LINCOLNVILLE — The four town managers and administrators of Camden, Hope, Lincolnville and Rockport have agreed on language inviting bids for emergency medical services, and officially posted their request for proposals March 25. The four are also proposing the towns compose an EMS Team that may include citizen representatives from each town.

The move to open up the market for competing ambulance service proposals follows discussions about significant financial issues confronting Camden First Aid Association this year. The four area towns that depend on ambulance service from the nonprofit are addressing EMS cost increases at the same time that they are putting budgets together for their next fiscal year, which begins July 1.

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• Camden First Aid seeking $407,000 in funding from four-town taxpayers

• Camden, Lincolnville, Rockport to circulate requests for emergency services proposals

Camden First Aid EMS Chief Julia Libby has met with the four towns now, either with selectmen or budget committees, coming away with varying responses.

Camden First Aid serves the four towns year-round and around the clock. The organization told the towns last year that it must raise its rates this year in order to remain solvent. On Feb. 27, town officials were officially told that Camden First Aid needed $407,000 from municipalities this coming year to meet budget, up from the $56,000 requested collectively from the four towns last year. The Camden-based nonprofit initially laid out its requests for this budget season: $174,000 from Camden, $129,000 from Rockport, $77,000 from Lincolnville, and $27,000 from Hope.

Camden's budget committee voted 17 to 2 to preliminarily budget $174,000 for this coming year for Camden First Aid service; however, that committee wants to meet with Libby again March 28. Lincolnville budgeted $77,000. Hope selectmen agreed to budget $5,000. Rockport initially agreed to hold $64,000 aside, half of Camden First Aid's requested amount from that town. But last week, the Rockport Select Board cut that number to $49,000.

While Libby and the association's board of directors attempts to keep the ambulance service in business, and town selectmen attempt to conduct due diligence for the sake of their taxpayers by circulating RFPs, there is a simultaneous exploration of transforming the nonprofit to a four-town quasi-municipal organization. Roger Moody, interim town manager of Rockport, is researching options available in state statutes for possible alternative organizational structures for providing regional EMS services.

The proposed EMS Review Team would consist of the manager/administrator of each town, a select board member from each town and then either another select board member or a community member. Lincolnville informally invited interested citizens to step forward when they met March 25 for their regularly scheduled meeting.

Request for Proposals

The Towns of Camden, Hope, Lincolnville, and Rockport are seeking proposals from Emergency Medical and Ambulance Service Providers to serve the 4-Town region to provide Basic Life Support (BLS) and Advance Life Support (ALS) care for the benefit of its citizens. To review the complete RFP, please go to www.camdenmaine.gov or contact Janice Esancy, Camden Town Office at jesancy@camdenmaine.gov. All proposals must be in sealed envelopes, clearly marked "Regional EMS Proposal" and must be received at the Rockport Town Office by close of business on Monday, April 8. The Towns reserve the right to reject any or all bids.

The Towns of Camden, Hope, Lincolnville, and Rockport are interested in receiving proposals from Emergency Medical and Ambulance Service Providers to provide Basic Life Support (BLS) and Advanced Life Support (ALS) care for the benefit of its citizens. Interested Providers should submit fifteen (15) hard copies and one electronic copy of your proposal and qualifications by noon on April 23, 2013, to

Town Manager’s Office Town of Rockport 101 Main Street PO Box 10 Rockport, Maine 04856

Proposals must be submitted in a envelope clearly marked: Regional EMS Proposal.

The Provider shall submit a proposal based on coverage for the 4 Towns that describes service levels and costs per Town, if any, as well as any additional services each Town or all Towns can select.

The Provider may choose to submit a proposal that covers all 4 of the Towns, 1 of the Towns or a combination. If the Proposal is not for all four Towns, the Provider must clearly state this.

Questions regarding this RFP should be submitted in writing via e-mail to: emsreviewteam@camdenmaine.gov by April 8, 2013. All of the questions received will be collected and responded to in one e-mail. If you do not submit a questions, but you wish to receive the responses, please submit your request via e-mail. To ensure a timely response, the subject line must be: EMS Review Team.

The Towns intend to negotiate and award a contract no later than June 15, 2013 to be effective July 1, 2013. The Towns reserve the right not to award a contract.

