for Priority EMD.
RFP# 12-005 0QMb� Ce ° Page 32
PROPOSALTO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE ift
National Clinical Quality Excellence Initiative
The recent launch of a Rural/Metro corporate initiative to improve clinical excellence by
standardizing protocols, utilizing best practices and sharing data will contribute to our clinical
quality program locally in Ocoee. Rural/Metro is able to leverage an incredible amount of
patient care data collected from the more than 425 communities where we provide service.
The initiative will target three key clinical areas, including data collection and protocol
standardization (wherever possible) for the following:
STEMI
Stroke Cardiac Arrest
• Track Drugs Used —Aspirin,
• Track time for Stroke ID - • Track high quality outcomes
(remove Beta Blockers?),
standard for Stroke • Track time to cool and how
Nitro, morphine, etc.
identification is critical long we cooled the patients
• Track lead time — Goal is to
• Pre -arrival notification time is • All CCR interventions must be
give a 20 minute head start
key documented: Any deviations
for the hospitals
• Collect a Contact number/info from CCR protocol must be
• Time Medic notified hospital
(witness and family) studied for raw numbers,
of the STEMI (or not)
• The time from identification of provider and intervention
• Track how many minutes
Stroke to hospital notification specific
prior to arrival STEMI
• Track Who/What/When/
notification was given
Where, unit#, deterioration of
• Track on -scene time
patient
• Tracking time aspirin was
• Tracking offload/care times:
given per Dispatch and
ADHS recommended this
separately by the crew
could be a national data point
• Track by paramedic —
• 02 Saturation level should be
personnel database to track
metric to track — 94% min.
procedure /protocol
• Measure and track the
compliance
discharge status
• How long does it take to get
• Recognition of care times is
the 12 Lead to the hospital?
critical
• Tracking missed vs. identified
STEMI tails and sharing with
the Medics and MDs
In support of this effort, we are actively working on several tools, including configuring ePCR
data points and developing a blog/listsery through which our local Medical Directors can share
data and exchange ideas. We are also working on developing a national awards program to
recognize local operations for standout efforts in achieving clinical excellence. Posters and
educational materials are being developed for deployment to field crews throughout the
organization.
RFP# 12-005 Bur00tre Page 33
Rm1lgWance
PROPOSAL. TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
G. In -Service Training
RFP: The contractor shall be responsible for providing in-
service training, quality assurance, and improvement
monitoring for contractors personnel. (C. Contractor's
Responsibilities, p. 20)
Rural/Metro has a seamless education system that reaches
all EMS stakeholders —from dispatch personnel to the first
responders, ambulance and hospital staff. Our
comprehensive training and education program, which will
be tailored to meet the City's specific needs, includes new
employee and continuing education, a Field Training Officer
program for pre/post accreditation paramedics and
continuing education that will be available at no cost to the
City of Ocoee first responders.
to the fire department first
responders at no cost.
The training and education curriculum is offered through four distinct but complementary
channels: traditional classroom training, online education, in-service training and one-on-one
education through the field training and continuous quality improvement process.
EMT to Paramedic Field Training Program
Rural/Metro provides a Field Training Program for EMTs transitioning to the position of
paramedic. New paramedics are afforded time with a field trainer prior to working as a
paramedic in the EMS system. Field trainers also mentor paramedics identified through the CQI
process as needing specific skills or procedure training. Field Training Officers are paramedics
licensed in the State of Florida.
EMT -to -Paramedic training covers:
• Professionalism
• Standard Operating Procedures
• Communications
• Documentation
• Infection Control
• Protocol Knowledge
• Equipment
• Basic Life Support
• Advanced Life Support
RFP# 12-005 0 Wal/Mefrn Page 34
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
Continuing Education
Rural/Metro will provide at least 24 hours
per year of no -cost continuing education for
paramedics and at least 12 hours of
continuing education opportunities for
EMTs. Hours spent in any mandatory
training are always paid. The first responder
agencies will be notified in advance of all CE
offerings and may participate at no cost to
the individual or the fire departments. CE
opportunities will be posted on our local
website, and we can notify the training
officer via email, if desired.
CE offerings include, but are not limited to:
ift
to support recertification requirements.
• Advanced Cardiac Life Support (ACLS)
• ACLS Renewal Basic Life Support (BLS) for Healthcare Provider (HCP) Renewal
• Certified Emergency Vehicle Operator (CEVO) 3
• CPR for the HCP Refresher
• CEVO Refresher
• Pediatric Advanced Life Support (PALS)
• Prehospital Trauma Life Support (PHTLS)
In addition, Rural/Metro offers a tuition reimbursement program for full-time employees who
have completed a minimum of one year's continuous full-time service. Reimbursement is
available for pre -approved, successfully completed courses offered through an accredited
academic educational institution or certified training program.
Rural/Metro offers employees the opportunity to apply for two local paramedic training
scholarships per year valued at $15,000. The scholarships pay for tuition, lab, book and ancillary
fees to any mutually acceptable, accredited paramedic program. The selection process for
these scholarships includes written and practical exams, and applicants must have a clean
employee file and interview. Those selected are monitored and mentored to promote success.
RFP# 12-005 Rupal/Now Page 35
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
Fire Department Paramedic Rotation
Rural/Metro will rotate any City of Ocoee Fire Department paramedic who does not get the
number of calls required to maintain skills onto a busy ambulance unit. Paramedics will be
paired on the ambulance with a Field Training Officer Paramedic and an EMT.
CentreLearn Online Education
In addition to on -site courses, Rural/Metro provides employees with convenient 24/7 online
educational opportunities via CentreLearn. CentreLearn provides unlimited access to a
comprehensive online library of high -quality multimedia continuing education materials and a
learning management system with a full set of administrative controls. The system is flexible,
allowing Rural/Metro to provide its own content, or City -desired programs. Features include:
• Customizable online training materials;
• A Comprehensive course library, including unlimited access to multimedia EMS courses;
• Communications, including e-mail, announcements and discussion boards;
• Online testing with instant grading;
• CE certificates that are automatically generated and can be downloaded to any
computer;
• Automated tracking that
monitors user progress
with on -demand and
automated reports;
• An event scheduling and
calendar tool;
• An online survey tool;
• Unlimited phone support;
• Secure custom content
storage (20 gigabytes);
• Branched logic tools to
build scenario -based
training and testing
programs; and
• Compliance Guard, which
automatically tracks every
employee's progress in
meeting training, licensure
t
CentreLearn tracks certifications and CE
requirements to ensure employees remain
compliant.
RFP# 12-0058 ° Page 36
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
and certification requirements. This system tracks everything from state -mandated
workplace training to periodic job -specific refreshers, driver requirements to EMT and
paramedic continuing education and recertification.
RFP: The contractor shall be responsible for providing notification and access of contractor's
EMS training to personnel from City's first response agencies (C. Contractor's Responsibilities, p.
20)
Rural/Metro welcomes the opportunity to integrate training with the first responders, as it
strengthens relationships between the crews and promotes seamless patient care. All
continuing education programs will be open to Ocoee Fire Department personnel at no cost to
the City. We will notify the training officer via email in advance of scheduled education, or
collaborate with the City to establish another desired notification process. We currently provide
at least 24 hours per year of no -cost continuing education for paramedics and at least 12 hours
of continuing education opportunities for EMTs. We will work with the Medical Director to
provide educational offerings that directly support the City's Clinical Quality goals.
H. Employee Recruitment, Screening and Orientation
RFP; Throughout the performance of the contract, the contractor agrees that it will comply with
all applicable provisions of federal, state and local laws and regulations prohibiting
discrimination. Specifically, the contractor warrants that it willfully comply with Title VI and V11
of the Civil Rights Act of 1964, as amended, the Americans with Disabilities Act (ADA), and all
other regulations promulgated hereunder. The contractor will not discriminate against any
employee or applicant for employment because of race, religion, color, disability, national
origin, sex, sexual orientation or age. (C. Discrimination Prohibited, p. 26)
Rural/Metro will continue to
comply with all applicable
provisions of federal, state
and local laws and
regulations prohibiting
discrimination. Specifically,
the Rural/Metro warrants
that it fully complies with
Title VI and VII of the Civil
Rights Act of 1964, as
amended, the Americans
with Disabilities Act (ADA),
Rural/Metro's top priority.
RFP# 12-005AIM Rural/metro' Page 37
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
and all other regulations promulgated hereunder. Rural/Metro does not and will not
discriminate against any employee or applicant for employment because of race, religion, color,
disability, national origin, sex, sexual orientation or age.
Paramedics and EMTs are the driving force behind any high-performance EMS system. We
believe Rural/Metro's customized recruitment and retention processes in Ocoee form the
foundation for pre -hospital clinical excellence. Work conditions, growth opportunities,
compensation and benefits packages, shift schedules and management attitude all affect
employee job satisfaction, retention and, ultimately, patient care. Attracting qualified EMTs and
paramedics, and promoting their job satisfaction and retention is, therefore, a top priority. To
this end, Rural/Metro dedicates a local, full-time Human Resources Manager.
The sections that follow discuss in detail Rural/Metro's proven recruitment practices,
comprehensive benefits package, screening process and New Employee Orientation Program.
Employee Recruitment
Rural/Metro was extremely fortunate to transition the Health Central workforce to the
Rural/Metro family following the acquisition of Health Central's workforce last fall. We're
pleased to be able to provide Ocoee with a smooth transition and a commitment, homegrown
workforce with strong ties to the community. Our intention is to continue to employ these
talented employees.
Moving forward, Rural/Metro does provide an aggressive recruitment and retention program
that gives employment priority to students trained through local EMT and paramedic programs.
Hiring local talent promotes employment longevity and quality care, because the employees
have a vested interest in the community. We take our employees' careers seriously, considering
them to be part of the Rural/Metro family. We embrace the fact that some employees desire to
grow their careers in medicine and fire fighting services, and have partnered with many fire
agencies to be supportive of this process. This philosophy has made Rural/Metro the employer
of choice with many EMS professionals.
Rural/Metro believes the recruitment process starts long before the need for an employee
arises. Our managers and supervisors understand that recruitment is everyone's responsibility,
and every public interaction is a potential opportunity to interest someone in potential
employment with Rural/Metro or simply a future career in EMS.
Rural/Metro routinely uses the following recruitment tools/methods: EMT & paramedic
classroom visits; newspaper classified advertisements; website postings; open house programs;
RFP# 12-005 Rrmalw8blo Page 38
40 ,4mbulance
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
trade publication advertisements; associate networking; college relationships; and community
events.
Commitment to Diversity
Rural/Metro follows a
comprehensive Equal Employment
Opportunity (EEO) program and
strictly prohibits discrimination in
accordance with all local, state and
federal laws. As mentioned
previously, Rural/Metro fully
complies with Title VI and VII of the
Civil Rights Act of 1964, as
amended, and the Americans with
Disabilities Act. In short, we do not
and will not discriminate against
to employ a diverse workforce.
any employee or applicant for employment because of race, religion, color, disability, national
origin, sex, sexual orientation or age.
As an EEO supporter, Rural/Metro developed a Diversity Outreach and Opportunity
Recruitment (DOOR) program. DOOR ensures our organization reflects the ethnically diverse
communities we serve by:
• Creating awareness of careers in emergency services;
• Supporting the training required to work in emergency services; and
• Providing job opportunities and placement services to qualified individuals of diverse
backgrounds.
HR representatives regularly participate in local events to provide information on employment
opportunities. Our recruitment efforts not only encourage qualified people to apply, but attract
and encourage people who may not necessarily be aware of careers in EMS. At the same time,
these events provide an opportunity for Rural/Metro to educate the public on the role of EMS
and appropriate use of the 9-1-1 system.
The DOOR program creates a pathway for communicating to various cultures within the
community, and its success relies upon partnering with diverse community groups. To that end,
Rural/Metro will forge community partnerships with local City organizations, support their
initiatives and solicit their participation in recruitment events.
RFP# 12-005Page 39
ambulance
ift
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
Comprehensive Benefits
Rural/Metro is dedicated to being the employer of choice. Our commitment to employees is
reflected in the competitive compensation and fringe benefit plan we offer, a key consideration
when evaluating a job offer. Every year, Rural/Metro runs salary comparisons on a national and
local level, comparing cost of living indices and salary differentials, to ensure our compensation
is competitive. We offer the following health and fringe benefits:
Vacation, Sick Time & Holidays
Eligible full-time employees accrue vacation based on their anniversary years of full-time
employment. New employees accrue vacation effective from their date of hire. Employees
are able to roll over 40 hours of unused vacation time, permitted they use it by June 30 of
the following year. Upon resignation or termination from the company, all unused vacation
time is paid out to the employee. However, all employees must take at least one week of
vacation per year.
Continuous Employment
0 to 4 years
Benefit
2 Weeks
5 to 10 years
3 Weeks
11 to 14 years
4 Weeks
15+ years
5 Weeks
Full-time employees are
eligible for paid time away
from work due to personal
illness or an illness in their
immediate family. All full-time
employees receive five days of
sick leave each year, awarded January 1 or prorated for new employees based on their start
date.
During the employee's first calendar year of employment, he or she will receive 50% of one -
week paid sick time based on the average hours worked. Beginning the first full calendar
year of employment, employees will receive one (1) week paid sick time per calendar year.
Rural/Metro offers the following paid holidays to full-time employees:
HolidaysRural/Metro Paid
• New Years Day • Independence Day • Friday After Thanksgiving
• Martin Luther King Day • Labor Day • Christmas Day
• Memorial Day • Thanksgiving Day
RFP# 12-005 ��8 Q Page 40
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
Bereavement & Leaves of Absence
In the event of death in a full-time employee's immediate family, Rural/Metro provides up
to five consecutive calendar days off with pay. Bereavement leave is payable to employees
for work time missed.
Rural/Metro also offers various types of leaves of absences, based on the employee's
needs. All leaves of absence are granted in accordance with Federal and State employment
laws.
Employee Assistance Program
Rural/Metro offers professional counseling, referral and educational services through our
Employee Assistance Program (EAP) provider. Counseling staff is comprised of state -
licensed psychologists, and therapists at master's and doctorate levels. If long-term therapy
or specialized treatment is required, the EAP program provides referrals to local
professionals and treatment sources.
Tuition & Certification Reimbursement
Rural/Metro supports employee development, realizing that it's as important to the
employee's future growth as it is to the company's success. To assist employees in
developing and learning new skills through external educational institutions or programs,
Rural/Metro offers a tuition reimbursement program for full-time employees who have
completed a minimum of one year's continuous full-time service. Reimbursement is
provided, upon successful completion, for pre -approved courses offered through an
accredited academic educational intuition or certified training program. Benefits cap at
$2,000 annually.
In addition, we provide at least 24 hours per year of no -cost continuing education for
paramedics and at least 12 hours of continuing education opportunities for EMTs. Hours
spent in any mandatory training are always paid.
Health Insurance & Health Savings Account
Rural/Metro currently offers employees the Prime plan through Cigna. The Prime plan is a
reduced premium, high -deductible plan offered in conjunction with a Health Savings
Account. Wellness visits and certain preventative medicines are covered 100%. The prime
plan also offers out -of -network coverage for individuals who seek care outside of the Cigna
network of healthcare practitioners.
RFP# 12-005 floral/Mello' Page 41
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PROPOSALTO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
With a Health Savings Account, employees can determine how much money to save for the
year, up to the federal limit. All contributions to the HSA are taken through payroll
deductions on a pre-tax basis. HSA dollars can be used to pay for qualified health care
expenses, such as co -pays, deductibles, co-insurance costs, eyeglasses, contact lenses and
even certain over-the-counter health aids and medications. There is no forfeiture on the
contributions made; any unused money in the HSA account rolls over to the next plan year.
Dental coverage is offered for preventative care, basic and major services, and orthodontia
benefits are available for children up to age 19. Vision benefits are provided through Cigna.
Life Insurance
Rural/Metro provides basic life insurance to employees and eligible family members. As
needs for financial protection vary, employees may also purchase additional life insurance
for themselves and their family.
Short- & Long -Term Disability
Short-term disability coverage replaces part of an employee's pay during a covered
disability and is available to employees who are actively working. Premiums are based on
the employee's age when the policy is issued, and benefits cover sickness or injury, as well
as pregnancy as long as it's not a pre-existing condition. This is a voluntary plan that the
employee must enroll in when they are first eligible or during annual enrollment.
Long-term disability benefits provide income protection for employees and their family
should they become totally disabled and can no longer work. Rural/Metro provides LTD
coverage, and offers employees the option to purchase supplemental LTD. The plan pays
benefits if the employee's disability lasts longer than 90 days. If the employee remains
disabled, the benefits are payable to age 65.
401(k) Savings Plan
Rural/Metro promotes employees' long-term financial security through a 401(k) savings
plan program. With Fidelity as a benefit partner, employees have access to tools and
information that assist in making savings and investment decisions. Employees pay no taxes
on the money they contribute to the plan, any matching contributions or any of the
investment earnings, until the money is withdrawn from the account. In some cases, loans
or hardship withdrawals may be permitted.
RFP# 12-005 Rmhue Page 42
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
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Employee Screening
RFP: All persons employed by the contractor shall undergo a criminal record check conducted by
the contractor. It is the City's intent in requiring a criminal record check that the contractor is
aware of any felony or misdemeanor convictions that could be a factor related to an individual's
performance in an EMS system. This should include at a minimum convictions related to driving
under the influence, drug related offenses, and sexual offenses including rape, sexual abuse, and
spousal abuse. The contractor must independently judge the employability and potential liability
associated with employing any individual with a past history of such offenses. The contractor
shall provide the City with its specific policies concerning sexual harassment. In addition, the
contractor shall provide as part of its proposal its employment policies relating to the hiring of
employees with felony and misdemeanor convictions. The contractor shall not employ or retain
any employee whose Florida drivers' license is revoked or suspended. (A.4. Employment
Practices and Background Checks, p. 25)
All persons employed by Rural/Metro undergo a criminal
record check as a condition of employment. Candidates with
felony or misdemeanor convictions that could potential impact
their performance in the EMS system are immediately
removed from consideration. At a minimum, convictions
related to driving under the influence, drug related offenses,
and sexual offenses including rape, sexual abuse, and spousal
abuse are immediate cause to deny employment.
As requested, specific policies concerning sexual harassment
are provided in Attachment 3. In addition, we have also provided employment policies relating
to the hiring of employees with felony and misdemeanor convictions in Attachment 3.
Rural/Metro agrees not to employ or retain any employee whose Florida drivers' license is
revoked or suspended.
Proper screening of applicants plays a critical role in the success of an organization. It minimizes
risk and is the first step in building a long-lasting and professional operation. Rural/Metro
believes in a search for excellence in the employment process. We seek to employ those
individuals with innovative ideas, a willingness to work as a team, and a desire to give back to
the community.
Field employees are required to successfully undergo the following processes:
RFP# 12-005 40 RuraUMetro' Pa a 43
Ilmhulaece g
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
Pre -Hire:
• Submit a complete application
• Provide copies of all required credentials/certifications
• Complete interview
• Successfully complete basic skills test, written and practical
Post -Hire Requirements, employment contingent upon passing:
• Physical capability test
• Government Excluded Parties Fist background check
• Criminal background check
• Driving record background check
• Background work history
• Urinalysis drug screen
• New employee orientation program
• Driver's training
Offers of employment are contingent upon each candidate's successfully completion of every
screening process.
Professionalism
RFP: The City expects and requires professional and
courteous control and appearance at all times from
the contractor's ambulance personnel, supervisors,
middle managers and top executives. The contractor
shall address and correct any occasional departure
from this standard of conduct. (A. Personnel
Qualifications and Staffing, p. 25)
Rural/Metro expects and requires professional and
courteous behavior and appearance at all times from
our ambulance personnel, supervisors, middle
managers and top executives. We provide employees
promoted through training and
policies that address everything from
appearance to patient interaction.
with training that specifically addresses professionalism. For example, our New Employee
Orientation Program includes training on uniform/appearance requirements, customer service,
Equal Employment Opportunity, harassment, drug and alcohol abuse, HIPAA/patient privacy
and other key areas that affect professional conduct. In addition, Rural/Metro provides staff
RFP# 12-005 40 Rural/Metpe Page 44
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCESERVICES
FOR THE CITY OF OCOEE
with training in and copies of General Compliance policies and procedures, which cover
everything from our Code of Ethics and Business conduct to Compliance with the Federal Anti -
Kickback Statute.
Rural/Metro also recently implemented a new corporate -wide supervisor training initiative that
deals with professional conduct on multiple levels, including topics such as managing conflict,
employee coaching and counseling, and harassment/discrimination prevention. This program
helps differentiate our leaders by preparing them to act as mentors and role models in all
aspects of their conduct. Please see Attachment 4 for an outline of the Supervisor Training
Program.
I. Incorporation of Area Hospitals In Service Delivery Model
Rural/Metro is fully integrated with all the medical receiving facilities and participates in clinical
meetings and the Orange County EMS Advisory Council and subcommittees. Rural/Metro's
General Manager and Business Development Manager will continue to regularly attend
meetings with the hospitals' ED administrators to gather their insight and feedback regarding
the medical care being provided by Rural/Metro EMTs and paramedics.
We currently maintain strong partnerships with the major area hospitals. Rural/Metro recently
signed a renewed agreement to serve as the preferred medical transportation provider to
Orlando Health's nine campuses. We also recently signed a 5-year contract to provide patient
transport services for Health Central Hospital and the Health Central Park Nursing Home.
RFP# 12-005 I!l11a1/INMn° Page 45
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
III. Human Resources
tft
A. Employee Work Schedules
Minimum Staffing: The contractor is required to staff a minimum of one (1) EMT-P and one (1)
EMT-B. At the contractor's option the requirement for EMT staffing levels on any units may be
enhanced to high levels of training without obligation to the City. (A, 1. Minimum Staffing, p. 25)
Rural/Metro will continue to staff ambulances in Ocoee with a minimum of one (1) EMT-P and
one (1) EMT-B. We understand that our option and expense, staffing levels may be enhanced to
higher levels of training without obligation to the City.
Shift Type
24 Hour - 7 Days
Mon
6:00
Tue
6:00
Wed
6:00
Thu
6:00
Fri
6:00
Sat
6:00
Sun
6:00
FTEs
6
24 Hour - 7 Days
6:30
6:30
6:30
6:30
6:30
6:30
6:30
6
24 Hour - 7 Days
7:30
7:30
7:30
7:30
7:30
7:30
7:30
6
12 Hour - 7 Days
7:00
7:00
7:00
7:00
7:00
7:00
7:00
.4
16 Hour - 3 Days
-----
9:00
-----
9:00
10:00
-----
-----
2
2-16 Hour, 1-24 Hour - 3
Days
10:00
-----
10:00
-----
-----
6:00 -
24
-----
2
B. Health and Safety Programs
RFP: It is the City's expectation that the
contractor will adopt procedures
specifically for the City of Ocoee contract
that will meet or exceed the regulatory
requirements for occupational safety and
health including but not limited to
infection control, blood borne pathogens
and Tuberculosis. These precautions shall
be designed for both the safety of
ambulance personnel and City of Ocoee
Fire Rescue Department first responders.
Additionally, such measures would include,
but not be limited to written procedures
and directives, universal precautions,
periodic training and safety alerts, annual
medical screenings and the wearing of
personal protection equipment. (B. OSHA
equipment [PPE] and training to protect
themselves and patients from infectious
disease exposure.
RFP# 12-005 Q rame ° Page 46
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
and Regulatory Compliance, p. 26)
Rural/Metro is in the safety business; without a healthy and safe workforce we cannot fulfill our
mission. Therefore, we provide comprehensive health and safety training, and require strict
adherence to OSHA and NFPA-compliant safety practices that were specifically designed to
protect patients and care providers. Many of our safety programs were initially developed and
implemented by frontline field employees.
Locally, we promote a workplace culture that focuses on
Occupational Safety and Health Administration (OSHA) -compliant
infection prevention, including training and policies/procedures WSM
that aggressively address proper hygiene, personal protective
equipment (PPE), bio hazardous waste management and
exposure reporting.
Many hours are dedicated to new -employee health and safety classroom education that covers
policies for infection control, cross contamination and soiled materials exposure. This training is
reinforced in the ride -along and field training phases of our New Employee Orientation
Program. Employees learn about reportable communicable disease exposures and the
reporting process. The program's overall focus is prevention, PPE and universal precautions.
Further, Rural/Metro maintains a strict airborne policy that includes annual mask fit testing and
annual health screenings, including TB testing.
During New Employee Orientation, employees are trained in accordance with Rural/Metro's
Standard Operating Procedures and the EMS Operations Manual. Our policies and procedures
comply with Joint Commission on the Accreditation of Healthcare Organizations (JCAHO)
requirements regarding biomedical equipment/waste, including:
• Biomedical Contamination & Decontamination
• Preventative Measures
• Daily Inspection
• PPE
• Apparatus Decontamination
• Gurney Decontamination
• Equipment Decontamination
• Equipment Bags
• Airway Equipment
• Equipment Received from a Hospital
• Bio hazardous Waste Incidents
RFP# 12-005 0 Q r ncPage �47
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
Infection Control
Training reinforces that all communicable disease issues must be followed by the designated
Infection Control Officer —the Division General Manager —who works closely with receiving
hospitals for follow-up on patient disease status. The Infection Control Officer is available 24/7
to promptly address employees' questions or concerns related to a potential exposure.
To prevent needle -stick exposures, Rural/Metro uses "needleless" drugs in the City of Ocoee.
Our needleless drugs include: Adenocard (6, 12mg), Amiodorone, Calcium Chloride, Dextrose
25, 50%, Diphenhydramine, Epinephrine 1:10,000, Magnesium Sulfate, Naloxone Hydrochloride
(Narcan), Sodium Bicarbonate (Pedi/Adult), Sodium Chloride (.9%), Flush Syringe (10cc) and
Ondansetron (Zofran). Rural/Metro also utilizes safety IV catheters and needleless IV tubing and
syringes in Ocoee.
