RFQ - EMERGENCY MEDICAL SERVICES (EMS) SYSTEM ASSESSMENTS

COUNTY OF SAN DIEGO - REQUEST FOR QUOTES (RFQ) 13153
SAN DIEGO COUNTY FIRE
EMERGENCY MEDICAL SERVICES (EMS) SYSTEM ASSESSMENTS
B. RFQ INSTRUCTIONS AND RULES
1. INSTRUCTIONS FOR SUBMITTING A QUOTE
1.1. It is Offeror's responsibility to submit a quote based on the most current RFQ, addenda thereto, County's
responses to Questions, any other information posted on BuyNet, and any diligence material made available by
the County. Offerors are advised to regularly check BuyNet for information. The County has no obligation to
contact Offerors directly with any such RFQ-related information.
1.1.1. To see all information related to this RFQ, to submit Questions, and to receive notifications of updates,
Offerors must select "Participate in RFx" for this solicitation in BuyNet.
1.1.2. If an Offeror is unable to download this document, an Offeror may request a hard copy from Department
of Purchasing and Contracting's front desk or contact clerical support at (858) 505-6367.
1.2. Forms required to be submitted with Offerors response to this RFQ are included in this RFQ or posted on the
County's web site at: https://www.sandiegocounty.gov/content/sdc/purchasing/purchasing-forms.html.
1.2.1. The County may update posted forms from time to time. Unless otherwise specified, Offerors may
submit the version of a form in place as of the date of the posting of this RFQ or any later version
thereof.
1.3. Offeror must submit a complete original quote in accordance with the format provided in this solicitation to the
County of San Diego, Department of Purchasing and Contracting, through electronic upload to BuyNet before
the Date and Time listed in Schedule.
1.3.1. If Offeror is unable to submit via BuyNet for any reason, Offeror may submit its quote via email to the
Contracting Officer listed in this document or provide the Purchasing and Contracting front desk with
either (i) electronic files on CD/DVD; or, (ii) a printed quote. Offeror must prominently mark such
submissions with the RFQ number on the outside of the packaging. Please use this method only if
unable to submit through BuyNet.
2. QUESTIONS
2.1. Offerors shall direct requests for explanation regarding the RFQ or related documents to the Contracting
Officer, in writing, as a question ("Question"). Offerors may submit Questions by sending a message to the
Contracting Officer through the "Discussions" functionality in BuyNet.
2.2. The County may choose not to respond to Questions received after the date and time stated in the Schedule for
Question submission. Offeror is responsible for ensuring that Questions are received by the County.
3. QUOTE FORMAT
3.1. Submit electronic quotes as files in .pdf format, except where specified otherwise. For pages other than
signature pages, converted and searchable formats are preferred.
3.2. All quotes shall be signed with a handwritten signature by an authorized officer or employee of Offeror.
4. QUOTE ORGANIZATION
4.1. Your quote should be organized in accordance with the Submittal Items in this RFQ.
4.1.1. Offerors shall organize content to correspond to the applicable exhibit and question or item within each
exhibit.
4.1.2. Offerors shall separate each exhibit into one or more files, clearly named as to the exhibit and order.
4.1.3. Pages shall be consecutively numbered within each exhibit at the bottom or top margin of each page.
4.1.4. Cost/Price information:
4.1.4.1. Offerors must place all cost and pricing information within the Cost/Price exhibit. Price shall
be inclusive of all proposed compensation.
4.2. Confidential/Proprietary information:
4.2.1. The County is a public agency subject to the California Public Records Act, Government Code
7920.000, et seq. Some or all of the documents submitted in response to this RFQ may be subject to
disclosure, and the County intends to publish any resulting contracts to its public website.
4.2.2. It is Offeror's responsibility to identify and separate into a "CONFIDENTIAL/PROPRIETARY"
exhibit and to provide a signed Nondisclosure Indemnification Agreement for:

COUNTY OF SAN DIEGO - REQUEST FOR QUOTES (RFQ) 13153
SAN DIEGO COUNTY FIRE
EMERGENCY MEDICAL SERVICES (EMS) SYSTEM ASSESSMENTS
4.2.2.1. All confidential information that Offeror represents, with legal basis, is exempt from
disclosure pursuant to the California Public Records Act, including PI (Personal Information),
PII (Personally Identifiable Information), or PHI (Protected Health Information);
4.2.2.2. Any proprietary or other information Offeror represents, with legal basis, is exempt from
disclosure under the California Public Records Act and wishes to protect from disclosure.
