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HomeMy WebLinkAbout2016-02-03 e-packet@6:00 S`iPECIAL MEETING CITY COUNCIL OF THE CITY OF SOUTH SAN FRANCISCO P.O. Box 711 (City Hall, 400 Grand Avenue) South San Francisco, California 94083 Meeting to be held at: M I 7NICIPAL SERVICES 131 JILDING Council Chambers 33 ARROYO DRIVE SOT11'H SAN FRANCISCO, CA WEDNESDAY, FEBRUARY 3:, 2016 6:00 P.M. NOTICE IS HEREBY GIVEN, pursuant to Section 54956 of the Government Code of the State of California,the City Council of the City of South San Francisco will hold a Special Meeting on Wednesday, the 3 d day of February, 2016, at 6:00 P.M., in the Municipal Services Building, Council Chambers, 33 Arroyo Drive, South San Francisco, California. Purpose of tile meeting: L Call to Order. 2. Roll Call. 3. Agenda Review. 4. Public Comments—comments arc,limited to items on the Special Meeting Agenda. 5. Items for Discussion: a. A Resolution approving an Ambulance Billing Services Agreement and a Lockbox Services Agreement;and authorizing the City Manager to execute an Ambulance Billing Services Agreement with Novato Fire Protection District and a Lockbox Services Agreement with the City's current banking services provider Wells Fargo Bank,and Transition Services of ADPI,for a combined total not to exceed $294,096 for Fiscal Years FY 2015-16, FY 2016-17 and FY 2017-18; and amending the FY 2015-16 Operating Budget in the amount of$97,471. (Gerald Kohlmann, Fire Chief). 6. Adjournment. --jCrista Martin Cler�.,7� s � H L.� Staff Re ort DATE: February 3, 2016 TO: Mayor, Vice Mayor and Councilmembers FROM: Gerald K:ohlmann, Fire Chief SUBJECT: A RESOLUTION APPROVING AN AMBULANCE BILLING SERVICES AGREEMENT AND A LOCKBOX SERVICES AGREEMENT; AND AUTHORIZING THE CITY MANAGER TO EXECUTE AN AMBULANCE BILLING SERVICES AGREEMENT WITH NOVATO FIRE PROTECTION DISTRICT AND A I,OCKBOX SERVICES AGREEMENT WITH THE CITY'S CURRENT' BANKING SERVICES PROVIDER WELLS FARGO BANK, AND TRANSITION SERVICES OF ADPI, FOR A COMBINED TOTAL NOT TO :EXCEED $294,096 FOR FISCAL YEARS FY 2015-16, FY 2016-17 AND FY 2017-18; AND AMENDING THE FY 201 5-16 OPERATING BUDGET IN THE AMOUNT OF '$97,471 RECOMMENDATION It is recommended that the City Council adopt a resolution approving an ambulance billing services agreement and a lockbox services agreement; and authorizing the City Manager to execute an ambulance billing services agreement with Novato Fire Protection District and a lockbox services agreement with the City's current banking services provider Fells Fargo Bank, and transition services of ADPI for a combined total not to exceed $294,096 for fiscal years FY 2015-16, FY 2016-17 and FY 2117-18; and amending the F'Y' 2015-16 Operating Budget in the amount of$97,471. BACKGROUNDIDISCUSSION The South San Francisco Fire Department (SSFFD) has been operating its own ambulance service since the early 1970's. In 1995, due to increasing Emergency Medical Services (EMS) call volume and growing complexities with ambulance billing processes, staff saw the need to outsource billing services. As a result of the contractor selection process, City Council adopted Resolution 119-95, which executed an agreement with Allied Information and Services Corporation (AIS) for ambulance claim coding and billing. Through a series of mergers and take-overs, AIS ultimately became Advanced Data Processing, Inc. (ADPI), which is the vendor that SSFFD uses today. Followin g the 1995 agreement, new contracts with AIS were executed in 2001 and 2004. The current agreement with ADPI was executed in 2009 for an initial period of three years, and has automatically renewed each year since then. Staff recognized the time span between the contract originally approved by Council was now protracted and that the percentage-based contractor compensation had risen above the Staff Report To: Mayor, Vice Mayor and Councilmembers Re: Ambulance Billing Services Agreement Date: February 3, 2016 Page 2 threshold currently requiring Council approval. In order to address the extended time period, the value of the contractor agreement, and to explore current providers of billing services, staff generated a Request for Proposal (RFP). On September 18, 2015, SSFFD released a RFP for ambulance billing services through regular mail service and posted in the bids and RFP page of the South San Francisco websitc. Eight proposals were received by the closing date of October 16, 2015 and reviewed by fire staff consisting of Bertha Aguilar, Management Analyst; Richard Walls, EMS Captain; and Luis Da Silva, Fire Marshal. Three of the most promising proposals were forwarded to the South San Francisco Information Technology (IT) Department for their review and feedback, The three proposers were invited to an in-person interview and presentation opportunity. Components of the RFP were; • Responsiveness of the proposal related to the scope of work. • Quality, quantity and relevance of Consultant's experience,resources and creativity. • Provide list of references with at least one being a municipal reference. • Staff size and qualifications. • Fees proposed for services to be performed. • Additional information as determined by proposer. The three firms with the most promising proposals were: • Health Services Integration • Wittman Enterprises, LLC. • Novato Fire Protection District Following the interviews, staff provided additional review of each proposer's presentation materials and conducted additional research. From this process, stafff selected the Novato Fire Protection District (NFPD) to recommend to Council. Similar to South San Francisco, NFPD has five fire stations and operates their own ambulances. NFPD has a ten year ambulance billing history and currently provides billing services to seven other California fire agencies. NFPD is familiar with reimbursement programs at the State and Federal level that, as a public agency and a taxing entity, can benefit South San Francisco. NFPD staff is recognized as subject matter experts on the advancement of reimbursement programs such as the Ground Emergency Medical Transportation Program (GEMT) and Intergovernmental Transfer Program (IGT). NFPD applies fire-agency oriented processes to maximize ambulance transport revenues. The NFPD billing process consists of the standard 30, 60 and 90 day notices. NFPD is prepared to recommend other collection strategies depending upon our payment experience. Other strategies may include additional notices, or outsourcing the collection of aged accounts Staff Report To: Mayor, Vice Mayor and Councilmembers Re: Ambulance Billing Services Agreement Date: February 3, 2016 Page 3 to a third-party collections agency. The level of effort provided by U-1c collections agency can be defined by Council direction. 'CONTRACT AMOUNT, TERM AND PRICING The cost of the new ambulance billing services contract will be paid through an expense account in the fire department budget, which is offset by ambulance revenues attributed to the fire department. The expense of utilizing an ambulance billing service provider is recovered not only by their basic billing function, but through their expertise at accurately representing (coding) services delivered and their ability to collect payer information when not adequately available during the actual incidents. It is staff's assessment that NFPD has an excellent capability to perform these functions. The cost of ambulance billing as proposed by NFPD is a flat rate of $18 per patient. At an estimated number of patient transports for FY 2016-17 of 4,200, this will be an annualized cost of$75,600, which will be a total of$153,324 over the two year contract and, and $18,900 to fund the remainder of fiscal year 2017-18. Exhibit E, Billing Services Cost Breakdown, describes the cost of the agreement aligned with Fiscal Years while the contract is in effect. In our situation, flat rate billing affords three benefits over percentage-based fee structures; less cost to the city, easily tracked and audited, and is reirnbursable through GEMT for Medicaid patients. For fiscal year 14-15 and 15-16 projected ADPI costs would amount to $159,424 while NFPD would amount to $94,266. These costs are based on actual ambulance transports and revenues through October 30, 2015. The contract terrn is for two years, with an option, at the City's discretion, to renew for two additional two year terms. The standard professional services contract and a business associate agreement, required for Health Insurance Portability and Accountability Act (HIPAA) compliance are attached and have been agreed to by NFPD. FUNDING As previously noted, an RFP process has not been completed since the 1995 City Council action. Therefore funding for a new contract was not included in the FY 2015-16 Adopted Budget. Staff is requesting funding in the amount of $294,096 which covers the term, of the contract, ongoing billing services by ADPI for claims received prior to April 1, 2016; and lockbox services (see Exhibit E: Billing Services Cost table for breakdown). The City will be required to obtain a banking lockbox where all payments are mailed, received by bank staff, scanned and then deposited into the City's account. A lockbox is an industry standard requirement for billing companies to reduce the potential of fraudulent activity. The ongoing cost for the lockbox. is estimated to be $8,900. Billing and lockbox services funding will be included in the assumptions for future fiscal years as ongoing expenses. There is no net impact to the General Fund as these costs will be offset by revenues. Staff Report To: Mayor, Vice Mayor and Councilmembers Re: Ambulance Billing Services Agreement Date: February 3, 2016 Page 4 TRANSITION The current ambulance billing contractor will remain engaged in priniary billing services until the end of March 2016, at which point, the primary billing services (routing of patient care reports) will be performed by the successor contractor. The current billing contractor will continue collection efforts for open accounts where they initiated billing actions. The City of South San Francisco Finance Department (Finance) will establish additional revenue and receivable accounts for revenues generated by the successor contractor's collection actions. Billing activity from the current and successor contractor will be posted to these separate revenue and receivable accounts to track revenue sources and payment status. Finance will represent the SSFFD to expand banking services in order to provide a lockbox for South San Francisco revenues. CONCLUSION It is recommended that the City Council adopt a resolution approving an ambulance billing services agreement and a lockbox services agreement; and authorizing the City Manager to execute an ambulance billing services agreement with Novato Fire Protection District and a lockbox services agreement with the City's current banking services provider Wells Fargo Bank, and transition services of ADPI for a combined total not to exceed $294,096 for fiscal years FY 2015-16, FY 2016-17 and FY 2017-18; and amending the FY 2015-16 Operating Budget in the amount of$97,471. .............. By: Approved: Gerald KohImann ike Futrell Fire Chief City Manage Attachments: Resolution Exhibit A: Standard Contractual Services Agreement Exhibit B: Business Associate Agreement Exhibit C: NFPD Proposal Exhibit D: NFPD Compensation Requirements Exhibit E: Billing Services Breakdown Table GK:rw/bla 2593949. 