Crew Chiefs monitor field crews for compliance with infection control, PPE and other safety
protocols using a checklist. They are required to evaluate a minimum of 10 crews per month
and submit the completed forms to the Quality Assurance Manager. The evaluations cover
appropriate PPE use, appropriate sharps container use, lifting techniques and more. In addition,
the management team meets on a monthly basis to evaluate any safety incident situations. The
team discusses if incidents were preventable and if any individual or system -wide training is
warranted to prevent recurrence.
Drug -Free Workplace
RFP: The contractor agrees, in accordance with Florida laws, to establish a Drug -Free Workplace
within its City of Ocoee operations. These guidelines will Include, but not be limited to: (D.
Establish a Drug Free Workplace, p. 26)
1. Published Statement of Notification
RFP: A published statement notifying employee that the unlawful manufacture,
distribution, dispensing, possession or use of controlled substance is prohibited in the
workplace and specifying the actions that will be taken against employees for violations
of such prohibition,
Rural/Metro publishes and posts the following statement notifying employees that the
unlawful manufacture, distribution, dispensing, possession or use of controlled
substance is prohibited in the workplace.
All employees are strictly prohibited from using, possessing, concealing,
manufacturing, transporting, selling, buying or promoting the sale of any drug
and from using alcohol on company premises at all times, and off premises while
RFP## 12-005 r qan E ° Page 48
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PROPOSAL TO PROVIDEEMERGENCyAMBULANCESERViCESFOR THE CITY OF OCOEE
they are performing duties and responsibilities within the scope of their
employment with the company. The term "use" and "using" shall include being
under the influence of any drug or alcoholic beverage, and not merely the
physical act of taking the drug or alcohol into the body.
This statement, as well as a full description of the actions taken against employees for
violating this prohibition, is documented in the company's Drug and Alcohol Use Policy,
provided in Attachment 5.
2. Information on Dangers of Drug Abuse in Workplace
RFP: Inform the employee about the dangers of drug abuse in the workplace, the
company's policy of maintaining a drug free workplace, any available drug counseling,
rehabilitation, employee assistance programs and the penalties that may be imposed
upon the employees for drug abuse violations.
Rural/Metro's Drug and Alcohol Use Policy states:
Drug and alcohol abuse has long been a problem of concern, and one that cuts
across all segments of society, including the workplace. Safety, health and
environmental quality are important to the company. The following policy has
been adopted not only to protect the health and safety of our employees and the
public we serve, but also to encourage any employee with a drug or alcohol
dependency problem to help him or herself by voluntarily seeking professional
assistance. The company shall take reasonable measures sufficient to assure that
drug or alcohol use by employees does not jeopardize the safety of company
operations, or adversely affect the company, its employees, its customers, and
the community; and that the organization complies with applicable state and
federal regulations.
During New Employee Orientation, staff are educated on the policy and informed of the
disciplinary actions taken following a violation.
3. Copy of Statement
RFP: Give each employee a copy of the statement specified in Paragraph 1.
Employees are provided with a copy of the comprehensive Drug and Alcohol Use policy
during the New Employee Orientation Program.
RFP# 12-005 Rural/MetrA g Pa a 49
Ambulance
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
4. Drug Rehabilitation
RFP: Impose a sanction on, or satisfactory participation in a drug assistance or
rehabilitation program, by any employee convicted of o drug -related crime or
determined to be a violation of the contractor's drug and alcohol control policy.
Employees who disclose to Rural/Metro that they have a problem with drug use will not
be terminated based upon that disclosure, provided they attend an approved
rehabilitation program. The employee will then be subject to unscheduled testing for at
least a 24-month period following the initial alcohol or drug test. Failure of any
subsequent test is cause for immediate termination. However, continued employment is
solely within management's discretion.
Rural/Metro also offers professional counseling, referral and educational services
through our Employee Assistance Program (EAP) provider. The EAP is a confidential
counseling and referral service that assists employees in managing personal concerns
that impact their well being. Licensed counselors are available 24 hours a day to assist
employees with concerns such as alcohol and substance abuse, among other issues.
5. Drug Testing Program
RFP: At the beginning of the contract period have a
drug -testing program in effect that addresses both
pre -employment drug screening and the periodic
testing of employees.
Rural/Metro's established Drug and Alcohol Use
Policy (Attachment 5) provides for both initial and
periodic drug testing of employees. Disciplinary
processes are in place to manage violations of the
policy. Failures upon initial pre -employment
screening are cause to deny employment.
C. Re->Employmem of Current Workforce
Upon Rural/Metro's acquisition of Health Central Paramedic Services last fall, the company
transitioned the workforce from Health Central to Rural/Metro of Florida. No Health Central
Paramedics or EMTs who applied for employment lost their positions. In addition, the
management team joined the Rural/Metro family. Both the Operations Manager and the
Market General Manager continue to oversee service delivery in Ocoee, bringing nearly 50
years of combined experience and history to our service.
RFPI# 12-005 RuraUMetro' Page 50
Ambulance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
The 41 Health Central Paramedic
Services employees who joined
Rural/Metro have deep roots in Ocoee
and the surrounding communities, and
we consider them to be valuable
assets to our program. No employees
lost pay, seniority or benefits in the
transition, and we remain committed
to employing these valuable team
members.
Our relationships with the local
hospitals remain strong. Rural/Metro is
the preferred ambulance provider for
ft
the employees that transitioned to
Rural/Metro following the company's
acquisition of Health Central Paramedic
Services.
all nine Orlando Health campuses, and recently signed a 5-year contract with Health Central
Hospital to serve their hospital campus and the Health Central Park nursing home.
RFP## 12-005 &P,911MeMo. Page 51
Ambulance
S,��crtlef of Gor�1j��
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES �I+f1Lti
FOR THE CITY OF OCOEE LLil�e
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IV. Customer Service Monitoring and Development
A. Program Development
Ensuring patient and stakeholder satisfaction is integral to Rural/Metro's system -wide
continuous quality improvement processes. Rural/Metro remains committed to working with
the City and Ocoee Fire Department to provide superior
customer service. Our customer service monitoring and
development initiatives will include:
• A dedicated customer service hotline published in
phone directories and online;
• An Ocoee -specific Web page that prominently
displays the customer service hotline number, key
corporate contacts (email and phone number), the
transport fee schedule and other desired
information;
• Web -based customer service surveys;
• Monitoring and reporting of key customer service
performance indicators; and
• Service objectives for patients, City/governmental
agencies and the receiving hospitals.
committed to providing
compassionate care and
superior customer service.
In Section B, below, we describe the mechanisms, recordkeeping processes and timeframes for
resolution of customer service inquiries. We also describe additional measures taken to address
any concerns among the key system stakeholders: patients, governmental entities and
receiving hospitals.
B. Mechanisms, Record Keeping and Time Frames for Resolution of Customer
Service Inquiries (Non -Billing)
RFP: The contractor shall log all inquiries and service complaints, including complaints involving
billing and collection issues. The contractor shall provide prompt response and follow-up to such
inquires and complaints. Such responses shall be subject to the limitation imposed by patient
confidentiality restrictions and HIPAA privacy rules.
The contractor shall on a monthly basis submit to the City a list of all complaints received and
their appropriate disposition/resolution. Copies of any inquiries and resolutions of a clinical
nature shall also be referred to the contractor's Medical Director within 24 hours.
RFP# 12-005ural/Metrn Page 52
Ambulance
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
It is the desire of the City that the contractor notify the Fire Chief regarding the most egregious
or criminal actions that could reflect negatively on the City or its employees. In these situations,
it is essential that this notification be made as soon as possible and apart from the monthly
reporting process. (G. Service Inquiries and Managing Complaints, pp. 24-25)
Patient satisfaction reflects not only upon our performance, but the City's entire EMS system.
Our goal is to ensure that every patient who accesses the 9-1-1 system leaves the experience
feeling that they or their loved one(s) were cared for in the best possible manner. Similarly, we
work every day to ensure our interactions with the EMS system's key stakeholders are positive
and productive. To accomplish these objectives, Rural/Metro will employ the following
customer satisfaction processes in Ocoee. These processes will be continuously refined with
input from the City, Ocoee Fire Department and the receiving hospitals.
Tracking Issues
Rural/Metro maintains a comprehensive customer service inquiry and unusual occurrence
reporting system that tracks all issues —regardless of source —via database.
Inquiries from all stakeholders are input via web interface and are designated a priority for
resolution, as listed below:
• Emergency: Paged out to the on -duty Crew Chief
• Priority 1: Entered into the database and allotted 24 business hours for resolution
• Priority 2: Entered into the database and allotted 72 business hours for resolution
Should an inquiry not be resolved in the required time, it is automatically "escalated" to the
senior management level. The following flowchart illustrates Rural/Metro's Customer Inquiry
Resolution Process.
RFP## 12-005 &P011Mfftra Page 53
ambulnnca
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
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RFP# 12-005 40 Q l$ �`p Page 54
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PROPOS
AL TO PROVIDE EMERGENCY /AMBULANCE SERVICES
FOR THE CITY OF OCOEE
Customer Hotline, Website & Surveys
Rural/Metro will invite patient feedback via a dedicated customer access hotline, a custom City
of Ocoee Web page and a Web -based survey system.
We will establish a dedicated Customer Access Hotline number and publish it in telephone
directories and on Rural/Metro's local Ocoee Web page. Calls will trigger a page to the on -duty
Crew Chief, who will promptly address critical issues. As described, above inquiries to the
customer access hotline will be attended to as follows:
• Emergency: Paged out to the on -duty Crew Chief
• Priority 1: Entered into the database and allotted 24 business hours for resolution
• Priority 2: Entered into the database and allotted 72 business hours for resolution
To ensure customer satisfaction, calls to the hotline number will be tracked as an indicator for
customer service and reported on a monthly basis to Rural/Metro's leadership team, as well as
to the City EMS Administrator, if
desired. Management promptly
addresses any issues that indicate
the need for system -wide
education to prevent recurrence.
In addition to the hotline,
Rural/Metro will develop a custom
Ocoee web page that contains
resources for the community, and
information about accessing 9-1-1
and the City's EMS system. Visitors
to the website will be able to view
service delivery information, such
as the fee schedule, the customer
service hotline number, a
dedicated customer service email
address, scheduled Rural/Metro
will provide customers with a current rate
schedule, access to contacts for billing and
other inquiries, and information about local
community education events.
and fire department community events, employment opportunities and information on public
access defibrillation. Rural/Metro will collaborate with the City and Fire Department to identify
the key information that will be included on the website.
RFP# 12-005 Page 55
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
Web -Based Customer Survey System
As the nation's leading provider of ambulance, fire protection and safety services, Rural/Metro
is committed to providing superior customer service in every area of our business. Through an
automated survey system, with a link on our local website, Rural/Metro seeks customer
feedback to help us gauge the quality of the services that our patients receive from our
personnel so that we may continue to build upon our reputation for providing clinical
excellence and superior customer service.
Information is collected and shared with local managers, so that feedback and responses can be
reviewed and the system improved. The data can also be compared to other service areas to
help us better identify industry trends, best practices or areas in need of companywide
enhancement. Following are screenshots of the survey system.
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RFP# 12-005 tdk NrrrallMetro' Page 56
Rmhrilance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
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RFP# 12-005 JIMflool/I Iro Page 57
Ambulance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
Community Outreach & Education
Rural/Metro believes community outreach and education
form the foundation for excellent customer service. We
recognize our responsibility to the public, and we strive to
be an exceptional community partner. Rural/Metro seeks
to be an integral part of the emergency medical service
system and the larger community in Orange County and
the State of Florida. We are committed to sharing
recognition of our public relations and educational efforts
with all the system's stakeholders. Further, we shall
continue to be an eager participant in community events
initiated by our partners in the City and will work
cooperatively with the City to develop customized
programs that address local community education needs.
Locally, Rural/Metro employs a full-time Business
Development Manager who directs multiple community
education outreach efforts. Our involvement in the
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outreach efforts will include
educating children about
health and safety issues and
the role of 9-1-1.
community begins at the top, where, in addition to the Business Development Manager, the
entire management team leads the organization by example. Rural/Metro's managers actively
participate in community organizations throughout Central Florida, including the Chambers of
Commerce, youth and senior organizations, nonprofits and others to educate specific
populations about emergency medical services and community health issues, as well as to
support their own initiatives.
Below are descriptions of a few popular programs that greatly impact health and safety among
Orange County residents.
• Community CPR: Rural/Metro of Central Florida
proposed to start community outreach CPR training
free of charge for the cities of Ocoee, Winter Garden
and the Town of Windermere. These programs were to
be done in collaboration with the Fire/Rescue
Departments from both cities. The classes would be
held the 3rd Saturday of each month and alternated
between the cities. Odd month's classes would be held
in the City of Winter Garden and even month's classes
RFP# 12-005 Ifural/MenrD Pa a 58
Ambulance g
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
would be held in the City of Ocoee. For the Town of Windermere, we proposed to host
CPR training and certification once every two months. We are thrilled to report that this
community program has been very successful. Demand for classes has been steadily
increasing. We have enjoyed the opportunity to educate and train an average of 100
citizens from all 3 cities.
• Community Event Participation: We at Rural/Metro of Central Florida take pride in
being considered more than just a 9-1-1 provider. We like to be known as community
partners to the cities and counties we serve throughout Florida. Here is a summary list
of all the community events we have either participated in, donated our stand—by
services to, or will be a part of in the near future.
Recent City of Ocoee Events:
Martin Luther King Jr. Parade
Education in Hands -Only CPR for children ages 6 to 18 during the Heart
Screening event hosted by Saving Young Hearts at Legacy Charter High School
Ocoee 7th Annual Spring Fling
Safety Saturday at the Park:
Rural/Metro hosts "Safety
Saturday at the Park" events to
educate citizens on the
importance of Hands Only CPR
and Safety in a fun and relaxed
environment. We serve hot dogs,
beverages and chips, and provide
face painting for the children. Two
learning booths are set up, one
dedicated to CPR training, and
another where folks can learn
how to create an inexpensive
first -aid kit. In addition, an
ambulance is available for touring.
CPR and safety education in a relaxed, family -
friendly environment.
Please see Attachment 10 for copies of a recent advertisement announcing local community
education events, as well as copies of recent media coverage on Rural/Metro events.
RFP# 12-005 40 AnyNdfince
&PRIMe1ro' Page 59
��cnler of Gooy Llvl^
S -sY
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES ���
FOR THE CITY OF OCOEE
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V. Fleet and Equipment Issues
A. Number of Vehicles Needed
RFP: The contractor shall be responsible for providing all necessary vehicles and vehicle
maintenance for vehicles owned by the contractor. (C. Contractor's Responsibilities, p. 20)
RFP: It is the contractor's responsibility to provide ambulances capable of transporting patients
receiving ALS care that meet the federal Triple K specifications, and State of Florida Minimum
Standards. The contractor shall also provide all medical and technical hardware and software
needed to properly equip each ambulance. (Scope of Services, Section B., p. 21)
Rural/Metro has dedicated 5 new
ambulances to our service in West Orange
County, including the City of Ocoee. Three
of these vehicles are brand-new Taylor
Made ambulances, and two Wheeled
Coach ambulances were purchased from
Health Central last fall. These are also
young vehicles with low mileage.
To maintain system continuity,
Rural/Metro maintained the Health Central
branding scheme, and the ambulances are
labeled "Rural/Metro Ambulance —Serving
West Orange."
dedicated to our service in West Orange
County.
These vehicles currently meet the federal Triple K specifications and meet or Exceed State of
Florida Minimum Standards. Rural/Metro will also continue to provide all medical and technical
hardware and software needed to properly equip vehicles in service in Ocoee.
B. Ambulance and Equipment Maintenance Practices
RFP. It is the contractor's responsibility to maintain and equip each ambulance in accordance
with State of Florida guidelines for ALS transport vehicles. The contractor and its medical
director may choose to stock each vehicle with additional equipment, tools, and protective
clothing beyond that which is required by state guidelines; such equipment shall be compatible
with the City's fire service agencies' equipment. (Section B., p. 21)
Rural/Metro will continue to maintain and equipment each ambulance in accordance with State
of Florida guidelines for ALS transport vehicles. We understand that Rural/Metro and the
medical director may choose to stock each vehicle with additional equipment, tools, and
RFP# 12-005 A AUj ° Page 60
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
protective clothing beyond that which is required by state guidelines; all such equipment will be
compatible the City's fire department equipment.
RFP: Vehicle Maintenance shall be the responsibility of the contractor in accordance with the
warranty maintenance specifications of the vehicle manufacturer. Records shall be kept far all
maintenance and repair work and shall be made available to the City upon request. The City
expects all ambulances and equipment used in the performance of the project to be maintained
in an excellent manner. Any ambulance, support vehicle, and/or piece of equipment with any
deficiency that compromises its function must be immediately removed from service. All
maintenance costs shall be the responsibility of the contractor. Any vehicle repairs, parts
replacements, or general up -keep shall be the responsibility of the contractor. Vehicles are to be
kept clean and fully stocked. The contractor shall maintain, store and dispose of all bio-medical
equipment and by products in accordance with the appropriate state and OSHA guidelines.
(Section 8, pp. 21-22)
Maintaining response -ready vehicles
and equipment is essential to our EMS
mission. Rural/Metro is highly
experienced at effectively managing
fleet and equipment inventories for
large EMS systems. Nationally,
Rural/Metro's fleet management
experts ensure the response readiness
of approximately 1,800 vehicles.
Our fleet maintenance program has
the following objective:
Eliminate equipment failure that may
endanger human life, and ensure
practices ensure our vehicles ready for
service in the City of Ocoee.
professional and effective delivery of pre -hospital care through Rural/Metro's safety inspections,
aggressive preventive maintenance program and proactive daily pre -trip inspections.
To this end, Rural/Metro utilizes well -monitored preventive maintenance and parts inventory
control programs. Detailed electronic maintenance records are maintained for the life of all
company vehicles using fleet maintenance software by Ron Turley & Associates (RTA,
www.rtafleet.com). This automotive repair information system provides immediate access to
current repair procedures, illustrations, vehicle wiring diagrams and recall notices.
RFP# 12-005 4$ Rur81/10MV, Page 61
Amhulance
tftPROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
Rural/Metro's local Fleet Manager maintains a close working relationship with the
manufacturers' representatives, who provide training and software updates as necessary. The
Fleet Manager also regularly accesses the Rural/Metro Fleet Web Service —a data -sharing
forum for Rural/Metro fleet managers throughout the United States that's used to exchange
vital information, such as vehicle tracking and monitoring, recall notices and ambulance
retirement.
To ensure our fleet maintenance program is achieving its objectives, Rural/Metro's Fleet
Manager tracks local key fleet performance indicators on a monthly basis. These indicators
provide a snapshot of the current fleet status, including:
• Vehicle count
• Pre -Trip Inspections
• Safety Inspections
• Preventive Maintenance Complete, 5,000 miles
• Preventive Maintenance Complete, 7,000 miles
• Drive Cam Activations
• Drive Cam Downloads
• Units Out of Service Internal, Days Out
• Units Out of Service Outsourced, Days Out
• Total Out of Service
• Mileage
To keep the field providers updated on the status of units out of service, the Fleet Manager
posts notices on a community board where crews receive their vehicle assignments.
Maintenance records are maintained for the life of each vehicle and shall be available to the
City for analysis and inspection at any time. Records include, but are not limited to, the items
referenced in the table below.
RFP# 12-005 Ilural�Metr° Page 62
0AP00fice
PROPOSAL. TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
M
Vehicle Maintenance & Records
Record Item
Description
Frequency
Inspections
every 11-14 days on vehicles doing less than
Weeks
2,500 miles per month. Includes
undercarriage visual, rear brake adjustment
fluid check, hose check, testing of all lights
and aesthetics inspection.
Preventative
Oil and oil filter change, lubrication and
5,000/mi
Maintenance I
additional visual inspection.
Preventative
PM I process completed and drive belt
20,000/mi
Maintenance II
replacement and transmission service
completed.
Preventative
Includes both PM I and PM II and differential,
40,000/mi
Maintenance III
cooling system service.
Maintenance Invoices
Repair maintenance invoices are completed
As needed
as needed for preventative maintenance
repairs and /or urgent repairs.
Vehicle Registrations
All vehicles are registered yearly with the
Annually
Florida Department of Highway Safety and
Motor Vehicles, with the exception of
exempt vehicles.
Florida Office of
FOEMS inspections and licensing
Annually
Emergency Medical
Services Reports
Vehicle Incident Reports
If a vehicle is damaged in any way complete
As needed
documentation of this, and any repairs done
as a result are included in damage reports
and kept in the vehicles file.
RFP# 12-005 IJ�°C/Metr° Page 63
Amlu�lance
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
Fleet Maintenance Personnel
Rural/Metro's Fleet Manager oversees two mechanics that work as a team to maintain a
response -ready fleet in Ocoee at all times. Qualifications of maintenance personnel include:
• Minimum two years of general automotive experience;
• Valid driver's license with an acceptable driving record;
• Flexible and on -call scheduling availability; and
• High school diploma or equivalent.
Field -Level Maintenance
Employees respect and take pride in vehicles and equipment that are well maintained,
enhancing the overall quality and delivery of pre -hospital medical care. Rural/Metro's
comprehensive fleet maintenance program involves both field personnel and fleet mechanics
that work together to provide regular inspections, appropriate documentation and preventive
maintenance.
Rural/Metro field crews complete a comprehensive daily vehicle inspection report for each
ambulance before it is put into service or at the start of each shift, whichever is more frequent.
The inspection includes:
• Tire pressure and condition;
• Oil and fuel levels;
• Electrical system condition;
• Safety and medical equipment condition; and
• Overall vehicle
condition and
cleanliness.
Crews log any concerns on a
Pre -Trip Inspection Form,
which is delivered to the
maintenance shop for further
attention. Any concern that
may compromise crew or
patient safety is addressed
immediately through the use
of a duty mechanic who is on
skilled, professionally trained and certified mechanics.
io
RFP# 12-005 !!oral/Meld Page b4
Ambulance
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PROPOSAL TOPROVIDEEMERGENCYAMBULANCESERVICESFOR THE CITY OF OCOEE
call around the clock, or the vehicle is placed out of service until concerns are addressed. All
ambulance crews are empowered to place a vehicle out of service, or not accept for service any
=-ambulance or piece of equipment that appears to be unsafe based on the "North American
Standard Out of Service Criteria."
Rural/Metro employees will maintain, store and dispose of all bio-medical equipment and by
products in accordance with the appropriate state and OSHA guidelines.
C. Equipment Replacement
Most durable medical equipment (DME) repairs are covered under a service agreement with
individual manufacturers. For example, Rural/Metro will contract with Physio Control to
maintain our !_ifePak 15 Defibrillator/Monitors. Stryker has trained and certified several local
according to the manufacturer's guidelines.
Rural/Metro employees to provide
preventive maintenance and minor repairs
to our stretchers. Ventilators and CPAP
machines are sent offsite for preventive
maintenance and repair per the
manufacturers' recommendations. DME
replacements occur if the equipment is
out of order, reaches its end of service life
as determined by the manufacturer, or an
upgrade is desired.
Injuries or equipment malfunction are
reported and documented the same day of
occurrence. When applicable, Rural/Metro will report DME failures to the FDA. The item serial
number is logged and tracked to ensure it is repaired prior to being re -issued. Once an item is
cleared, a label is applied stating it is available for use. All maintenance records are maintained
for the life of the equipment and will be available for City inspection upon request.
Crews are required to keep all medical equipment clean and properly maintained. Ambulance
personnel who encounter a failure of their defibrillator/monitor or gurney must immediately
notify the Crew Chief, who will place the unit out of service until such equipment is exchanged.
Additional policies exist to address drug boxes, airway bags, suction equipment, blood pressure
cuffs and other durable medical equipment. Field personnel perform daily equipment checks
prior to the start of their shift to ensure all equipment is accounted for, in working order and
ready for service.
RFP# 12-005 QO QcE g Page 65
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FORTH E CITY OF OCOEE
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The Materials Manager ensures all DME undergo preventative maintenance according to the
table below, maintaining logs for the life of all equipment.
Name
MaintenanceEquipment
Type of
Frequency
CPAP device
Inspect, test, measure, calibrate and
Semi -Annual
repair
End Tidal CO2 Monitors
Inspect, test, measure, calibrate and
Semi -Annual
repair
Extremity Traction Splint
Safety Check Inspection
As Needed
Gurney
Safety Check Inspection
Semi -Annual
KED type device
Safety Check Inspection
As Needed
Pediatric Immobilization device
Safety Check Inspection
As Needed
Pelican Type Portable Medication
Box
Safety Check Inspection
As Needed
Portable cardiac monitor
Inspect, test, measure, calibrate and
Semi -Annual
repair
Portable Defibrillator
Inspect, test, measure, calibrate and
Semi -Annual
repair
Portable Medication Box
Safety Check Inspection
As Needed
Portable Oxygen with Regulator
Inspect, test, measure, calibrate and
As Needed
repair
Portable suction (battery powered)
Inspect, test, measure, calibrate and
As Needed
repair
Pulse Oximeter
Inspect, test, measure, calibrate and
Semi -Annual
repair
Spinal Immobilization Device
Safety Check Inspection
As Needed
W/Straps
Standard Trauma Bag or Box
Safety Check Inspection
As Needed
Rural/Metro's comprehensive Standard Operating Procedures include procedures that ensure
response vehicles are properly stocked and that equipment is clean and fully functional. In
addition, the Rural/Metro intranet offers a simple online process for ordering supplies via the
J.D. Edwards supply system.
Rural/Metro's Standard Operating Procedures include policies on the following
vehicle/equipment/supply issues. These policies also cover controlled substance storage,
distribution, usage and documentation in compliance with all state and local laws:
• Expiration of Consumable and Disposable Goods
RFP# 12-005 1lrrral/MeMn Page 66
AMAIA nce
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
• Supply Restocking
• Apparatus Medical Equipment
• Disposition of failed or broken equipment
• Gurney failure
• Daily Vehicle and Equipment Inspections
• Ambulance Out -of -Service Criteria
• Clinical criteria
• Mechanical criteria
• Operational/administrative criteria
• Controlled Substances (Initial stocking of controlled substances, Restocking of controlled
substances, Expired/damaged medication, Controlled substance record keeping,
Controlled substance inspection/audit, Lost medication)
• Pharmaceutical Rotation
• Out of Service Vehicle Switch Process
RFP# 12-005 Bura+�tr° Pa a 67
40AMAfflance g
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
VI. Billing and Collection
A. Billing Processes to Maximize 31'd Party Payments
RFP: The contractor shall conduct all billing and collection functions for the EMSsystem in a
professional and courteous manner. The City's goal is for the contractor to collect the maximum
amount available from patients and third party payers, without unduly pressuring those who
legitimately cannot pay.