4.2.3. The "CONFIDENTIAL/PROPRIETARY" exhibit must be clearly labeled with all pages marked as
"CONFIDENTIAL/PROPRIETARY."
4.2.4. Offeror should reference material in the "CONFIDENTIAL/PROPRIETARY" exhibit where it is
needed to respond to a Submittal Item through citation to the "CONFIDENTIAL/PROPRIETARY"
exhibit (for example "See response 1 contained within the 'CONFIDENTIAL/PROPRIETARY'
exhibit for staff Social Security numbers").
4.2.5. If the County determines that a submission improperly designates information as confidential or
proprietary, the County may, at its sole discretion: (i) deem the information releasable; (ii) declare the
submission non-conforming/non-responsive; (iii) remove such information, or (iv) take any other
appropriate action. (Note: Pricing and Terms and Conditions are generally not confidential under the
California Public Records Act).
5. QUOTE EVALUATION
5.1. Evaluations may consider factors such as technical merit, experience, capacity, history of Offeror compliance,
availability, price, and more to determine the quote(s) that provide the best value to the County.
5.2. During evaluation, the County may appropriately consider the sustainability and social, human health,
environmental, and economic impact of Offeror's proposed products and/or approach to providing goods and/or
services, in accordance with Board Policy B-67. Therefore, Offerors are encouraged to include relevant
information in their quotes, to the degree related to the goods or services sought.
5.3. During evaluation, the County may appropriately evaluate the cultural competency of Offeror and Offeror's
proposed approach to providing goods and services. Therefore, Offerors are encouraged to include relevant
information in their quotes, to the degree related to the goods or services sought.
5.4. When evaluating an Offeror's cost or pricing, the County may also consider the effect of the quote on the overall
total cost to the County.
6. COUNTY COMMITMENT
6.1. This RFQ does not commit the County to award a contract, nor does it commit the County to pay any of
Offeror's costs incurred in the preparation or submission of the quote. Further, Offeror shall not incur any
reimbursable cost in anticipation of a contract award.
6.2. Neither Offeror nor any of its representatives shall have any claims whatsoever against the County or any of its
respective officials, agents, or employees arising out of or relating to this RFQ or these procedures (other than
those arising under a definitive contract with Offeror in accordance with the terms thereof).
6.3. The County reserves the right to separately procure the same or similar goods or services.
6.4. The County may withhold all information regarding this procurement until after negotiations are complete,
including, but not limited to: the number of quotes received; the identity of Offeror(s); the content of quotes;
the County's evaluation and results thereof. Information releasable after the conclusion of negotiations is
subject to the disclosure requirements and withholding exemptions of the California Public Records Act.
6.5. Pursuant to County Charter 703.10 and 916, award of a contract resulting from this RFQ may be subject to
the County's requirement to determine that the services can be provided more economically and efficiently by
an independent contractor than by persons employed in the Classified Service.
6.6. In the event that an Offeror is involved in a merger, acquisition, or other change in control, the County reserves
the right to award a contract to a resulting entity.
7. DILIGENCE AND DUTY TO INQUIRE
7.1. Should Offeror find discrepancies in or omissions from, or be in doubt as to the meaning of, the RFQ or related
documents, Offeror shall have a duty to submit a Question to the County.
7.2. Offerors are expected to perform reasonable due diligence with regard to this RFQ and the work required,
including, but not limited to, information that is publicly or otherwise reasonably available and, if applicable,
information that can be obtained during a site visit (including verification of measurements, conditions, and

COUNTY OF SAN DIEGO - REQUEST FOR QUOTES (RFQ) 13153
SAN DIEGO COUNTY FIRE
EMERGENCY MEDICAL SERVICES (EMS) SYSTEM ASSESSMENTS
other attributes). Neither the selected Offeror(s), nor any Offerors, shall be entitled to any price adjustment or
other relief based upon information that was discovered or should have been discovered through due diligence.
