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Item #06c Approval of Fire-Based EMS Transport Services - Approval of Third Amendment to Transport Agreement with AMR
Contact Name. - Contact Number: I k4l Y 0%k 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 2 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 3 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) 4 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. 5 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 0 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; 7 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. 9 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. 10 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) 13 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. 15 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. 16 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; 17 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. 18 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 19 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 20 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 21 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. 22 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. 23 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 Pdll,Pa eeUa]tA ex, WP A- et asap., _ — Vaaa PMl1fA6 Atld[egcrdr'e Nerve emwe+a; __ eaunen¢ xraa+EaE_ COVERAGES xxYEE[fl1 ealFD r0lxe wwrEUNH®Pa'a rox Tllf POLIGV PPNW lgchlFA NONTWTNIoale TILE PaLlaaa (K PfauPNKELLSrwe4uY +xraLaAxuLexr, raw eacaxwlLdl oP.lrr canwar oavn<eeOocuexn Pnm eETPEcrtowncxTnmcumrArE qAr eeiaaueoae LurPEarAw. T� eaLlLxxceAfPLwOPoertra Encca aeaeaer,d Ord nlaleeT re PUTrq TEPxLt FJLL WgMAxo coxoma W rc wcn P011ea!-AOOREOAIE Lglta alPvawlYlNVf IEHI PEpar{_deY PAd fl/lLI. Lee Wa TReG YdVrYFE rGl!-Y g1YElR Lua! Erexeu+w�e+ce 't 1, 6O0,000 aexuvl Caesar axExatEl Fi axwP"°e s96, OOD 31 x aOeaLEx'-v1aExEeAi LeaLrry cwwwoe ®°�°' �I aEOraww'r�w�^I l5,000 PePlowLe wYxLarrr 11.000, 000 a—xwlra.rE L2,O0O,000 Pancuare mmgnxaO a S, 000, 000 nfwt xaaaFeAlE uL■tAPPLalrEn wear x iOa AeleeaNaEwunr coxeaxeos.reLe Lear 11,000,000 lu ev/.el x urwr0 � �P ��I R, L HLOYMfe PlllOa •"�a1AW xUTGI �iml.�ll Y I 7L xReoxar0a x I40xTYxeoauTOe —' PxdPER1YaALN46 I prx:elnl uwaELweLLnr /xn OOA<vUxladf�ll L I M Ano P,.enacwerfhce ! 1 000, 000 oueeaNaeauueuxrrc Qa,.n WOE Aormewn: 1 7, 000, "1 ! x x OEWCTIeIE i PCTwnax F ! ege111W CaLYlsewlgN111a WPLdrPl�N�-LrNpLLvPRY x xYL ��Encx AccnExT ISdo, a0o uaaP.11. PAu,wore.e IsOO,O00 OTT,"°PPnIUA'FJi MTEvraL®"mia"'�ear�vE aEABf•wLFY Lain L5O0, 6O0 MrK �1,._- Auy 1 Lnr 100,OM Builders Ri-k M 1 0ac 1. O0O, DOO 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 'SA-O�k R z r' 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 E AOOPEaS, 75Ss Last ramelbAck Rd, sus to 700 INSURE7y6)ArpOR01N0 WVFITAOB NA1oR Pl,..nlx AI I:S016 USA 41RMED 14SUAEa A: ACE American Insurance Cowpony 22667 Rural/Metro Corp. and all Subsidiaries Affiliates, and Other Business Assoc. owned operated of controlled by Rural/Net a DeVPnt8 Scot E. via INSURER 0; 1-01109ton I115urallce company 19432 N9URERCc e16URFR I k 05PRFA E: U Scotts ale Az B525USA XrsURw A: 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 R remor INSURAnci: pi R FOLIGYMIAII) Il1 I -RI UnTS OEIIERAL LUNXITY % COLFRC/AL CEIHRAL UAbLITy SIR applies per policy ter IS E, condi ions EACHOCCURRElr-E $1.000.000 r c FRr1 EBFa alG�nM'1' 550,000 µrDE)fPIA^Y^^arelw•1 SS,000 X CLIPASWCE OCCUR RR50.•lALaAWrINRY S1,000,000 7C P AnEs'+nY L�oSAT! GEIIEFALAG{IREGATE SS,DOO.000 GEfILAGORE0A7ELIY.TAP?VLGPER FROOUCTS•COWWPA60 $1,000.000 9R $1,000.000 k POl1GY FRG LCC A AU70A10aRe UABILIrY ISA 110869656/ 1 2 12 of 201 3cOAreel�CrXaETA'R 12,000,000 WIMLY VW:tY iFrrrCWnf X NIl AUTO PAEiLY 9 WAY Oki Mp1Y.tt ALLU.yIIEa DCHECVL ED _ Moe AUTOS NATOAUTOS licitamim +UTO$ FROPERTYDAIaIGE e!F{[bv D X U6rRRFltA1V.9 OG{iAi 5797007 OS/al/7a12 as/01 2013 EACNOPDtI1R01C.e s7r000, 000 AGGREGATE SZ,GOD,000 G%Ces4LIA9 % ;,A—,,,- LIEOf IRUCILI A 15TIRNEAGCPA'PEIISAtIONNNI kLIAC46782422OS10112013 )( tiQ TSl Tr Tµ l! P LOVER9'LwalMTV Ylll N!l Plh]MN,Err51l rARllllR /rlrLVIN: Vr14LsW LAIaIe EXGIVWcai [E MNIndA."kI Nil WA ELEACII AObD10lT T2, GOD, OLIO EL. DIZEAW-. V.PDYIF 17, 000, OLIO X ))ca arw:e"Iva LCYJI P11]flq aPlJr A1ARS bcAv EL. CISEASF-F JCYtWI[ 57, 000, OLIO a FHcess AUtO L a 021391532 o$101 200 Os/OL 70 0 Each OccUrrelice 111,000,000 SIR applies Per policy ter is b