1 RESOLUTION NO. CITY COUNCIL, CITY OF SOUTH SAN FRANCISCO, STAT"E OF CALIFORNIA. A RESOLUTION APPROVING AN AMBULANCE BILLING SERVICES AGREEMENT AND A LOCKBOX SERVICES AGREEMENT; AND AUTHORIZING THE CITY MANAGER TO EXECUTE AN AMBULANCE BILLING SERVICES AGREEMENT WITH NOVATO FIRE PROTECTION DISTRICT AND A LOCKBOX SERVICES AGREEMENT WITH THE CITY'S CURRENT BANKING SERVICES PROVIDER WELLS FARGO BANK, AND TRANSITION SERVICES OF ADPI, FOR A COMBINED TOTAL NOT TO EXCEED $294,096 FOR FISCAL YEARS FY 2015-16, FY 2.016-17 AND FY 2017-18; AND AMENDING THE FY 2015-16 OPERATING BUDGET IN THE AMOUNT OF $97,471 WHEREAS, the South. San. Francisco Fire Department (SSFFD) has been operating its own ambulance service since the early 1970's, and first employed paramedics in 1975; and WHEREAS, beginning in 1995, in order to accommodate increasing ambulance service volume and regulatory complexity, pursuant to Resolution 119-95 the City Council authorized an agreement with a third-party ambulance billing contractor; and WHEREAS, on September 18, 2415, SSFFD issued an ambulance billing Request for Proposal (RFP) through regular mail service and posted in the bids and RFP page of the South San Francisco website; and WHEREAS, eight responsive proposals were received by the final filing date of October 1.6, 2415, and reviewed within the fire department; and three of the most promising proposals were forwarded to the South San Francisco Information Technology Department for their technical review and feedbag:; and WHEREAS, the proposals were evaluated on the following: responsiveness of the proposal related to the scope of work; quality, quantity and relevance of consultant's experience and creativity; four references with at bast one being a municipal reference; staff qualifications; fees proposed for services to be performed; and additional information as determined by the proposer; and WHEREAS, after review of three most promising proposers' presentation materials during their interviews and after conducting additional research, staff recommends Novato Fire Protection District (NFPD) to provide the City with ambulance billing services, and WHEREAS, NFPD has provided billing services for themselves and seven other California fire agencies for ten years; and applies fire-agency oriented processes to maximize ambulance transport revenues, and 1 WHEREAS, NFPD is familiar with reimbursement programs at the State and Federal level that, as a public agency, can benefit South San Francisco; NFPD staff is recognized as subject -matter experts on the advancement of reimbursement prograrns such as the Ground Emergency Medical Transportation Program (GEMT), and WHEREAS, NFPD conducts billing operations similar to other billing providers with the standard 30, 60, and 90 day notices; NFPD is prepared to recommend other collection strategies such as additional notices, and outsourcing the collection of aged accounts to a third party collection agency which can be defined by Council direction, and WHEREAS, the cost of ambulance billing services as proposed by NFPD would be a flat rate of$18 per patient transport; and WHEREAS, staff recommends entering into a two year contract with NFPD; WHEREAS, staff expects to initiate transfer of Patient Care Reports (PCR) to NFPD's billing system beginning on April 1, 2016; and WHEREAS, staff recommends that the City continue its current relationship with Advanced Data Processing Incorporated (ADPI) to allow for a smooth transition to a new billing contractor and continue revenue collection activities for the PCRs currently in their billing queue; and WHEREAS, staff also recommends that the City's Finance Director obtain a lockbox with the City's current banking services provider; and WHEREAS, staff recommends amending the FY 2015-16 Operating Budget in the amount of $97,471 for continued billing activity by ADPI, transmittal of all PCRs to NFPD starting on April 1, and setup of a lockbox; and WHEREAS, funding for FY 2016-17 is anticipated at an amount of$109,500 which will pay for continued collection activity prior to April 1, 2016 by ADPI, monthly dues for use of a lockbox and full billing and revenue collection activities by NFPD (as shown in exhibit A); and WHEREAS, funding needs for FY 2017-18 will be $87,125, which will close the ADPI collection cycle, and be the second contract year with NFPD as well as continued lockbox monthly service fees. NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of South San Francisco hereby takes the following actions: 1. Authorizes the City Manager to enter into a two year ambulance billing services agreement with Novato Fire Protection District (NFPD) at a flat cost of $18 per transport in a sum not to exceed $153,324, subject to approval as to form by the City Attorney. 2 2, Authorizes the Finance Director to engage tockbox services with the City's current banking Services provider Wells Fargo Bank. 3. Authorizes the expense of a combined total of $294,096 over the life of the ambulance billing contract for services with FPD, Setup and monthly fees of banking lockbox and a continued relationship with ADP 1. 4. Authorizes a budget amendment to the FY 15-16 Operaing Budget in the amount of $97,471 to provide for continued billing activity by AL) I, transmittal of all PCRs to NFPD starting on April 1, and the setup of a lockbox with Wells Fargo Bank. 5. Authorizes the City Manager to take any other related actions consistent with the intent of this Resolution. I hereby certify that the foregoing Resolution was introduced aiad adopted by the City Council of the City of South San Francisco at a special meeting held oil the 3rd day of February, 2016, by the following vote: AYES: NOES: ABSTAIN: ABSENT: ATTEST: City Clerk 25971.74.1 3 NFPD #6138-011316 Staff Report - Exhibit A CONSULTING SERVICES AGREEMENT BETWEEN THE CITY OF SOUTH SAN FRANCISCO AND NOVATO FIRE PROTECTION DISTRICT FOR AMBULANCE BILLING SERVICES THIS AGREEMENT for consulting services is made by and between the City of South San Francisco ("City") and Novato Fire Protection District("Consultant") (together sometimes referred to as the "Parties") as of February 3,2016 (the"Effective Date"). Section 1. SERVICES. Subject to the terms and conditions set forth in this Agreement, Consultant shall provide to City the services described in the Scope of Work attached as Exhibit C, attached hereto and incorporated herein, at the time and place and in the manner specified therein. In the event of a conflict in or inconsistency between the terms of this Agreement and Exhibit C, the Agreement shall prevail. 1.1 Term of Services. The term of this Agreement shall begin on March 1, 2016 and shall end on March 30, 2018 the date of completion specified in Exhibit C, and Consultant shall complete the work described in Exhibit C prior to that date, unless the term of the Agreement is otherwise terminated or extended, as provided for in Section 8. The time provided to Consultant to complete the services required by this Agreement shall not affect the City's right to terminate the Agreement,as provided for in Section 8. 1.2 Standard of Performance. Consultant shall perform all services required pursuant to this Agreement in the manner and according to the standards observed by a competent practitioner of the profession in which Consultant is engaged in the geographical area in which Consultant practices its profession. Consultant shall prepare all work products required by this Agreement in a substantial, first-class manner and shall conform to the standards of quality normally observed by a person practicing in Consultant's profession. 1.3 Assignment of Personnel. Consultant shall assign only competent personnel to perform services pursuant to this Agreement. In the event that City, in its sole discretion, at any time during the term of this Agreement, desires the reassignment of any such persons, Consultant shall, immediately upon receiving notice from City of such desire of City, reassign such person or persons. 1.4 Time. Consultant shall devote such time to the performance of services pursuant to this Agreement as may be reasonably necessary to meet the standard of performance provided in Sections 1.1 and 1.2 above and to satisfy Consultant's obligations hereunder. Section 2. COMPENSATION. City hereby agrees to pay Consultant at a flat rate of$18 per transport in a sum not to exceed $153,324 notwithstanding any contrary indications that may be contained in Consultant's proposal, for services to be performed and reimbursable costs incurred under this Agreement. In the event of a conflict between this Agreement and Consultant's proposal, attached as Exhibit C, regarding the amount of compensation, the Agreement shall prevail. City shall pay Consultant for services rendered pursuant to this Agreement at the time and in the manner set forth herein. The payments specified below shall be the only payments from City to Consultant for services rendered pursuant to this Agreement. Consultant shall submit all invoices to City in the manner specified herein. Except as specifically authorized by City, Consultant shall not bill City for duplicate services performed by more than one person. Consultant and City acknowledge and agree that compensation paid by City to Consultant under this Agreement is based upon Consultant's estimated costs of providing the services required hereunder, including salaries and Consulting Services Agreement between [Rev2.132014] Executed:February 3,2016 City of South San Francisco and Novato Fire Protection District Page 1 of 22 1 NFPD #6138-011316 Staff Report - Exhibit A benefits of employees and subcontractors of Consultant. Consequently, the parties further agree that compensation hereunder is intended to include the costs of contributions to any pensions and/or annuities to which Consultant and its employees, agents, and subcontractors may be eligible. City therefore has no responsibility for such contributions beyond compensation required under this Agreement. 