7.3. The County makes no representation or warranty, express or implied, as to the accuracy or completeness of any
diligence material or other information provided by the County or any of its agents, representatives, contractors,
or consultants. Such information may reflect good faith assumptions, estimates, or projections, which may or
may not prove to be correct.
7.4. Offeror should not rely upon oral statements made or explanations given by the County, including any oral
responses to Questions or other inquiries. No prior, current, or post award communication(s) with any officer,
agent, or employee of the County shall affect or modify any terms or requirements of this RFQ, except as
explicitly provided for in this RFQ.
8. OFFEROR COMMUNICATIONS
8.1. All communications from Offeror (including its employees, agents, and representatives) to the County or its
officers and employees (including consultants working on or assisting with this procurement), related to this
RFQ or Offeror's quote, must be directed in writing exclusively to the Contracting Officer, unless otherwise
authorized in writing by the Contracting Officer. Offerors shall not communicate with or attempt to contact any
other County personnel about this solicitation, except as otherwise allowed for in this RFQ or by law. Any
improper contact may, at the County's sole discretion, cause Offeror to be removed from consideration for
contract award.
8.2. If Offeror issues any public announcement or otherwise engages in communication that, in the County's sole
determination, compromises the integrity of this RFQ process or attempts to restrain competition, Offeror may
be removed from consideration for award.
8.3. Audio and/or video recording of presentations, discussions, negotiations, or other communications with the
County regarding this RFQ are prohibited, unless specifically authorized in writing by the Contracting Officer.
9. SOLICITING EMPLOYEES
9.1. Until contract award, Offerors shall not, directly or indirectly, solicit any employee of the County to leave the
County's employ in order to accept employment with Offeror, its affiliates, actual or prospective contractors,
or any person acting in concert with Offeror without prior written approval of the County's Contracting Officer.
This paragraph does not prevent the employment by Offeror of a County employee who has initiated contact
with Offeror.
10. PROHIBITED CONTRACTS AND SUBCONTRACTS
10.1. In accordance with Section 67 of the San Diego County Administrative Code, the County shall not contract
with, and shall reject any quote submitted by, the person or entities specified below, unless the Board of
Supervisors finds that special circumstances exist which justify the approval of such contract:
10.1.1. Persons employed by the County or of public agencies for which the Board of Supervisors is the
governing body;
10.1.2. Profit-making firms or businesses in which employees described in subsection 11.1.1 serve as officers,
principals, partners, or major shareholders;
10.1.3. Persons who, within the immediately preceding twelve (12) months, came within the provisions of
subsection 11.1.1 and who (i) were employed in positions of substantial responsibility in the area of
service to be performed by the contract; or, (ii) participated in any way in developing the contract or its
service specifications; and
10.1.4. Profit-making firms or businesses in which the former employees described in subsection 11.1.3 serve
as officers, principals, partners, or major shareholders.
10.2. Per Board Policy A-79, a successful Offeror that is a non-profit corporation shall not subcontract any work
under the agreement with a related for-profit subcontractor where an interlocking directorate, management, or
ownership relationship exists, unless specifically authorized by the Board of Supervisors.
10.3. Offeror certifies that, if awarded a contract under this RFQ, such contract will be in compliance with Sections
11.1 and 11.2 above. Offeror shall promptly notify the County of any change in circumstance affecting these
provisions.

COUNTY OF SAN DIEGO - REQUEST FOR QUOTES (RFQ) 13153
SAN DIEGO COUNTY FIRE
EMERGENCY MEDICAL SERVICES (EMS) SYSTEM ASSESSMENTS
11. CALIFORNIA REVENUE & TAXATION CODE 18662
11.1. In compliance with California Revenue and Taxation Code 18662, if Offeror is a non-resident of California
(out-of-state invoices) that receives California source income and has not completed Franchise Tax Board Form
590, there may be a backup withholding on all payments. Fifteen (15) business days prior to the first payment
from the County, new suppliers or suppliers with expired forms or forms with incorrect information must submit
new forms to the County (forms are available from the Franchise Tax Board website listed below).