condi IOUs PFCgRIPUOa PF PAb1ATIDN9 rLOr:ATlDit9 rVEIefLES IA}beh ACORP lei, AXY21oru1 Renvhs 5<hnlWr, irnvFspx, 6regWrtel City or Ocoee is included RE Addi LlodAl Insured as IV uired by written contract, but lilli Led to tba pellati.ol of the Insured under said contract per the applicable ando—Oiint with ovspect to Wv Cunural LiabiliLy tool AutOO-bile Liability policies. The Oeueral Liability coveragpe e0denited herein is Pr'inary RIW Nan-eagtrOutory to other insurance availahle to the certificate Rolder but only CO the aktent regained 4y wrlccen contract with the Insured, A waiver of subroyati on is granted in favor or certificate Bolder as required by written contract but limited to the operations of the Insured under said contract, with rasped to the Genar,t Liabill ty, AUTomobile Liability and h'orkers' compensation policies. CFRTIFICATF HOLDER CANCELLATION Tr.I INOOLP NIV OF 711E ABOVE DESCRIDED FOUMS BE CAjxnLED BEFORW THs EAPIRAIgII DATE TION&OF. NOTICE WALL Be DELIVERED IN AOC B.Ce WIN 111E AOLicy FROYi510115 . - city of vcvte AUrHaAIIEPREP0EIEI1TA1rK ISO N. Lakeshore Drive FA OCBCC FL 34761-2ZS8 USA all ,-kAA.�fit . 4DJOSS-2010 ACORO CORPORATION, All rights roservad. ACORD 26(201010S) The ACORD name eml logo are regletolcd mooki of ACORD RFA# 12-005 Rriral/MEfro, Page 165 Rural/Metro ambulance City of Ocoee Finance Department/Purchasing Joyce Tolbert, Purchasing Agent 150 N. Lakeshore Drive Ocoee, FL 34761-2258 ACCR$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 �1�Ccnlee of G� �i� Fln�bh 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 __ e:o� �aa 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 ����kf n[ C,opd L� �4' era�iae RFP# 12-005 IJIR'al/Me�ry Page 4 Rmbulance PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES FOR THE CITY OF OCOEE tft a � 4v_ oto a� N pm v" 9 LL papdp:. ,.26 RFP# 12-005 Rural/Metro' Page 5 RMaulonce tft 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 tft 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 tft 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 tft 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: KE ,pyL f� l` R::' ®®®® �0 00 X ®®® LID 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 tft 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 tft 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'.��� H ftwaUm81po' AmdufanC8 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 tft 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 K 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 sft 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 Ambulance g tft 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 tft 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 tft 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 Rxwonce g tft 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 tft 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 tft 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 tft 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 tft 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 Jft 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 tft 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 tft 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. RFP# 12-005 Q p ltp Page 30 tft 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 Ambulance g 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 Ambulance g tft 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 tft 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 Ambulance g tft 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 tft 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 tft 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 Ambulance tft 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 tft PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES FOR THE CITY OF OCOEE 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 tft 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 Ambulance tft 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 Rmbulance 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 tft 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 tft 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 tft 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 tft 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 Fforlda 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 Jft 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 tft RFP# 12-005 40 Q l$ �`p Page 54 tft 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 tft 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. I seerm... rusYauvR cuavEv I voranows I rvirturus f eiuvac iNr:owunnN RFP# 12-005 tdk NrrrallMetro' Page 56 Rmhrilance PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES FOR THE CITY OF OCOEE cutrottER MAWEY I LMAWort I cOlfrncr Ut I MU' OWFOrOh4T" Stara_ ift r r In o r_ _ Was the tralumd the ?L dce a 9ILcm or ar en+ft"[[r'fireexs 4ty tranpert? ". 