The Respondent must fully outline its billing and collection policies and procedures in its
proposal. This should include samples of invoices, reminders, telephone collection methods and
handling accounts turned over to collection. Policies about acceptance of assignment and write-
off should be specifically addressed. (D. Billing System Access to Information, p 29)
1. Local Access
RFP: A specified local phone number for inquiries from patients and third party payers
shall be provided by the contractor for patient's use.
Rural/Metro will provide our Ocoee customers with a local phone number for billing
inquiries from patients and third -party payers.
2. Web Page Access
RFP: The contractor shall provide billing and payment information in a web -based
format. Patients shall have the opportunity to make inquiries, access service fees and
locate company contact information.
Rural/Metro has made it easy for
patients to contact the company
regarding billing issues. On the
company's web page is a link dedicated
billing -related inquiries, including online
payments, email links for submitting
questions, and contact phone numbers
for people seeking direct assistance.
To make it easier for website visitors, a
second page entitled "Contact Us"
provides a feedback form, local address
and local phone number for non -billing
related questions.
E �
u
� &+ IKG NTACTS
� � a
PeyA@P,y a:!Iwi .Yhm wPaaOnPrw :� Wan.
mbuf." Bill E 3 Pad Flrc Su -I
RFP## 12-005 Rural/Me�a' Page 68
AWWWnce
tft
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
A new page sharing rate information for the City of Ocoee, as requested in the RFP, can
also be quickly added to the local pages of the website. All inquiries are promptly
addressed in compliance with HIPAA guidelines.
3. On -Scene Collection Prohibited
RFP: For services provided within the City of Ocoee service area, the contractor shall not
engage in on -scene collection for local services at scene, en route, or upon delivery of the
patient at the receiving medical facility.
Rural/Metro field employees never attempt or engage in on -scene collection for
services at scene, en route or upon delivery of the patient at the receiving medical
facility. Field employees' sole focus is on providing exceptional patient care without
regard for patients' ability to pay. These policies and expectations are discussed in detail
during our New Employee Orientation Program.
4. Third -Party Billing and Collection
RFP: The contractor may engage, at its sole expense, a third -party agent to provide EMS
billing and collection services.
Rural/Metro does not intend to utilize a third -party agency to provide our EMS billing
and collection services. Billing functions will occur locally, with oversight and
administration from our national billing office based in Indianapolis. In addition to
providing customers with a toll -free number and website access to the billing office,
Ocoee customers will receive a local phone number for billing inquiries. Internal
collections will be handled out of Rural/Metro's Scottsdale, Ariz., office.
5. Audits and Inspections
RFP; The contractor shall provide the City with an annual audited financial statement
prepared by an independent public accounting firm in accordance with generally
accepted accounting principles consistently applied. Statements shall be available within
150 days of the close of each fiscal year. If the contractor's financial statements are
prepared on a consolidated basis, then separate balance sheets and income shall be
subject to the independent auditor's opinion.
Rural/Metro will provide the City with an annual audited financial statement prepared
by an independent public accounting firm in accordance with generally accepted
accounting principles consistently applied. Statements will be available within 150 days
of the close of each fiscal year. Rural/Metro requires that all financial information
provided to the City remain confidential and not subject to public records requests.
RFP# 12-005 40 RuraUMetru Page 69
Ambulance g
�Gcnter °FCC, ��
S
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
�,caE�
FOR THE CITY OF OCOEE
Flandl
Billing and Collection Program Overview
Rural/Metro's billing process integrates our field and operations personnel, resulting in
improved customer service and timelier collection of outstanding invoices. Our data processing,
billing, collection and accounts receivable management system was custom -designed to meet
the specific needs of ambulance operations. We have proven experience managing ambulance
service billing in more than 425 communities throughout the nation, including the City of
Ocoee.
Our billing program
operates on an IBM
AS400-Model 70, and will -
link with the ambulance
computer -aided dispatch
(CAD) system as well as BILLINOCuSTOM RR FIELD CUSTOMER RELATIONS
RELATIONe
Rural/Metro's electronic 19,
patient care record (ePCR)
system to accurately and
immediately capture
charges in the field. The 04LLINO AND COLLErnONs
COMMl1NICAiION9 CENTER
AS400's enhanced data t�v/
processing capabilities and
customer -driven systems a
allow Rural/Metro billing
personnel to maintain OPERAnO T AININGCILIAT ONa CREW
accurate records and
include the capacity to:
• Automatically generate Medicare and Medicaid statements;
• Accommodate private -pay, contract accounts, Medicare Diagnosis Related Groups
(DRGs) and other reimbursement classifications;
• Produce itemized statements, with a corresponding charge for each;
• Respond to inquiries regarding submission of insurance claims, dates and types of
payments made, itemized charges, Explanation of Medicare Benefits (EOMB) resolution,
and other inquiries;
• Provide specialized follow-up on outstanding accounts; and
• Provide adequate audit functions to account for bad debt ratios to support rate
adjustments.
RFP# 12-005Page 70
Ammance
ift
PROPOSALTO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
Patient billing functions will be performed at Rural/Metro's local business office. Patients will
receive a local telephone number to contact a local billing liaison as well as an 800 number with
which to reach the office. Our local website link for Ocoee will also provide phone contact
information and email access to billing customer service representatives.
Capture of Patient Charges in the Field
Rural/Metro's billing process begins with the automated capture of patient care data in the
field. Our AS400 billing program ties directly in our computer aided dispatch (CAD) and
RescueNet ePCR systems, to ensure the immediate and accurate documentation of services
provided from the initial call through transport to the hospital. This system eliminates the
possibility of losses due to missing paper patient care records as well as the need for billing
personnel to re-enter data into the billing system. Further, the automated ePCR system
requires field crews to thoroughly document care before a record can be closed, ensuring
complete documentation.
Patient Accounts Pre -Bill Function
Data collected in the field is automatically transmitted to the patient account office, which
performs Rural/Metro's pre -bill and post -bill functions, and provides customer service. The pre -
bill function:
• Receives and logs -in run tickets;
• Prepares run tickets for processing;
• Determines medical necessity;
• Builds customer records;
• Builds invoices; and
• Codes invoices.
At this point, Rural/Metro generates and sends an invoice to the responsible party (e.g.,
Medicare, Medicaid, commercial insurance, the patient, etc.). The ambulance billing system
automatically sets an appropriate follow-up date based upon the expected response time from
that payer. Sample invoice are provided as requested on the following pages.
RFP# 12-005 am E Page 71
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
0 RURAL METRO AMBULANCE
PO BOX 99999
ORLANDO. FL 32811
99999
1880q-0289
RETURN SERVICE REQUESTED
PAY THISAMOUNT
INVOICE
DATE
$506.50
9999999
11/17/10
r�rll�lllll�Irtllllllllrllhr'11i1rurrl4l[Ilhldllla�llrrlul
JOHN DOE
1234 MAIN ST
ANYTOWN, USA 99999
M
INSURANCE INFORMATION
IF YOU PROVIDE US WITH INSURANCE INFORMATION,
WE MAY BE ABLE TO SUBMIT A CLAIM ON YOUR
BEHALF. HOWEVER, PAYMENT IN FULL 15 DUE
UPON RECEIPT OFTEN BILL,
INSURANCE NAME:
MEDICARErPOLICY NO:
GROUPNO:
NAME OF INSURED:__
EMPLOYERISCHOOLNAME:
I I J II l ll i 1h191iu rI I ILL II I I'l l l l l l l ll' l l' l l ll ll l r rl l it l lu i[I
RURAL METRO AMBULANCE
PO BOX 99999
ORLANDO. FL 32811
PB
f-1%ease check bax d yauraddres is incorrect ar insurance information SD 00010067588672 00000010448 9
"has changed, and iodic afe change(s) on reverse side,
PAGE NO. 1 OF 1 1B80q-0289 T2WOBWPF100D001
I iucsa
r FLEASEDETACHAT PDT MD RETURN TOPFORT10N WfrH YOUR FAYMWT STATEMENT PATIENT: JOHN DOE
SERVICE PROVIDED BY:
RURAL METRO AMBULANCE
Federal Employer ID 91-1176902
CALL SOURCE: ST JOSEPH HOSPITAL TACOMA
PICK-UP: ST JOS HOSP TAC
DESTINATION: HARBORVTEW HOSP
DATE OF
PAYMENT/
QTY/
CHARGE
SERVICE
ADJUST DATE
DESCRIPTION OF SERVICE
UNITS
RATE
-AMOUNT
10/08/10
ALS EMERGENCY
1
475.00
975.00
10/08/10
ALS MILEAGE
3
10.50
31.50
We recently had the opportunity to serve you by providing medical services andlor transpo.rtatlon.as required by
your medical situation,
At this time, the balance for the above account is now due and payable. We request that you remit the balance in
full today, or that you contact our office to make payment arrangements.
If you provide us with insurance information, we may be able to submit a claim on your behalf; however, payment In
full is due upon receipt of this bill.
Visa, Mastercard, Discover, American Express or your personal check is accepted by phone
CUST ACCT #
INVOICE#
SERVICE DATE
TIME OF CALL
INCIDENTff
TOTAL PAID
TOTAL CHARGES
SD9999999
9999999
10/08/10
17.30:15
99 99 99 999 99 99
$0.00
$506.50
INQUIRIES CALL: 206/652-4779 OR: 1 8771571-2544
"r r bill Afly ON-LINE or SPEEDPAW For ON-LINE PAYMENTS; KIrurarmeetra,cwisparodipy
Fry. Fast, Bah nd rnmeaate For TT1nFI9 StJVBLITY �I1 UR 71PIS
16804-0289'T2VV0RV14TI 000001
PLEASE PAY
(THIS AMOUNT $506.50
IIIIII�1��11�11�111��11���11
RFP# 12-005 OWP Page 72
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
tft
IF ANY OF THE FOLLOWING HAS CHANGED SINCE YOUR LAST STATEMENT, PLEASE INDICATE ....
ABOUT YOU:
YOUR NAME ILa.i. First, Middle InllfaU
ADDRESS
CITY
STATE
ZIP
TELEPHONE
}
MARITAL STATUS
Single
❑Married
EjSeperalsd
❑ DI -rand
❑ wd—d
EMPLOYER'S NAME
TELEPHONE
S F
EMPLOYER'S ADDRESS
CITY STATE
ZIP
ABOUT YOUR INSURANCE:
YOUR PRIMARY INSURANCE COMPANY'S NAME
EFFECTIVE DATE
PRIMARY INSURANCECOMPANY'SADCRESS
PHONE
CITY
STATE ZIP
POLICYHOLDER'S IO NUMBER
GROUP PLAN NUMBER
YOUR SECONDARY INSURANCE COMPANY'S NAME
EFFECTIVE DATE
SECONDARY INSURANCE COMPANY'S ADDRESS
PHONE
CITY
STATE ZIP
POLICYHOLDER'S ID NUMBER
GROUP PLAN NUMBER
RFP# 12-005 Rural/Matra' Pa a 73
AmmOned g
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
RURAL METRO AMBULANCE
PO BOX3495
TOLEDO, OH 43607
1 FRRd_N96R
PAYTHISAMOUNT
CUSTACCT#
DATE
506.50
9999999
Nov 12, 2010
4oter of Coin y2n �
Fladde
INSURANCE INFORMATION
IF YOU PROVIDE US WITH INSURANCE INFORMATION,
WE MAY BE ABLE TO SUBMIT A CLAIM ON YOUR
BEHALF. HOWEVER, PAYMENT IN FULL IS DUE
UPON RECEIPT OF THIS BILL.
INSURANCE NAME:
MEOICAREIPOLICY NO:
GROUP NO:
NAME OF INSURED:
FMPLOYER/SCHOOL NAME:
III Jill l'lIIII'llllll'lll'llllll'llllllllllllllllllllllll'll11111 Ilrllllllllldyllrlrllllllllll'11llllllllll'IIIIIIIIIIIII11'Irll
JOHN DOE RURAL METRO AMBULANCE
1234 MAIN ST PO BOX 999999
ANYTOWN, USA 99999 OR LAN DO, FL 32811
P1
PAGE NO, 1 OF 1
18804-82AG' T200NH2U3000001 PI.RIPI.RM P I RP2
11 Please check boa if your address is incorrect or insurance information
II has changed, and indicale change(s) on reverse side.
1 FLEASEDErACHATPHdFANDREfURNTOPFORTIONWITH YOUR MYMMT STATEMENT
SERVICE PROVIDED BY:
RURAL METRO AMBULANCE
WA 00010❑L5944331 DDD❑D139800 7
PATIENT: JOHN DOE
INVOICE #
REGARDING
AMOUNT
OWED SERVICE DATE
9999999999999
JOHN DOE
506.50
08/27/10
OUR RECORDS INDICATE THAT YOU HAVE NOT RESPONDED TO OUR PRIOR REQUEST.FOR INFORMATION
AND PAYMENT FOR SERVICES RENDERED. WE REALIZE CIRCUMSTANCES MAY HAVE PREVENTED YOU
FROM ATTENDING TO THIS MATTER.
VISA, MASTERCARD, DISCOVER, AMERICAN EXPRESS OR YOUR PERSONAL CHECK IS ACCEPTED BY'
"PHONE:
PLEASE REMIT BALANCE IN FULL TODAY, OR TELEPHONE OUR OFFICE TO MAKE PAYMENT ARRANGEMENTS.
INQUIRIES CALL: (999) 999-9999
CUSTACCT # 9999999 11PLEASE PAY 71
PATIENT: JOHN DOE IITHIS AMOUNT 506.50 II
P1 THIS BILL IS YOUR RESPONSIBILITY
ELEPHONE 24 hours a day.
SPEEDPAY®Pay your bill Inslantly ON For ON-LINE PAYMENTS: -LINE orwww ru aimetro.com/speadpiiy
"Easy. Fast, safe and Irnmediafe" For TELEPHONE PAYMENTS: 1-866.215-2699 (Toll Free)
16004-02AG`T2QONH2U3000001 IIl1II111111loll am mill
RFP# 12-005 40 fluraUMe�r° Page 74
amlwlance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
RURAL METRO AMBULANCE ®'
PO BOX 5
TOLEDO, EDO, OH 43607
I88n4-A9An
BALANCE DUE
OUST ACCT *
DATE
506.50
9999999
Nov 12, 2010
rlAllrllllllr.r111trr1ill111111111loll Pirrrlpllrr1114111111
JOHN DOE
1234 MAIN ST
ANYTO", USA 99999
�R Y�aA ORA�eieeN eeFP nLLoue eF�ne_
CHEGM. CA=o U911K+FOR PAYNFxT
OTeO fluHBEk rn 80NArWE 000E ,F
SHOWAMOUNT
PAID HERE $
dul1Jill Jill 1111rrr91111111Jdllrltllhl'I'll"IIu11r1u11J
RURAL METRO AMBULANCE
PO BOX 911203
DALLAS, TX 75391-1203
D1
PAGE NO. 1 OF 1
16004-92AUT20ONDOV4000001 DI.RMD1.RMD1FP2 pq pppp1p5p 699113 pppp p1p2161 7
11 Please check boot if your address is incorrect or insurance information
I I I has changed, and Indicate change(s) on reverse gde. Iu W
r PLFASE DFrACO AT PEZF AND RETURN TOP POUION WITH YOUR PAYMENT
COLLECTION DEPARTMENT NOTIFICATION
IMMEDIATE ACTION REQUIRED
BALANCE DUE: 506.5D
Dear JOHN DOE:
YOU R ACCOUNT(S) HAVE B EEN ASSIGNED TO THIS DEPARTMENT FOR COLLECTIONS.
If paid in full to this office, all collection activity will stop. Keeping in mind this is a legal obligation, we demand that you remit the
balance In full today, or contact us by telephone immediately to arrange for suitable payment arrangements.
Visa, MasterCard, Discover, American Express, and personal checks are accepted:
ON-LINE PAYMENTS: www.ruralmeiro.com/speedpay
TELEPHONE PAYMENTS: 1-866-215-2699 (Toll Free.24•hours day)
MAILINGPAYMENT: RURAL METRO AMBULANCE
PO BOX 911203
DALLAS, TX 75391-1203
If you have already made payment - Thank You -Please disregard this notice.
COLLECTION DIVISION of
RURAL METRO AMBULANCE
1-800-468-0219 YOU CAN EMAIL US AT: RMCollect&metro.com
Detail of Accounts:
lax
INVOICE# REGARDING AMOUNTOWED SERVICEDATE
9999999999999 JOHN DOE 506.50 11/01/04
Pay Your bill inelell0y ON-LINE Or by TELEPHONE 24 hours a day.
For ON-LINE PAYMENTS: www.ruminietro.comfspeedpsy
•Euy. Fmi, esh and rmmadlam" For TELEPHONE PAYMENTS: 1-855-215-2699 (Tall Free)
188n4-92AG'T2Q0ND9V4000001
®An
RFP# 12-005 ALM ffi ral/Melre' Page 75
Rmhrrlance
tft
PROPOSAL TO PROVIDEEMERGENCYAMBULANCESERVICESFOR THE CITY OF OCOEE
Patient Accounts Post -Bill Function
If Rural/Metro does not receive payment for the full balance within the expected time frame,
the post -bill staff follows up. Past -bill personnel:
• Contact the payer to determine the status of the claim;
• Initiate appropriate action taken based on the payer's response;
• Resubmit the claim, if not received by the payer;
• Research missing payments;
• Research denials, bill secondary insurance, bill the customer or adjust the balances, as
appropriate; and
• Invoice the customer if the payer has paid him/her directly.
When all insurance has been exhausted, the customer or responsible party is billed for any
balance remaining on the invoice. The following diagram illustrates Rural/Metro's billing and
collection timeline.
RuraVMetro COrporatlon
BILLING & COLLECTION LETTERS
PRIVATrz PAY CYCLE
BILLING STATEMENTS COLLECTION STATEMENTS
MIA' am INN I
Patient Second Collection Final
Bill Notice Notice I Nolice
21 days 1 21 days 1 21 days
Day 1 Private Pay Cycle Day 120 Oulsource to Collection Agency
Interest -Free Payment Plans
It is unlawful to waive/fail to collect or discount co -payments, deductibles, coinsurance or other
patient responsibility payments per the Federal False Claims Act, Federal Anti -kickback Statute,
and state and federal insurance fraud laws. It is also in violation of our many managed care
contracts. This includes services deemed as "professional courtesy" and "TWIPS --Take What
Insurance Pays."
RFP# 12-005 40 Rural/Metro' Page 76
Ambulance
tft
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
Therefore, Rural/Metro's Billing Department cannot waive or apply a discount to fees deemed
to be the patient's responsibility, except under very specific circumstances. However, we do
recognize that a patient may not be able to pay the account in full in one payment, and have a
procedure in place that allows for the patient or responsible party to make payments. Our
Customer Service Representatives are authorized to set up reasonable, interest -free monthly
payment plans.
Under extreme circumstances, after all collection activity has failed, the account will be
considered for write-off if the patient is at or below 200% of the current federal poverty
guidelines. Evidence of this status is obtained from W-2 withholdings statements, pay check
stubs, income tax returns, forms from Medicaid or other state -funded medical assistance,
forms from employers or welfare agencies.
City Inspection & Access to Records
RFP: At any time during normal business hours and as often as may be reasonably deemed
necessary, City representatives may observe the contractor's office operations, and the
contractor shall make available to the City for its examination any and all business records,
including incident reports, patient records, and financial records of the contractor pertaining to
the contract, The City may audit, request a subsequent audit or a special audit, copy, make
transcripts, or otherwise reproduce such records including but not limited to contracts, payroll,
accounts receivable, inventory, personnel, and other records, daily logs, employment
agreements, and other documentation for the City to fulfill its oversight role.
A City representative may ride as a "third -person" on any of the contractor's ambulance units at
any time, provided, that in exercising this right to inspection and observation, City
representatives shall conduct themselves in a professional and courteous manner, shall not
interfere with the contractor's employees' duties, and shall at all times be respectful of the
contractor's employer/employee relationship. (D. Billing System and Access to information, pp.
29-.30)
Rural/Metro will welcome, at any time during normal business hours and as often as may be
reasonably deemed necessary, City representative to observe office operations, and
Rural/Metro will make available to the City for its examination any and all business records,
including incident reports, patient records, and financial records of the contractor pertaining to
the contract. We agree that the City may audit, request a subsequent audit or a special audit,
copy, make transcripts, or otherwise reproduce such records including but not limited to
contracts, payroll, accounts receivable, inventory, personnel, and other records, daily logs,
employment agreements, and other documentation for the City to fulfill its oversight role.
RFP# 12-005 Rural/Metrn Page 77
Ambulance
tft
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
Rural/Metro also agrees that a City representative may ride as a "third -person" on any of the
ambulance units at any time, provided, that in exercising this right to inspection and
observation, City representatives shall conduct themselves in a professional and courteous
manner, shall not interfere with Rural/Metro employees' duties, and shall at all times be
respectful of Rural/Metro's employer/employee relationship.
B. Mechanisms, Record Keeping and Time Frames for Resolution of Customer
Service Inquiries (Billing)
RFP: The contractor shall log all inquiries and service complaints, including complaints involving
billing and collection issues. The contractor shall provide prompt response and follow-up to such
inquires and complaints. Such responses shall be subject to the limitation imposed by patient
confidentiality restrictions and HIPAA privacy rules. (G. Service Inquiries and Managing
Complaints, p. 24)
Customer service is a top priority, and our billing personnel receive extensive training and
oversight to ensure customers receive prompt, courteous service that complies with company
policies and state and federal laws. Customers in the City of Ocoee will be provided with a local
billing customer service phone number as well as a link to billing customer service
representatives via the website described previously in Section 2, Web Access. Service rates will
also be posted for public access on our local website.
Customer service performs various functions throughout the billing process to ensure
appropriate recordkeeping and billing inquiries. Customer service:
• Prepares invoice forms for mailings;
• Promptly handles all incoming service -related calls and correspondence;
• Processes payments and monetary adjustments;
• Fulfills legal requests;
• Distributes mail;
• Handles return mail; and
• Responds to customer service inquiries within 24 hours.
To ensure appropriate employee performance and the highest level of customer courtesy, each
employee receives extensive training and regular feedback from supervisors and managers.
Our Billing Department QA processes ensure supervisors regularly monitor calls, and provide
the feedback necessary to promote excellent customer service.
Rural/Metro retains all records in accordance with government, including HIPAA, requirements.
Billing records are maintained for at least three years after settlement, with the exception of
RFP# 12-005 SuraUMelro Page 78
tft
PROPOSALTO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
authorizations for writing off receivables, which are maintained per the IRS for five years after
tax return filing.
C. Examples of Transport Collection Audits
Rural/Metro uses a two -layer audit process to ensure the integrity of our billing processes.
Within the Billing Department, supervisors perform monthly paper and customer service phone
line audits to ensure all claims are recorded, all reports balance and customers receive the
highest level of service. Our corporate office conducts separate but similar audits as an external
review. In addition, the corporate office performs audits to ensure our billing practices remain
compliant with all Sarbanes Oxley requirements, and the company provides employees with
specific policies regarding government audits and investigations.
Following is an example of the form used to perform transport collection audits. In addition, the
corporate policy on Internal Federal Payor Audits is provided in Attachment 6.
RFP# 12-005 Rura!/Mello' Page 79
0 Ambulance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
V& awyn.
IWCNMVHW
Monthly Medicare Audit Summa
raddl Zone raddl 2011
tft
Records Requested: Total Universe:
%
Findings: N/A
�TT
Agreed
Dish
PendinciJ
Correct Modifiers:
40140
%
Findings: NIA
Agreed r
Disa reeds
Pendin r
Correct ICD-9 Codes:
I
%
Findings: N/A
Agreed I
Disagreed
Pendin
Correct Gondition Codes:
1
%
Findings: NIA
Agreed I
DisagreedDisagreedJ
Pendingi
Valid PCS on file if Required:
I
%
Findings: NIA
AgreedAgreedl
DisagreedDisagreadl
Pendingi
Crew Signature Requirements Met:
!
%
Findings: NIA
Agreed I
Disagreed
PendingT-
Patient Signature on PCR:
1
%
Findings: NIA
Signature in AS400:
NIA
NIA
Findings: NIA
Crew Member Signature
1
%
Findings: N/A
Agreed I
Disaweedl
Pendingi
*Signed NPP or valid P.U.T.S reason:
1
%
Findings: N/A
Agreed I
Disagreed
Pendingi
Correct HCPC Code:
I
%
Findings: N/A
Correct Mileage:
I
%
Findings: NIA
Agreed I
(Disagreed
Pendingi
*Medical Necessity for LOS:
1
%
Findings: N/A
Agreed I
Disa reed
PendinqF
*ABN required Records:
MIA
NIA%
Correct Denial Modifier (scared):
NIA
NIA%
Findings: N/A
Agreed I
Disagreed
Pendln?,[
Mandatory Claims Score:
I
Overall Claim Score:
1
%
Additional Finding(s):
* Not applicable to billing score. Operational category
RFP# 12-005 0 Rup"eira Page 80
Ambulance
M
PROPOSALTO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
VII. Organizational Experience and Key Personnel
A. Experience Providing Similar Service
RFP. The City will, in part, base its award on the experience of the provider and key staff
personnel in administering, managing and operating a 911 emergency transport system. (6.
Experience, p. 26)
Rural/Metro's highly experienced
team of ambulance service
professionals will ensure Ocoee's
residents and visitors continue to
benefit from high -quality,
efficient and cost-effective
prehospital care. Rural/Metro
Corporation provides ambulance
services in more than 425
communities throughout the
United States, including many
that are similar in service scope
and size to Ocoee. We operate
under several business names
from Health Central Paramedic Services last fall after
acquiring the hospital -based program.
throughout the country,
including Rural/Metro Corporation of Florida, to accommodate local systems.