11.2. Under certain circumstances, Offerors may be eligible for reduced or waived nonresident withholding. If
Offeror has already received a waiver or a reduced withholding response from the State of California and the
response remains valid, Offeror should submit the response to the County in lieu of the forms. Failure to submit
the required forms will result in withholding of payments. Offerors should access the Franchise Tax Board
websites, listed below, for tax forms and relevant information regarding non-resident withholding, including
waivers or reductions. The County will not give Offerors any tax advice. It is recommended that Offerors speak
with their tax advisers and/or the State of California for guidance.
Franchise Tax Board Websites:
https://www.ftb.ca.gov
https://www.ftb.ca.gov/forms/search/
11.3. If selected for award, Offeror must submit applicable forms to the Auditor & Controller via fax, at (858) 694-
2060, or mail originals to: County of San Diego, 5530 Overland Avenue, Suite 410, San Diego, CA 92123. The
P.O. Number or Contract Number (if available) and "California Revenue and Taxation Code 18662" must
appear on fax cover sheet and/or the outside of the mailing envelope.
12. W-9 FORM
12.1. If selected for award, Offeror must complete and submit a W-9 form if a current form is not on file with the
County.
13. PREVAILING WAGE
13.1. Reserved.

COUNTY OF SAN DIEGO - REQUEST FOR QUOTES (RFQ) 13153
SAN DIEGO COUNTY FIRE
EMERGENCY MEDICAL SERVICES (EMS) SYSTEM ASSESSMENTS
C. SUBMITTAL ITEMS
1. EXHIBIT 1 - REQUIRED FORMS
1.1 Submit a completed and signed Offeror's Cover Page (PC600) form
* Required for all Offerors
* Located at:
https://www.sandiegocounty.gov/content/dam/sdc/purchasing/docs/PC600_dpc_Offerors_Cover_Page.pdf
1.2 Submit a completed and signed Representations and Certifications form (PC601)
* Required for all Offerors
* Located at:
https://www.sandiegocounty.gov/content/dam/sdc/purchasing/docs/PC601_dpc_Reps_and_Certs.pdf
1.3 Submit a completed and signed Small-Local Business Self-Certification Form (PC610)
* All Offerors are encouraged to complete this form to support County data collection.
* Located at:
https://www.sandiegocounty.gov/content/dam/sdc/purchasing/docs/PC610_dpc_Small_Local_Self_Cert.pdf
1.4 Submit a completed and signed Nondisclosure Indemnification Agreement (PC620) (if applicable).
* Required if submitting Confidential/Proprietary Information (see RFQ Instructions and Rules section 4.2)
* Located at:
https://www.sandiegocounty.gov/content/dam/sdc/purchasing/docs/PC620_dpc_Nondisclosure_Indemnity.pdf
2. EXHIBIT 2 - PROGRAM/TECHNICAL EXHIBIT
2.1 Confirm (YES/NO) Offeror has read, understands, and accepts the Statement of Work (SOW).
YES NO
2.1.1 If NO, provide a marked-up redline version of the SOW that provides applicable alternative language
with an explanation to support any alternative standards/language being proposed. Failure to specifically
reject a proposed requirement(s) will be deemed an acceptance of such requirement.
2.2 Organizational Experience. Provide a detailed description of Offeror's experience in Emergency Medical
Services (EMS) consulting and EMS System Assessments, including whether Offeror possesses a minimum of 5
years of experience within the last 10 years performing the following activities:
2.2.1 Collecting, compiling, and analyzing financial and business operational data of the Offeror and other
similar entities for analysis and comparison purposes.
2.2.2 Reviewing an organization's existing and historical financial and business operations.
2.2.3 Conducting financial, statistical, cost, budget, and business operations analysis.
2.2.4 Comparing financial, business operations, revenue sources, service costs and deliverables to
organizations of similar size and scope in other regions/areas.
2.2.5 Providing financial and business operations reports, including findings with multi-year projections.
2.2.6 Providing reports of analysis identifying areas of efficiency, deficiencies, and models for improvement
with detailed methods for implementation.