911 cal[ ll '. M10r,G-MNer,-'Y YYriviact�j trarnparq '.. Y"t t(pe of sets wasP—Bd. .[ ° - - '`-is••c7 rarer- �i smra h P�-+oree Dtsaaro- Nar+61 Awes S�wyil rev i a p emva Dugs ca wee niaal Ann Stntl Aarx RFrarJY.",=tro`s aarcme�,�, E.N7s a:?9 all`rs pe,ra-.sr-I w=rteo'.�s a^] resptiKhi. rrst ®®®® t?.e e,Krn7 S" ,.�, of care ys� reri:ea tram R-,e`!fi'-tro ras essei:=*.t ®®®® rfY.sg Faetwai�[u�lhrt witL csr d.�- ef}a:e, art �.resccars c..eeverea in a pruleirs .m em ro_�ts-a mz-.:.�? y�,� ®®®®®® I A )d rr arnma.4 FL �'JM..etra to my f m ry eco fr c,= ®®®® A'.• __v!R ti_��r�_._ Heys 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 tft 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 tft 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 e8ogd. 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 tft 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 tft 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 tft 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 tft 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 eft 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 tft 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 ambulance M 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. RFP# 12-005 Rura�/Meho Page 83 ambulance g ft PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES FOR THE CITY OF OCOEE 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. RFP# 12-005 Ruralwafre Page 84 Amdula�ce M 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, RFP# 12-005 � Ul ° Page 85 M PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES FOR THE CITY OF OCOEE 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. RFP# 12-005 RbrOMAN *° Page 86 amdulaWO tft 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' RFP# 12-005 0 Ambulance Page 87 PROPOSAL TO PROVIDE EMERGENCY AMBUL4NCESERVICES FOR THE CITY OF OCOEE tft ti _ RFP# 12-0054AMbff le Page 88 • PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES FOR THE CITY OF OCOEE 4 4 q � V V.6 4 T 0 Z " 9� 'L V L - Y 6 �aN ma`s Y:�m z ��crtlel a(C,o�L�v� R 4 � s rrn�,ee y SLM u ' r 0" Ytl Ic� r � IUD N �06U p'; Y.. N a r vex �a4 c IL u -L U� W.D. :IL C M.,.« m a>� 0 .0 RFP# 12-005 RrmaUMe�ro Page 89 Ambulance g PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES FOR THE CITY OF OCOEE 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 �����er o(G�LIY�4 F O�O� vlo.id� Christopher Blach 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- RFP# 12-005 Q PuaNe d Page 90 M PROPO5ALTO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE 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' RFP# 12-005 ambulance Page 91 iv ���enlcr o(Gae.HGvt?e PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES aC© FOR THE CITY OF OCOEE F[anda 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 RFP# 12-005 Aurel/Melra' Page 92 Rmbr�la�ce tft PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE 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 RFP# 12-005 0 Awal/Merro Page 93 AmdNAW6 PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES .� FOR THE CITY OF OCOEE Plalda 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. RFP# 12-005 Horalllm*a Page 94 AMNIMce ��cn4cf of Gtrxi L/yr K �+ PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES QCQ FOR THE CITY OF OCOEE Flaridn 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 RFP# 12-005 Ambulance Page 95 ? PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES FOR THE CITY OF OCOEE Lol 2�9 0 ift RFP# 12-005 Page 96 Rmlwlance hft PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES FOR THE CITY OF OCOEE 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 RFP# 12-005 Rural/Me1rd Page 97 Amdnlance eft PROPOSAL TO PROVIDE EMERGENCY AMBULANCESERVICES FOR THE CITY OF OCOEE 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 RFP# 12-005 Aaral/lfletra. Page 98 Rmhulance PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES FOR THE CITY OF OCOEE tft 