Rural/Metro customizes solutions for each community we serve. Access to a national
knowledge base and assets enables us to cost-effectively and efficiently optimize local system
status planning, communications, support services, data collection and reporting. In short, we
are uniquely positioned to draw from our national strengths while addressing the City of
Ocoee's unique needs.
The following Rural/Metro operations contain all or some of the proven system components
contained within the City's RFP.
Ocoee, Florida
Rural/Metro is the current Emergency Medical Service provider for the City of Ocoee, following
the acquisition of the Health Central ambulance service last fall. We successfully directed a
seamless transition, ensuring the continued provision of quality care to Ocoee's emergency 911
patients.
RFP# 12-005 0 ROPAN"Va, Page 81
Ambulance
tft
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
Our local team, many of whom transitioned from Health Central to the Rural/Metro family, has
deep roots in Ocoee and other local Orange County communities. These dedicated EMS
professionals oversaw the introduction of five new, state-of-the-art ambulances, LifePak 15
monitor/defibrillators and power cots to our Ocoee service area.
We continue to maintain close ties with Health Central, Ocoee's largest employer, recently
inking a 5-year agreement to provide interfacility medical transportation services for the
hospital system, including their skilled nursing facility. In addition, we've maintained Health
Central's rate schedule, ensuring patients receive the same great care at a reasonable price.
Our operations in Ocoee, including operations facilities in Ocoee, Winter Garden, the Town of
Windermere and Orlando, are already established and would continue uninterrupted under a
new agreement with the City.
Orlando, Florida
Rural/Metro Corporation of
Florida has served the residents
and visitors of the City of Orlando
for nearly 30 years. In 2011,
Rural/Metro responded to 14,062
emergency 9-1-1 requests for
service and transported 9,811
patients.
Our commitment to the
community goes beyond simply
answering the call. We pride
Orlando for nearly 30 years.
ourselves on the level of clinical excellence we deliver to our patients. Rural/Metro's Orlando
service has been CAAS accredited since 1993. In fact, the organization was the first in the state
of Florida to achieve this prestigious designation. This record of excellence continues today. In
September, the Florida Department of Health's Bureau of EMS conducted a site survey. Finding
no deficiencies, the department thanked Rural/Metro for "being a role model of excellence as
an EMS provider in the state of Florida."
Rural/Metro's Orlando team is dedicated to community education, participating in health fairs
in cooperation with Orlando Health, Orlando Fire, the Orlando Police Department and Florida
Highway Patrol. The operation also sponsors swim safety programs, provides community -based
RFP# 12-005 JIM IPiral/Mew, Page 82
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PROPOSALTO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
CPR and recently organized "Truck or Treat" in partnership with approximately 30 other
agencies and organizations that came together to pass out candy to children on Halloween.
We are not only a provider of vital emergency services to our community, but have become an
integral part of the total health care delivery system. The strong partnership between the City
of Orlando, Rural/Metro and Orlando Health ensures the right emergency medical resources
are always available at the right time.
Rural/Metro's non -emergency transport contract with Orlando Health provides valuable backup
resources for the City's busy 911 system. Rural/Metro purchased "Mobile Care," the Orlando
Health hospital -based ambulance service, six years ago, and we have been their preferred
provider since. Rural/Metro services all seven Orlando Health campuses: Orlando Regional
Medical Center, Lucerne Hospital, Winnie Palmer Hospital, Arnold Palmer Hospital, Doctor
Phillips Hospital, South Seminole Hospital and MD Anderson Cancer Center, providing
approximately 31,000 non -emergent transports annually.
Our relationship with Orlando Health enables us to work closely with their staff and share
educational resources, such has training, facilities and instructors. Last year, we also assisted
them with a critical component of their "heart center" certification from the state. Orlando
Health comprises about 50% of our transport volume. We also provide transport for the Orange
County Jail, skilled nursing facilities and Town of Eatonvilie 911.
With more than 300 paramedics, EMTs and support staff, our team members live, work and
play in the community we serve. We support
local organizations with our time and talents,
including notable youth programs such as
Frontline Outreach, The Gift of Swimming Safety
Program, Read Around the Park and After School
All Stars.
Notably, Rural/Metro's Orlando operation will
provide local backup resources to the City of
Ocoee in disaster or MCI situations, and for
other large-scale events.
San Diego, California
Rural/Metro's San Diego operation exemplifies
our success in creating formal and informal
public -private EMS partnerships. Rural/Metro
responds to nearly 100,000 emergency
medical calls every year.
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
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has provided ALS ambulance transport in the City of San Diego since 1997 in cooperation with
San Diego Fire -Rescue Department. Rural/Metro is San Diego County's largest and most
respected private service provider, employing more than 500 local EMTs and paramedics and
responding to nearly 100,000 emergency medical calls each year.
San Diego Fire -Rescue firefighter -paramedics and EMTs provide initial treatment for ill and
injured patients; Rural/Metro paramedics then provide the majority of patient care and
transportation. Fire personnel and Rural/Metro paramedics work cooperatively to ensure
seamless patient care and transport. San Diego Fire -Rescue oversees EMS operations, including
911 dispatch, first response, training, continuous quality improvement and paramedic rotation
ambulances. Rural/Metro maintains and staffs the majority of ambulances and provides
medical equipment, supplies, billing services and administrative support.
The partnership combines the best of both systems to create a unified emergency response
service. Standardized training, communications and clinical quality policies ensure superb,
consistent patient care and promote a harmonious work environment for crews.
Knox County, Tennessee
Rural/Metro of Tennessee has provided emergency and non -emergency ambulance
transportation services in Knox County since 1985. In addition, the Rural/Metro Fire
Department has met the County's fire protection need for more than 25 years. The company
remains the state's only ambulance service provider to receive national CAAS accreditation.
Rural/Metro of Tennessee employs more than 700 EMTs, paramedics and firefighters in Eastern
Tennessee, responding to approximately 80,000 calls each year.
Rural/Metro of Tennessee was the first emergency service provider in the country to fully
integrate a STEMI early warning system with all area hospitals, with the exception of Children's
Hospital. The program provides for the transmission of LifePak ECG data to the receiving
facilities while the ambulances are en route, enabling the hospitals to ready their cath lab for
quick intervention when the patient arrives.
As a testament to this operation's performance, Rural/Metro's Division General Manager for
East Tennessee was appointed by Governor Phil Bredesen to serve on the Tennessee
Emergency Medical Services Board, which establishes all rules government emergency systems
throughout the state.
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
Western New York
In 1995, Rural/Metro Medical Services acquired LaSalle Ambulance and began operations in
Buffalo, N.Y. Rural/Metro has earned the trust of Western New York by providing safe, cost-
effective and reliable ambulance service that is available 24 hours a day. Our commitment to
excellence in the field of EMS has allowed Western New York Operations to achieve the highest
standard in the ambulance industry. Since 1994, the Commission on Accreditation of
Ambulance Services (CAAS) has recognized the operation as one that meets or exceeds the
industry's strict standards — a standard achieved by only 1% of all ambulance services
nationwide.
Headquartered in Buffalo, New York, Rural/Metro Medical Services also has satellite offices and
ambulance bases in Cheektowaga, Hamburg, and Niagara Falls. Our 600+ employees are
responsible for servicing 22 hospitals and over 100 nursing homes and health care facilities, as
well as the over one million residents of Western New York.
Syracuse, New York
Rural/Metro Medical Services of Central New York, based in Syracuse, has been a lifeline to the
Central New York Community for decades. As an integral part of the region's healthcare system,
Rural/Metro is the area's only ambulance service that is nationally accredited by the
Commission on the Accreditation of Ambulance Services (CAAS). This designation is the gold
standard for ambulance services, both public and private.
Rural/Metro's Syracuse operation responds to more than 50,000 calls for medical assistance
across six counties every year. We work collaboratively with several volunteer agencies and
health care organizations to provide a truly integrated approach to meeting the area's
emergency medical needs. Rural/Metro also funds the EMSupport grant, administered by the
Central New York Community Foundation, which provides organizations with funding for
medical supplies and equipment.
In addition to providing ambulance transportation services, Rural/Metro of Syracuse is the
area's largest American Heart Association training center.
Aurora, Colorado
Rural/Metro is proud to be the exclusive 9-1-1 ambulance provider for the City of Aurora and
provides 9-1-1 backup ambulance service for the City of Littleton, Littleton Fire Protection
District and Highlands Ranch through a partnership with Littleton Fire Rescue. In 2010,
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
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Rural/Metro acquired Pridemark Paramedic Services, which is the exclusive 9-1-1 ambulance
provider in the cities of Arvada, Edgewater, Fairmount and Wheat Ridge.
In addition to 9-1-1 emergency ambulance services, Rural/Metro and Pridemark provide non -
emergent medical transportation throughout the Denver Metro area, including HCA-HealthOne
facilities. The companies also accommodate out-of-state transports to serve the Rocky
Mountain states, and provide non -emergency interfacility ambulance transportation and event
medical standby services throughout the Denver area, including Dick's Sporting Goods Park and
Arapahoe Park Horse Track.
With a fleet of 90 vehicles and 430 employees, we are one of the largest private ambulance
services in the state of Colorado.
References are provided in Section IX., Other Required Content. Please see Attachment 7 for
letters of recommendation.
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
S. On -Site and Off -Site Personnel
RFP: The City will, in part, base the award of the contract upon the qualifications of the
organization and upon the qualifications of its key personnel. The contractor will be expected to
furnish the personnel identified in the proposal submitted and throughout the term of the
contract. The contractor is expected to furnish the some personnel or replacement personnel
with equal or superior qualifications. It is the specific intent of this provision to prevent "bait and
switch" bidding practice whether intended or not. (5. Key Personnel, p. 26)
Following are organizational charts for Rural/Metro's key on -site and off -site personnel, as well
as biographies on -site team who will be directly responsible for ensuring Rural/Metro's
continuing operational success in the City of Ocoee. Rural/Metro will continue to provide the
same personnel or replacement personnel with equal or superior qualifications throughout the
term of its contract with the City.
Rural/Metro'
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Key On -Site Personnel Biographies
Division General Manager for Florida
In his role as the Division General Manager, Chris Blach ensures the
overall operational and financial performance of Rural/Metro's
Florida operation. Currently, Rural/Metro operates in the Florida
counties of Seminole, Osceola, Orange and Sumter.
Prior to joining Rural/Metro, Chris served for 10 years as Director of
Operations for American Medical Response Northeast. In this role,
he was responsible for all financial and operational oversight for
Southeastern Massachusetts and the State of Rhode Island. The
operation serviced more than nine primary 911 contracts, over 10
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major hospitals and 100 skilled nursing facilities with 450 employees and 100 ambulances.
Chris is currently appointed to the Orange County EMS Advisory Board and the Valencia
Community College EMS Advisory Board. He also sits on the Orange County EMS Operations,
Communications, Medical Control and Quality Council Committees. Chris is a member of the
Orlando Economic Development Commission and serves as Co -Chair of the Central Florida After
School All Star Program.
Chris completed the Paramedic Program with Northeastern University in 1989. He has received
Official Citations from the Massachusetts Senate and House of Representatives for
contributions to the EMS field.
Tom Daniels
Market General Manager
In his role as the Market General Manager, Tom Daniels is
responsible for ambulance operations in the Orlando and West
Orange markets.
Prior to joining Rural/Metro, Tom was an integral part of Health
Central Paramedic Services; West Orange County's hospital -based
911 transport agency, from 1966 until August of 2011. For the
latter half of his 27-year career at Health Central, Tom served as
Assistant Director where he shared responsibility for operations,
budget, personnel, community affairs and quality management of clinical services.
Over the years, Tom has served as a member of to the Orange County EMS Advisory Board,
Valencia Community College EMS Advisory Board and numerous other EMS and hospital-
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related committees. He is currently active in the Orange County EMS Operations,
Communications, Medical Control, AED and Quality Council Committees. Recently, Tom has
been involved with the Habele Outer Island Education Fund; a charitable organization serving
the low-lying atolls in the Federated States of Micronesia.
Torn studied tropical agriculture at the University of Guam in the early 1970s, completed his
Bachelor of Arts degree in biology and education from North Central College in 1977, and in
1984 received his Associates Degree in Paramedic Technology from Valencia Community
College.
Operations Manager & Paramedic
Operations Manager Larry Marshall is an accomplished healthcare
professional with a strong background in operations, clinical support,
and performance improvement in a patient -centric environment. He
has demonstrated success in motivating and directing staff at all
organizational levels.
He has 20 years of experience as a healthcare provider in a hospital -
based ambulance service in Central Florida. Working in a high -volume
911 system, Larry quickly developed a strong rapport in the EMS
community as an outstanding clinician and a compassionate
Larry Marshall
healthcare professional. His innate leadership abilities combined with a high performance drive
enabled him to achieve the position of Operations Manager while enhancing individual and
team performance. Larry joined Rural/Metro Ambulance in September 2011 as Operations
Manager where he manages the 911 services and general transport in Central Florida
encompassing the counties of Orange, Seminole and Osceola.
Prior to joining the Rural Metro team, he managed the daily activities, operations, and
personnel for a hospital -based ambulance service providing 911 services and general transport
for a 220 square mile area handling over 25,000 calls annually. He developed and implemented
standard operating policy, and procedure for a department consisting of 70 employees
including 14 ambulances ensuring operational readiness 24 hours a day. One of his most
notable contributions was working with the West Orange Health Care District as a
communicator and de facto mediator during a labor crisis resulting in an alliance between
exempt and non-exempt staff.
Larry also works as a consultant in the area of organizational and leadership development
utilizing experiential based techniques and business simulations. He has a particular interest in
Rura!/Metro'
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making connections on an individual level to help people realize their potential while
functioning in a high-performance team. His vast years of experience enable him to bridge
conceptual theories into practical experiences. One of his most personally gratifying
contributions as a consultant was working with the United States Women's Soccer Team to
prepare for the 1996 Atlanta Olympic Games and the 1999 World Cup.
Early in his career Larry worked in the aerospace industry while earning his Bachelor Degree in
Business Finance from Florida Southern College in Lakeland, Florida. Larry lives in Orlando with
his wife and two daughters. He is an accomplished runner completing four marathons to
include the 2009 New York Marathon, the 2010 Chicago Marathon and plans to run the Marine
Corps Marathon in Washington D.C. later this year. He has run for multiple charities including
Team for Kids, Relay for Life and Semper Fi Fund.
Juli Mills
Clinical Manager
Jul! Mills is responsible for ensuring Rural/Metro field providers
comply with patient care policies, procedures and protocols as
directed by the Medical Director and Rural/Metro. To meet this
objective, she conducts audits to monitor compliance with the
Standard of Care and implements improvement plans to address and
correct any performance falling outside the identified benchmarks.
These improvement plans are then monitored to ensure resolution.
Juli also implements, organizes and supervises all in-house education
and training on a continual basis.
Juli became part of the Rural/Metro team in July of 1994 when she was hired as an EMT. She
continued her service with Rural/Metro as a paramedic before becoming a Field Supervisor. She
now brings those 17 years of field experience to the Quality Assurance/Training Supervisor
position.
Jul! is currently a member of the Orange County Quality Council. She
also dedicates time to the community by serving on the board of
College Park Little League.
Human Resources Manager
Mary Mulvie is responsible for Rural/Metro's human resource
functions in Florida, ensuring the recruitment and retention of the
area's best talent. She brings more than 17 years of human resources
experience to managing Rural/Metro's 200 local employees. Mary
Mary Mulvie
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prides herself on being a medium between employees and managers, facilitating strong
communication and mutual respect among all parties while ensuring the organization's best
practices are upheld.
Mary is an active member of both the Central Florida Human Resources Association and the
Society for Human Resource Management. She obtained a Bachelor of Science degree from
Barry University and graduated from the University of Central Florida Society of Human
Resource Management Certification Program in 2002.
Yaima Acosta
Business Development Manager
In her role as the Business Development Manager, Yaima Acosta is
responsible for the strategic business development planning and
community outreach programs for Rural/Metro's operations in Central
Florida.
Prior to serving as the Business Development Manager for
Rural/Metro, Yaima was the Business Administrator for a medical
marketing company in Ocala, Florida. She brings over 10 years of
experience in marketing, sales and management.
Yaima currently sits on the planning committee for the Dick Batchelor
Children's Run and is an active member of the Hispanic Chamber of Commerce Metro Orlando.
She earned a Master's in Public Administration in 2010 and holds a Bachelor of Science in
Business Administration from Barry University.
Communications Manager
In her role as the Communication's Manager with Rural/Metro
Ambulance, Sharon Crotty endeavors to make sure that every call for
help is processed in a timely and suitable manner. She is responsible
for maintaining the reliability of the Communications Department's
equipment, personnel and response processes, ensuring that all
quality and compliance goals are met.
Prior to joining Rural/Metro, Sharon served 24 years with the Miami -
Dade County Fire Department. While with Miami -Dade, Sharon held
multiple positions to ensure cross training. Sharon is the Vice
President of the Hernando County Sheriff's Office Volunteer,
Mounted Patrol Unit. She is also currently a certified Paramedic in
Sharon Crotty
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the State of Florida. Sharon lives in Hernado County where she enjoys riding horses, one of her
many passions in life.
Angel Perez
Fleet Manager
In his role as the Fleet Manager, Angel Perez is responsible for
maintaining more than 60 ambulances and support vehicles operating in
the Central Florida area. He oversees Rural/Metro's preventative
maintenance program, visual safety inspections and vehicle
recordkeeping.
Before joining Rural/Metro, Angel worked in the automotive repair and
maintenance field for over 10 years. Angel is certified in Automotive
Service Excellence, Detroit Diesel Engines, Wheeled Coach, Ricon
Wheelchair Lift and Ford Power Stoke Engine Performance.
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VIII. Administrative/Financial
A. Transition Plan/Schedule
Rural/Metro became the City's current EMS
provider on September 1, seamlessly
transitioning operations from Health Central
Paramedic Services. As such, the vast majority
of our ambulance program is already in place in
Ocoee. An implementation schedule is provided
on the following for the remaining key
operational areas.
R40ural/Me1ro
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B. Provision of Insurance
RFP: The contractor shall be responsible for providing the required insurance coverage for all
employees and response personnel operating under the oversight of the contractor's medical
director. (C. Contractor's Responsibilities, p. 20)
Rural/Metro will continue to be responsible for providing required insurance coverage for all
employees and response personnel operating under the oversight of Rural/Metro's Medical
Director. We currently meet the City of Ocoee's insurance requirements. Please see
Attachment 8 for a copy of Rural/Metro Certificate of Insurance.
Risk Management and Loss Control Provisions
RFP: The City believes that education and aggressive prevention of conditions in which losses
occur, is the best mechanism to avoid injuries to the contractor staff, City personnel and
patients. Therefore, the City requires the contractor, at a minimum, to employ the following risk
management processes: pre-screening of potential employees (including drug testing); initial
and on -going driver training using a curriculum equivalent to EVOC, significant event
investigations (e.g., motor vehicle accident with injuries or any vehicle accident which requires
the towing of the ambulance from the scene of the accident), lifting technique training, hazard
reduction training and other training or policy guidelines that are directed towards injury
prevention and accident avoidance. If requested by the City, the contractor will provide the City
an annual report of their risk management activities and adverse events. Note: the prescreening
of employees must begin at the initiation of the contract. (E. Risk Management and Loss Control
Provisions, p. 23)
Rural/Metro maintains a comprehensive corporate -wide Risk Management and Loss Control
Program that includes, among other provisions: prescreening of employees (including drug
testing); initial and on -going Certified Emergency Vehicle Operator driver training; significant
event investigations; lifting technique training; hazard reduction training; and other training,
policies and procedures designed to prevent injury, avoid accidents and reduce risk to
individuals and the organization. Upon Request, Rural/Metro will provide the City with an
annual report of risk management activities and adverse events. The prescreening of
employees is currently in practice in Ocoee and would continue through the initiation of a new
contract. Risk Management practices are described in detail below.
Pre-screening of Employees
Hiring the right employee the first time reduces training and turnover costs, promotes better
patient care and reduces risk and losses to the organization. As such, Rural/Metro pre-screens
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all potential employees prior to extending an offer of employment. Candidates with felony or
certain misdemeanor convictions, as well as those without the appropriate
certifications/lice nsure, are eliminated during this screening process. Prescreening includes:
• Background checks performed online through the U.S. Government's Excluded Parties
List System (EPLS) website (www.epls.gov);
• Background checks performed through the U.S. Department of Health and Human
Services Office of the Inspector General;
• Background checks performed via Life Scan;
• Five panel drug screening;
• Physical ability assessment by a licensed medical practitioner;
• State license/certification verification;
• A five-year driving record; and
• Visual verification of current licenses and certifications.
Any candidate to who fails to pass any one of these
screens is not considered for employment.
Driver Training
Operating an ambulance poses a risk for our
employees, patients, the public and the organization.
Therefore, safe vehicle operation is one of
Rural/Metro's highest -priority safety initiatives. Our
comprehensive driver training programs begins with a
six -hour, nationally recognized Certified Emergency
Vehicle Operator 3 (CEVO 3) driving training course
from Coaching Systems.
Required upon initial hire and mandatory for all
employees who operate a company vehicle, this program teaches students defensive driving
skills. Rather than waiting for a situation to occur, CEVO instructs employees to drive in a
manner that avoids circumstances that cause accidents. Drivers learn navigation skills for
moving through traffic safely, and instructors challenge participants to develop solutions for
varied circumstances. The course addresses backing up, parking with caution, ambulance
hydroplaning, nighttime driving, hospital approach, patient drop off, tailgating and more (see
course outline table, below). Rural/Metro takes the CEVO training one step further by adding
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modules that focus on intersections, as the majority of accidents involving EMS vehicles occur
in or near roadway intersections.
In addition to CEVO, Rural/Metro's complete 16-hour driver education course integrates
mapping training and cone/course skills assessments. The program also covers Rural/Metro's
accident reporting and review process, as well as Event Recorder systems (described below).
Following is a course outline for the CEVO 3 program.
CERTIFIED EMERGENCY VEHICLE OPERATOR 3 COURSE OUTLINE
SESSION 1 (45 MINUTES)
Introduction
Response Book: Self Appraisal
Video Presentation: Introduction/Vehicle Inspection
Response Book: Discussion/Questions
SESSION 2 (50 MINUTES)
Video Presentation: Cushion of Safety
Response Book: Situation Analyses/Discussion Questions
DVD/PowerPoint: Situation Analyses
SESSION 3 (70 MINUTES)
Video Presentation: On the Road
Response Book: Situation Analyses/Discussion Questions
DVD/PowerPoint: Situation Analyses
SESSION 4 (45 MINUTES)
Video Presentation: Special Considerations
Response Book: Situation Analyses/Discussion Questions
DVD/PowerPoint: Situation Analyses
SESSION 5 (2.5 HOURS)
Video Presentation: Emergency Driving
Response Book: Situation Analyses/Discussion Questions
Operator Learning Teams
Collision Reporting Procedures
Response Book: Self -Appraisal Review
Operator Test
Upon completion of the Driver Training coursework and prior to operating an ambulance, new
hires are placed into a Field Training Program that includes objectives on area familiarization.
Candidates must successfully complete these mapping objectives with a Field Training Officer
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prior to being released for duty. Rural/Metro requires all employees to attend annual refresher
training to ensure continued competence and to reiterate our safety priorities and safe driving
policies.
DriveCam Event Recording System
In addition to classroom instruction, mapping skills
assessment and street/cone course training and
assessment, Rural/Metro's safe driver program
incorporates G-force activated event recorders in all
company vehicles to continually monitor for safe driving
practices as well as reduce the company's liability in the
event of a collision. Our ambulances are currently
equipped with the DriveCam system.
DriveCam is a compact, self-contained camera unit installed in all Rural/Metro vehicles. The
camera activates and begins recording following a G-force trigger caused by braking, swerving
or a collision. The device records and captures a 20-second loop of video, including the 10
seconds prior to and after an incident. The camera provides a 120-degree view of both inside
and outside the vehicle —valuable footage that's used to assess crews' actions and adherence
to protocols during the event. DriveCam also features a "panic button" that crews can activate
if they wish to document an unusual occurrence.
DriveCam data are downloaded daily, and supervisory staff reviews all footage to ensure
appropriate documentation and action. Incidents are evaluated in a peer -review setting and are
used to identify areas where we can improve training, equipment or policies to prevent
recurrence. Crews are typically very supportive of the cameras, as the videos have exonerated
many employees following a collision, particularly when another party provides a conflicting
account of the circumstances.
Importantly, the system not only documents adverse events, but also helps to identify our
safest drivers. To encourage and reward good driving habits, Rural/Metro recognizes
employees found to have prevented an accident with Safe Driving Awards. Please see
Attachment 9 for a DriveCam product information sheet.
Significant Event Investigations
Randomized and significant event investigations are integral to Rural/Metro's Risk
Management and Loss Control Program, both on an individual and organization -wide level. In
addition to evaluating/mitigating the individual event, findings often translate into training
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PROPOSAL TOPROVIDEEMERGENCYAMBULANCESERVICESFOR THE CITY OF OCOEE
program enhancements or new policies/procedures designed to prevent recurrence.
Investigations may be clinical or administrative in nature. Areas of investigation include, but are
not limited to:
• FDA Reportable Events, Equipment Failures & Accidents: Rural/Metro technicians
troubleshoot any equipment that's returned to the Supply Department, ship broken
equipment out for repair, work with manufacturers to ensure regularly scheduled
maintenance is performed, and report all required FDA -reportable events.
• Employee Health/Infection Control: Rural/Metro's Human
Resource Manager oversees our Communicable Disease
Exposure Program, which covers airborne, droplet and blood -
borne pathogens. The HR Manager follows all local, state,
National Fire Protection Agency (NFPA) and OSHA protocols and
remains apprised of all local communicable disease issues that
must be addressed to protect our workforce, Fire Department
partners and patients. The HR Manager also investigates and provides appropriate
follow up on employee injuries, including but not limited to: needle sticks, lifting injuries
and communicable disease exposures, and collects and maintains records of employee
immunizations and health screenings.