2.1 Invoices. Consultant shall submit invoices, not more often than once per month during the term of this Agreement, based on the cost for services performed and reimbursable costs incurred prior to the invoice date. Invoices shall contain the following information: • Serial identifications of progress bills(i.e., Progress Bill No. 1 for the first invoice, etc.); • The beginning and ending dates of the billing period; • A task summary containing the original contract amount, the amount of prior billings, the total due this period, the balance available under the Agreement, and the percentage of completion; • At City's option, for each work item in each task, a copy of the applicable time entries or time sheets shall be submitted showing the name of the person doing the work, the hours spent by each person, a brief description of the work, and each reimbursable expense; • The total number of hours of work performed under the Agreement by Consultant and each employee, agent, and subcontractor of Consultant performing services hereunder, as well as a separate notice when the total number of hours of work by Consultant and any individual employee, agent, or subcontractor of Consultant reaches or exceeds eight hundred (800) hours, which shall include an estimate of the time necessary to complete the work described in Exhibit C; • The amount and purpose of actual expenditures for which reimbursement is sought; • The Consultant's signature. 2.2 Monthly Payment. City shall make monthly payments, based on invoices received, for services satisfactorily performed, and for authorized reimbursable costs incurred. City shall have thirty (30) days from the receipt of an invoice that complies with all of the requirements above to pay Consultant. City shall have no obligation to pay invoices submitted ninety(90)days past the performance of work or incurrence of cost. 2.3 Final Payment. City shall pay the last ten percent (10%) of the total sum due pursuant to this Agreement within sixty (60) days after completion of the services and submittal to City of a final invoice, if all services required have been satisfactorily performed. 2.4 Total Payment. City shall pay for the services to be rendered by Consultant pursuant to this Agreement. City shall not pay any additional sum for any expense or cost whatsoever incurred by Consultant in rendering services pursuant to this Agreement. City shall make no payment for any extra, further, or additional service pursuant to this Agreement. In no event shall Consultant submit any invoice for an amount in excess of the maximum amount of compensation provided above either for a task or for the entire Agreement, unless the Agreement is modified prior to the submission of such an invoice by a properly executed change order or amendment. 2.6 Payment of Taxes. Consultant is solely responsible for the payment of employment taxes incurred under this Agreement and any similar federal or state taxes. Contractor represents and warrants that Contractor is a resident of the State of California in accordance with California Revenue & Taxation Code Consulting Services Agreement between [Rev2.132014] Executed:February 3,2016 City of South San Francisco and Novato Fire Protection District Page 2 of 22 2 NFPD #6138-011316 Staff Report - Exhibit A Section 18662, as may be amended, and is exempt from withholding. Contractor accepts sole responsible for verifying the residency status of any subcontractors and withhold taxes from non-California subcontractors as required by law. 2.7 Payment upon Termination. In the event that the City or Consultant terminates this Agreement pursuant to Section 8, the City shall compensate the Consultant for all outstanding costs and reimbursable expenses incurred for work satisfactorily completed as of the date of written notice of termination. Consultant shall maintain adequate logs and timesheets in order to verify costs incurred to that date. 2.8 Authorization to Perform Services. The Consultant is not authorized to perform any services or incur any costs whatsoever under the terms of this Agreement until receipt of authorization from the Contract Administrator. Section 3. INSURANCE REQUIREMENTS. Before beginning any work under this Agreement, Consultant, at its own cost and expense, unless otherwise specified below, shall procure the types and amounts of insurance listed below against claims for injuries to persons or damages to property that may arise from or in connection with the performance of the work hereunder by the Consultant and its agents, representatives, employees, and subcontractors. Consistent with the following provisions, Consultant shall provide Certificates of Insurance, attached hereto and incorporated herein as Exhibit B, indicating that Consultant has obtained or currently maintains insurance that meets the requirements of this section and under forms of insurance satisfactory, in all respects, to the City. Consultant shall maintain the insurance policies required by this section throughout the term of this Agreement. The cost of such insurance shall be included in the Consultant's bid. Consultant shall not allow any subcontractor to commence work on any subcontract until Consultant has obtained all insurance required herein for the subcontractor(s). 4.1 Workers' Compensation. Consultant shall, at its sole cost and expense, maintain Statutory Workers' Compensation Insurance and Employer's Liability Insurance for any and all persons employed directly or indirectly by Consultant. The Statutory Workers' Compensation Insurance and Employer's Liability Insurance shall be provided with limits of not less than ONE MILLION DOLLARS ($1,000,000) per accident. In the alternative, Consultant may rely on a self-insurance program to meet those requirements, but only if the program of self-insurance complies fully with the provisions of the California Labor Code. Determination of whether a self-insurance program meets the standards of the Labor Code shall be solely in the discretion of the Contract Administrator(as defined in Section 10.9). The insurer, if insurance is provided, or the Consultant, if a program of self-insurance is provided, shall waive all rights of subrogation against the City and its officers, officials, employees,and volunteers for loss arising from work performed under this Agreement. 4.2 Commercial General and Automobile Liability Insurance. 4.2.1 General requirements. Consultant, at its own cost and expense, shall maintain commercial general and automobile liability insurance for the term of this Agreement in an amount not less than ONE MILLION DOLLARS ($1,000,000.00) per occurrence, combined single limit coverage for risks associated with the work contemplated by this Agreement. If a Commercial General Liability Insurance or an Automobile Liability form or other form with a general aggregate limit is used, either the general aggregate limit shall apply separately to the work to be performed under this Agreement or the general aggregate limit shall be at least twice the required occurrence limit. Such coverage shall include but shall not be limited to, protection against claims arising from bodily and personal injury, including death resulting there from, and damage to property resulting from activities contemplated under this Agreement, including the use of owned and non-owned automobiles. Consulting Services Agreement between [Rev2.132014] Executed:February 3,2016 City of South San Francisco and Novato Fire Protection District Page 3 of 22 3 NFPD #6138-011316 Staff Report - Exhibit A 4.2.2 Minimum scope of coverage. Commercial general coverage shall be at least as broad as Insurance Services Office Commercial General Liability occurrence form CG 0001 or GL 0002 (most recent editions) covering comprehensive General Liability and Insurance Services Office form number GL 0404 covering Broad Form Comprehensive General Liability. Automobile coverage shall be at least as broad as Insurance Services Office Automobile Liability form CA 0001 (ed. 12/90) Code 8 and 9. No endorsement shall be attached limiting the coverage. 4.2.3 Additional requirements. Each of the following shall be included in the insurance coverage or added as a certified endorsement to the policy: a. The insurance shall cover on an occurrence or an accident basis, and not on a claims-made basis. b. Any failure of Consultant to comply with reporting provisions of the policy shall not affect coverage provided to City and its officers, employees, agents, and volunteers. 4.3 Professional Liability Insurance. 4.3.1 General requirements. Consultant, at its own cost and expense, shall maintain for the period covered by this Agreement professional liability insurance for licensed professionals performing work pursuant to this Agreement in an amount not less than ONE MILLION DOLLARS ($1,000,000) covering the licensed professionals' errors and omissions. Any deductible or self-insured retention shall not exceed ONE HUNDRED FIFTY THOUSAND DOLLARS $150,000 per claim. 4.3.2 Claims-made limitations. The following provisions shall apply if the professional liability coverage is written on a claims-made form: a. The retroactive date of the policy must be shown and must be before the date of the Agreement. b. Insurance must be maintained and evidence of insurance must be provided for at least five (5) years after completion of the Agreement or the work, so long as commercially available at reasonable rates. C. If coverage is canceled or not renewed and it is not replaced with another claims-made policy form with a retroactive date that precedes the date of this Agreement, Consultant must provide extended reporting coverage for a minimum of five (5)years after completion of the Agreement or the work. The City shall have the right to exercise, at the Consultant's sole cost and expense, any extended reporting provisions of the policy, if the Consultant cancels or does not renew the coverage. d. A copy of the claim reporting requirements must be submitted to the City prior to the commencement of any work under this Agreement. 4.4 All Policies Requirements. 4.4.1 Acceptability of insurers. All insurance required by this section is to be placed with insurers with a Bests' rating of no less than A:VII. 4.4.2 Verification of coverage. Prior to beginning any work under this Agreement, Consultant shall furnish City with complete copies of all policies delivered to Consultant by the insurer, including complete copies of all endorsements attached to those policies. All copies of policies and certified endorsements shall show the Consulting Services Agreement between [Rev2.132014] Executed:February 3,2016 City of South San Francisco and Novato Fire Protection District Page 4 of 22 4 NFPD #6138-011316 Staff Report - Exhibit A signature of a person authorized by that insurer to bind coverage on its behalf. If the City does not receive the required insurance documents prior to the Consultant beginning work, it shall not waive the Consultant's obligation to provide them. The City reserves the right to require complete copies of all required insurance policies at any time. 4.4.3 Notice of Reduction in or Cancellation of Coverage. A certified endorsement shall be attached to all insurance obtained pursuant to this Agreement stating that coverage shall not be suspended, voided, canceled by either party, or reduced in coverage or in limits, except after thirty (30) days' prior written notice by certified mail, return receipt requested, has been given to the City. In the event that any coverage required by this section is reduced, limited, cancelled, or materially affected in any other manner, Consultant shall provide written notice to City at Consultant's earliest possible opportunity and in no case later than ten (10) working days after Consultant is notified of the change in coverage. 