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Unicoi County Commission votes to issue RFP for ambulance service

By Kendal Groner

While it is still being determined whether or not Unicoi County can use the $440,000 Community Development Block Grant allocated to the Town of Erwin for the purchase of ambulances that would be used to create a locally-operated service, county officials met to discuss proposed changes to the request for proposal (RFP) that MedicOne, the county’s current ambulance provider, had bid on.

Following the April 20 meeting of the Unicoi County Ambulance Committee, the Unicoi County Commission voted to issue out the RFPs on May 8 during its meeting on Monday, April 23.

Until the First Tennessee Development District finishes a round of surveys to determine whether the county can use the block grant, officials felt it would be prudent to go ahead and see what service offers they receive from other ambulance providers, seeing as MedicOne was the only company that bid four years ago.

“We’ve got several different ones (RFPs) from other counties that we’ve been looking at,” said Jason Harris, Ambulance Committee chairman, during the April 20 meeting.

After dissatisfaction with long wait times and not enough ambulances, one of the major issues the county has faced is being unable to penalize the company due to the weak wording of the contract and RFP.

Unicoi County Mayor Greg Lynch said he has been looking at RFPs and contracts from Marion County, Knox County and Sequatchie County, which has a population similar to that of Unicoi County.

“The problem is, the more stuff we put in there, the less likely we are to get bidders and the more likely we are to get high bidders,” said Lynch.

Unicoi County Commissioner Glenn White asked if the main issue with MedicOne’s service had been a lack of vehicles.

“We have the vehicles, but not the staffing,” said Lynch.

Ed Herndon, Unicoi County Emergency Management Services director, said all ambulance service providers across the country are having similar problems. Bobby Westberry, senior account executive for Lifeguard Ambulance Service, attended the meeting and confirmed that staffing is an issue across the board and even though pay increases have helped, they haven’t solved the problem.

With MedicOne’s contract not expiring until April of 2019, County Attorney Doug Shults pointed out that the time frame might be an issue for some ambulance service providers.

“You’re asking people to make proposals a year ahead of time,” said Shults. “I’m not in the ambulance business, but that might make me hesitant.”

White asked about the possibility of going ahead and terminating the contract with MedicOne, but Lynch felt it was best to leave the contract as is and allow MedicOne to place a bid if they choose to do so.

“It’s also within our right to write a refusal of any bid,” said Unicoi County Commission Chairwoman Marie Rice.

Westberry with Lifeguard Ambulance service, which has Tennessee locations in Nashville, Humphrey’s County, Knoxville and Spring Hill, said an established ambulance service with facilities available could be ready within 60 days.

“But just in my opinion, with a year out projection a lot of things can change,” Westberry said. “We definitely do have interest here (placing a bid for service) and it’s in our wheelhouse … as long as it’s sensible.”

Commissioner Gene Wilson asked why Lifeguard didn’t bid four years ago and Westberry said the climate of the company was considerably different at that time.

Next, the board began discussing changes they could make to the current RFP to attract a satisfactory service.

“We want to get the wheels rolling in the next two months that it will take us to get the surveys for the grant going,” said Lynch.

The board discussed changing the required time for notice of withdrawing services, the amount of the subsidy provided to the company, the number of required ambulances and how many years and miles the ambulances would be good for.

The original RFP required the company to provide a 60-day notice if they intended to end their services; however, the board felt it would be better for the county to stipulate that the company had to provide a 120-day notice.

As opposed to having two locations, the board suggested just having one central location as home to the service within 1.5 miles of the Harris Hollow exit because the majority of ambulance calls originate from within the Town of Erwin.

“I think roughly 49 percent of our population is in or around Erwin also,” said Herndon.

The current RFP calls for two advanced life support ambulances running 24/7, with one basic life support ambulance for peak times.

“I think if we did create our own service, the idea had been to have three ambulances running full time,” said Unicoi County Commissioner John Mosley.

The board recommended having the two advanced life support ambulances running 24/7 along with a basic life support ambulance that runs for 12 hours a day as opposed to the vague wording of “peak times.”

They also included that a company may wish to include a backup ambulance, in case one ambulance went down for maintenance reasons.

“They would basically be in violation of their contract if one went down,” Rice said.

For the advanced life support ambulances, the original RFP allowed them to be used for four years, up to 200,000 miles. The board suggested changing it to four years and 250,000 miles because ambulances are required to go through state inspections.

“The key is a good maintenance program,” Wilson said.

Lynch suggested a $200,000 performance bond as opposed to $150,000 due to the fact that he said it could cost up to $2,000 a day if the county had to rely on services from neighboring counties.

“The biggest thing is going to be determining how to word the penalty with the contract,” said Rice.

Instead of stipulating what response times should be, Lynch suggested having a periodic review of response times and Rice also mentioned that since they would have to subsidize any ambulance company they enter into a contract with, there should be an expectation that a financial statement of revenue is provided.

The board discussed penalties for violations of the proposed contract, such as not having enough ambulances available, and Harris said most RFPs he looked at, called for a penalty of up to $5,000 per violation.

Unicoi County Commissioner and Ambulance Committee member Kenneth Garland suggested issuing a warning for the first violation and then penalizing subsequent violations.

“Everyone is going to make mistakes once in awhile,” Garland said.

During the county commission meeting on Monday, commissioners also discussed voting to purchase property to build an ambulance station in the Harris Hollow Area of exit 36.

However, Wilson felt it would be unwise to confine the ambulance station to that area when he said he had heard from a few people on the south end of the county with potential property.

Commissioner Loren Thomas agreed and said he would like it to be better researched on what the best central location would be.

“Somebody needs to do a study,” said Thomas.

Thomas made a motion to table any further action regarding the purchase of property to construct an ambulance station until the Building and Grounds Committee is able to complete a study.

“We need to meet quickly so any of this available land doesn’t go away,” said Harris.

His motion was seconded by White before it unanimously passed.

“I’d like to see one central location and do it right so it benefits everyone,” said Wilson.

During the commission’s discussion on the RFPs, Garland made a motion to table the matter, but later withdrew his motion.

Thomas, who was unable to attend the Ambulance Committee meeting, did not feel the commissioners had adequate time to look over the RFPs before voting in the meeting.

“We were just handed this (RFP) as we got in … how can we vote on something we just got,” Thomas said. “He may have a point,” White said about Thomas’s remark.

Lynch said he was hoping they could “test the waters” with the RFP and get an idea of what kind of services would be interested in bidding.

“There’s still a split in Unicoi County on whether or not we should start our own or turn it over to another corporation,” he said.

Jimmy Erwin, MedicOne’s current operations manager, cautioned the commissioners that they should be fully confident with the RFP and specifications they were putting out.

“When you do this bid, put it out exactly like you want it,” he said.

Harris made a motion to place the RFPs out for bid on May 8 with a deadline of noon on June 20 to have them in the mayor’s office. The motion was seconded by Wilson before it passed, with only Thomas voting in opposition.