• Clinical Errors: The Clinical Manager documents any potential clinical issues. Education
and/or disciplinary action are taken in accordance with the CQi program. Random audits
are also conducted to ensure field employees adhere to established clinical protocols.
• Work Related Injuries/Exposures: All work -related injuries and infectious disease
exposures are immediately reported to the on -duty supervisory and, subsequently, the
Human Resources Department for thorough reporting and investigation. We work
closely with an occupational injury and specialist and medical group to ensure the
highest quality care for our employees. Rural/Metro's Human Resources Department
follows a comprehensive reporting, treatment and follow-up structure for all work -
related injuries and exposures. In addition, our Clinical Manager follows up and reviews
each claim and treatment course to proper handling from the medical providers.
• Damage, Loss & Theft of Company Property: Employees who are involved in or discover
any type of damage, loss or theft of property document the occurrence on an Accident
Report Form. This form is used as a starting point to document, investigation and, when
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFORTHE CITY OF OCOEE
necessary, report a loss to Rural/Metro's insurance carrier. Completed forms are
maintained in the employee's personnel file and in the corporate Claims/Risk
Management department.
Employees who cause or discover any type of damage, loss or theft of a vehicle
document the loss on a specific form. The employee and their supervisor also complete
separate investigation report forms. When appropriate, losses are reported to our
insurance carrier. In addition, we have an internal Accident Review Committee that
considers the information provided on these forms in their investigation. Copies are
maintained in the employee's personnel file and the Risk Manager's office. All auto
accidents/incidents are recorded in a database used to maintain control of claims and to
compile data for insurance and training enhancement purposes.
Suspected Civil Risk: Our corporate Risk manager investigates and tracks in a database
all events that could result in a future claim or litigation. At the national level,
Rural/Metro has a Corporate National Risk Management Group that provides the local
operations with support on risk management issues. For instance, this group developed
and EMS Ergonomics Program, including our Back Safety and Injury Prevention training.
Lifting Technique Training
Rural/Metro provides a comprehensive Back Safety and Injury Prevention program as part of
the New Employee Orientation training and for all employees who return to work following an
injury. This program addresses the six major risk factors responsible for the majority of EMS -
related injuries: loading and unloading equipment, transferring patients to lifting or moving
devices, transferring patients on stairs, operating stretchers on uneven terrain, moving or
transferring equipment, and getting in and out of vehicles.
Hazard Reduction Training
We provide training and policies/procedures designed to reduce hazards to both patients and
our employees. In addition to the driver and lifting technique training, examples of
Rural/Metro's efforts to reduce hazard exposure include, but are not limited to:
• An OSHA -approved respiratory protection program;
• Gurney -use policies, including management of and equipment for bariatric patients;
• Incident Command System (ICS) training;
• Incident reporting policies and investigations;
RFP# 12-005 swauMeMo' Page 102
QO Rmbylance
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES Q�� ..,
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• Personal Protective Equipment (PPE) equipment, standards and policies/procedures;
• Equipment and/or ambulance failure policies/procedures;
• Harassment and professionalism policies;
• Station and ambulance security policies;
• Controlled -substance policies/procedures;
• Drug -free workplace policies; and
• Chemical and biological materials training and decontamination policies.
These strong risk management practices have proved effective both locally and nationally. We
will continue to provide this program under a new contract with the City. In addition,
Rural/Metro maintains comprehensive insurance.
C. Method of Providing Required Reporting for Performance Measurements
RFP: The contractor shall provide detailed and comprehensive monthly reporting on response
activities, patient treatments, billing and collection reports, customer and citizen complaints,
accidents and equipment malfunctions (C. Contractor's Responsibilities, p. 20)
Rural/Metro is committed to maintaining complete transparency throughout the term of our
agreement with the City of Ocoee. We will therefore provide reports that measure our
performance with regard to: response activities, patient treatments, billing and collection,
customer and citizen complaints, accidents and equipment malfunctions. Below, we discuss the
required data and our proposed methods for reporting it to the City.
Response Activities
Rural/Metro proposes to provide monthly reports to the City detailing response activities
during the preceding month, as specified below, based upon CAD data:
• Total responses
• Total emergency (911 generated) transports
• Total patients transported
• Total responses and transport activity by ambulance unit
• Total cancelled calls (prior to arrival)
• Total patient refusals (treatment and transport)
• Distribution of responses by time of day and day of week
• Distribution of incidents by location (ambulance service zones)
• Description of incidents by call type
• Summary of patient complaints (by situation found)
• Response time summary for all responses
RFP# 12-005 MAUlancero' Page 103
Rmbulaece
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES Q��
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• Response time summary by ambulance service zones
• Response time summary by ambulance unit
• Frequency of simultaneous calls for service (countywide)
• Summary of mutual aid requests (given and received)
• Summary of call duration (transports and non -transports)
• Listing of equipment or vehicle breakdown/malfunctions
• Dispatch Quality Assurance report summary
Patient Treatment Reports
Rural/Metro will utilize the ZOLL RescueNet electronic patient care reporting system,, which is
National EMS Information System (NEMSIS)-Gold compliant and compatible with the Florida
Bureau of EMS EMSTARS project. The system interfaces with both our ambulance CAD system
and our billing software, ensuring on -the -spot collection of medical and billing data from the
initial call through transport to the hospital.
As described in Section II., Clinical Performance, the RescueNet ePCR system captures all
pertinent patient care data. Reports can be customized to track any one of the interventions
documented in the patient care report. Additionally reports can be generated based on chief
complaint or pertinent medical history to monitor treatment modalities used by the field
providers. We will work with the Medical Director to identify the frequency and desired data
provided in these reports.
Please see Attachment 2 for more information on the RescueNet ePCR system.
Billing and Collection Reports
Billing and collection reports will be provided on a quarterly basis, if desired, with regard to:
• Total average charge per patient
• Total average patient charge for mileage
• Distribution of payments by all payment groups (Medicare, Medicaid, private insurance,
direct payment, non-collectables/bad debt)
• Quarterly collection rate (percentage) for all ambulance billings
• Total of uncollected accounts with 180 days of aging
Reports will be submitted on a quarterly basis as Excel spreadsheets, or in another format as
desired by the City.
RFP# 12-005 Rp�al/Me�rrd Page 104
Ambulance
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
Customer and Citizen Complaint Reports
Rural/Metro tracks all customer and citizen complaints or inquiries in a database through to
completion. A monthly report will be submitted to the City of all complaints received in the
preceding month, including a description of how the is was resolved.
We remain committed to providing exceptional customer service. As described in Section IV.,
Customer Service Monitoring and Development, Rural/Metro utilizes innovative tools, including
a Web -based customer survey form, to gather customer feedback. If desired, we will report
survey results to the City at regular intervals.
Accident Reports
All vehicle accidents will be reported to the City on a monthly basis. We maintain maintenance
records for the life of each vehicle utilizing fleet maintenance software by Ron Turley and
Associates (RTA).
Equipment Malfunction Reports
In accordance with established Risk Management procedures, Rural/Metro documents
equipment malfunctions and ensures reportable events are submitted to the FDA as required.
We will report to the City any significant equipment failure/malfunction issues from the
preceding month, or sooner if future patient safety is a concern. Rural/Metro maintains close
relationships with our vendors, as well as service contracts for the recommended maintenance
of durable medical equipment. Records are maintained for the life of each piece of equipment.
Our goal is to provide the City with any information it desires regarding EMS system
performance. Should other reports be desired, we will cooperate with the City to accommodate
data requests.
D. Delineation of Ambulance Service Zones
Rural/Metro shall establish ambulance service zones, as depicted on the following page, that
are identical to the City's current fire department response zones for the purpose of analyzing
the response capabilities within those co -defined zones, and capturing and reporting data.
RFP# 12-005 Awal�Melto Page 105
Ambulance
JIV
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
E. User Fee Information
RFP, The contractor shall be entitled to charge patients for the services rendered according to
the patient fee schedules included and proposed by the contractor as part of this procurement
process. The proposed rate schedule shall be in effect far the initial 12 months of operations and
shall not be increased during this timefrome. All emergency transport rates shall be based on
the patient condition or the services rendered. There is no intent on the City's part to require ALS
care on every situation found.
The contractor shall provide as part of their proposal a comprehensive rote schedule for all
services, materials, medications and other actions or items that may be billed to a patient in the
course of their treatment and transport. The contents and description of the "Proposed Rate
Schedule" shall include but not be limited to the following; (C. Ambulance Fees and Guidelines
for Rate Increases, p. 28)
• Whether a "bundled or unbundled" rate structure is being proposed
• Single base rate charge and what items are included and excluded from the base charge
• If "unbundled," a complete schedule of charges for medical supplies, equipment,
procedures or other services that may be charged to the patient
• Oxygen charge
• Mileage charge
• Emergency standby charge at special events
Rural/Metro will charge patients for services rendered according to the following "bundled"
rate schedule. These are the rates Rural/Metro currently charges in the City of Ocoee, which
were carried over from the previous provider, Health Central. (The rates have been in place
since October of 2006). The rate schedule will be in effect for the initial 12 months of
operations and will not be increased during this timeframe. All emergency transport rates will
be based on the patient condition or the services rendered. We understand that the City does
not intend nor required ALS care on every situation found; we will provide only the level of care
required.
Proposed Rate Schedule
Level of Care Rate
BLS Non -Emergency
$625.00
BLS Emergency
$625.00
ALS 1 Emergency
$755.00
ALS 2 Emergency
$817.00
Mileage
$17.00
ALS Standby Rate
$100/hour
Page 107
RFP# 12-005 HuraUMefra
Page
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES QCa
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Disclosure of Fee Schedule
RFP: It is the City's desire to provide complete disclosure of all charges and fees associated with
the delivery of ambulance services. As such, the contractor shall establish as part of this
proposal its full and complete rate schedule for all services and charges. These charges shall be
posted at the contractor's business office, be made available as a handout to all patients and/or
family members, and be posted on the contractor's web page. The contractor may not deviate
or alter the established fee schedule without prior written authorization by the Ocoee City
Commission. (C. Disclosure of Fee Schedule, p. 28)
Rural/Metro's full and complete rate schedule for all services and charges is provided above.
These charges will be posted at Rural/Metro's business office, will be made available as a
handout to all patients and/or family members, and will be posted on our local web page for
the City of Ocoee. We will not deviate from or alter the established fee schedule without the
prior written authorization of the Ocoee City Commission.
Rate Increases
RFP: The contractor may request a rate increase after the initial 12 months of operations and
base this request on market factors, collection rates and inflationary impacts in the City of
Ocoee area. Request for rate increases are to be made in writing to the City's Fire Chief. The Fire
Chief shall investigate the situation and make a recommendation to the Ocoee City Commission.
All changes to ambulance rates are made by the City Commission. Any contract rate structure
increase shall be in effect for a minimum of 12 months. In no instance may the contractor
request more than one rate increase in any consecutive 12-month period. (C. Rate Increases, p.
28)
Rural/Metro understands and agrees that it may request a rate increase after the initial 12
months of operations and will base this request on market factors, collection rates and
inflationary impacts in the City of Ocoee area. Requests for rate increases will be made in
writing to the City's Fire Chief. We understand and agree that the Fire Chief shall investigate the
situation and make a recommendation to the Ocoee City Commission, and that all changes to
ambulance rates will be made by the City Commission. Any contract rate structure increase will
in effect for a minimum of 12 months. Rural/Metro will not request more than one rate
increase in any consecutive 12-month period.
Page 108
RFP# 12-005 �'
Rmbrv1811ce
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
Billing for the City
RFP: Any patient transports performed by the City of Ocoee Fire Department Rescue unit, due to
long ETA from contractor, urgent transport required, multiple patient or for any other reason,
contractor may be required to provide billing and remit any funds received to the City (C., p. 29)
Rural/Metro proposes to make the City of Ocoee Fire Department a "subcontractor," so that
Rural/Metro may legally bill for and remit funds received to the City for any transports
performed by a City of Ocoee Fire Department Rescue unit. We will collaborate with the City to
establish a billing process that's effective and convenient for all parties.
F. Term of Offer
RFP: The initial term of the contract ultimately executed by the contractor shall be for a period
of three (3) years beginning September 1, 2012. The City may offer, at its sole option, and based
in port upon the contractor's superior performance, two (2) twelve (12) month renewals. The
offer of extension shall be for one 12-month extension after the completion of the initial three
(3) year contract period and then a second 12-month extension at the completion of the first 12-
month extension period. Each extension will be considered independent of the other and will be
offered at the sole option of the City. If the City determines that an extension of the contract is
warranted, such offer shall be made at least six months prior to the scheduled end of the term
of the control or previously granted extension. (A. Term of Contract and Renewal Provisions, p.
27)
Rural/Metro agrees that the initial term of the contract ultimately executed by Rural/Metro
shall be for a period of three (3) years beginning September 1, 2012. We understand that the
City may offer, at its sole option, and based in part upon Rural/Metro's superior performance,
two (2) twelve (12) month renewals. The offer of extension shall be for one 12-month extension
after the completion of the initial three (3) year contract period and then a second 12-month
extension at the completion of the first 12-month extension period. We also understand that
each extension will be considered independent of the other and will be offered at the sole
option of the City, and that if an extension of the contract is warranted, such offer shall be
made at least six months prior to the scheduled end of the term of the control or previously
granted extension.
Methods and Form of Compensation
RFP: The contractor receives a variety of compensation for providing services. The following are
specific types of compensation available to the contractor in this procurement. (Methods and
Form of Compensation, pp. 27--28)
RFP# 12-005 RimaUmeftPage 109
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PROPOSAL TO PROVIDE EMERGENCYAMBULANCE SERVICESFOR THE CITY OF OCOEE
1. Market Rights
RFP: the City, except as otherwise outlined in these specifications, shall utilize the
contractor as the primary provider of emergency response and ambulance transport
services within the defined service area boundaries.
Rural/Metro agrees that the City, except as otherwise outlined in these specifications,
will utilize Rural/Metro as the primary provider of emergency response and ambulance
transport services within the defined service area boundaries.
2. User Fees
RFP: The primary financial compensation for the contractor for the services rendered
under this RFP will be from funds received for fee -for -service billings and collections and
contractual arrangements with insurance organizations and other payers.
Rural/Metro agrees that the primary financial compensation for Rural/Metro's services
rendered under this RFP will be from funds received for fee -for -service billings and
collections and contractual arrangements with insurance organizations and other
payers.
3. Local Subsidy
RFP: The City desires a no -subsidy contract; however, the Ocoee City Commission may
include into the final contract o final subsidy/user fee if deemed appropriate. Any
contractor fee subsidy must include a rate and fee structure as well as any inflationary
rate and fee plan of said fee structure.
Rural/Metro will not require a subsidy from the City to provide service in Ocoee.
4. First Responder Assistance
RFP: The contractor shall have the benefit of BLS and ALS level first responder services
throughout the entire service area.
Rural/Metro recognizes the benefit of BLS and ALS level first responder services
throughout the entire service area.
5. Term of Offer
RFP: The term of the Respondent's offer shall be in effect for at least 120 days from the
closing date of this request for proposals.
Rural/Metro's offer will be in effect for at least 120 days from the close date of this
request for proposals.
R.
RFP# 12-005 ' uraUlt9etpv Page 110
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PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
Prohibition of Contract Transfer without Prior Approval
RFP: The contractor agrees that they will not transfer or assign any provisions of the contract to
another entity or service provider without prior written approval of the City. (H. Prohibition of
Contract Transfer without Prior Approval, p. 25)
Rural/Metro does not intent to transfer or assign any provisions of the contract to another
entity or service provider; however, in the unlikely event that should be desired, Rural/Metro
will acquire prior written approval from the City.
Financial Depth and Stability
RFP: Respondents may be required to provide evidence of financial stability which clearly
documents the financial history of the organization and demonstrates that the Respondent has:
(F. Demonstration Depth and Stability of Financial, p. 30)
• The financial capacity to handle the expansion (including implementation and startup
costs) necessitated by the award of the contract.
Rural/Metro currently provides emergency medical services in the City of Ocoee,
indicating our financial capacity to handle implementation and start-up in the City.
However, Rural/Metro has a $110 million revolving credit facility in place, of which $15
million was drawn at March 31, 2012.
• Respondents shall include copies of financial statements for the most recent two-year
period. Audited financial records are preferable. If audited financial records are
unavailable, Respondent must provide unaudited financial statements supported by
federal tax returns. In cases where the Respondent is forming a new entity, the financial
records of the parent company shall be available for review.
Rural/Metro's consolidated financial statements, which include the most recent two-
year period, are provided on the CD enclosed with this proposal.
• Has expertise billing Medicare Part B and other 3rd party payers of ambulance services
(or contracts with a third -party agency with necessary expertise)
As one of the nation's largest medical transportation companies, Rural/Metro is highly
experienced at billing Medicare Part B and other third -party payers of ambulance
services. Please refer back to Section VI. Billing and Collection for a detailed description
of our program.
RFP# 12-005 Rural/INetra' Page 111
AMAVIanc8
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PROPOSALTO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
• Respondent shall provide information, which demonstrates a clear and convincing
capability to implement and manage a billing and collection system. The respondent
should include information about what steps, policies, procedures, training, equipment
and management techniques would be utilized on award of the contract.
Rural/Metro currently provides billing and collection services related to service in
Ocoee. With more than 400 service contracts throughout the country, Rural/Metro is
highly experienced at managing billing and collection systems for emergency medical
service contracts. Our billing processes include established and proven policies,
procedures, training practices, equipment and management techniques to provide
effective billing and collection services in full compliance with all applicable laws and
regulations. A full description of the billing program was provided in Section VI. Billing
and Collection.
• Has the ability to secure insurance coverage required under this procurement. Any
existing self-insurance plan used far the purpose of qualification must substantially meet
the requirements set forth in the RFP.
Rural/Metro maintains comprehensive insurance coverage that complies with the RFP
requirements. Please see Attachment 8 for a copy of our Certificate of Insurance.
• Respondent shall detail any and all notifications of pending insurance (separate listing
for auto and professional liability) claims, investigations and settlements, including both
status and resolution.
Please see the Section IX., Other Required Content, for a list of pending claims.
Ambulance Service Licensing/Permits
RFP; The contractor is expected to comply with all applicable City, state and federal guidelines in
the delivery of pre -hospital medical care and to obtain the necessary licensing and/or permits
required to provide emergency transport services. (C. Contractor's Responsibilities, p. 20)
Rural/Metro will comply with all applicable City, state and federal guidelines in the delivery of
pre -hospital medical care and will continue to maintain the necessary licensing and/or permits
required to provide emergency transport services. Attached are copies of the current license
and permit authorizing Rural/Metro's service in the City of Ocoee, as well as a copy of
Rural/Metro's Commission on Accreditation of Ambulance Services (CAAS) certificate.
Page 112
RFP# 12-005 LAW
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G. Proposed Design of Company Web Page
RFP: The contractor shall establish and maintain a published telephone number for customer
contacts and an updated and interactive web -page for customer service, including posting up to
date transport fee schedules and the disclosure of corporate contact information. (Contractor's
Responsibilities, p. 20)
Rural/Metro will establish and maintain a published telephone number for customer contacts
and an updated and interactive web page for customer service, including posting up-to-date
transport fee schedules and the disclosure of corporate contact information. Our current
website includes links to billing and customer service contacts, and provides access to a
customer survey form. A special link for Ocoee customers will be added to the site and will
include the transport fee schedule, as well as information about community education or other
Ocoee -specific events.
To view the current website, please visit
http://www.ruraimetrosouth.com/locations/florida/central-florida.htmi.
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Rural/Metro will provide Ocoee customers with access to pertinent service information and
contacts via a link on our local web page.
RFP# 12-005 i i wxmewo Page 116
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PROPOSAL TO PROVIDE EMERGENCY AM BU LANCE SERVICES �Ca�
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IX. Other Required Content
A. Forms Listed on Table of Contents
The following pages include the RFP's required forms, including the:
• Company Information Signature Sheet
• Summary of Litigation
• Acknowledgement of Addenda and Subcontractors
• References/Experience of Respondent with Similar Work
• Bank or Other Financial References
RFP# 12-005 Il1►ral/Metro' Pa e 117
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Flaildr
RFP 912-005 COMPANY INFORMATIONISIGNATURE SHEET
FAILURE TO COMPLY WITH THE RFP INSTRUCTIONS WILL RESULT IN
DISQUALIFICATION OF YOUR PROPOSAL. PLEASE SIGN BELOW ATTESTING THAT
YOU HAVE READ AND UNDERSTAND ALL RFP INSTRUCTIONS AND THAT YOU
UNDERSTAND THAT THE SUCCESSFUL RESPONDENT WILL BE REQUIRED TO ENTER
INTO A LEGALLY BINDING CONTRACT WITH THE CITY OFF OCOEE.
Rural/Metro Corporation of Florida (407) 578-3601 _
COMPANY NAME TELEPHONE (INCLUDE AREA CODE)
(40'7) 578-3603
AUTHORI7_ D ffIGNATURE (manual) FAX (INCLUDE AREA CODE)
Christopher Blach/
Division General Manager christopher,blachormetro.com
NAME/TITLE (PLEASE PRINT) E-MAIL ADDRESS
472a old Winter Ga.rdexl Road
STREET ADDRESS
Orlando, FL 32811
CITY STATE ZIP
FEDERAL ID # 590934668
Individual
(Specify) i'
Sworn to and Subscribed before me this { �I --- day ofy , 7-U�•
IF REMITFANGE ADDRF,•SS IS DIFFERENT
FROM PURCHASE ORDER ADDRESS,
PLEASE INDICATE BELOW:
X Corporation Partnership - Other
Personally Known _ or Produced Identification
Notary Public - State of rttir i
(Type of Identification) County of 0%r'Q-n1S1k_
MELISSA WHP-eLFR Signature of Notary Public
NOTANy PU9LIC
it-ExpIros
srA7E aF 13959DA
Cdnm# EE139S99 Printed, Typed or Stomped Commissioned
io11912015 Name of Notary Public.
51
RFP# 12-005 Emergency Ambulance Services
RFP# 12-005 RuraUMeU° Page 118
Ambulance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
16. SUMMMARY OF LITIGATION
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Provide a summary of any litigation, claim(s), proposal disputes, or contract
dispute(s) flied by or against the Respondent in the past 5 years that is related to
the services that the Respondent provides In the regular course of business. The
summary shall state the nature of the litigation, claim or contract dispute, a brief
description of the case, the outcome or projected outcome, and the monetary
amounts Involved. If none, please so state.
During the past five (5) years, Rural/Metro Corporation of Florida. Inc. has been involved in
contract and tort litigation and disputes arising out of its normal business dealings. Each matter
Is described below:
2010 bid protest. In 2010, Rural/Metro Corporation of Florida protested a bid award by
the City of Orlando to American Medical Response ("AMR"). Rural/Metro challenged
the award alleging that a proposed clinical enhancement fund offered by AMR was not
permitted under Medicare restrictions, Rural/Metro also questioned the propriety of
AMR's use of a lobbyist who had potential conflicts of interest arising from his
representation of the City of Orlando. As a result of the protest, the bid solicitation was
cancelled and the City of Orlando extended Rural/Metro's contract for an additional two
(2) year period.
• Kenny v. Rural/Metro Corporation of Florida; U.S. District Court, FLSD, Case No. 11-CV-
61926-WPD. Mr. Kenny brought suit against Rural/Metro alleging Fair Debt Collection
Practices Act violations in connection with a billing dispute. The matter settled within
several months for a nominal amount,
• Clements v. Rural/Metro Corporation of Florida; Orange County Circuit Court, Case
2011-CA-002395. Negligence suit brought by patient when a stretcher tipped over on a
cobblestone street. Case was recently filed and discovery Is still on -going.
• Daniel v. Rural/Metro; Orange County Circuit Court, Case No. 08-CA-019796. Negligence
sult arising out of an alleged stretcher tip in November of 2005, Case was filed in 2008
and settled in March of 2010.
• Monroe v. Rural/Metro; Negligence suit filed in 2008 for an incident occurring in April
of 2006. The plaintiff alleged that Rural/Metro's employee tripped while transporting a
patient and caused the glass door to fall partly on the plaintiff, a by-stander. The case
was settled in 2010.
Rural/Metro management has changed in the past five years. Accordingly, the matters
disclosed are based on a review of corporate records and the knowledge of present
management personnel.
12
RFP# 12-005 Emergency Ambulance Services
RFP# 12-005 40 Hur�/Me�re Page 119
Rmbufamce
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
17. ACKNOWLEDGEMENT OF ADDENDA:
Respondent acknowledges receipt of the following addenda:
No. —Addendum No. 1
No
No.
18. LIST OF SUBCONTRACTORS:
None.
Dated _May 15, 2012
Dated
Dated
M
RFP# 12-005 openut'° Page 120
amaulance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
REFERENCESIEXPERIENCE OF RESPONDENT WITH SIMILAR WORK
eft
The Respondent shall complete the following blanks regarding experience with similar
type of work. Respondent must demonstrate that It has performed emergency ALS
services within the State of Florida during at least the past five (5) years.
DATE OF CONTRACT / AMOUNT OF PROJECT! CLIENT'S NAME AND ADDRESS
TELEPHONE NUMBER I EMAIL ADDRESS 1 NAME OF CONTACT
Client's Name: Sumter County
Client's Address: 7375 Powell Road
City: WIdwood I State: FL Zip Code:
Name of Contact: Chief Leland Greek
Date of Contract: 10101 /2011
Telephone Number: 352-689-4500
1 E-mail Address:
Brief Description of Project: Rural/Metro Ambulance provides 9-1-1 Medical
Transportation as well as Dispatch services to the county.
Client's Name: Town of Windermere
Client's Address: 614 Mani St.
City: Windermere
I State: FL.
Zip Code:
Name of Contact: Robert Smith Date of Contract: 812011
Telephone !Number: 407-876-2563 1 E-mail Address:
Brief Description of Project: : RuralMetro Ambulance provides 9-1-1 Medical
Trans ortation to the Town of Windermere.