4.4.4 Additional insured; primary insurance. City and its officers, employees, agents, and volunteers shall be covered as additional insureds with respect to each of the following: liability arising out of activities performed by or on behalf of Consultant, including the insured's general supervision of Consultant; products and completed operations of Consultant, as applicable; premises owned, occupied, or used by Consultant; and automobiles owned, leased, or used by the Consultant in the course of providing services pursuant to this Agreement. The coverage shall contain no special limitations on the scope of protection afforded to City or its officers, employees, agents, or volunteers. A certified endorsement must be attached to all policies stating that coverage is primary insurance with respect to the City and its officers, officials, employees and volunteers, and that no insurance or self-insurance maintained by the City shall be called upon to contribute to a loss under the coverage. 4.4.5 Deductibles and Self-Insured Retentions. Consultant shall disclose to and obtain the approval of City for the self-insured retentions and deductibles before beginning any of the services or work called for by any term of this Agreement. Further, if the Consultant's insurance policy includes a self-insured retention that must be paid by a named insured as a precondition of the insurer's liability, or which has the effect of providing that payments of the self-insured retention by others, including additional insureds or insurers do not serve to satisfy the self-insured retention, such provisions must be modified by special endorsement so as to not apply to the additional insured coverage required by this agreement so as to not prevent any of the parties to this agreement from satisfying or paying the self-insured retention required to be paid as a precondition to the insurer's liability. Additionally, the certificates of insurance must note whether the policy does or does not include any self-insured retention and also must disclose the deductible. During the period covered by this Agreement, only upon the prior express written authorization of Contract Administrator, Consultant may increase such deductibles or self-insured retentions with respect to City, its officers, employees, agents, and volunteers. The Contract Administrator may condition approval of an increase in deductible or self-insured retention levels with a requirement that Consultant procure a bond, guaranteeing payment of losses and related investigations, claim administration, and defense expenses that is satisfactory in all respects to each of them. 4.4.6 Subcontractors. Consultant shall include all subcontractors as insureds under its policies or shall furnish separate certificates and certified endorsements for each subcontractor. All coverages for subcontractors shall be subject to all of the requirements stated herein. 4.4.7 Wasting Policy. No insurance policy required by Section 4 shall include a "wasting" policy limit. Consulting Services Agreement between [Rev2.132014] Executed:February 3,2016 City of South San Francisco and Novato Fire Protection District Page 5 of 22 5 NFPD #6138-011316 Staff Report - Exhibit A 4.4.8 Variation. The City may approve a variation in the foregoing insurance requirements, upon a determination that the coverage, scope, limits, and forms of such insurance are either not commercially available, or that the City's interests are otherwise fully protected. 4.5 Remedies. In addition to any other remedies City may have if Consultant fails to provide or maintain any insurance policies or policy endorsements to the extent and within the time herein required, City may, at its sole option exercise any of the following remedies, which are alternatives to other remedies City may have and are not the exclusive remedy for Consultant's breach: a. Obtain such insurance and deduct and retain the amount of the premiums for such insurance from any sums due under the Agreement; b. Order Consultant to stop work under this Agreement or withhold any payment that becomes due to Consultant hereunder, or both stop work and withhold any payment, until Consultant demonstrates compliance with the requirements hereof; and/or c. Terminate this Agreement. Section 5. INDEMNIFICATION AND CONSULTANT'S RESPONSIBILITIES. Consultant shall indemnify, defend with counsel selected by the City, and hold harmless the City and its officials, officers, employees, agents, and volunteers from and against any and all losses, liability, claims, suits, actions, damages, and causes of action arising out of any personal injury, bodily injury, loss of life, or damage to property, or any violation of any federal, state, or municipal law or ordinance, to the extent caused, in whole or in part, by the willful misconduct or negligent acts or omissions of Consultant or its employees, subcontractors, or agents, by acts for which they could be held strictly liable, or by the quality or character of their work. The foregoing obligation of Consultant shall not apply when (1) the injury, loss of life, damage to property, or violation of law arises wholly from the gross negligence or willful misconduct of the City or its officers, employees, agents, or volunteers and (2) the actions of Consultant or its employees, subcontractor, or agents have contributed in no part to the injury, loss of life, damage to property, or violation of law. It is understood that the duty of Consultant to indemnify and hold harmless includes the duty to defend as set forth in Section 2778 of the California Civil Code. Acceptance by City of insurance certificates and endorsements required under this Agreement does not relieve Consultant from liability under this indemnification and hold harmless clause. This indemnification and hold harmless clause shall apply to any damages or claims for damages whether or not such insurance policies shall have been determined to apply. By execution of this Agreement, Consultant acknowledges and agrees to the provisions of this Section and that it is a material element of consideration. In the event that Consultant or any employee, agent, or subcontractor of Consultant providing services under this Agreement is determined by a court of competent jurisdiction or the California Public Employees Retirement System (PERS) to be eligible for enrollment in PIERS as an employee of City, Consultant shall indemnify, defend, and hold harmless City for the payment of any employee and/or employer contributions for PIERS benefits on behalf of Consultant or its employees, agents, or subcontractors, as well as for the payment of any penalties and interest on such contributions,which would otherwise be the responsibility of City. Section 6. STATUS OF CONSULTANT. 6.1 Independent Contractor. At all times during the term of this Agreement, Consultant shall be an independent contractor and shall not be an employee of City. City shall have the right to control Consultant only Consulting Services Agreement between [Rev2.132014] Executed:February 3,2016 City of South San Francisco and Novato Fire Protection District Page 6 of 22 6 NFPD #6138-011316 Staff Report - Exhibit A insofar as the results of Consultant's services rendered pursuant to this Agreement and assignment of personnel pursuant to Subparagraph 1.3; however, otherwise City shall not have the right to control the means by which Consultant accomplishes services rendered pursuant to this Agreement. Notwithstanding any other City, state, or federal policy, rule, regulation, law, or ordinance to the contrary, Consultant and any of its employees, agents, and subcontractors providing services under this Agreement shall not qualify for or become entitled to, and hereby agree to waive any and all claims to, any compensation, benefit, or any incident of employment by City, including but not limited to eligibility to enroll in the California Public Employees Retirement System (PERS) as an employee of City and entitlement to any contribution to be paid by City for employer contributions and/or employee contributions for PIERS benefits. 6.2 Consultant No Agent. Except as City may specify in writing, Consultant shall have no authority, express or implied, to act on behalf of City in any capacity whatsoever as an agent or to bind City to any obligation whatsoever. Section 7. LEGAL REQUIREMENTS. 7.1 Governinq Law. The laws of the State of California shall govern this Agreement. 7.2 Compliance with Applicable Laws. Consultant and any subcontractors shall comply with all laws applicable to the performance of the work hereunder. 7.3 Other Governmental Regulations. To the extent that this Agreement may be funded by fiscal assistance from another governmental entity, Consultant and any subcontractors shall comply with all applicable rules and regulations to which City is bound by the terms of such fiscal assistance program. 