II. Project Background

The Towns of Camden, Hope, Lincolnville, and Rockport (hereinafter “Region”) are currently served by a non-municipal, non-profit organization which provides emergency medical and transport services. It operates 4 ambulances 24 hours a day, 7 days a week to provide Advanced Life Support (ALS) and Basic Life Support (BLS) care, as well as an extrication team (volunteers), and technical rescue team (volunteers). The current Provider stands by at fire and other incidents to provide medical and rehabilitation services to fire fighters, as well as treatment and transport at no charge to the Towns’ firefighters.

The Region seeks to contract for emergency medical and transport services to provide comparable service to the four 4 Towns. All personnel, supplies, capital equipment and business expenses shall be the responsibility of the Provider.

Page 1 of 5III. Term

The initial contract terms shall be for two (2) years commencing on July 1, 2013, with one three (3) year renewal period at the option of the municipality.

If the Region or the Provider wishes to terminate the contract, either party must provide a minimum of 6 months written notice. In the event the contract is not approved by the Town meeting, the contract shall terminate 30 days after the Town Meeting vote.

IV. Scope of Services

Services, vehicles, equipment and personnel must meet the standards of the Maine Emergency Services Act (32 M.R.S.A. section 81 et seq.), any rules promulgated by the Emergency Medical Services Board, and state and federal regulations.

A. Service. Based on the Provider’s understanding of best practice, the Towns demographics, and call volume trends, Provider’s proposal will commit to service levels which, at a minimum will provide 24 hour coverage 7 days a week for the purposes of treating and transporting sick or injured persons in the coverage area of the Region.

The proposal will specify whether the Provider will serve as the Region’s First Responders.

The proposal shall specify what level of coverage the Provider commits to: BLS and ALS care on all calls, BLS, only, ALS as needed, etc.

The proposal shall describe the staffing levels and whether the Provider proposes to adjust staffing, ambulance availability, and level of service (BLS, ALS, etc) based on call volume trends, peak hour coverage, or other criteria.

There is no minimum or maximum number of calls that will be guaranteed to the Provider. The proposal shall include a description of the Provider’s Quality assurance protocols.

B. Personnel. The Provider will supply trained, experienced personnel who are licensed as necessary to provide the emergency medical and transport services required to meet the service levels as agreed upon by the Provider and the Region. The personnel shall at all times meet the requirements of the Maine Emergency Medical Services Board.

The proposal shall state the number of personnel to be assigned on each shift and per vehicle, their years of service, training and certification.

C. Response times. The proposal shall specify the Provider’s intended response times. The proposal shall specify the response time for BLS service and ALS service. This includes:

Expected response time on average;

Expected response time based on the location of the emergency specific to each Town. Specifically respond to these locations:

Camden – Camden-Rockport Middle School Hope - Hope Corner Fire Station and Hope Elementary School Rockport - Camden Hills Regional High School Lincolnville – Lincolnville Central School

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The Provider will include information regarding when they would likely need to use “back up” service and what entity would provide that service.

The Provider will be expected to maintain a record of the response times and submit these records to the Region each quarter during the term of the contract.

D. Vehicles and Equipment. The Contractor shall provide, maintain, and house at its own cost and expense, State certified ambulances and other equipment. The proposal will specify the number of vehicles dedicated to the Region and the principle location(s) where the ambulances/ rescue vehicles will respond from.

The proposal will list the type, year, and replacement schedule for vehicles and equipment.

V. Cost

All personnel, supplies, capital equipment and business expenses shall be the responsibility of the Provider. The proposal shall state the fixed amount expected for each of the first two (2) years of the contract. The proposal will specify the lump sum cost to the Region, as well as the cost to each Town.

The Provider may propose a cost per town that the Provider would charge if the 4 Towns do not award a contract as a Region. The cost shall specify the services being proposed if they differ from those covered in the proposal for the Region.

Cost will be a factor in determining the successful Provider, but the lowest-cost proposal will not necessarily be awarded the contract. The proposal will be evaluated to determine whether the cost is appropriate to best meet the needs of the Region.

If the contract is renewed as specified in Section III, costs for services will be increased annually based on the CPI-U Northeast as a minimum.

In no event shall the Region or any individual Town be responsible for paying an amount higher than the agreed upon annual bid price.

VI. Financial Management, Billing, and Service Reports

The selected Provider will be responsible for submitting quarterly financial and service reports to the Region. As part of the RFP review process, Providers may be asked to de submit the most recent and prior 2 years 990’s, audits, or similar financial information, including proof of financial ability to fulfill the contract with the Region.