2.2.7 Providing financial and business operations reports, including multi-year projections with:
2.2.7.1 Current models and data.
2.2.7.2 Varying data, models, revenues, and costs.
2.3 Staffing
2.3.1 Identify lead staff and team members that will be assigned to this project, including the roles and
responsibilities of each individual.

COUNTY OF SAN DIEGO - REQUEST FOR QUOTES (RFQ) 13153
SAN DIEGO COUNTY FIRE
EMERGENCY MEDICAL SERVICES (EMS) SYSTEM ASSESSMENTS
2.3.2 Provide a detailed response demonstrating that lead staff members possess a minimum of 5 years of
experience within the last 10 years.
2.3.3 Provide resumes of lead staff who will be assigned to this project. Resumes should include the following
information: level of education; years of relevant experience, certifications, and qualifications. Do not
include any confidential, sensitive or personal information in this portion of Offeror's response.
2.4 References. Provide three (3) business references for which the Offeror has provided services in the last 5 years
which are of a similar scope to the County's requirements. References shall include the following:
2.4.1 Name of customer/agency
2.4.2 Dates of services provided
2.4.3 Contact name, position
2.4.4 Contact business email and business telephone number
County will make reasonable attempts to contact any reference, and the inability to contact a reference may be
treated as an unfavorable reference for evaluation purposes. An unfavorable response is a response from a listed
reference stating they would not enlist the Offeror to perform services again in the future, or comments provided
that the County deems to be substantially negative or reflective of substandard service. The County reserves the
right to contact County departments or any other agency for which an Offeror has previously performed under
contract. The County may, at its sole discretion, disqualify an Offeror if the requested number of references stated
is not provided or responses are considered unfavorable.
3. EXHIBIT 3 - COST/PRICE EXHIBIT
3.1 Submit a completed Payment Schedule.
4. EXHIBIT 4 - ACCEPTANCE OF TERMS AND CONDITIONS
4.1 Confirm acceptance "YES/NO" of the County of San Diego's Draft Agreement (including insurance
requirements):
YES NO
4.1.1 If "NO," provide a detailed list of exceptions to the terms and conditions, the nature of its concern, and
what terms the Offeror is willing to accept.
Note: The Offeror will be deemed to have accepted any terms and conditions of the Contract to which
it does not take exception to. The County may, as part of its evaluation process, conclude that exceptions
are so numerous and/or material as to make Offeror's response to the solicitation unacceptable.
5. EXHIBIT 5 - CONFIDENTIAL PROPRIETARY
5.1 Include any Confidential/Proprietary Information in this exhibit, in accordance with RFQ Instructions and Rules
section 4.2

COUNTY OF SAN DIEGO - REQUEST FOR QUOTES (RFQ) 13153
SAN DIEGO COUNTY FIRE
EMERGENCY MEDICAL SERVICES (EMS) SYSTEM ASSESSMENTS
D. REQUIRED FORMS
(RESERVED)

COUNTY OF SAN DIEGO - REQUEST FOR QUOTES (RFQ) 13153
SAN DIEGO COUNTY FIRE
EMERGENCY MEDICAL SERVICES (EMS) SYSTEM ASSESSMENTS
E. STATEMENT OF WORK
1. Scope of Work
Contractor shall conduct a comprehensive assessment of the Emergency Medical Services (EMS) systems in two designated service
areas: CSA 17 Ambulance Service Area and the San Diego County Fire Protection District (SDCFPD) Ground Ambulance Service
Area (ASA). Additional service areas, such as the Grossmont Ambulance Service Area, may be assessed as needed, and others may
be added at a later time. The assessments shall focus on evaluating the level of care, response time standards, deployment models,
and additional operational considerations to ensure optimal resource allocation, clinical effectiveness, and operational efficiency.
2. Background Information
County of San Diego's (County) San Diego County Fire (County Fire) provides administrative oversight, medical direction, and
quality assurance for the prehospital emergency medical services system in San Diego County through its Board of Supervisors
(Board)-designated San Diego Emergency Medical Services (EMS) Office. In addition, County Fire is the designated EMS transport
provider in the SDCFPD ASA through a Cooperative Agreement with CAL FIRE and through a contractor in the CSA 17 (San
Dieguito EMS District). The CSA 17 Advisory Committee and the Fire Advisory Board have been established to advise the Board
on issues related to County Fire's ambulance operations in these two areas. Each of these advisory bodies report their findings to
the Board through County Staff.