Client's Name: City of Orlando
Client's Address: City Hall 710 Floor 400 S. Orange Ave. P.O. Box 2846
City: Orlando
State: FL
Zip Corte:
Name of Contact: Chief John Miller
Date of Contract: 28 years
Telephone Number: 407-246-2390
E-mail Address:
Brief Description of Project: Rural/Metro Ambulance provides 9-1-1 Medical
Transportation to City of Orlando.
Have you any similar work In progress at this time? Yes_XX No
Length of time In business: Rural/Metro of Central Florida, 27 years; RurallMetro
Corporation, 64 years
Bank or other financial references.
(Attach additional sheets If necessary)
13
RFP# 12-005 Emergency Ambulance Services
RFP# 12-005 r polgaw Page 121
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
REFERENCES/EXPERIENCE OF RESPONDENT WITH SIMILAR WORK
M
The Respondent shall complete the following blanks regarding experience with similar
type of work. Respondent must demonstrate that it has performed emergency ALS
services within the State of Florida during at least the past five (5) years.
DATE OF CONTRACT 1 AMOUNT OF PROJECT 1 CLIENT'S NAME AND ADDRESS /
TELEPHONE NUMBER 1 EMAIL ADDRESS 1 NAME OF CONTACT
Client's Name: City of Winter Garden
Client's Address; 300 West Plant St
City: Winter Garden
I State: FL
Zip Code: 34784
Name of Contact: Michael Bolhoefer
Date of Contract: 812011
Telephone Number: 407-656-411 t
1 E-mail Address:
Brief Description of Project: Rural/Metro Ambulance provides 9-1-1 Medical
Transportation to the City of Winter Garden,
Client's Name: City of Aurora
Client's Address: 75 North Broadway
City: Aurora
I State: CO
Zip Code: 60506
Name of Contact: Fire Chief Mike Garcia
Date of Contract: Since 1988
Telephone Number: (303) 326-8989
1 E-mail Address: rgarcia@auroragov_org
Brief Description of Project: Rural/Metro provides emergency and non -emergency
ambulance service in Aurora, CO.
Client's Name: City of Sioux Falls, REMSA
Client's Address: 521 N. Main Ave.
City: Sioux Falls State: SD Zip Code: 57104
Name of Contact: Julie Charbonneau,
Date of Contract: Since 1968
Exec Director
Telephone Number: (605) 367-8763
E-mail Address:
jcharbonneakA@siouxfalls.org
Brief Description of Project: Rural/Metro has provided ALS 911 service to 51oux Falls
and the surrounding communities of Crooks, Tea, Harrisburg and Renner for the past
44 years.
Have you any similar work in progress at this time? YesJXX_ No
Length of time in business: Rural/Metro of Central Florida, 27 years; Rural/Metro
Corporation, 64 years
Bank or other financial references. (Attached Separately)
(Attach additional sheets if necessary
13
RFP# 12-005 Emergency Ambulance Services
RFP# 12-005 0 Rural/Metrd Page 122
Ambulance
PROPOSALTO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
4VRural/Matra'
Corporation
Corporate Information
Corporate Address:
9221 E Via De Ventura
Scottsdale, AZ 85258
Phone: (480) 606-3886
General: (800) 352-2309
BANK AND OTHER REFERENCES
Credit Application Addendum
Mailing Address:
P.D. Box 0553
Scottsdale, AZ 85252
Chief Executive Officer: Michael DiMino
Incorporated 1948: Arizona
Type of Business: Emergency Service Provider
Federal ID Number: 86-0084388
Financial References
Bank: Chase Manhattan Bank
Address: PO Box 260195
Baton Rouge, LA 70826-0195
Phone Contact: Sharon Mayreis
Fax (310)860-7110
Please send all faxes to the attention of Sharon Mayreis
Account Number: 512055580
Trade References
WorkFlowone
410 N 44' St. Ste 150
Phoenix, AZ 85008
Contact: Jamie Chatham
Phone (858) 627-1503
Facsimile (858) 541-0093
Physio — Control, Inc.
PO Box 97006
Redmond, WA 98073-9706
Phone (800) 426-8047, Ext 74298
Facsimile (425) 891-2405
Henry Schein Company
PO Box 3227
Irmo, SC 29063-4013
Contact: Scott Burner
Phone (800) 845-3550, Ext 336
Facsimile (800) 533-4793
Bound Tree
PO Box 8023
Dublin, OH 43016
Phone (800) 533-0523, Ext 4002
Facsimile (866) 284-7504
tft
RFP# 12-005 40 R Mapco Page 123
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
Conclusion
Thank you for the opportunity to present
Rural/Metro's response to the City of Ocoee's
Request for Proposals for Emergency Ambulance
Services. We believe our proposal presents the City
with the best possible option for the continued
delivery of clinically sophisticated, efficient, cost-
effective and truly seamless emergency ALS
ambulance transportation services in partnership
with Ocoee Fire Rescue Department. We have
greatly enjoyed working alongside Ocoee Fire to
provide the City's residents with the best possible
prehospital care.
In addition to meeting or exceeding the RFP's
requirements, Rural/Metro offers several
innovative service enhancements that we believe
will greatly benefit Ocoee's residents and the
overall EMS system. Our company has a long-
standing tradition of partnering with municipalities
to co -develop customized EMS solutions. Our
strong history and relationships in the community
provide an excellent foundation for advancing
Ocoee's EMS objectives under a new contract. We
look forward to collaborating with Ocoee Fire
Rescue to build upon the City's tradition of EMS
excellence.
7liank you
�Gcnlea of Gor.� Leyl„
'f tY
eloada
Rural/Metro
Service Highlights
➢ CAAS accreditation
➢ Committed & experienced EMTs
and Paramedics
➢ Unparalleled dedicated & surge
vehicle & fleet resources
ZOLL RescueNet electronic
patient care reporting
➢ Proven response -time
performance
➢ The region's most sophisticated &
modern communications system
➢ Commitment to integration with
Ocoee Fire Rescue
Comprehensive community
outreach & education programs
➢ Opportunities for Fire Rescue
staffing of R/M ambulances in
support of credentialing
requirements
RFP# 12-005 0 Hppal/991m, Pa a 124
Ambulance g
tft
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
Attachments
Attachment 1: Disaster Response Shelter Information & Agreement
RFP# 12-005 40 ReraUMMPage 125
ambulance
I Jli ,A1 -I LF1 I-IL-;I-'i-lH',-;L-
OK'S Cascade Company
OVEFAVIFW
Disaster Fiespnn r I this fufuufation of our business and die core of our srri rnp,lr Wrtfl nor ruobile
kitchens, showers r efngeralur trucks and laundry trailers, we have the abildy uo se6up a viftrcil 1t
sell -supporting city In p IGt. f1 lew Flours. We can provide hot rumning water vdierp rintll, n ;Iv:;lilrabit,
and ernerrlencv fend when anrf supplies are non-existent.
In OUP J 5yEur hislrirq. Cl<'6 I�JGCadE tlJrrlpflrly Itas lirnl Ig1'It:
[eu :rclt.IIGV resl)onse to such large-scale disasters aG r,he
mr-in Mn11rd t. Flelan❑ Isruptlnn, Die U Kon Vrdde< col spill in
Alaska, IJu, urthyuakcs In Loma Prieto and Northridge
lAulffornlu, I'll 161 D Iluude, in North Dukutu, and I lurricunvr,
Fran, Floyd, Andren, Knlrin r Rita, Wilma, Ilse and Gustay.
Whether a naruml dlsasl er, fin: rrr terrorist event, OK S
rascade has 111F. ahtlny to rilGhilve arx' IlrEt wlthm Tour h0ors.
Q:I lei' providers may sev they can do wl lot we du, btrt only
GCS Cascade Col npanq as I liepT ❑voi I Justory and
prufereiunal lulow-Flow it tLikes to rr)spun c suucvselully
Linder preEelirv. YOU can rixio, IIII�. on largenav services frorn
LK'u L❑ hrl rig ca n1 to 117E cerlLP,r of ynllr aorYn.
There are Unto.; whoa the I edEral, 9,al e, and Local
govemi norlt or, corporations need a "One At OXOrI"
solution for all al Ilir.ur dlsa-ter Iwedu, OI<'P Coreade
Cornpany can ufld h s provided base camps with all
thr,nceelrcary; ©Illruinla, IVlcherlr;, Inod, Dining
Facilities, Showery, Lrulodiv Facilities, Restrouin,
Gcncrt�Lun;, Air Cbndiuriorlg and evrn Ruu-cimon
Facifi cr. We have the Inrget t Ileet ulits tope in the
nal.inn.
Altar, hurricanes Katrina and flila. OK'G Cascade was
providing 12 c6nGurR1N, urinps for either icdcral or
static government and privalu irduri;ry, ❑euving more
than G ,LUO people, server over 2134,COM Ideals and
pri'virled for other dail'i needs, OI<TS al ra ;v�sisted
otlror uDrupuniut; In Lhoo-ellurts In iond o Ifund. in LhkU
wake of clue. hurricanes, Waste Management
nnrnpnnV ret up a uol nf1 in Ntm Oiienn.n to bore I,h
drivers who wen brought in to help with ncc cleanup.
UK'S 1--aucade was cunlearl,%xl Ixl pravidii Owll,en ,
laundry, food acid other services to the Waste
Mnnuflon-iont Frrrpluyees who whew jI,oq[niI I.hom.
In repose to hurricnnnr GIISUav and Ilre in 2Lll k1,
OI<'S Cascade was dispal.ched by LUOSlana'S
Oeporttnent of Sorial Servicr,s trj prrsvidE in evacuee
shelters. Muse shcitors (;Orunlsted of loonies fur•
citizens as well as sln=.cinl rwuds Shelters fur disabled
Lind those requiring rnediOal attention. In addition,
DSS dispatched for 431 Oomtnrt stations do
Fw'6!-,t Ifr diuly cmergenc�� land stmnq) progmvil. This
involved providing tenting, tolrlrls, rhairs, fans, water
Mid flOX00111 InGIIIIJOR fsd, rl IES' Lill ovr:r MO rl:1b"
OK'S f ascade also }provided hasc cr1ln. pc,urvices at
mAtipko, alJ iev uiteE cunrum rILly.
PEIGONNFL BASF OAIVOr'
OK'S Cascade Cbrf iparly hero thn
NIMF; cobeTlcrirls of fivo L%ma )1-V) of
standardized packages aril can feed
np Lu 1tJJ,nUO people if ruecessari.
Tvpe I
1010 Pclrrnnrlel
Type II -
750 Personnel
Tvpe III
500 Poirormel
Tvifr' IV
250 Personnel
Tvpe V
1QC Per noel
ISl,al,io or Mobile,.]
WWW . OICS . COIYI
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
OK'S CASCADE COMPANY NON -DISCLOSURE AGREEMENT
tft
In order to protect the confidential and proprietary information of OK'S Cascade Company ("OK'S") to be
disclosed to RURAL/METRO CORPORATION the parties hereto agree that:
1. OK'S intends to provide to RURAL/METRO CORPORATION a proposal containing information including but not
limited to equipment descriptions, capacities, response capabilities and pricing, in oral or written form, which is
proprietary to OK'S (hereinafter "Information") for the purposes of RURAL/METRO CORPORATION's evaluating
OK'S as a potential primary vendor of Emergency Base Camps, Kitchens & Food Service, Showers, Laundries
and/or other confidential business information to the RURAL/METRO CORPORATION (the "Permitted Use"),
z. If the Information is provided In a tangible form, the OK'S shall clearly mark It PROPRIETARY or
CONFIDENTIAL. If the Information is provided orally, OK'S shall clearly Identify it as being proprietary or
confidential. If the Information Is provided in electronic or other media, all information or data contained
therein shall be assumed to be confidential or proprietary Information of OK'S and shall be treated as such
under the terms of this Agreement.
3. RURAL/METRO CORPORATION, for three (3) years from the date of disclosure, shall hold such Information in
confidence, shall restrict disclosure of such Information to its employees with a need to know (and advise such
employees of the obligations assumed hereln), shall use the Information only for Permitted Use, shall not,
except as provided herein, disclose such Information to any third party without prior written approval of OK'S,
and shall use reasonable care to prevent its unauthorized disclosure. No Information may be used by
RURAL/METRO CORPORATION In any manner whatsoever for any other purposes (other than the Permitted
Use), Including but limited to use In connection with any third party or potential provider of services to
RURAL/METRO CORPORATION. Notwithstanding the restrictions contained In this Section 3, RURAL/METRO
CORPORATION may disclose information if each of the following conditions are met: (i) such disclosure is
required by applicable law, regulation or other governmental requirement; (ii) RURAL/METRO CORPORATION
gives OK'S prompt advance written notice of such requirement, to the extent permitted by law, in order to
enable OK'S to object to such disclosure; (III) RURAL,/METRO CORPORATION discloses only that portion of
Information which it is advised by counsel it is required to disclose; and (iv) RURAL/METRO CORPORATION uses
reasonable efforts to obtain safeguards that confidential treatment reasonably acceptable to OK'S will be
accorded to such Information.
4. This Agreement shall be in effect for a period of three (3) years unless sooner terminated in writing by either
party. RURAL/METRO CORPORATION agrees that all of Its obligations undertaken herein with respect to
Information received pursuant to this Agreement shall survive and continue after any expiration or termination
of this Agreement.
5. All Information shall remain the property of OK'S and all copies thereof, on whatever physical, electronic I
other media such Information may be stored, shall be returned within ten (10) business days of OK'S' request.
6, This Agreement constitutes the entire understanding between the parties hereto and supersedes all previous
communications, representations and understandings, oral or written, between the parties with respect to the
subject matter of this Agreement. No amendment or modification of this Agreement shall be valid or binding on
the parties unless made in writing and signed on behalf of each of the parties by their respective duly
authorized officers or representatives. If any provision of this Agreement shall be held by a court of competent
jurisdiction to be illegal, invalid or unenforceable, the remaining provisions shall remain in full force and effect.
OK'S CASCADE COMPANY RURAL./METRO CORPORATION
By:
Name:
Title:
Dated:
By:
Name:
Title:
Dated:
R0FP# 12-005 q a ! nCe Page 127
r
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
Attachment 2: ZOLL RescueNet ePCR Information
ift
RFP# 12-005 Rufial/Metro' Page 128
Rmdulance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
tft
The RescueNet® ePCR Suite is a complete electronic patient
care reporting solution that combines the proven, easy -to -use
TabletPCR product with a web -based PCR editor (RescueNet
WebPCR) and advanced document routing for better 0A/01-
It's designed to capture and allow access to all pre -hospital
patient, clinical and system information on tablet PCs and
mobile computers. The RescueNet ePCR Suite simplifies data
input and improves access to information. This fifth -generation
solution offers dynamically configurable screens to capture
patient care data, an easy -to -use touch -screen user interface,
advanced reporting of all data captured in the field, a graphical,
configurable workflow editor fordesigning custom workflows for
PCR reviews, and a web -based solution for reviewing and editing
patient care reports.
ZOLL
RFP# 12-005 QM8 Page 129
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
Intelligent Design
The core product of the RescueNet ePCR Suite is
TabletPCR. Its user interface brings the latest ideas
and technology in usabilityto the electronicfield
data experience.
• Optim ized for touch -screen tablets
• Easily tabfrom field -to -field when using
keyboard -based input
• OuickLog allows f ast time-stam ping of
common procedures
• Complete Call Rules with hyperlinks to
required fields
• Spell-checkwith a medical dictionary to
help ensure professional reports.
RescueNet TabletPCR is the most effective field data
solution for record accuracy, data integration and
advanced analysis TabletPCR iswidely used in the
EMS industry and has consistently improved from years
of feedback from the field.
• Prevent incomplete patient care reports
• Improve medic efficacy
• Reduce risk in the event of litigation or audits
• Eliminate inefficient paper processes
• Ensure protocol is followed consistently
• Utilize integrated field data forsyndromic
surveillance.
Configurable to Meet
Your Needs
ift
With configurable screens for TabletPCR and WebPCR,
you can quickly customize the system to meet the
needs of your organization. Administrators can modify
screen layout, change labels and create their own
pick lists — all without costly custom programming.
Complete Call Rules ensure that calls are both accurate
and corn plete.
In simple terms, the software adapts to your business
—your business doesn't have to adapt to the software.
Designed foreasy data entry, iraining time to transition
from papersystems is minimal The system administrator
can customize the data entry screens to add fields,
change label names and rearrange fields on the screen
(see image).
RFP# 12-005 RuPfilIMetro' Page 130
i0AMINN1178
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
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ePCR Suite Modules and Features
The RescueNet ePCR Suite has a number of features
and components that give you control overthe
documentation process in your organiza0on:
Rescuoftr WebPCR
• Web -based PCR editor provides PCR editing a nd
review from any workstation with a compa bble web
browser
• Built with the same screen layout as TabletPCR
so that everything is in the same location in the
application as it is with TabletPCR
• Integral component of the PCR Workflow module,
which allows the automatic routing of PCRs
for review and the manual routing of PCRs for
corrections
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review or correction
• Supports "route and return" to ensure that aftef the
PCR is feviewed, it is returned to sende(.
RescueNet eDistr&lion
■ Saves money by allowing the automatic distribution
of fifes and updates to mobile units without having
to physically "touch" the mobile units.
RescueNet ePCR Workflow Editor
• Advanced, giaphicaIeditor todesign the flow of
PCRs through the review process
• Designed to allow quick layout of conceptual flow to
simplify the design process.
RFP# 12-005 FEW Ambulance° Page 131
PROPOSALTO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
ZOLL
Reporting on Results
4M.r or Caxl L1v�
FIgIIAa
RescueNet Reporting provides administrative personnel
with out -of -the box reports on many aspects of the
operation. You can use these reports to collect and print
ePCR information. In addition to the standard reports
provided with RescueNet TabletPCR, you can also
create custom reports using Crystal Reports' award -
winning report designer. Over fifty reports are included
in the following categories:
• Administration reports
• Treatments and impressions reports
• Medic skills reports
a Trip lists
• Performance>On Scene reports
• Genera l>HIPAAro ports
• Statistics reports
• RescueNet Dispatch and Billing reports
GOLDCERTIFIEDD• ISV/SoHwareSolutioru
Partner
www.rolldata.com
US Sales 800 474 4489 j US Fax 303 801 0001 1 US Direct Dial +1 303 0010000
Asia/Pacific +61 2 9420 87331 Fufope +44 (011925 846400
�:AW U['ale Sys— All,ighls W-1. ZOLL U- 02MM16I G,.r aan AL six nl I§-iI��lira awxs
RFP# 12-005 Qmral� 8r° Page 132
PROPOSALTO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
tft
Attachment 3: Harassment & Background Screening Policies
RFP# 12-005 JTW RUraluff n' Page 133
IV ambulance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
10 Ila+alZmah ,
Cwparaft
HARASSMENT
tft
HR-18
Sef.9ion: HR (Human Resuwvus)
Effective Date: November 1, 2010
Policy Type: Company Wide
Revision Date(s):
PolicyLueatiun: i�rtps:!inrrrrlmeiro.hccs,cwre%orc frnmes.crsn
POLICY: It is the policy of the Company to provide a workplace free of harassment,
Intimidation and coercion on any basis prohibited by law Including age, ancestry,
color, marital status, medical condition, mental disability, physical disability,
national origin, race, religion, sex or sexual orientation.
RESPONSIBLE OFFICER: Vice President of Human Resources
PROCEDURE;
DEFINITION OF HARASSMENT
A. Harassment Is unwelcome verbal, visual or physical conduct on a basis
prohibited by law that creates an intimidating, offensive or hostile work
environment or that interferes with work performance or adversely affects an
individuals employment opportunities.
This policy stresses Rural/Metro's strong disapproval of harassment on any basis
prohibited by law, identifies the procedures available to employees for reporting
harassment, outlines the disciplinary action(s) that will be imposed and reaffirms
Rural/Metro's commitment to the principle of respect for each employee.
Such conduct may take many forms and includes, but is not limited to, slurs,
statements, gestures, pictures, or cartoons, regarding an employee's age,
ancestry, color, marital status, medical condition, mental disability, physical
disability, including persons infected with HIV virus or persons with AIDS,
national origin, race, religion, sex or sexual orientation.
B. Sexual harassment in the workplace is unlawful and may involve a wide variety
of unwanted, unwelcome and repeated behaviors, including unwelcome sexual
advances, requests for sexual favors, and other verbal or physical conduct of a
sexual nature when:
1. submission to the conduct is made either explicit or implicit condition of
employment; or,
2. submission or rejection of the conduct is used as a basis for an
employment decision; or
Page 1 of 2
RFP# 12-005 Rorel�Meifrta Page 134
Ambulance
PROPOSAL. TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
4v, o • fim
HARASSMENT
tft
HR-18
3. the harassment unreasonably interferes with an employee's work
performance or creates an intimidating, hostile or offensive work
environment.
REPORTING HARASSMENT
A. Managers and supervisors are required to exercise reasonable care to prevent
conduct or behavior at work that creates an Intimidating, hostile or offensive work
onvironment, Failure to insure a non -hostile work environment makes the
manager liable for disciplinary action, up to and including termination.
B. Regardless of position, if you have a complaint of or witness harassment in the
work environment by anyone, Including supervisors, managers, employees or
non -employees, you should immediately bring the matter to the Company's
attention. While an employee is encouraged to confront the offender about the
alleged harassment, there Is no requirement to do so.
C. The complaint or observation must be reported to your manager, a Human
Resources representative or reported on the Hotline at 877-631-6722, When
the complaint or observation of harassment involves someone In your direct line
of command, or if you are uncomfortable discussing the matter with your
manager, you are urged to ga to another member of management or a Human
Resources representative. All complaints reported to management must also be
reported to Human Resources for investigation.
INVESTIGATION
A. When a charge of work related harassment is brought to the Company's Human
Resources representative, immediate action is taken to gather information about
the allegation and resolve the problem in a timely and confidential manner, to the
extent possible.
B. The prospect of initiating a formal investigation must not be a deterrent to an
employee seeking assistance.
C. It is absolutely forbidden for any employee to punish or conduct reprisals against
another employee who has reported an incident of harassment. Such retaliation
will result in discipline up to and including termination.
D. Anyone filing a false, frivolous or malicious complaint is subject to discipline up to
and including termination.
E. Any employee found to have harassed another employe
appropriate disciplinary action, up to and including termination.
t
Approved by: Date: _
President and Chief Executive Officer
Page 2 of 2
is subject to
11/18/10
RFP# 12-005 Ilapiwatrd Page 135
Ambrtlr�e
tft
PROPOSAL TO PROVIDE EMERGENCYAMBULANCE SERVICES
FOR THE CITY OF OCOEE
Ri romew
cO Wslion
BACKGROUND SCREENING HR-02
background check may be useful to aide in the company's investigation of the
incident.
b. The company will obtain necessary and appropriate signed authorizalions and
consents before performing background checks. Authorizations and consents
generally will remain in effect until revolted in a written document signed by the
employee or in the event of a separation of employment. Failure or refusal to
consent to a background check may be grounds for termination or the company's
rescinding an offer of employment.
E. Providing false, incomplete or misleading information in an employment
application or authorization may disqualify a candidate or current employee from
employment and may be grounds for termination or rescinding an offer of
employment.
F. Pre -employment background checks are completed after the company has
offered a candidate a position. Job offers generally are conditional upon the
satisfactory completion of the pre -employment background checks.
G. Before the company takes an adverse action against an applicant or an
employee, such as withdrawing a conditional job offer or terminating an
employee's employment, based on the results of a background check, the
company will provide the individual with any notices and other information the law
requires.
H. The company individually reviews each candidate and employee who Is the
subject of a background check and makes decisions with respect to employment
based upon the totality of the candidate's qualifications and the results of the pre-
employment background checks.
Adverse information in a background check report, including a criminal history or
conviction, does not automatically disqualify a candidate from the position
sought, When adverse information is obtained as a result of a background
check, in determining whether or not an individual is disqualified, the company
generally considers the following factors:
1. The nature of the position for which the individual is being considered.
2. The nature of information obtained by the background check; in the case
of criminal matters, the facts surrounding the matter are particularly
relevant.
3. The age of any incident discovered as a result of the background check.
4. The forthrightness and honesty of the individual with respect to the
information obtained by the background check.
Page 2 of 6
RFP# 12-005 0 �1 n�E Page 136
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
0 fiWTMW
rim im
BACKGROUND SCREENING
tft
HR-02
J. The company maintains records of background checks either within the records
of the applicable region or at the company's headquarters.
TYPES OF BACKGROUND CHECKS CONDUCTED
A. The company conducts the following checks:
1. Social Security Number Verification - An individual's social security
number is checked against a national database to determine the validity
of the number.
2. County Criminal Records Search - This entails a check of criminal
records maintained by courts in specific counties requested. Counties
checked ordinarily include the county in which the individual currently
resides and counties in which the Individual has resided or worked during
the past 7 years. To the extent permitted by applicable law, a check will
Include felony and misdemeanor records for the past 7 years.
3. National Criminal Database Search — This entails a search of compiled
national databases maintaining criminal background information from
multiple sources, including various state agencies and several counties.
Information generally includes county data, state corrections department
files and sexual offender lists. This tool enhances county criminal records
searches and may be used as a "safety net" search for some positions.
4. Office of Inspector General (OIG) - Federal legislation is in place to
prevent certain individuals and businesses from participating in federally
funded health care programs. Under this Congressional mandate, the
OIG established a program to exclude individuals and entities affected by
these various authorities and maintains a list of all currently excluded
parties called the List of Excluded Individual s/Enlities. Exclusion can
occur as a result of convictions for program -related fraud and patient
abuse, licensing board actions and default on Health Education
Assistance Loans. The company generally searches the list to determine
whether or not an Individual is an excluded individual.
5. Excluded Parties List System (EPLS) — This system contains
information regarding Individuals and entities debarred, suspended,
proposed for debarment, excluded or disqualified or who are otherwise
declared ineligible from receiving Federal contracts, certain subcontracts,
and certain Federal assistance and benefits. This information may
include names, addresses, Social Security Numbers, Employer
Identification Numbers or other Taxpayer Identification Numbers, if
available and deemed appropriate and permissible to publish by the
agency taking the action.