Provider is expected to include specific information regarding their billing operations such as whether billing is done in-house, contracted to a separate entity, etc., and who or what entity manages collections of outstanding bills.

VII. Insurance

The Provider will obtain and maintain comprehensive general liability, property damage insurance, and ambulance attendants’ malpractice insurance naming the Towns that are party to the contract as an additional insured, in an amount not less than $400,000 for injuries to each person in one accident and $100,000 for damage to or destruction of property in any one accident.

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The Provider agrees to procure and maintain at its own expense during the contract period in accordance with the provisions of the laws of the State of Maine, Workers Compensation Insurance, including occupational disease provisions for all employees.

All of the insurers shall be satisfactory to the Region and certificates shall be filed with each town in the region. The insurance shall contain provisions that they shall not be cancelled without at least seven (7) days’ prior written notice to the Region.

VIII. References

The proposal shall identify municipalities where the Provider has performed similar services in the past ten (10) years and list at least three (3) non-municipal references of persons who are not employed by the Provider and who do not currently serve on the Provider’s Board of Directors.

IX. Value Added Services/Options

These services are not considered part of the base proposal but the Region requests that the Providers include proposals regarding additional services they propose to provide including but not limited to:

1. Availability to be present at fire department calls when requested 2. Stand-by coverage at Town-sponsored functions attended by 500 or more people 3. Stand-by coverage at Public High School athletic events 4. Community wellness clinics, CPR education, and similar outreach 5. Community Paramedicine services 6. Extrication team 7. Technical Rescue Team

X. Transition Provisions (Incumbent Primary Provider and Employees)

In the event the selected Provider is not the current Provider, every effort shall be made to ensure there is a seamless transition in emergency medical care and transportation. In the event of a change in Providers, the proposal shall describe how the prospective Provider intends to maintain continuity of service in terms of service levels, response times, and efforts to retain and employ the personnel of the current Provider through the term of the Agreement.

If the Proposer is the current provider, it shall describe how it intends to transition to the services, equipment, and personnel if they differ from existing services through the term of the new Agreement.

XI. Review of Proposals

The Region reserves the right, at its sole discretion, to: Reject any and all proposals; award a contract based on qualifications and services, which are not necessarily the low bid; negotiate with any and all Providers. Proposals will be reviewed for compliance with the terms and conditions of the RFP. Any proposals not responsive to the RFP will be rejected.

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A. Proposal Contents. Each proposal submitted must include: 1) Executive Summary: This section should include a summary of the key of the Provider’s

response and the pricing contained in the proposal.

2) Scope: The Provider should state what they believe to be the scope of services being requested and what they are proposing in response. If there are differences between what the Region is requesting and what the Provider is proposing this must be clearly stated.

3) Business and Background: Describe the Provider’s background, the parent company, its services, organization chart, goals, and a brief biography of those involved in the management of the company

4) Staffing: Describe the number of EMS personnel that will be designated to fulfill the contract as proposed and their qualifications, as well as the background or resumes of the management team that will be primarily assigned to fulfill this contract.

5) Assumptions: State any assumptions being made relating to any part of the proposal so it is clear what the Provider is proposing for services.

6) Timing: State the timing necessary for the Provider to commence service.

B. Review Criteria

There following primary areas are the criteria by which proposals will be evaluated by the EMS Review Team.

1) Scope of services. The proposals will be evaluated to determine which proposal offers comparable services to the current Provider and best meets the Region’s needs for emergency medical and transport services as described in the request for proposal including: service levels, personnel, vehicles and equipment, and response time, and quality improvement protocols

2) Experience. Proposals will be evaluated to determine whether they have a documented record of successful operations in municipalities of similar size and density. Background and overall clinical experience will be considered including references, patient satisfaction, service levels, and response time reports.

3) Qualifications of Personnel. The purpose of the RFP is to ensure the Region’s residents are served by a Provider that has a record of delivering high quality, efficient, and timely emergency medical and transport services. Qualifications of the Provider’s management team and personnel assigned to fulfill this contract will be scrutinized to ensure this requirement is met.

4) Cost. Cost will be a factor in determining the successful vendor, but the lowest proposal will not necessarily be awarded the contract. The proposal will be evaluated to determine whether the cost is responsive to the requested scope of service and what value it provides to the Region.

Review of proposals will begin immediately after the submission deadline.

Editorial Director Lynda Clancy can be reached at lyndaclancy@penbaypilot.com; 706-6657.