CSA 17: In 1969, the San Diego County Board established CSA 17 to provide Basic Life Support (BLS) ambulance service within
an unincorporated north-coastal area and within the City of Del Mar. In 1975, the service level was upgraded to include Advanced
Life Support (ALS)-level, or paramedic, ambulance services. In 1976, the Del Mar Heights and Del Mar Terrace portions of the
City of San Diego, located west of Interstate 5, were annexed into the CSA. In 1992, CSA 17 was redesignated as an EMS District
to allow CSA 17 fire departments to provide comprehensive prehospital services. In 1993, CSA 17 annexed the remainder of the
Rancho Santa Fe Fire Protection District areas of Del Dios and the 4-S Ranch. The CSA 17 service area presently covers the cities
of Encinitas, Del Mar, and Solana Beach, the community of Rancho Santa Fe, the areas identified as Crosby Ranch, 4-S Ranch, Del
Mar Heights, Del Mar Terrace west of Interstate 5, and Elfin Forest. As of 2020, CSA 17 includes approximately 73 square miles
and has a resident population of approximately 125,000 (Source: San Diego Association of Governments, 2020). Additionally, there
is considerable influx into the CSA of non-residents participating in or traveling to area attractions, including resorts, beaches, and
camping. CSA 17 is funded through property taxes, voter-approved benefit fees, and resident and non-resident transport fees. As of
2023, each of the fire departments within CSA 17 (the cities of Encinitas, Del Mar and Solana Beach, and the Rancho Santa Fe Fire
Protection District) provides paramedic first responder services. In addition to the four fire agencies and the primary ambulance
provider (American Medical Response (AMR)), the County contracts for ambulance billing, dispatching, and financial services.
San Diego County Fire Protection District: The SDCFPD is the fire service provider in most of the County's unincorporated
areas. County Fire is the administrative agent for SDCFPD and oversees contracts and services. Ambulance service in the area is
under the management of the SDCFPD, which includes the existing SDCFPD boundaries and service outside of these boundaries
in three smaller Fire Protection Districts. On May 23, 2023 (19), the Board approved a contract with the SDCFPD under Health and
Safety Code Sections 1797.230-231. As of September 30, 2023, the SDCFPD has been responsible for managing and/or providing
ambulance services, in whole or in part, throughout the SDCFPD.
Grossmont Ambulance Service Area: In 1979, the San Diego County Board expanded the then-new paramedic program to an
area that became known as the "Grossmont Zone 1" ambulance service area. Through this Board action, the County established a
contract with the Grossmont Hospital District to provide paramedic services within its boundaries. Today, this service area includes
the Cities of La Mesa and Lemon Grove, and most of the San Miguel Fire Protection District. This service mode has not been
substantially reviewed since its inception, with successor private entities continuing the subcontracted service. Currently, the
Grossmont service area is served by three paramedic first responder fire departments, and the private ambulance provider operates
paramedic/EMT and EMT staffed ambulances, together providing approximately 8,000 transports annually. The Grossmont
Ambulance Service Area is funded through patient transport fees. The private ambulance provides the first responder agencies with
funds for these services. Dispatch services for this area include call taking and dispatch by the Heartland Communications Facility
Authority, and system management is provided by the private provider's communication center.
3. Goals and Outcomes
3.1. Goals: Contractor shall provide the services described herein to accomplish the following goals:
3.1.1. Conduct comprehensive EMS system assessments across designated service areas that evaluate current level of care
staffing configurations, alignment between patient acuity and the level of care provided, and service delivery utilizing
ALS and BLS ambulances.
3.2. Process Objectives: Contractor shall achieve the following process objectives:
3.2.1. Review dispatch criteria, response time targets, and system performance metrics in the context of national benchmarks
and medical evidence.
3.2.2. Identify opportunities to improve clinical quality, equity of access, operational effectiveness, and economic efficiency.
