Award of a contract to study different methods proposed for emergency services in Pinellas County adds fuel to the dispute between the county and local firefighters.
CLEARWATER – It’s a matter of trust, say supporters of a plan for fire-based ambulance transport. County officials argue that it all comes down to cost and quality of service.
Pinellas County Commissioners voted, 4-3, July 24 to negotiate a contract with Fitch and Associates LLC. of Platte City, Mo., for an operational analysis of the county’s current system for delivery of emergency medical services, a plan presented by local firefighters, a plan from consultant, Integral Performance Solutions, as well as other scenarios.
Commissioners Nancy Bostock, Neil Brickfield and Norm Roche voted no.
The contract approval was the latest step in an ongoing process to find a more affordable way to deliver countywide emergency services.
A brief history
The county hired Integral Performance Solutions in 2009 to study the issue and make recommendations on ways to curb rising costs of first responder service. The firm delivered its recommendations in 2011.
IPS’s proposals, including elimination of advanced life support first responder units and replacing them with the use of larger advanced life support engines, proved unpopular. The plan to change how fire departments and fire districts would be paid for first responder services was met with stiff resistance.
In response to the IPS plan, Capt. Jim Millican with Lealman Fire Rescue and Lt. Scott Sanford, firefighter and paramedic with Palm Harbor Rescue put together an alternative plan that advocates allowing firefighters and paramedics employed at local fire departments provide ambulance service in lieu of the private company the county contracts with for exclusive transport service.
The firefighters say their plan will save money. County staff says it will cost more.
The two sides reached an impasse with both asking local state legislators to support amendments to the Special Act.
At a special meeting on Nov. 30, 2011, Sen. Jack Latvala, R-Clearwater, chair of the county’s Legislative Delegation, strongly advocated creating a committee, representing both sides, to select a nationally recognized accounting firm to operationalize, analyze and compare costs of three variations of EMS service. Latvala recommended that the county pay for the study, which had a due date for completion of July 1.
The EMS Fire Transport Evaluation Committee met on Dec. 22, 2011, and chose to do the operational study first followed by the cost analysis. According to staff notes, the committee canceled the original RFP and then worked through the county’s Purchasing Department to release a new RFP.
Former State Senator James Sebesta chaired the EMS committee and the subcommittee that evaluated the four RFP responses. Other members included St. Petersburg Mayor Bill Foster, EMS Manager Craig Hare, Pinellas Park Fire Chief Doug Lewis, Clearwater Finance Director Jay Ravins, Lealman Fire District Capt. Jim Millican and Baycare Healthcare Administrator Kelly Triolo.
Hare replaced Commissioner Karen Seel on the evaluation committee to avoid a voting conflict from serving on the committee to recommend and the commission to approve.
Cost and bidding process
The No. 1 ranked firm, Fitch and Associates, submitted a bid for $298,600. The firm ranked No. 2, Tri Data, bid $99,639. The Ludwig Group ranked No. 3. The fourth was Tindale Oliver and Associates. Only four firms bid the job.
According to Joe Lauro, county Purchasing director, the EMS committee “short listed” two of the four bidders with Fitch and Associates and Tri Data asked to give an oral presentation.
Before the oral presentation, Tri Data was on top with an average score of 808.57 to Fitch with 804.34. The next highest score was 504.36. At the end of the oral presentations, Fitch was on top with 868.57 to 798.57 for Tri Data.
Lauro said the biggest reason Tri Data came out on top before the oral presentations was cost.
Bostock said she was “dismayed” that in general the RFP process only gives price 15 percent of the bid score.
“Low cost is not dominant,” she said. “Price is not much of a factor at 15 percent.”
“This is a controversial issue,” Commissioner Ken Welch added. “I’m surprised there wasn’t much background (on bid process) prior to going into it.”
Lauro said he explained the process to the committee more than once, including the process of using an oral presentation if two firms were very close in points. He said Tri Data was only five points ahead in the end.
“Five out of 1,000 (points) is almost nothing,” he said.
“I do agree we need to move forward. The clock is ticking,” Welch said.
Nevertheless, Welch admitted there was some confusion with the issue.
“We need all to be on the same page or we’ll have problems down the road,” he said.
Sebesta admitted that the RFP process was confusing and he didn’t understand it at first.