Page S of 6
RFP# 12-005 a lMe a Page 137
���c++lc, oL cgtd Guar
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
rre��a�
Rrrral/Melra'
Cnrpnraflaa
BACKGROUND SCREENING HR-02
Motor Vehicle Record Check — The company conducts this check both
during the selection or placement process for new applicants applying for
driving positions and also annually for existing drivers. The company may
also conduct this check an on -duty collision or upon an individual's
receiving a citation for a moving violation while operating a company
controlled vehicle. (See Policy FN-08 Driver Performance Standards and
Motor Vehicle Record (MVR) Checks.)
B. The company may conduct additional types of background searches if the
position is classified as a position of trust; if the state in which the Individual
resides requires the search; or if a contract between the company and a
customer requires the search. For example, the company may conduct the
following types of additional searches:
1. Employment & Education — The company generally will do this type of
screening with respect to manager level positions and above.
2, Professional Certifications/Licenses — The company generally will do
this type of screening with respect to positions that require a specific level
of education, certification or license and with respect to positions of trust.
3. Credit History — The company generally will do this type of screening
with respect to positions of trust.
IV. CRIMINAL GUIDELINES
Criminal events are not an automatic bar to employment. The company considers all
relevant circumstances, including applicable law, the nature and seriousness of the
crime, the date of the crime, rehabilitation, and the individual's forthrightness and
honesty with respect to the conviction. The company generally applies the following
chart to employment decisions, while taking into account the factors listed above in the
General Guidelines Section of this policy.
Exceptions to the chart guidelines require written approval by the VP of Human
Resources and will be made in accordance with applicable law.
The company reserves the right to consider all other charges not listed below in making
determinations.
Page 4 of 6
RFP# 12-005 - Alice Page 138
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
Rara!/M w
I1WCMWa1kff
BACKGROUND SCREENING
Criminal Background Guidelines Chart (This list is not all inclusive)
��Cen1e� of C.acy LrN�
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Fia,�u.
HR-02
Disqualifying Events
Non -Disqualifying Events
DUI - Any within the last 5 years or current
DUI older than 5 years with all fines
outstanding fines on past DUls for driver
paid for driver positions.
positions.
Non -drivers positions — DUI other than
Non -driver positions — Felony DUIs.
felony DUI.
Any Drug charges or Drug possession charges
within the last 3 years.
Drug possession charges older than 3
years.
Possession with intent to sell charges.
Theft of Property or the writing of bad checks —
over $500.
Theft under $500 for positions of non -
Theft of any kind for applicants applying for
financial responsibility AND older than 5
positions with any financial responsibility and/or
years.
access to patient property & information (finance,
collections, billing, payroll or EMS positions).
Felony convictions older than 7 years if
Any Felony convictions within the last 7 years or
not a crime against a person and
any felony for a crime against a person.
successfully completing all conditions of
their probation.
Currently or within the last 2 years have been on
Probation successfully completed
probation and have not successfully completed all
2 years.
conditions of their probation.
Traffic Violations in accordance with driving policy
Traffic Violations for non -driving
for driving positions.
positions.
Stalking Convictions.
Trespassing.
Unlawful possession of a weapon.
Failure to pay child support.
Any Sex Offenses
(Rape, prostitution, molestation, etc.).
Disturbing the peace.
Misdemeanor convictions under 3 years will be
reviewed based on the factors listed in the policy.
Misdemeanors older than 3 years.
Page 5 of 6
RFP# 12-005 fJural/MEtfo Page 139
AM&MCe
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
0 Rtmel/Melra'
cmwalft
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BACKGROUND SCREENING IIR-02
V. CRIMINAL GUIDELINES FOR CURRENT EMPLOYEES
Current employees must make Human Resources aware of any arrest, conviction or
disqualifying event wlthin 24 hours of either occurrence.
A. Human Resources will review the incident in accordance with the above chart
and factors.
B. The employee may be placed on Administrative Leave of Absence pending the
outcome of the investigation.
Approved by: Date:
President and Chief Executive Officer
Page 6 of 6
-
RFP# 12-005 EM wofiletr° Page 140
Ambulance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
tft
Attachment 5: Supervisor Training Program Outline
RFP# 12-005 l�ur�l/Metro' Page 141
Ambulance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
tft
Bru'al/Metl'o'
CI~u'ptlrsllUn
SUPERVM G
TABLE OF CONTENTS
Module 1
• DISC Assessment Profile Training, 2.5 Hrs
o Course Presentation
o Facilitator's Guide
o Participant Handouts
o Administering DISC (Facilitator's Course)
• Peer to Leader, 2 Hrs
o Course Presentation
o Facilitator's Guide
o Participant Handouts
• Diversity and Inclusion, 1.5 Hours
o Course Presentation
o Facilitator's Guide
o Participant Handouts
• Change Management, 2 Hours
• Employee Coaching and Counseling, 1 Hr, 10 Minutes
o Course Presentation
o Facilitator's Guide
o Participant Handouts
Module 2
• Performance Management, 2 Hrs
o Course Presentation
o Facilitator's Guide
o Participant Handouts
• Harassment/Discrimination Prevention: Professionalism and Respect for Others,
1 Hr, 40 Mlns
o Course Presentation
o Facilitator's Guide
o "The Right Side of the Line" Training Video
o Participant Handouts
Puge I ur2 ]unuary 20I2
RFP# 12-005 Ilk Rupfi/Watro' Page 142
ambulance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
tft
0 llflf "oYlIfRY'o
cmwafim
SVPERYlS'Q C
TABLE OF CONTENTS CONTINUED
Module 2 (Continued)
• Fair Labor Standards Act, 1 Hr, 15 Minutes
o Course Presentation
o Facilitator's Guide
o Participant Handouts
• ADA and FMLA, 1 Hr
o Course Presentation
o Facilitator's Guide
• Worker's Compensation 1 Hour
o Course Presentation
o Facilitator's Guide
• Litigation Avoidance, 2 Hours
o Course Presentation
o Facilitator's Guide
o Participant Handouts
Module 3
• Interviewing Skills,1 Hour, 45 Minutes
o Course Presentation
o Facilitator's Guide
o Participant Handouts
• Employee Motivation 1 Hr
o Course Presentation
o Facilitator's Guide
• Managing Interpersonal Conflict 2 Hrs
o Course Presentation
o Facilitator's Guide
o Participant Handouts
• Rural Metro's Approach to Union Organization 1 Hr
o Course Presentation
o Facilitator's Guide
Page 2 or January 2012
RFP# 12-005 ALM ROSI Nelra' Page 143
Ambulance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
Attachment 5: Drug & AIcohoI Use Policy
tft
RFP# 12-005 Rpralmetra Page 144
ambulance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
Rural/Metro'
Medical Services
Policy and Procedure Manual
Page: I of 8
so Yews of Sspving Gums
Policy: 2.09 Drug and Alcohol UsuPollcy
This Policy applies to the following employees:
X_ RMMS (non union)
X RMMS (union)
_X_ RMMS (nursing)
Origination Date: 412005
Revision Date:
Originator: Human Resources Department
Approved: General Manager
Policy:
Drug and alcohol abuse has long been a problem of concern, and one that cuts across all
segments of society, including the workplace. Safety, health and environmental quality are
important to the company. The following policy has been adopted not only to protect the health
and safety of our employees and the public we serve, but also to encourage any employee with a
drug or alcohol dependency problem to help him or herself by voluntarily seeking professional
assistance. The company shall take reasonable measures sufficient to assure that drug or alcohol
use by employees does not jeopardize the safety of company operations, or adversely affect the
company, its employees, its customers, and the community; and that the organization complies
with applicable state and federal regulations.
As used throughout this policy, the term "drug" shall mean illegal drugs or other controlled
substances, inhalants, prescription drugs, and drug paraphernalia.
1. All employees are strictly prohibited from using, possessing, concealing, manufacturing,
transporting, selling, buying or promoting the sale of any drug and from using alcohol on
company premises at all times, and off premises while they are performing duties and
responsibilities within the scope of their employment with the company. The term "use" and
"using" shall include being under the influence of any drug or alcoholic beverage, and not
merely the physical act of taking the drug or alcohol into the body.
2. Any use of a drug while off duty which subsequently impairs the employee's job
performance or jeopardizes the safety of other employees or customers shall not be tolerated
A positive test will be considered proof of impairment.
3. The term "company premises" includes: company offices, parking lots, work locations,
garages, desks, lockers, and any vehicle engagedin company business.
4. Where the term "drug test" is used, the following substances will be tested for:
amphetamines, cocaine, marijuana, opiates, phencyclidine, PCP, barbiturates,
benzodiazepines, and methaqualone, and any additional substances that maybe specified
from time to time by the U.S. Department of Transportation Regulations. Employees will be
notified at least two (2) weeks in advance of any additional substances added to the
Department of Transportation test panel.
RFP# 12-005 40 Page 145
RMAIAR O
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
tft
Rupal/Metpo
Medical Services
50 Years of Sep ft MWE
Policy and Procedure Manual
Page: 2 of 8
Polley: 2.09 Drug and Alcohol Use Policy
Any employee undergoing prescribed medical treatment with a drug must give the company
a letter indicating tha t their physician understands the content of the employee's normal job
and that the drug prescribed will not impair the employee's ability to perform their j ob safely
and effectively. If such treatment impairs the employee's ability to perform their usual work
duties, the employee shall be expected to undergo a change in duties to accommodate this
impairment. If such an accommodation cannot be made, the employee shall be placed on a
medical leave of absence in accordance with company policy.
Violators of this policy shall be subj cot to disciplinary action up to and including termination.
Any employee convicted of off -the job drug activity shall be considered in violation of this
policy and will be subject to disciplinary action. Employees charged with a drug- related
felony shall report the occurrence to the supervisor before reporting to duty. In determining
appropriate action, the company will consider the nature of the conviction or charge, the
employee's job assignment, past performance record and any other factors relative to the
impact which the conviction or charge has on the company's operation, including future risk
of use.
A. Applicants:
1. Urine drug testing shall be conducted on all applicants as part of the employment
screening process as a condition of employment.
2. A confirmed positive test result shall be cause to deny employment,
3. Refusal to submit to testing will result in the application being withdrawn from
consideration.
4. If any individual wishes to he reconsidered for employment, they nnist show evidence of
rehabilitation satisfactory to the company's Human Resources Department and medical
advisor.
B. Employees:
The company recognizes that drug dependency is a medi Gat problem, and, therefore, will
assist the employee in obtaining appropriate care for such a problem. Voluntary seeking
of such care is encouraged. Seeking or participation in a rehabilitation program does not
protect the individual from appropriate managerial action, including discipline.
In order to enforce this policy, an employee may be requested to undergo a drug or
alcohol test if the company has a reasonable suspicion that the employee is impaired as a
result of using a drug or alcohol.
RFP# 12-005 Rural/Metro Page 146
409091ance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
4nlci of Copy W,.�
aa��d�
Rural/Metpo'
Medical Services
60 Years of Serving Gaws
Policy and Procedure Manual
Page: 3 of S
Policy: 2.09 Drug and Alcohol Use Policy
3. Following a motor vehicle accident with a company vehicle, employees shall be tested
when there is an indication that drug or alcohol use played a role or where injury to the
employee or others has occurred
4. A "reasonable suspicion" shall mean that evidence or information eadsts which appears
reliable and disguises facts or circumstances which, taken together, would lead a
reasonably intelligent person to suspect that the employee has or is using drugs or
alcohol.
5. Failure to comply with a request for substance screening will be considered an act of
insubordination subjecting the employee to termination of employment.
6. Every employee tested for drugs will be informed ofthe results in writing. Positive test
results shall be communicated by the testing contractor. Negative test result shall be
communicated by the company as soon as possible after it receives results from the test
contractor. Positive test results shall be confirmed by a test of the original split sample.
The employee will be given the opportunity to explain positive results before any adverse
employment action is taken. All records kept by the company pertaining to any drug
testing shall remain strictly confidential and will not be released to thud parties without
the written consent of the individual tested, unless subpoenaed.
Any employee who, as a result of testing, is found to have identifiable traces of a drug in
his/her system regardless of when or where the drug entered in his/her system, will be in
violation of this policy and shall be subject to discipline, including discharge.
Drug Screenine Procedure:
Applicants:
1. All applicants are informed at the time ofinterview that drug screening is part of the pre-
employment process. They shall be required to sign a release authorizing this testing.
2. Urine drug testing is conducted as part of The pre- emp loymcnt physical, scheduled by the Human Resources
Department at a federally certified laboratory (from the preferred vendor list), before employment begins.
3. All testing reports will be returned to the Human Resources Department.
4. If the applicant refuses to sign the test authorization form, or if the drug screening test result
is positive, the applicant will no longer be considered for employment and will be notified in
writing of this decision by the Human Resources Department
RFP# 12-005 RrmallMelyd Page 147
Ambulance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
RupallMetpo'
Medical Services
80 Yaers at 8erWhy Oows
Policy and Procedure Manual
Page. 4 of S
Policy: 2.09 Drug and Alcohol Use Pdtcy
Employees:
tft
1. If, under circumstances where there has been no incident, accident, or investigation which
calls into question the employee's compliance with this policy, the employee admits to drug
use and requests assistance, the manager will refer him/her to the Human Resources
Department for referral for follow-up counseling. A drug screening will be requested at this
time.
2. Any supervisor who reasonably suspects any employee has reported to work or is working
while impairedby any drug or alcohol must immediately notify the appropriate manager and
remove the employee from duty.
3. Any supervisor who reasonably suspects that an employee is possessing, selling, or using a
drug while on duty must immediately notify the appropriate manager.
4. Any employee driving a company vehicle involved in a motor vehicle accident, where there
is reasonable suspicion that drug use played a part or when personal injury has occurred,
must be reported to the appropriate manager immediately by the investigating supervisor.
5. It is the responsibility ofthe manager to meet with the employee in a timely manner and
discuss the suspicions of drug use. The manager may at that time request that the employee
undergo a drug or alcohol test,
6. Actions:
A. If the employee achnits a violation of this policy, appropriate disciplinary action will be
taken.
B. If the employee denies drug use and refuses to participate in drug screening, he/she will
be suspended pending further investigation, and shall be subject to discipline up to and
including termination of employment.
C. If the employee denies drug use and agrees to drug screening, he/she will be taken
immediately to a federally certified laboratory (see preferred vendor list) for the
screening to be completed
Employees suspected of violating this policy maybe suspended pending completion of the
investigation according to company policy. Employees participating in drug or alcohol
screening may be suspended without pay until test results are available. If negative test results
are received, the employee shall be returned to duty with pay for work time missed during
suspension. Work time missed by an employee without a regular schedule shall be based on
the average time worked by the employee during the preceding thirteen (I 3) weeks.
RFP# 12-005 Hural�MeMo Page 148
Ambulance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
Ruraineft
Medical Services
09 yaws of BePY149 Wwrs
Policy and Procedure Manual
Page: 5 of S
Policy: 2.09 Drug and Alcohol Use Pdicy
When positive test results are received, the employee will be notified by the manager
concerning the results. If there ha s been injury to another employee or any member of the
public, or injury to the comparr s reputation in the community, the employee will be
terminated. If there has been no such injury, then the following action will be taken:
A. Less than one year of employment: termination, referral to community rehabilitation
program.
B. More than one year of employment and no prior drug related problem: referral to
community rehabilitation program; unpaid medical leave of absence; random testing for a
period of two years after return to service. The company may offer alternate employment,
if available, during the rehabilitation program.
C. More than one year of employment and prior drug rehabilitation program within one
year; referral to community rehabilitation program, termination Reinstatement possible
upon satisfactory evidence of rehabilitation within 90 days, subject to random testing for
a period of two years after rehire.
D. Any application of this policy resulting in disciplinary action may be reviewed according
to the terms of Article XV (Grievance and Arbitration) of the Iabor agreement between
the parties. The employer shall provide a copy ofthis policyto all current and future
employees for which employee will sign an acknowledgment of receipt.
January 1995 Addendum:
The Omnibus Transportation Employee Testing Act of 1991 required alcohol and drug testing of
safety -sensitive employees in the aviation, motor carrier, railroad and mass transit industries.
Drivers of vehicles in our AT Division who are DOT drivers are inclusive in this act. This act
and its rules are enforceable as of January 1, 1995.
The FHWA (Federal Highway Administration) has issued rules requiring drug and alcohol
testing of drivers who are required to have a CDL (commercial drivers license). The DOT rules
include procedures for using drug testing and breath alcohol testing.
Our policy and procedure regarding drug testing will stay as written. The policy is now revised
to include alcohol testing requested at:
Pre -employment:
Conducted before applicants are hired or after an offer to hire, but before actually performing
safety -sensitive functions for the first time. Also required when employees transfer to a safety -
sensitive (driver) position
RFP# 12-005 Rural/Metro' Page 149
Amdulaece
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
Rupal/metpo Policy and Procedure Manual
Medical 3epvices
5Q VMS of 8Br079 GUWS Page: 6 of 8
Policy: 2.09 Drug and Alcohol Use Pdicy
tft
Post -Accident:
Conducted after accidents on drivers whose performance could have contributed to the accident
(as determined by citation for a moving trafficviolation) and for all fatal accidents even ifthe
driver is not cited for a moving traffic violation.
Reasonable Suspicion:
Conducted when a trained supervisor or company official observes behavior or appearance that
is characteristic of alcohol misuse.
Random,
Conducted on a random unannounced basis just before, during or just after performance of
safety -sensitive functions.
Return -to -Duty and Follow Up:
Follow-up conducted when the individual who has violated the prohibited alcohol conduct
standards returns to performing safety -sensitive duties. Follow-up tests are unannounced and at
least six (6) tests must be conducted in the first 12 months after a driver returns to duty. Follow-
up testing may be extended for up to 60 months following return to duty.
How will random alcohol testing work
Random alcohol testing must be conducted just before, during, or just after a driver's
performance of safety -sensitive duties. The driver is randomly selected for testing (usually from
a "pool" of drivers subject to testing). The testing dates and times are unannounced and are at an
unpredictable frequency throughout the year. Each year, the number of random tests conducted
by the employer must equal at least 25% of all the safety -sensitive drivers.
Results for alcohol testing:
Alcohol Breathalyzer Testing (EBT) results must be within the DOT recommended levels which
are:
.02 -.039 Employee to be removed from safety-sensitivejob for 24 hours.
over .04 Removed from job and referred to professional counseling (if employed
for more than one year). If employed less than one year, their employment
is terminated. (This complies with page 5, section 8 of the Drug and
Alcohol Policy and Procedure.
* If an employee has two EBTs they will then have a blood alcohol test done as confirmation.
RFP# 12-005 Rw me Page 150
AMAOnce
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
M
Rural/Metro
Medical Services
60 Yaws of serMy f]f Wo
Policy and Procedure Manual
Page: 7 of s
Policy: 2.09 Drug mid Alcohol Use Pdicy
June 1997 Addendum:
Impairment:
Would you want someone who was impaired by alcohol or other drugs to take care of your
grandmother, father or child during a critical event? Of course not[ Would you want to entrust
your life to the person driving the ambulance, van or fire truck if they had been using drugs? Of
course note[ Our commitment to you and the people we serve is that we will do everything
possible to insure these scenarios will not occur.
Alcohol and Drug Testing
Rural/Metro Corporation believes that a safe, efficient and productive work environment is
important. In keeping with this commitment, employees and job applicants may be asked to
provide body substances samples (e.g., blood, urine, hair) to detect the use of alcohol and illicit
drugs. The company will attempt to protect the confidentiality of all drug test results. Alcohol
and drug test may be conducted in any of the following situations:
Pre -Employment:
For new and promoted individuals, as part of the initial screening process.
Post -Accident:
Employees involved in a serious incident or accident while on duty, whether on or off the
employer's premises, may be asked to provide a body substance sample at management's
discretion.
Fitne ss-for-Duty:
This test may be requiredif observable changes in employee performance, appearance, behavior,
speech, etc. provide reasonable suspicion of some type of impairment and/or the influence of
alcohol or drugs. A fitness -Far- duty evaluation may include the testing of a body substance
sample.
An individual who is involuntarily relieved of duty solely because of alcohol or drug testing will
be paid for time away from scheduled work if the alcohol or drug test results are negative.
Depending on the circumstances, Rural/Metro Corporation may allow an employee to continue
their employment following (heir first positive alcohol or drug test, provided the employee
successfully completes a rehabilitation program. The employee will be subject to unscheduled
RFP#t 12-005 BIMB109ft' Page 151
Ambffl=8
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
RurallMetro
Medical Services
50 Yaws at 80l'009 others
Policy and Procedure
Manual
Page: 8 of 8
Policy: 2.09 Drug and Alcohol Use Policy
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testing for at least a twenty-four (24) month period following the initial alcohol or drug test.
Failure of any subsequent alcohol or drug test, or failure to complete the rehabilitation, will be
cause for immediate termination.
The decision as to whether continued employment will be offered after the first positive test is
solely within management's discretion and depends, among other factors, on the employee's
previous job performance, length of service with Rural/Metro Corporation, the seriousness of the
incident giving rise to the drug testing, and whether the employee voluntarily sought assistance
and rehabilitation.
individuals opting not to participate in any required testing may be considered as having
voluntarily resigns.
RFP# 12-005 40 RHAR/Metro, Page 152
Ambulance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
Attachment 6: Transport Collection Audit Policy
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Fladd�
RFP# 12-005 Qj8 ° Page 153
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
I _Am_
IM RiV811NElysv'
Corporallon
tft
INTERNAL FEDERAL FAYOR AUDIT LG-11
Section: LG (Legal—specifrc Compliance) if[ective Date: May15, 2012
Policy Type: Company Wide Revision Date(s): May 4, 2012
Annual Approval: August 30, 2011
Policy Location: hfi s://rutaimetro.hccs.comfcore frames,as
POLICY: To establish an effective audit, monitoring, and corrective action process for both
the EMS crews and the Billing Center personnel so as to maintain compliance
with Medicare and other federal payors coverage and reimbursement guidelines.
RESPONSIBLE OFFICER: Compliance Officer
PROCEDURE:
INTRODUCTION
The Rural/Metro Compliance Department will conduct monthly audits of claims billed to
the Medicare and Medicaid programs. These audits will be conducted on a monthly
basis and a random sample of claims selected according to the following policy. Audits
requested outside of the following parameters will conducted on an as needed basis at
the discretion of the Board of Directors, Senior Executive Management, or Billing Center
Managers.
PRE -BILLING AUDIT
A. Prior to billing a Medicare, Medicaid, or other federal payor pre -billing personnel
should complete a thorough review of the transport documentation to ensure that
proper coding, medical necessity documentation, and other required components
are present.
1. The Pre -billing Audit will cover the claims documentation from the Run
Ticket (CAD or otherwise) and continuously updated as more information
becomes available until the claim is verified and filed.
2. A Medicare or Medicaid claim should not be submitted without required
documentation on file. Required documentation includes but Is not limited
to:
a. The complete, accurate, Physician's Certification Statement (PC5)
for non -emergent and routinely scheduled trips.
I. When a PC5 is not on file for the non -emergent and
routinely scheduled trips documentation must support the
attempt to obtain. At minimum proof of a certified malling
to the physician.
Page 1 of 6
Page 154
RFP# 12-005 RUraUMetrd
Ambulo e
S���y{cc a! Go,a-! Llv4{4
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES CO
FOR THE CITY OF OCOEE
eieaa�
li!!I'81/MBar'0
Corparativn
INTERNAL FEDERAL PAYOR AUDIT LG-11
b. The signed and dated Assignment of Benefits Form from the
patient or the patient's Authorized Representative.
c. In cases where the Medicare beneficiary will likely not meet
current Medicare coverage and payment criteria for reasonable
and necessary, there should be a complete, signed and dated
Advance Beneficiary Notice. If no Advanced Beneficiary Notice
has been obtained on or before the non -covered transport begins
the Advanced Beneficiary Notice cannot be obtained retroactively,
and Rural/Metro will not be able to obtain payment from the
Medicare program or the Medicare beneficiary. (See Specific
Policy LG-10 Federal Payor Coverage Criteria, Documentation
and Billing Requirements.)
POST -BILLING AUDIT
A. post -billing audits will be conducted on a monthly basis, in accordance with the
audit schedule set by the Corporate Compliance Committee or the Board of
Directors.
B. The monthly audit sample for each Billing Center will included sample will be
determined by the audit schedule and may change from time -to -time at the
direction of the Corporate Compliance Committee or the Board of Directors.
Routine monthly audits will review the most recently billed claims for each payor
group; Medicare and Medicaid. The sample claims will represent the entire
monthly universe of Medicare and Medicaid billed claims.
C. The Post -Billing Audit Sample will be selected from Impromptu or Crystal Billing
reports during the first working week after the dose of the business period. In
order to draw the sample, the following methodology will be used:
t. The Office of the Inspector General recommended statistical sampling
software, RAT-STAT, will randomly select the sample charts from the
Impromptu or Crystal billing reports.
2. Each chart will be submitted for review with all billing documentation.
3. The dumping of a sample is prohibited. All findings are necessary to
continuously Improve the claims submission process.
D. Accounts will be audited to ensure that required documentation is both in
compliance with Medicare, Medicaid and Rural/Metro policy and on file in the
supplier records. At a minimum, the following documentation will be reviewed for
accuracy and completeness:
Complete, accurate, Physician Certification Statement or documentation
to attempt to obtain (non -repetitive, non -emergency transports).
Page of
RFP# 12-005ALM
Rural/Metrd Page 155
Ambulance
Sft
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE
' RuraUMeb o'
Corporation
INTERNAL FEDERAL PAYOR AUDIT LG-11
2. Complete Patient Care Report (PCR), including the patient's signature,
3. Dispatch information.
4. Where necessary a complete Advanced Beneficiary Notice Form.
5. Where necessary clinical or other medical necessity documentation.
6. When necessary authorization was obtained.
7. A legible signature of the crew member who provided care.
8. Rural/Metro documentation standards have been met.
IV. ADDITIONAL AUDITS
A. Rural/Metro's Compliance Specialists may conduct audits outside of the post -
billing and retrospective reviews. These audits will be conducted on an as
needed basis to determine the existence of systemic problems that may require
corrective action.