3.2.3. Assess revenue cycle data for ALS and BLS level of care to determine the impact of a potential change in deployment
model.

COUNTY OF SAN DIEGO - REQUEST FOR QUOTES (RFQ) 13153
SAN DIEGO COUNTY FIRE
EMERGENCY MEDICAL SERVICES (EMS) SYSTEM ASSESSMENTS
3.2.4. Recommend a deployment model that ensures the right care, at the right time, with the right resources.
3.3. Outcomes Objectives: Contractor shall achieve the following outcome objectives:
3.3.1. Provide a documented analysis of how effectively the EMS system matches resources to patient needs.
3.3.2. Provide evidence-based operational and clinical standards that emphasize quality of care, patient outcomes, and other
best practice measures rather than arbitrary benchmarks.
3.3.3. Provide a tiered deployment strategy that maximizes the utilization of Emergency Medical Technician (EMT) and
paramedic resources.
3.3.4. Provide actionable recommendations that can inform policy, budget, and staffing decisions.
4. Target Population
4.1. Contractor shall provide the services described herein to County staff.
5. General Requirements for Service Delivery
5.1. Contractor shall provide an EMS System Assessment for the CSA 17 and the SDCFPD ASAs.
5.2. Contractor shall provide EMS System Assessments to additional ambulance service areas, such as the Grossmont Ambulance
Service Area, on an as-needed basis upon written request by the Contracting Officer's Representative (COR).
5.2.1. Additional and as-needed EMS System Assessments will follow the Task Order process, as outlined in Section 7 of
this Exhibit A - Statement of Work.
6. Specific Requirements for Service Delivery
6.1. Contractor shall perform the following tasks under this agreement, for each Task Order project:
6.1.1. Task 1: Project Initiation and Data Collection
6.1.1.1. Conduct a kickoff meeting, within 75 calendar days of contract start, with project stakeholders to confirm
goals, timelines, and deliverables.
6.1.1.2. Identify and request relevant data sets, including Computer Aided Dispatch (CAD) and electronic Patient
Care Record (ePCR) data for a 12 to 24-month period, staffing levels, dispatch protocols, and clinical
outcome metrics.
6.1.2. Task 2: Assessment of Level of Care
6.1.2.1. Analyze ambulance distribution, including, but not limited to, call volume, geographic coverage, and
workload.
6.1.2.2. Evaluate level of care (ALS/BLS) and its relationship to call acuity and patient outcomes.
6.1.2.3. Benchmark against peer systems and national standards for ALS/BLS utilization.
6.1.2.4. Identify gaps, redundancies, or inefficiencies in the deployment of clinical resources.
6.1.3. Task 3: Response Time and Performance Analysis
6.1.3.1. Review current response time performance by zone, call type, and unit type.
6.1.3.2. Compare existing standards to evidence-based guidelines.
6.1.3.3. Develop recommendations for revised response time goals, differentiating between ALS vs. BLS responses,
urban/suburban/rural areas, and high- vs. low-acuity calls.
6.1.4. Task 4: Deployment and Resource Allocation Modeling
6.1.4.1. Conduct geospatial analysis of incident locations, posting patterns, and unit availability.
6.1.4.2. Model various deployment scenarios (e.g., tiered ALS/BLS system, dynamic posting, peak-load staffing,
use of mutual aid for closest unit response).
6.1.4.3. Evaluate operational and financial implications of scenarios.
6.1.4.4. Develop recommendations for an optimized deployment plan that balances clinical proficiency, operational
effectiveness, financial efficiency, coverage, and patient outcomes.
6.1.5. Task 5: Billing Optimization and Accountability
6.1.5.1. Make recommendations for an enhanced billing methodology, which may or may not include the use of a
public billing entity, allowing the provider to do the billing, or engaging a third-party to do the billing.
6.1.6. Task 6: Analyze Automatic/Mutual Aid Service Opportunities
6.1.6.1. Analyze automatic/mutual aid service use to confirm that overuse is not present.
6.1.6.2. The analysis shall include consideration of contract service areas, mutually beneficial service area swaps,
and/or service area hybrid services.
6.1.7. Task 7: Final Report and Presentation