7.4 Licenses and Permits. Consultant represents and warrants to City that Consultant and its employees, agents, and any subcontractors have all licenses, permits, qualifications, and approvals, including from City, of what-so-ever nature that are legally required to practice their respective professions. Consultant represents and warrants to City that Consultant and its employees, agents, any subcontractors shall, at their sole cost and expense, keep in effect at all times during the term of this Agreement any licenses, permits, and approvals that are legally required to practice their respective professions. In addition to the foregoing, Consultant and any subcontractors shall obtain and maintain during the term of this Agreement valid Business Licenses from City. 7.5 Nondiscrimination and Equal Opportunity. Consultant shall not discriminate, on the basis of a person's race, religion, color, national origin, age, physical or mental handicap or disability, medical condition, marital status, sex, or sexual orientation, against any employee, applicant for employment, subcontractor, bidder for a subcontract, or participant in, recipient of, or applicant for any services or programs provided by Consultant under this Agreement. Consultant shall comply with all applicable federal, state, and local laws, policies, rules, and requirements related to equal opportunity and nondiscrimination in employment, contracting, and the provision of any services that are the subject of this Agreement, including but not limited to the satisfaction of any positive obligations required of Consultant thereby. Consultant shall include the provisions of this Subsection in any subcontract approved by the Contract Administrator or this Agreement. Section 8. TERMINATION AND MODIFICATION. Consulting Services Agreement between [Rev2.132014] Executed:February 3,2016 City of South San Francisco and Novato Fire Protection District Page 7 of 22 7 NFPD #6138-011316 Staff Report - Exhibit A 8.1 Termination. City may cancel this Agreement at any time and without cause upon written notification to Consultant. Consultant may cancel this Agreement for cause upon 30 days' written notice to City and shall include in such notice the reasons for cancellation. In the event of termination, Consultant shall be entitled to compensation for services performed to the date of notice of termination; City, however, may condition payment of such compensation upon Consultant delivering to City all materials described in Section 9.1. 8.2 Extension. City may, in its sole and exclusive discretion, extend the end date of this Agreement beyond that provided for in Subsection 1.1. Any such extension shall require a written amendment to this Agreement, as provided for herein. Consultant understands and agrees that, if City grants such an extension, City shall have no obligation to provide Consultant with compensation beyond the maximum amount provided for in this Agreement. Similarly, unless authorized by the Contract Administrator, City shall have no obligation to reimburse Consultant for any otherwise reimbursable expenses incurred during the extension period. 8.3 Amendments. The parties may amend this Agreement only by a writing signed by all the parties. 8.4 Assignment and Subcontracting. City and Consultant recognize and agree that this Agreement contemplates personal performance by Consultant and is based upon a determination of Consultant's unique personal competence, experience, and specialized personal knowledge. Moreover, a substantial inducement to City for entering into this Agreement was and is the professional reputation and competence of Consultant. Consultant may not assign this Agreement or any interest therein without the prior written approval of the Contract Administrator. Consultant shall not assign or subcontract any portion of the performance contemplated and provided for herein, other than to the subcontractors noted in the proposal, without prior written approval of the Contract Administrator. 8.5 Survival. All obligations arising prior to the termination of this Agreement and all provisions of this Agreement allocating liability between City and Consultant shall survive the termination of this Agreement. 8.6 Options upon Breach by Consultant. If Consultant materially breaches any of the terms of this Agreement, City's remedies shall include, but not be limited to, the following: 8.6.1 Immediately terminate the Agreement; 8.6.2 Retain the plans, specifications, drawings, reports, design documents, and any other work product prepared by Consultant pursuant to this Agreement; 8.6.3 Retain a different consultant to complete the work described in Exhibit A not finished by Consultant; or 8.6.4 Charge Consultant the difference between the cost to complete the work described in Exhibit A that is unfinished at the time of breach and the amount that City would have paid Consultant pursuant to Section 2 if Consultant had completed the work. Section 9. KEEPING AND STATUS OF RECORDS. Consulting Services Agreement between [Rev2.132014] Executed:February 3,2016 City of South San Francisco and Novato Fire Protection District Page 8 of 22 8 NFPD #6138-011316 Staff Report - Exhibit A 9.1 Records Created as Part of Consultant's Performance. All reports, data, maps, models, charts, studies, surveys, photographs, memoranda, plans, studies, specifications, records, files, or any other documents or materials, in electronic or any other form, that Consultant prepares or obtains pursuant to this Agreement and that relate to the matters covered hereunder shall be the property of the City. Consultant hereby agrees to deliver those documents to the City upon termination of the Agreement. It is understood and agreed that the documents and other materials, including but not limited to those described above, prepared pursuant to this Agreement are prepared specifically for the City and are not necessarily suitable for any future or other use. City and Consultant agree that, until final approval by City, all data, plans, specifications, reports and other documents are confidential and will not be released to third parties without prior written consent of both parties unless required by law. 9.2 Consultant's Books and Records. Consultant shall maintain any and all ledgers, books of account, invoices, vouchers, canceled checks, and other records or documents evidencing or relating to charges for services or expenditures and disbursements charged to the City under this Agreement for a minimum of three (3) years, or for any longer period required by law, from the date of final payment to the Consultant to this Agreement. 9.3 Inspection and Audit of Records. Any records or documents that Section 9.2 of this Agreement requires Consultant to maintain shall be made available for inspection, audit, and/or copying at any time during regular business hours, upon oral or written request of the City. Under California Government Code Section 8546.7, if the amount of public funds expended under this Agreement exceeds TEN THOUSAND DOLLARS ($10,000.00), the Agreement shall be subject to the examination and audit of the State Auditor, at the request of City or as part of any audit of the City, for a period of three (3)years after final payment under the Agreement. 9.4 Records Submitted in Response to an Invitation to Bid or Request for Proposals.All responses to a Request for Proposals (RFP) or invitation to bid issued by the City become the exclusive property of the City. At such time as the City selects a bid, all proposals received become a matter of public record, and shall be regarded as public records, with the exception of those elements in each proposal that are defined by Consultant and plainly marked as "Confidential," "Business Secret"or"Trade Secret." The City shall not be liable or in any way responsible for the disclosure of any such proposal or portions thereof, if Consultant has not plainly marked it as a "Trade Secret" or "Business Secret," or if disclosure is required under the Public Records Act. Although the California Public Records Act recognizes that certain confidential trade secret information may be protected from disclosure, the City may not be in a position to establish that the information that a prospective bidder submits is a trade secret. If a request is made for information marked "Trade Secret" or "Business Secret," and the requester takes legal action seeking release of the materials it believes does not constitute trade secret information, by submitting a proposal, Consultant agrees to indemnify, defend and hold harmless the City, its agents and employees, from any judgment, fines, penalties, and award of attorneys fees awarded against the City in favor of the party requesting the information, and any and all costs connected with that defense. This obligation to indemnify survives the City's award of the contract. Consultant agrees that this indemnification survives as long as the trade secret information is in the City's possession, which includes a minimum retention period for such documents. Section 10 MISCELLANEOUS PROVISIONS. Consulting Services Agreement between [Rev2.132014] Executed:February 3,2016 City of South San Francisco and Novato Fire Protection District Page 9 of 22 9 NFPD #6138-011316 Staff Report - Exhibit A 10.1 Attorneys' Fees. If a party to this Agreement brings any action, including arbitration or an action for declaratory relief, to enforce or interpret the provision of this Agreement, the prevailing party shall be entitled to reasonable attorneys' fees in addition to any other relief to which that party may be entitled. The court may set such fees in the same action or in a separate action brought for that purpose. 10.2 Venue. In the event that either party brings any action against the other under this Agreement, the parties agree that trial of such action shall be vested exclusively in the state courts of California in the County San Mateo or in the United States District Court for the Northern District of California. 10.3 Severability. If a court of competent jurisdiction finds or rules that any provision of this Agreement is invalid, void, or unenforceable, the provisions of this Agreement not so adjudged shall remain in full force and effect. The invalidity in whole or in part of any provision of this Agreement shall not void or affect the validity of any other provision of this Agreement. 10.4 No Implied Waiver of Breach. The waiver of any breach of a specific provision of this Agreement does not constitute a waiver of any other breach of that term or any other term of this Agreement. 10.5 Successors and Assigns. The provisions of this Agreement shall inure to the benefit of and shall apply to and bind the successors and assigns of the parties. 10.6 Use of Recycled Products. Consultant shall prepare and submit all reports, written studies and other printed material on recycled paper to the extent it is available at equal or less cost than virgin paper. 10.7 Conflict of Interest. Consultant may serve other clients, but none whose activities within the corporate limits of City or whose business, regardless of location, would place Consultant in a "conflict of interest," as that term is defined in the Political Reform Act, codified at California Government Code Section 81000 et seq. Consultant shall not employ any City official in the work performed pursuant to this Agreement. No officer or employee of City shall have any financial interest in this Agreement that would violate California Government Code Sections 1090 et seq. Consultant hereby warrants that it is not now, nor has it been in the previous twelve (12) months, an employee, agent, appointee, or official of the City. If Consultant was an employee, agent, appointee, or official of the City in the previous twelve (12) months, Consultant warrants that it did not participate in any manner in the forming of this Agreement. Consultant understands that, if this Agreement is made in violation of Government Code §1090 et.seq., the entire Agreement is void and Consultant will not be entitled to any compensation for services performed pursuant to this Agreement, including reimbursement of expenses, and Consultant will be required to reimburse the City for any sums paid to the Consultant. Consultant understands that, in addition to the foregoing, it may be subject to criminal prosecution for a violation of Government Code § 1090 and, if applicable,will be disqualified from holding public office in the State of California. 