“It took me a couple times to understand,” he said.
He also said he believed others on the committee had a hard time understanding it. Sebesta said he had expressed his concern to LaSala and county staff.
“I don’t know if it was a good way to score or not,” he said. “I’ve not had that much experience with scoring.”
Sebesta “finally did figure it out,” and said the method should help “eliminate the possibility of fraud.”
“It’s difficult to manipulate and it’s also difficult to understand. It is what it is,” he said. “Staff did an excellent job.”
He agreed that on face value, it “doesn’t make sense” to pick a bid for $300,000 over one for $99,000.
“But it did make sense,” he said. “If you watched the oral presentation, it was like night and day. The difference in the one picked is light years over the other one.”
Firefighter’s objections
“July 14th marked the one-year anniversary of this ugly process we’re in,” Sanford said.
He said while it was good that officials were starting to look more seriously at different transport methods, “absolutely do not award this bid to Fitch.”
Supporters of fire-based transport object to hiring Fitch for several reasons. The first is the firm’s history of not recommending fire-based transport.
Jay Fitch, president of Fitch and Associates, said generally his firm did not make recommendations one way or the other, but instead provides needed information so the client can make an informed choice. The firm uses software that allows data to be input to run simulations on a variety of scenarios using the same data to allow officials to compare different factors.
Sanford brought up an implied prior relationship between Fitch and Paramedics Plus, the company that contracts with the county to provide ambulance transport. Paramedics Plus and Fitch have both served as faculty at past Pinnacle EMS Leadership & Management Conferences, he said. He also mentioned that the county had objected to Tri Data due to past work for the St. Petersburg Fire Department.
Sanford questioned the bidding process, saying Hare had given Tri Data the lowest score possible, while giving Fitch and Associates the highest scores. Sanford and Millican prefer The Ludwig Group, but Sanford said Tri Data would be acceptable.
“Staff is driving the process toward Fitch,” he said. “If you pick Fitch you’re virtually killing the option for fire-based transport. If fire-based won’t work, if you pick Tri Data it will come back with the same answer.”
Commissioner Susan Latvala asked Sanford what the real problem was behind all the objections.
“Trust,” Sanford said.
“It’s not trust for us,” Latvala replied. “For us it is the budget and cost to provide the service.”
Commissioner Karen Seel said if Hare’s vote was eliminated from the process, Fitch still came out on top. Welch pointed out that St. Petersburg Mayor Foster and Pinellas Park Fire Chief Doug Lewis had scored Fitch higher.
“Sebesta said it was the best one,” Welch said.
Bostock was bogged down in trying to understand the RFP scoring process and questioned staff’s numbers. Finally, Latvala made a motion to stop discussion and call the vote. Four of seven commissioners voted in support of Latvala’s motion. Then talk moved to how many votes were needed to call the question.
Finally, Welch retracted his vote, allowing the discussion to go forward. Seel’s suggestion to take a recess was not approved. Bostock continued to question staff’s math.
“I assure you the math on this is right,” Lauro said.
Bostock then asked County Attorney Jim Bennett if there was any possibility of a legal problem if the vote went through. Soon after, Brickfield made a motion to table the matter, which was defeated 4-3 with only Bostock and Roche joining Brickfield in the vote to put the decision off to another day.
“I’d like to know how it turned out (bid vote),” Brickfield said. “It goes to all this. I want it to be a clean process.”
County administrator takes some heat
The commission took the county administrator to task. Commissioners objected to LaSala’s recommendation that Fitch limit its work to the IPS plan due to his opinion “it is the only one that merits being operationalized.”
“I’m disappointed that the recommendation only looks toward IPS,” Welch said, expressing concern that staff was not following the commission’s direction or that of local state legislators.
“I don’t like feeling like I’m playing a game of chess with my own staff,” Welch said.
The commissioner was adamant that Fitch be contracted to operationalize not only the IPS plan, the firefighter’s plan and the current process, but also other scenarios to find the best solution.
Fitch assured the commission that his firm would and could run computer simulations on other alternatives.
“It’s a transparent process all can see,” Fitch said.
He also said he understood that his “customer” is the board of county commissioners, not staff.
“We’ll look at it all objectively,” he said. “The goal is to bring people together, looking at multiple ways to do things.”
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