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 RFP# 12-005 awe,Page 99 Ambulance PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES FOR THE CITY OF OCOEE ift 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 RFP# 12-005 io Ilu1811NEZr° Page 100 Ambulance Jft 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 RFP# 12-005 40 RUPA Metre Page 101 RmDulance M 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 �(Snter of Coctf ��� PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES Q�� .., FOR THE CITY OF OCOEE Floriar • 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 R��ePle10! C.WrI Lrv�{4' PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES Q�� FOR THE CITY OF OCOEE Fland. • 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 tft 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 ����{er of c.� U� PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES QCa FOR THE CITY OF OCOEE eia��a� 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 tft 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 Ambulance tft 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 Rmbulance Sft 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 eft 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 Rlmal/Metro' Ambulance PROPOSALTO PROVIDE EMERGENCY AMBULANCE SERVICES FOR THE CITY OF OCOEE q U) LLJ 5M li U3 W Q Z. d 602 x to QL V U)lqw •� W LL 0 a� 0 c W N 4! IL o 7 m Z f� tft 8 p RFP# 12-005 0 Rural/meld Page 113 Ambulance tft PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICESFOR THE CITY OF OCOEE 0 mow r v U A U u O 0 U 'C 0 O Q r� IaGW�^7� � a e G7W�, x � 0 C�4 RFP# 12-005 io Rm'allmoPage 114 ambulance PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES FOR THE CITY OF OCOEE mafcoad�' RFP# 12-905 40 mpsla e a Page 115 tft PROPOSAL TO PROVIDE EMERGENCY AMBULANCE SERVICES FOR THE CITY OF OCOEE 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. Cu t,AF[0d0XOme Cityof0_. N aumt-ca..t, Home 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 AmMance ���eraler of Cp,r[ L� PROPOSAL TO PROVIDE EMERGENCY AM BU LANCE SERVICES �Ca� FOR THE CITY OF OCOEE Florida 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 Ambulaftce g �Cenler ofC�UiI� K PROPOSAL TO PROVIDE EMERG ENCYAMBULANCE SERVICES aCa: FOR THE CITY OF OCOEE 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 tft 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 Cofor-mdir J hd relae q.,.l wiich s ba dal llll�lJ end whkh me alAl b be mmPleled. GuslaNrahla llam Nod— .lb- lebab to 6e Wh g.d hrdlona to ba db.bl amend sari tiara r pkk-rme. nlWdr redo. b arry Nam In . e�I. L tft The Pcer Imedece ie daeujned la frow bgkaNy left-m. '.. rlghl by lapping m dte recte.gew WAMn . yel allawp for maR7pla eoeen. in d A 11IV, ty btpdM I Iheowl bulkns reaahkp In a mPirukrn eTetsln are� geua a eoaen. __Ydp ® Inlwvonl�e Pulcamr . R�+rlar Cia(Cnmplahr a Catdlac a rJian¢m cMal C■mplelnl Cndiec`Nrael - — Cardin Must V Cardiac CeStbleozation Peal HLlgy Chest Pain bledlcm:.n Cwteniiy Pain Free AII•rgke . snaraq;. Ogler 1 2 3 4 5 0 7 8 9 0 v Q W E R T Y U 1 O P A S 0 F G H J K L Bk Z X C V Space B N M Clr �Inemr. .���fl l■ _._�Hdp 4�Oplwrra:. �sP�h �Prmimu ♦_rye>.1.._ Ctelordr.Na hdP euaen eNq■e M agency-cpedre doamramalbn tndddarp p .WW d— arW d.r g I.Iarf .8.0"Pad.1a W mle WHng end diegmrm 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 Egegy 1pcale where Ye. are N a neUe01b1 by gdeq dp nr+VgatpnlNrYe. Tb.m h keytlo" Www fly eppaem bt orm W —to. q." to en ilem - — J crrtc4fl'revNleb 1. bias $1 pretlaus hem_ -- - • Allows routing of calls to users on the system for 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� IpC�E 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 ��tcntef o� C,�LIi'�4 Q� no��aa 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 �Cenlar of Goal Lip 'C OL�� FlnilA� 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 ����t�� o� caf i1y� pCDE :, 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 0 _N N 0 Q (3) 3.9A to w m gUNo'oo 9aa Nqo gaCi m cn�'�.y6E��u. aye@$o+m�� o(D IJ vE`�°v uCa pv+�v mL o a�0,U oc_aa� x_o �d�u aa-5a0.2.r�12, kU��v3- xaaya� o � Ero � ¢` c aro3? 0 o a�iv o G. k ton �a W m 'pcw'c�U.�2 �•G.���w��'a� A0. 4BO�w ro qa; in SNP>Ri%m 10W --'ms1 w'�' a 0o v c4�� ,.sd = ow .5 I -91 �a, Sib '.o o a 8- 6 ON �,�U] �• 5 y� PrN N �7'O ��LLdd� CD 11 o b121 Qom; eft w o gym[ E m$E$ rc@� p E 't MCC a CL s cL e 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