10.8 Solicitation. Consultant agrees not to solicit business at any meeting, focus group, or interview related to this Agreement, either orally or through any written materials. 10.9 Contract Administration. This Agreement shall be administered by Gerald Kohlmann, Fire Chief ("Contract Administrator"). All correspondence shall be directed to or through the Contract Administrator or his or her designee. Consulting Services Agreement between [Rev2.132014] Executed:February 3,2016 City of South San Francisco and Novato Fire Protection District Page 10 of 22 10 NFPD #6138-011316 Staff Report - Exhibit A 10.10 Notices. All notices and other communications which are required or may be given under this Agreement shall be in writing and shall be deemed to have been duly given (i) when received if personally delivered; (ii) when received if transmitted by telecopy, if received during normal business hours on a business day (or if not, the next business day after delivery) provided that such facsimile is legible and that at the time such facsimile is sent the sending Party receives written confirmation of receipt; (iii) if sent for next day delivery to a domestic address by recognized overnight delivery service (e.g., Federal Express); and (iv) upon receipt, if sent by certified or registered mail, return receipt requested. In each case notice shall be sent to the respective Parties as follows: Consultant: Battalion Chief Peterson Novato Fire Protection District 95 Rowland Way Novato, CA 94945 City: Fire Chief Gerald Kohlmann EMS Captain Rich Walls 480 North Canal Street 480 North Canal Street South San Francisco, CA 94080 South San Francisco, CA 94080 10.11 Professional Seal. Where applicable in the determination of the contract administrator, the first page of a technical report, first page of design specifications, and each page of construction drawings shall be stamped/sealed and signed by the licensed professional responsible for the report/design preparation. The stamp/seal shall be in a block entitled "Seal and Signature of Registered Professional with report/design responsibility,"as in the following example. Seal and Signature of Registered Professional with report/design responsibility. 10.12 Integration. This Agreement, including all Exhibits attached hereto, and incorporated herein, represents the entire and integrated agreement between City and Consultant and supersedes all prior negotiations, representations,or agreements, either written or oral pertaining to the matters herein. 10.13 Counterparts. This Agreement may be executed in multiple counterparts, each of which shall be an original and all of which together shall constitute one agreement. 10.14 Construction. The headings in this Agreement are for the purpose of reference only and shall not limit or otherwise affect any of the terms of this Agreement. The parties have had an equal opportunity to participate in the drafting of this Agreement; therefore any construction as against the drafting party shall not apply to this Agreement. Consulting Services Agreement between [Rev2.132014] Executed:February 3,2016 City of South San Francisco and Novato Fire Protection District Page 11 of 22 11 NFPD #6138-011316 Staff Report - Exhibit A The Parties have executed this Agreement as of the Effective Date. CITY OF SOUTH SAN FRANCISCO Consultants City Manager, Mike Futrell Novato Fire Protection District Attest: Krista Martinelli, City Clerk Approved as to Form: City Attorney 2514799.1 Consulting Services Agreement between [Rev2.132014] Executed:February 3,2016 City of South San Francisco and Novato Fire Protection District Page 12 of 22 12 NFPD #E138-011316 Staff Report- Exhibit A Contract- Exhibit A EXHIBIT A Business Associate Agreement Consulting Services Agreement between City of South San Francisco and Novato Fire Protection District-Exhibit A Page 13 of 22 13 NFPD #E138-011316 Staff Report- Exhibit A Contract- Exhibit B EXHIBIT B INSURANCE CERTIFICATES Consulting Services Agreement between City of South San Francisco and Novato Fire Protection District-Exhibit B Page 14 of 22 14 NFPD #E138-011316 Staff Report- Exhibit A Contract- Exhibit C Exhibit C SCOPE OF SERVICES Statement of Work: This documents the mutual understanding of the Parties as to the scope of services contemplated by the Parties hereto commencing on April 1, 2016 and completing on March 30, 2018. A. Objective: The objective of this project is to maximize the timely collection of revenue due from the provision of emergency medical services provided by the City. Furthermore, the objective is to provide for continuing review and improvement to the overall billing process. It is the intent of the Parties that they shall make all reasonable efforts to collect for any emergency medical services provided by the City to residents or nonresidents of the City. Consultant, in the course of identifying payment sources and a patient's ability to pay for services, shall approach patients in a courteous, sensitive and professional manner. Consultant shall follow the City's established policies / practices regarding the direct billing of residents of the City. B. Project organization: The basic project organization shall be: DISTRICT PROJECT MANAGER, in cooperation with the CITY PROJECT MANAGER, shall provide and oversee an integrated billing process for emergency medical services within the City. Through the use of the Consultant's staff, Consultant shall process the patient care report forms through a data processing system in order to produce invoicing and corresponding reports. Through the use of Consultant's staff, Consultant shall post all monies received by the City and produce the necessary balance billing, account registers and accounting documents as outlined for the City. The City will identify and maintain the `lock box account' that the Consultant will post all monies to. C. Project staffing: Staffing for the project shall be the responsibility of Consultant. The CITY shall provide sufficient liaison personnel time to insure that report information is received by the Consultant on a regular and timely basis. D. Outline of authorized work: Consultant shall produce invoicing (billing) for all qualified emergency medical responses within the City, with corresponding completed report forms. Consultant shall produce cumulative and detailed accounts receivable reports in generally accepted Consulting Services Agreement between City of South San Francisco and Novato Fire Protection District-Exhibit C Page 15 of 22 15 NFPD#E138-011316 Staff Report- Exhibit accounting format. Invoicing and/or reports shall be produced on a monthly basis or in such other time frame as mutually agreed. Consultant shall provide all necessary personnel, equipment and products necessary for producing said invoicing and reports. Consultant shall review and make recommendations, for change, if necessary, with respect to current report forms content, data collection procedures therefore and billing amounts for related services. Consultant shall serve as the City representative in negotiation for payments with various Health Maintenance Organizations, Preferred Provider Organizations, and Medicare / Medi-Cal. Consultant shall provide on-site training for the City personnel relating to proper billing information procedures at City's request. Consultant shall utilize TRITECH Software as a means to receive ambulance billing information. E. Deliverables: Consultant shall produce and cause delivery of all invoices, statements and reports as required. (See list of reports in Section F-4). In addition, Consultant shall provide City with a report on its review of the report form, billing amounts and other items. This report shall be provided to City no later than sixty (60) days after the commencement of the contract. Consultant believes they will improve the billing process for service. F. Work Plan: To accomplish the objective, authorized work, and deliverables of this Scope of Services the following is agreed upon as the necessary action steps: 1. Action Steps The following is an outline of steps to be taken by Consultant and City: a) On a minimum time frame of twice per week, City will provide to the Consultant a report of all calls that generated Ambulance Order numbers in the Data system within the City. b) On a minimum time frame of twice per week, Consultant will receive and screen via TRITECH the Patient Care report forms for ambulance billing information within City. c) On a minimum time frame of twice per week, Consultant staff shall compare the Ambulance Order report generated and provided by City with the information received from TRITECH and report missing Patient Care Report information to City. d) Consultant staff shall input all pertinent data to Consultant data processing system. Consulting Services Agreement between City of South San Francisco and Novato Fire Protection District-Exhibit C Page 16 of 22 16 NFPD#E138-011316 Staff Report- Exhibit e) Consultant staff shall process the accounts and produce statements, invoices and reports as required. f) City shall receive all payments due and forward facsimiles (photocopies) of the deposit information to Consultant staff on a routine basis. g) Consultant shall post or credit the monies which City receives on accounts and shall produce all corresponding reports and balance billing. h) Consultant will meet at least monthly with CITY PROJECT MANAGER or designee to discuss the project process and to review the projects reports. 2. Review Points Consultant and City will review local demographic data and actual costs and Consultant will make recommendations for change in billing procedures if necessary. 3. City Participation City will provide a billing liaison person during normal business hours to Consultant. 