B. Rural/Metro's Compliance Specialists may conduct audits that are specific to
industry issues or based on alleged violations reported to the Corporate
Compliance Department.
V. ZONE LEVEL AUDIT
A. Rural/Metro encourages the individual locations to develop and conduct audits to
be used for quality assurance measures. In order to ensure the rights of the
company and Its employees, the Corporate Compliance Department, must be
aware of the audit findings To that end, Zone Audit protocols should include:
1. A methodology for the audit.
2. The use of some form of random sampling protocol (RAT-STAT
generated report).
3. Audit finding review that includes;
a. Corrective Actions
b. Refunds as needed
C. Work papers
4. Copy of audit results submitted to the Corporate Compliance Department
with a summary of the findings and corrective/preventative measures
taken as a result of the audit.
Page 3 of 6
Page 156
RFP# 12-005 Rut�l/Mett�d
Ambulance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
loBrmamtlro,
capp"Imn
tft
INTERNAL FEDERAL PAYOR AUDIT LG-11
VI. REMEDIATION AND CORRECTIVE ACTION
A. Acceptable audit scoring parameters will be determined by the Corporate
Compliance Committee and any score that falls below the threshold requires
remediation and corrective actions.
B. Depending on the actual category requiring remediation, billing, operational
management or both will be responsible to conduct complete the remediation
process, Remediation steps will include but are not limited to the following:
1. Analysis of the operational or billing process to identify deficiencies;
2. Documented plan to identify correctivelpreventative action steps; and
a. Correctivelpreventative action may include individual retraining,
and progressive discipline up to and Including termination of
employment with Rural/Metro.
3. Approval of corrective action plan by the Compliance Officer and/or the
Management Compliance Committee.
4, Confinmation that corrective/preventative action steps have been taken and
that documentation provided to the compliance department.
C. The Compliance Department will maintain the documentation that supports the
remediation process including the documents that confirm the correctivelpreventative
action measures taken, proof of refunds, etc.
D. The Compliance Officer will present a remediation report to the Corporate
Compliance Committee on a quarterly basis.
VII. CORRECTIVE ACTION AUDIT
A. Corrective Action Audits will be conducted as needed to confirm that necessary
actions to improve audit findings and overall compliance for a specific division
have been taken. The methodology will be the same as above.
B. Corrective and Preventive Actions will be in line with Rural/Metro's Corrective
Action Policy.
1. Depending on the severity of a negative audit finding
corrective/preventive actions may include, but are not limited to:
a. Policy and procedure enhancement
b. Personnel progressive disciplinary action: training, written
warning, up to and including termination.
Page 4 of 6
RFP# 12-005 w Aural/Me�o' Page 157
AMAVI CO
PROPOSAL. TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
JAM NursUMelro'
Corporation
M
INTERNAL FEDERAL PAYOR AUDIT LG-11
Ix.
C. Divisions must submit written documentation of corrective actions to the
Corporate Compliance Department within two weeks of audit result notification.
REVIEW OF AUDIT RESULTS
A. Upon completion of the routine monthly audits, the results will be conveyed to the
area management and the Compliance Committee for review. During the
Corporate Compliance Committee review of the findings, any discrepancies will
be addressed and any corrective actions that have not already been identified
will be documented and issued to the appropriate area. Corrective action
recommendations will be made in conjunction with Rural/Metro Corrective Action
Policy guldelines.
B. The results of the Medicare Audit and the recommendations will be forwarded to
the impacted management in the following manner:
1. Audit results will be communicated within one (1) week of the conclusion
of the audit.
2. There must be written documentation of the method(s) used in the
Corrective Action Process, if applicable. Documentation must be sent to
the Corporate Compliance Department with a copy to the Compliance
Committee.
3. Corrective Action documentation will be kept in separate Corrective
Action files for reference, and if necessary, future documentation
purposes.
C. In the event any monthly Post -Billing Audit Sample reveals a material (note,
material and routine overpayment are two different categories) overpayment
received by Rural/Metro or other significant violation of any compliance policies
or procedures, Rural/Metro shall verify sample results using generally accepted
sample guidelines and, with the assistance of legal counsel and the Corporate
Compliance Department, determine whether and how to report such findings to
the applicable carrier(s) or Department of Health and Human Services' Office of
the Inspector General.
F-01111nrr-1% Z11a_111
A. Each area will have the opportunity to appeal audit findings. Appeals will take
place during the post audit discussion with management.
The appeal must specifically stale what documentation Is available to
request reconsideration of corrective action recommendations by the
Corporate Compliance Department.
Page 5 of G
Page 158
RFP# 12-005 Ilura!/Me�o'
AmGrr�lance
PROPOSALTO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
RuraUR9eb a'
Carpararian
tft
INTERNAL FEDERAL PAYOR AUDIT LG-11
2. When there is a need to request and/or obtain additional documentation
from the patient, physician, or facility(ies) involved, this must be stated
during the post audit discussion.
3. The Corporate Compliance Department will allow time for the additional
documentation to be submitted for review, but once the audit is presented
to the Compliance Committee, the results are considered final.
B. When the appeal does not specifically address all compliance related concerns
that prompted corrective actions including refunds to the appropriate carrier, the
compliance recommendation will stand.
X. QUESTIONS AND REPORTING
Questions regarding this policy, should be directed to your manager, supervisor, or the
Compliance Department. Promptly report any suspected violations of this policy to the
Corporate Compliance Department, Legal Department, or the Rural/Metro Hotline at:
1-877-631-5722.
tLApproved by: Date: 6/09/12
President and Chief Executive Officer
Page 6 of 6
RFP# 12-005 AM RureUmetro° Page 159
Ambulance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
Attachment 7: Letters of Recommendation
�Gcnter of Coal Lf�,,^
K -+5,
QC�
Flaiida
RFP# 12-005 RareUMelre Page 160
�m�rdance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
May 15, 2012
City of Ocoee
EMS Selection Committee
150 North Lakeshore Drive
Ocoee, FL 84761
Dear EMS Selection Committee Members,
It is with great pleasure that I send this letter of recommendation .on behalf of Rural Metro to you
for your Emergency Medical Services and Transport bid process_ .As you know, the West Orange
Chamber of Commerce, the largest business association in West Orange County representing over
900 businesses, over 100,000 employees and over 250,000 residents, is proud of the work that Rural
Metro does in our community. The ambulance services that are provided and the safety initiatives
they facilitate are heneflcial to the economic vitality and health of our community.
Rural Metro, through these services is enabling our community to achieve goals determined in a
Visioning Process that we undertook for the West Orange area nearly t0 years ago. Two of the
primary goals defined in this process are to ensure that high quality healthcare is accessible and
available to all citizens and to promote a safe environment in West Orange County.
The day to day quick response In transporting people in their state of the art ambulances is just one
of the benefits of Rural Metro in our community. Their community programs such as the
Community Outreach CPR Training Courses and Safety in the Park events which provide instruction
on creating First Aid Kids, in addition to CPR training all have contributed to realizing the vision for
West Orange.
Not only are we appreciative of their community efforts and transport abilities, we were very
pleased with the seamless transition of services from Health Central to Rural Metro and are certain
that the citizens of West Orange County have benefitted from this transition. A continued
relationship with Rural Metro would be an excellent decision,
Ki est Regards,
I Stina D Uva
President/CEO
�Ccnlcr of C.r�J C�rI
R w
tloudr
Community
Trustees
Ace Hardware
BorkFIRST
8051 Cleonars
cross BAre rhlefd of Florid❑
Mght Fulure be -obit, LLC
Castle & Cooke
ConluryUnk
OaWlll NcovatIng. Inc.
Dlt'ic Ber,019 Grmp
Flal Ctass Cleunurs
Flrsl Seulhern Bank
nshbKx*, Dorrintk, Bannell,
Slopler, Ardo n. Mors, &
LwiooV, LLP
PWOa Hospllol
Hedlh Cenlral
fJeurospine Inslnuto
pdondo Hedlh
Process Energy
A, C, slevem
Conslructk> Gar»pony
VnnverAy of Cenfrol noddo
Wart Danay World Ccanpa,ty
C ]AMBER
is1. THI YCAR
Page 161
RFP# 12-005 Kura!/Metro
Page
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FORTH E CITY OF OCOEE
Tobin of Vinbermere
PA, Drawer 669 Windermcre, FL 34786
Office: (407) 876-2563 fax: (407) 876-0103
1 I � yi�����1
83"iR,
May 15, 2012
Mayor and Commissioners
150 N. Lakeshore Dr.
Ocoee, FL 34761
Re: Rural Metro Letter of Recommendation
Honorable Mayor and Commissioners,
tft
Zulu lflauager
ROnERTSMITH
clerh
DOROTHY BURK]IALTER
Rural Metro has been providing the Town of Wlndermere residents Emergency Medical and Transport
Services since October of 2011. Although the relationship is still in its infant stages, the service has been
exemplary. The time from dispatch, to on scene, to transport have been adequate and the level of
service has met all of our expectations, In addition to transport services, Rural Metro has become one
the Town's strongest community sponsors by participating in such events as Safety Saturday, Food
Truck Night, Festival among the Lakes, Windermere Sk, among others. Please accept this letter as my
personal recommendation for Rural Metro Ambulance Service while you conslderyour EMT options.
Regards,
Robert Smith
Town Manager
RFP# 12-005al/Me�o Page 162
ambulance
tft
PROPOSAL TO PROVIDEEMERGENCYAMBULANCESERVICESFOR THE CITY OF OCOEE
r= Health Central Caring.
HEALTHCARE BEGINS WITH CARING, Compassion.
COlrl llJitnl en Z.
Ocoee EMS Selection Committee
Re: Rural Metro
To whom it may concern,
I would like to express my support of Rural Metro Ambulance In their continued service to the Ocoee
community. We were extremely grateful that Rural Metro was able to make a seamless transition from
the Health Central Paramedic operations last fall. A key to that transition was their wise decision to
keep the continuity of management along with accepting all employees. Not only did they make an
offer to every employee, but they went the extra step to offer the same rates of pay, seniority, etc.,.
showing they really cared and valued the dedicated group of staff. They were able to make the
transition with minimal advance notice and performed admirably, We have continued to work with
their organization since that point to continue enhancing EMS capability in the area.
I have found them to be professional, dlllgent and caring. They operate locally, but with the support of a
strong national company. Their recent significant purchase of new vehicles for West Orange Is a strong
sign they are willing to Invest In our community and are committed to the region. I recommend their
continued a point i nt as the EMS ambulance provider for our community.
Michael Mueller
Chief Financial Officer
Health Central
RFP# 12-005 Aura!/Metro' Page 163
Ambulance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
Attachment 8 Certificate of Insurance
tft
RFP# 12-005 JIM Ilrmal/Me1rn Page 164
LAW Ambulance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
tft
AC Rd DATE(MMIPD+ VY
CERTIFICATE OF LIABILITY INSURANCE III
THIS CERTIFICATE 16 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(&I. AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: II the certificate Komar Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subjeci to
the terms and conditions of the policy, certain policies may require an endorsement, A statement on this certificate does not confer rights to the
eardficale holder In lieu of such andoreementie).
PRODUCER
OOInEA.CT
NAh1
AOn Risk Insurance Services west, Inc.
Phoenix AZ Office
FROM P
WC. No. E+Q: (866) asi-7121 Na (1{7) 853-5390
E4"(
ADDRL9s:
2555 East Caaelback Rd.
suite 700
WBURFRI$I AFFOADIHD CAVBHADIE
RAC/
Phoenix Az SS016 USA
INSURED
INSUREAA ACE American Insurance Carpany
22667
Rural/Metro Corp. and all Subsidiaries
Affiliates, and other Business Assoc.
owned, operated or controlled by
INSURER 6: Ldxington Insurance Company
19431
INSURER O
Rural/Me rra
9221 E. Via DeVenLurn
s"ER 0
INSURER B:
Scottsdale AZ S5258 USA
INSURER F;
C0VFRAI%F6 CERTIFICATE NUMBER: 670046116450 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSUHANC6 LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMBS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, Limits shown are as requested
TYPE OF DIMIRANLE
Pmm uumfle !
LIIATS
GENERAL LURBLnY
tAL/AEROALOEIIEPALLIAnUT`
SIN applies per policy toris
6 condi
ions
EACH OCCURREIICE
S1, 000, 000
FFEhTffi6S nFKA
$50, 000
NeO EXP IMy k P-hftO1
$ 5. Qua
k Ce AUASMADE OCCUR
PFPEGfIAi a ADV riJURY
S1,000, 000
% PrdnAi'�+I LIncAN
GB`ERALA40RPOATF
15,000,000
GEYrL ACGPEGATELMT APPLIES PER:
PRODUCTS• COMPIOP A00
$1.000.000
an
$1,000,000
x I POLICY n R LOD
A
AuTomor LFIIADIDrY
ISA N 5
Ma DOnIEDMIOLELIIAT
(E. 20G40111,
$2,D00,000
&X&YItWRYIP1lIe U
% ANT AUTO
n0DRYIy_r AYIPxaer33eQ
ALLOWIIEDP1CIIEDU11D
AU700 AUTOSIJOIEC NED
NAEOAUrpgAUYOS
PnOPEATY0.41AAGE
Per+xW
D
K
RMRNRFLLI LIAR
OCCLIA
T 70D2
1 1
OS 0 011
Z ClIOCCURFENCE
i2, 000,0 O
AGOkEOATE
$2.000.000
EXCESS LIA9
K
CLAM44ADE
DEo RL�EnION
A
worIKEns COAPENSATION ARID
WLRCe6782e22
0 01 2012OS
el 207
y
X OTDT Rr Llr ig OTIR
eRrLOTEnSL1AE uTY
ANY I'ko PRIETCg1PMnILn YfXiGUTP/i YIN
DFHCEPMEU9EN E LUUEoi 1
IM.Ae�Rcry lA 1/0
NfA
E L CAC! ACCIDE7JT
12, 000,D00
EL DISSASE-EA EMPLOYEE
$2,000,000
X ��is++ amviln OF cF o
nE9EAPl ION PERATIOrlS be'aw
EL O'sEASE•FiIUT.Y LIIaT
$2,000.000
e
Excess AUTO L1a
B21311532
SIR applies per policy to 11
1 OS 01 2 12
1, condi
5 13
I ions
Enc Occurrence
fFollp,060
DESCRIPTION OF OPEFATIDNS I LUCAMONB I VEEWLES (AftI, AUORO 101, Rdd{Ipae Ramx.L• sGMaula. it gplw•+P+w is "qulredl
City of Ocoee is included as Additional Insured as required by written contract, but limited to the alterations of the insured
under said contract, per the applicable endorsement with respect to the General Liability and Auraulobi le Liability policies.
Tile General Liability reverage evidenced herein is Prioary and Non-contributory to Other insurance Available to the
Certificate holder, but Only to The extent required by written contract with the Insured, A Waiver of subrogation is granted
in favor of Certi Flcata holder as required written contracr but limited to the operations of the Insured under Said
contrac[, with respeee re the Gena ra Ll abii t , Adtouabile Liability and workers' trapensarib" policies,
CERTIFICATE HOLDER CANCELLATION
city of Occee
150 N. Lakeshore Orive
Ocoee FL 34761-2258 USA
ACORD 25 (2010106)
(SHOULD ANY of THE ABaVE DEIGRIBED POLICIES BE CANCELLED BEFORE THE
CXPAATION DATE. TIEREOP, NOTICE WILL W DELIVERED IN AICCORDANC6 WIN THE
POLICY PROVISIONS.
Ma 91 L�r/d�F . Y..1,oss iJdbGL f.
01980-2010 ACORD CORPORATION. All rights reseivsd.
The ACORD name and too Ate registered (harks of ACORD
RFP# 12-005 Rrmal/Metra' Page 165
Ambulance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
Attachment 9: DriveCam Information Sheet
Sft
RFP# 12-005 4ura!/R9eMa Page 166
Ambulance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
__C1_1_
DRIVECAM. PRODUCT SWEET
What is DriveCamO?
DrlveCam" is essentially a small digital camera in.
stalled near the rearvlew mirror that will be triggered
to record events based on G-Forces of the vehicle. (;-
Forces caused by activities such as hard braking, ac-
celeration, harsh cornering or collisions, that trigger
the DrlveCama camera to record a 20.30 second
event for later viewing_
t+�Ccnkr of Cox{ Lr
�CQE:
n�rin.
What triggers the DrlveCam event recorder to start recording?
The camera makes the decision that when the vehicle Is involved in unusual motion it needs to record and
save (determination is made through the camera's g-force accelerometers or sensors). G-forces caused by
activities such as hard braking, acceleration, harsh cornering or collisions trigger the DrlveCamO camera to
save a 20 or 30 second event for later viewing. The driver can also manually activate the DrlveCanng at any
time by hitting the panic button.
Does the camera record my entire shift of driving?
No. The camera is constantly on, however, the device is not recording until unless there is an event that ex
ceeds the 9-force setting of the unit.
WIII I know when the device has been triggered?
Yes- The camera has a green light that is constantly lit. When an event is triggered, the light blinks red for
20 seconds, and then remains red until the event has been downloaded.
Is sound recorded by the device?
Yes, sound is recorded by the device when the device is triggered.
How are events downloaded off the cameral
Events are either downloaded using a docking station and a USB connection, or the use of a laptop. The local
management team will be responsible for communicating the appropriate procedure.
How long does it take to download events off the camera?
Between 15-30 seconds per event.
For what purposes will the device be used?
The goal of the program is to utilize the device for training purposes to help correct aggressive driving be-
havior, and consequently reduce the possibility of a motor vehicle collision.
Will corrective actions be issued due to negative events captured on the video?
Yes. While this is not the goal of the program, correction actions will be given to those drivers who violate
Company policy
What other EMS companies use DrlveCam417
There are several EMS agencies that currently use DrlveCann*, such as:
Paratech, Bell Ambulance, Mayo Clinic, Bayshore Ambulance, City of Plano, Huntsville EMS, Noga Ambulance
Service, Inc., as well as the following Rural/Merro sites, Seattle, Tacoma, Aurora, Youngstown, and San Diego.
Rural/Metro,
Corporation
U17 years of 981"019 others
RFP# 12-005 Rppal/apa, Page 167
Ambulance g
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
morcm,wt"
Attachment 10: Local Ad & Media Coverage Featuring Rural/Metro
RFP# 12-005 RifflaNB ° Page 168
I'.
PROPOSAL TO PROVIDE EMERGENCYAMBULANCE SERVICES
FOR THE CITY OF OCOEE
�' __.' wv�
d
. 4
P
� Amblu�ce•
May 2, 2012 —Ambulance "ribbon cutting"
at the West Orange Chamber
.„ of Commerce
RutailMeim Imbulance is proud to unveil rive new, state-of-the-art ambulances to
tFe West Orange community. These vehicles will help provide the best service,
safety and comfort for patients and passengers.
For 27 years, Rural/Metro has been a Central Florida community partner, Today
we serve all ofWcst Orange County, includingWincer Garden, Ocoee and the
Town of Windermere, Our three dedicated West Orange stations serve a
population of more than 72,000,
M
i
Rural/Metro stays engaged in the
community by participating in local
events across West Orange.
• Training and certification In Hdart
Saver CPR classes
• Teaching monthly hands -only
CPR classes
• Community heart screenings
bring the family for food, Tun and safety Ups
Training city and town employees
May 19
Winter Garden -- Newton Park
• Sponsor community events
12:00 p.m. - 2:00 p.m.
and picnics
June 2
• Donated stand-by units for local
Qcoee -- Freedom Park
events
12.00 p.m,- 2:00 p.m,
www.ruraimetro.com
i..
5
RFP# 12-005 ��r�Em° Page 169
Ambulance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
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RFP# 12-005 �/Page 170
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
tft
RFP# 12-005 RurallN.Wo' Page 171
ambulance g
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
tft
I -A.-
RFP# 12-005 ALM IW"Oftlo Page 172
Ambulance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
tft
Vol. 76 No. 17 Wlnlrrr Gar ien, Flml{le Thursday, April 26, 2012 Tlvno Seepnns, as Pages 50 GUMS
Safety .evOt Is
Saturday In.the park
Rural/Metro.Ambuiance
invites. the public to attend
Safety Salurday'in the Park
festivities from noon to 3
p,na. tNs.5a4rday, April 28,
at Central Park on Oakdale
$ treet in. Windermere.
Bvent�'will zocind@,free -
snacks.and drinks,,en-
tertainfnedf for childrerl,
giveaways, and tours of an
ambulance, fire'truck and
policecar.
Rural/Metro professionals
will demonstrate the latest
hands -only CPR'metlods.'
Safe Kids -certified in-'
structors will do bike checks
and hielmetfitlings..Win- ."` ` ;
d6firlere's boat patrol will of-
fer boating safety tips. Town:
elected 'officials will. he. on
hand. to greet the public. ,
_.
Wi#dermere
Safety e►re Satulyday in the pk
,RurellNletmAmhplaace. mvilaw the: lingerJntro�ll� Rpra�r�dptm kmbu. d bike y�.heak@And hplmat fittingsoomcr we wsn�lu help keepp fluadree
i pdbllc to attend Sxfa[v Salurdev Nthe lanm , `s.. L,` .. u°f1nA.:.1.. . Mar.......1 .,..n.. 0— ..r...iM......1..,
noon 1n 7. p in.
.at Central hark-
DM-
Durmg lhe.�rpall ltlea; Mayor Qary amhnlanct.. is - `
:y ep erg ¢Ipl'gjh[i1Wit�,liio Windermarp RUigUMetrp'9lagip dr pere[nvdic=_
`Brvhrt :lU g1'.01VQ
e tJfipalee or'gppra - RuryllMpim Ill Beni Pp vew ar(m6nas iho, Windprmere and IiM-n currently serve lhrough_«
ciq[lon lq_niign, including onsirete the iy CPSaka t reW1gn Cnrnnl l e ph6 tall Contrnl Florida, including Win-
memgara:ti<Jarmere_dennere, NVinier Garden, Ocoee'Or-
'l)p�arupell[,+.. Sale Kidgrgelj ftlydo®Will: " 0Ind drVrlghl ground the lando.end Orange County.
'
The news ran on the front page and was the lead story In the Windermere section.
RFP# 12-005 HuraUMefro' Page 173
Ambulance
PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES
FOR THE CITY OF OCOEE
.. Photo odudeoy
The new ambulances In West Orange County 9? reminlsoeht "oft
Orange" Memorial Hospltal;gnd Health Central emaigertcy vehleli
M
R u rai,etro
noel is ambulances
for West Orange
st °Osage Cbamber .or
RuraYN6WAnlbulaatelo be.
nary mcmbe. and local
cama'the.frW*poii$Cra nhe;
m1a"had a twinge of noB-
Health Cantrsl a rmbbrt`ced'Ahni
leaf. Wednesday when.
new,arrangemontswould'n..eei
toured Uvo stawof-tw
'to be mado. due to lts pandIng
rbWhncea-tt♦al will serve
Inftor with Orlando Dcelih.:
a.- 2;fao9 "tesidents:
, Health Centraland 1Ws fnedo
.tom, La9t year.: wi
(West Windermere and
proved. one -years
sta- lance service sin
alai Windertnem
deh= Bruhn. 'caRed
until his rellrement In Janu- IRMA SI:RRANO 79, Winter 32714. Baldwin -Fairchild
ary 1977, Ily.IN the Douglas Garden, Bled April 30. Col Funwr Home, Winter. Garden
- i
k
Ambulance
Commissioner Bobby 011�wsltitold tile oruA d.
"Thank you foitha service."
ChmnberPresident and CEO $tire D`Uva and
former Florida Itep. Dick Rateltelor were Wrong
.
ihose who"tGured the ambulances. `me now aqt `
.
balances are the"latest inn series of tntt>atYves-
16tendedto show RurdMctro'a commith"tn to'
tw wcg. Oralrge comrnurlity.
Tha eompay's ambulances &a lypically white'
With &lime-gleert sb ipe.butthe five I6cnl vehielr<s
were petaled W,mht(;h tlie,lraditionel blue and
orange cnlots f1lF1kW9r to W_ est OmAge reddz> ls, ,
lZorall Ora -la ejso spansoriQ -;a senea;gf
"$sfalY..$elufdaq. ul ibePark" e_vemt9,"rYhed4 it,
conducts hnndiranly CPR demo a' end
Other activrt W aimed at keeping Rdulls aad chil-
dren safe. ThQfiist°sUch eVeut wss a truccea4 Tel
ttdt�rmerr Wl
en
Wi
Windermere oil April28•
The next Safety Saturday will be May ,19 at
wife
_JUI
Newton Park, located, at 31 W. Garden Avejii
Market Dev
Waller Garden, and on:Lune 2 at Freedom Palk;
ndbe" the h
loeated nt 351 Thomebrooke Drive en.Oeaee.
lanc@s that,
the
tie
gn.;
rvlCe'�ouurGndleig:"
IluralRdetM is a very good
riner Winter Garden City
[;fie a�alofAlwt►crf 2A)
w ur vl3VCH
from three area fire de-
ts teVD)ided to:a kitchen
ic'w otr595 2nd Ave., in
Weille'BruceYoutig(leftf.ttnd at v+Xlcrunla
earner) h5 en'to Rkirel/Metro -offera�aartthti
> Manager YelrnaAcosta de- .seniorcihzatts;
-tech leatures, of new ambu- 218 E, Oakiarn
berve,Weskdrange. mation;call40'
Ocoee, West I
ge County at- j
to hnd:white .;I
howltlg from j
;esingie-sloiy.
rs'guickly.ea- ;I
i�exungprshcd' fl
s:..gxt ned to j
"M nd"waler l
dto. this 1*4-: I
'erpg,to light j
r4tp°rrrsbf ',I
tsa of lk;a'fite , I
tie�idgne,tl
(hero werg. no :1
lF[•irdnges.
Irdrlp
hunch
twine Church
o. amup for
n churchds at
4."Forinfo(--
56 A52.
RFP# 12-005 B a Page 174