4. Reports Accounts Established Report: Commencing April 1, 2016, and thereafter by the 10th of the month, City may request a report listing of all accounts established in the system for the previous month or any specified period. This listing will include the following: • Alphabetized order by Patient name • Account Number • Date of Service • Total Charges Charge Summary Report: Commencing May 1, 2016, and thereafter by the 10th of the month a report listing of a summary of all charges by type of service for the previous month will be delivered to the City. Credit Summary Report: Commencing May 1, 2016 >, and thereafter by the 10th of the month a report listing of a summary of all payments received by type of payer for the previous month will be delivered to the City. Charge Adjustments Report: Commencing May 1, 2016, and thereafter by the 10th of the month a report listing of a summary of all charge adjustments made by type of service for the previous month will be delivered to the City. Credit Adjustments Report: Commencing May 1, 2016 and thereafter by the 10th of the month a report listing of a summary of all payment adjustments made by type of payer for the previous month will be delivered to the City. Consulting Services Agreement between City of South San Francisco and Novato Fire Protection District-Exhibit C Page 17 of 22 17 NFPD#E138-011316 Staff Report- Exhibit Closing Balance Summary: Commencing May 1, 2016, and thereafter by the 10th of the month a report listing the beginning balance, charges, credits, and adjustments, and the ending balance for the previous month will be delivered to the City. Paver Aging Report: Commencing July 1, 2016, and thereafter by the 10th of the month a report listing each type of payer showing amounts owed by due date status. The due dates should be in monthly increments for four months, followed by a two month period, followed by accounts over 180 days will be delivered to the City. The line item reserved for patients being billed should only include direct bill patients that are actually billed based on City policies and practices. Paver Summary Report: Commencing July 1, 2016 for the period of April 1, 2016 through June 30, 2016 and thereafter by the 10th of the month following the end of a calendar quarter a report summarizing the number of calls, charges, adjustments, and payments by payer type will be delivered to the City Non Active Accounts: Commencing August 1, 2016 and thereafter by the 10th of the month a report detailing accounts that have had no activity or response for 120 days will be identified and delivered to the City. RENUMERATION PROVISIONS A. DISTRICT: DISTRICT, commencing on May 1, 2016, will invoice City on a Monthly basis on the 1st of the Month for payment as described in the Consulting Services Agreement dated January 27, 2016. B. CITY: City, commencing on May 1, 2016, will forward payments to the Consultant no later than thirty (30) days after receipt of invoices for services. Consulting Services Agreement between City of South San Francisco and Novato Fire Protection District-Exhibit C Page 18 of 22 18 NFPD #E138-011316 Staff Report - Exhibit B Contract- Exhibit A South r nci Fire Department Business i Agreement Between South r nci sco Fire Department and Novato it Protection District ........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... This Business Associate Agreement ("Agreement") between South San Francisco Fire Department and Novato Fire Protection District is executed to ensure that Novato Fire Protection District will appropriately safeguard protected health information ("PHI") that is created, received, maintained, or transmitted on behalf of South San Francisco Fire Department in compliance with the applicable provisions of Public Law 104-191 of August 21, 1996, known as the Health Insurance Portability and Accountability Act of 1996, Subtitle F — Administrative Simplification, Sections 261, et seq., as amended ("HIPAA"), and with Public Law 111-5 of February 17, 2009, known as the American Recovery and Reinvestment Act of 2009, Title XII, Subtitle D — Privacy, Sections 13400, et seq., the Health Information Technology and Clinical Health Act, as amended (the "HITECH Act"). A. General Provisions 1. Meaning of Terms. The terms used in this Agreement shall have the same meaning as those terms defined in HIPAA. 2. Regulatory References. Any reference in this Agreement to a regulatory section means the section currently in effect or as amended. 3. Interpretation. Any ambiguity in this Agreement shall be interpreted to permit compliance with HIPAA. B. Obligations of Business Associate Novato Fire Protection District agrees that it will: 1. Not use or further disclose PHI other than as permitted or required by this Agreement or as required by law; 2. Use appropriate safeguards and comply, where applicable, with the HIPAA Security Rule with respect to electronic protected health information ("e-PHI") and implement appropriate physical, technical and administrative safeguards to prevent use or disclosure of PHI other than as provided for by this Agreement; 3. Report to South San Francisco Fire Department any use or disclosure of PHI not provided for by this Agreement of which it becomes aware, including any security incident (as defined in the HIPAA Security Rule) and any breaches of unsecured PHI as required by 45 CFR §164.410. Breaches of unsecured PHI shall be Consulting Services Agreement between City of South San Francisco and Novato Fire Protection District—Exhibit A Page 19 of 22 19 NFPD #E138-011316 Staff Report- Exhibit B Contract- Exhibit A reported to South San Francisco Fire Department without unreasonable delay but in no case later than 60 days after discovery of the breach; 4. In accordance with 45 CFR 164.502(e)(1)(ii) and 164.308(b)(2), ensure that any subcontractors that create, receive, maintain, or transmit PHI on behalf of Novato Fire Protection District agree to the same restrictions, conditions, and requirements that apply to Novato Fire Protection District with respect to such information; 5. Make PHI in a designated record set available to South San Francisco Fire Department and to an individual who has a right of access in a manner that satisfies South San Francisco Fire Department's obligations to provide access to PHI in accordance with 45 CFR §164.524 within 30 days of a request; 6. Make any amendment(s) to PHI in a designated record set as directed by South San Francisco Fire Department, or take other measures necessary to satisfy South San Francisco Fire Department's obligations under 45 CFR §164.526; 7. Maintain and make available information required to provide an accounting of disclosures to South San Francisco Fire Department or an individual who has a right to an accounting within 60 days and as necessary to satisfy South San Francisco Fire Department's obligations under 45 CFR §164.528; 8. To the extent that Novato Fire Protection District is to carry out any of South San Francisco Fire Department's obligations under the HIPAA Privacy Rule, Novato Fire Protection District shall comply with the requirements of the Privacy Rule that apply to South San Francisco Fire Department when it carries out that obligation; 9. Make its internal practices, books, and records relating to the use and disclosure of PHI received from, or created or received by Novato Fire Protection District on behalf of South San Francisco Fire Department, available to the Secretary of the Department of Health and Human Services for purposes of determining Novato Fire Protection District and South San Francisco Fire Department's compliance with HIPAA and the HITECH Act; 10. Restrict the use or disclosure of PHI if South San Francisco Fire Department notifies Novato Fire Protection District of any restriction on the use or disclosure of PHI that South San Francisco Fire Department has agreed to or is required to abide by under 45 CFR §164.522; and 11. If South San Francisco Fire Department is subject to the Red Flags Rule (found at 16 CFR §681.1 et seq.), Novato Fire Protection District agrees to assist South San Francisco Fire Department in complying with its Red Flags Rule obligations by: (a) implementing policies and procedures to detect relevant Red Flags (as defined under 16 C.F.R. §681.2); (b) taking all steps necessary to comply with the policies and procedures of South San Francisco Fire Department's Identity Consulting Services Agreement between City of South San Francisco and Novato Fire Protection District-Exhibit A Page 20 of 22 20 NFPD #E138-011316 Staff Report- Exhibit B Contract- Exhibit A Theft Prevention Program; (c) ensuring that any agent or third party who performs services on its behalf in connection with covered accounts of South San Francisco Fire Department agrees to implement reasonable policies and procedures designed to detect, prevent, and mitigate the risk of identity theft; and (d) alerting South San Francisco Fire Department of any Red Flag incident (as defined by the Red Flag Rules) of which it becomes aware, the steps it has taken to mitigate any potential harm that may have occurred, and provide a report to South San Francisco Fire Department of any threat of identity theft as a result of the incident. C. Permitted Uses and Disclosures by Business Associate The specific uses and disclosures of PHI that may be made by Novato Fire Protection District on behalf of South San Francisco Fire Department include: 1. The preparation of invoices to patients, carriers, insurers and others responsible for payment or reimbursement of the services provided by South San Francisco Fire Department to its patients; 2. Preparation of reminder notices and documents pertaining to collections of overdue accounts; 3. The submission of supporting documentation to carriers, insurers and other payers to substantiate the healthcare services provided by South San Francisco Fire Department to its patients or to appeal denials of payment for the same; and 4. Other uses or disclosures of PHI as permitted by HIPAA necessary to perform the services that Novato Fire Protection District has been engaged to perform on behalf of South San Francisco Fire Department. D. Termination 1. South San Francisco Fire Department may terminate this Agreement if South San Francisco Fire Department determines that Novato Fire Protection District has violated a material term of the Agreement. 2. If either party knows of a pattern of activity or practice of the other party that constitutes a material breach or violation of the other party's obligations under this Agreement, that party shall take reasonable steps to cure the breach or end the violation, as applicable, and, if such steps are unsuccessful, terminate the Agreement if feasible. 3. Upon termination of this Agreement for any reason, Novato Fire Protection District shall return to South San Francisco Fire Department or destroy all PHI received from South San Francisco Fire Department, or created, maintained, or received by Novato Fire Protection District on behalf of South San Francisco Fire Department that Novato Fire Protection District still maintains in any form. Novato Fire Protection District shall retain no copies of the PHI. If return or Consulting Services Agreement between City of South San Francisco and Novato Fire Protection District-Exhibit A Page 21 of 22 21 NFPD #E138-011316 Staff Report- Exhibit B Contract- Exhibit A destruction is infeasible, the protections of this Agreement will extend to such PHI. Agreed to this day of , 2016. South San Francisco Fire Department Novato Fire Protection District Signature: Signature: Title: Title: Date: Date: Consulting Services Agreement between City of South San Francisco and Novato Fire Protection District-Exhibit A Page 22 of 22 22 Staff Report- Exhibit C VA NOVATO FIRE PROTECTION DISTRICT EMS Ambulance Billing Services RFP SUBMITTAL j i aiu . SAW F'"J� r +' ,o "y7rr 'Swu %'� w FIRE REQUEST FOR PROPOSAL (RFP) EMS Ambulance Billing Services SUBMITTAL DEADLINE Date: October 16, 2015 Time: 3:OOPM prevailing time Location: City of South San Francisco Fire Department Administration Attn: Management Analyst, Bertha Aguilar 480 N Canal Street South San Francisco, CA 94080 ORIGINAL 23 OVAT Staff Report - Exhibit C NOVATO FIRE PROTECTION DISTRICT "FABLE OF CONTENTS A. Statement of Qualifications........................................................................................................3 B. Detailed Presentation of Tasks.................................................................................................1 l C. Compensation Requirements ...................................................................................................15 1111. Contract Exceptions.................................................................................................................16 Em APPENDIX..............................................................................................................................17 Exhibit 1: Personnel resumes Exhibit 2: EMS Billing Process Flowchart; confidential and proprietary information D; y of South Sain I�'ir� ndsco )epai tirn en L� IIrrrNm ll nce I[�pl,lllhng Seiivuces acto r 2 o 25 24 OVAT Staff Report - Exhibit C NOVATO FIRE PROTECTION DISTRICT a. Emergency Medical Services (EMS) Billing Department Firm Name: Novato Fire Protection District Site: Administration Building Address: 95 Rowland Way, Novato CA 94945 Telephone: 415-878-2690 Facsimile: 415-878-2660 b. Overview Background. The Novato Fire Protection District (District) is presided over by a Board of Directors which serves in staggered four-year terms and consists of five elected community members. The Board of Directors appoints the Fire Chief who is responsible for the day-to-day operations of the District, and who oversees all District Divisions, Operations, Administration, and Fire Loss Management. At present, the District facility consists of six sites; one administrative building and five fire stations as shown in the table below. TABLE 1: CURRENT FACILITY Site Address Administration Building 95 Rowland Way, Novato CA 94945 Fire Station 61 7025 Redwood Blvd., Novato CA 94945 Fire Station 62 450 Atherton Ave., Novato CA 94945 Fire Station 63 65 San Ramon Way, Novato CA 94945 Fire Station 64 319 Enfrente Rd., Novato CA 94949 Fire Station 65 5 Bolling Cir., Novato CA 94949 EMS Billing Services Once the District had established its own fully operational EMS Billing Services Division (Division) in 2005, it began to see increased revenue as a result of those efforts. The program became so successful that word began to circulate in the community and soon the District was entering into Joint Powers Agreements with other fire service agencies for outside assistance with their Ambulance and/or First Responder billing. Each agency utilizing these services has stated that they realized increased revenue of at least 25% beyond what their previous contracted billing services provider had been retrieving for them. They have also stated that their customer service needs were being met far better with our services than with their previous service provider. Over the past ten years, the Division has had an opportunity to fine tune its processes and procedures regarding many aspects of billing services, including, but not limited to, the following: Billing; receivables; debt collection; integration/support of client ePCR applications; production of itemized billing statements based on client data and fee schedules; detail-oriented research and follow up regarding PCR data; monthly reporting on Dty of South Sain I�'ir ndsco )epai tirn in L� IIrrrNm ll nce I[pl'lllhng Seiivuces acto r 3 o 25 25 OVAT Staff Report - Exhibit C NOVATO FIRE PROTECTION DISTRICT current/delinquent accounts; payment posting; refund processing; quarterly analyses; in-service training; coordination of disputed claim; excellent communication with both internal and external customers. Even the Division's Cost Report was approved by the DHS and CMS as a template document for the GEMT program, and members of the Division have been sought after as a subject matter expert for presentations at events such as the International Association of Fire Chiefs Annual EMS Conference, Cal Fire Chiefs Association Annual Conference, and CFED West Annual Conference. The Division currently provides enhanced EMS Billing services to six fire service agencies in the Northern California area. c. Staffing EMS Billing Organizational Chart m ® m dda Contact Information District Liaison to District Alternate Ted Peterson Shannon Wager Battalion Chief EMS Billing Analyst 1petersonLnovatofire.org swa er ,novatofire.org 415.878.2690 415.878.2690 Hours of Operation Monday—Friday 8:OOam-5:OOpm (Pacific Time) EMS Billing Services 800 Number: 855.222.8848 C Ly of South Sain I:ranc.isc.a I ire I epaitmen I imlau.a anc� e I[3,H ng `^ev t e e y of Z5 26 OVAT Staff Report - Exhibit C NOVATO FIRE PROTECTION DISTRICT Director of EMS: Battalion Chief Ted Peterson (one at 20%; this is a median value as involvement will range from 10%-80% depending on the stage of the project). See Appendix: Exhibit 1 Essential Functions Knowledge/Shills/Abilities Planning, organizing, budgeting and strategy of Excellent written and verbal skills with the EMS Billing Services Division while demonstrated experience in conveying detailed supporting the organizational priorities and policies and procedures; EMS System Delivery; values of the District; member of a high Ambulance Billing; EMS Education and performing Chief Officer team; model the Fire Training; Public Access Defibrillator Program; Chief's established mission, vision, goals and Wellness Fitness Initiative; Workers objectives; overall medical oversight, Compensation; Recruitment; Public Education; supervision, and performance evaluation; Hiring; Physical Resources; organizational recruitment program development; revenue vision; leadership; analysis; teamwork increase and grant applications (where possible); Minimum Position Qualifications instruction in EMS topics at annual fire service BA Business Administration; Paramedic (and other) conferences; oversight of ongoing Certification; EMT Certification; 10 years of intensive personnel training and experience with the fire service for 10 years; management/procurement of state of the art 10-15 years of managerial experience in equipment for enhanced District service to the emergency medical services community; ongoing oversight and management Preferred Position Qualifications of training and certification for EMS Billing MA Business Administration Services Division employees EMS Billing Manager: Shannon Wager (one at 70%). See Appendix: Exhibit 1 Essential Functions Knowledge/Shills/Abilities Manage up to seven (7)individuals and the Excellent written and verbal skills with billing system; reliable attendance is vital to the demonstrated experience in conveying detailed success of the division;participate in Quality policies and procedures; online payer systems Improvement activities including audits,peer such as, Medi-Cal, UGS (Medicare), and review and data collection activities;participate others; coding and compliance;policies and in continuing-education activities as student, procedures; MS Office—Basic to Intermediate instructor, and proctor; serve as a company Minimum Position Qualifications representative promoting positive customer High School diploma or GED equivalent; three relationships through proactive involvement in (3) years ambulance billing; managerial public business and community activities; follow experience; expertise with Medicare, Medi-Cal up on denials and appeals on claims when and commercial billing needed; serve as a resource for facilities having Preferred Position Qualifications questions about billing to federal funded Over three(3) years in hospital/ambulance agencies; ensure that all government guidelines billing; AA/AS in a related field and one year are being followed during the billing process; of experience in administrative analysis or serve as a mediator to resolve conflict within the operations or an equivalent combination of department and other duties as required/assigned education and experience; expertise in TriTech/tevixMD software; Certified Professional Coder(CPC) D; y of South Sain I�'ir ndsco )epai tirn en L� IIrrrNm ll nce Seiivuces 1 acto r 5 of 25 27 OVAT Staff Report - Exhibit C NOVATO FIRE PROTECTION DISTRICT Administrative Clerk: TBD/Agency* (one at 100%) Essential Functions Knowledge/Skills/Abilities Input EMS reports on the computer; prepare and Accounting principles and procedures, HIPAA mail ambulance bills to customers including guidelines and requirements, medical terms; gathering billing data; enter data on computer, correct English usage, arithmetic, general office review EMS reports and fee schedules to obtain practices; basic knowledge of MS Office billing amounts, and print billing notices; ability (Word, Excel) and use of computer equipment; to deal well with upset people; contact with other proper accounting procedures with regard to departments; furnish and obtain information; use ambulance billing payables and receivables of general office equipment; follow established Minimum Position Qualifications accounting policies and procedures; monitor High School Diploma or GED; at least six staff office area; straighten up area if needed; months of accounting, business or related provide back-up coverage and assist in daily training; one year of related work experience; office routine; takes Meeting minutes; monitor may substitute additional experience for and maintain staff office equipment/Orders office required education supplies; follow written and verbal instructions, Preferred Position Qualifications and other duties as assigned Medical coding certification, experience and skills Supervisor/Payment Poster: TBD/Agency* (one at 100%) Essential Functions Knowledge/Skills/Abilities Supervise five(5) EMS billing personnel Basic math skills; basic money handling skills; (Payment Poster 2, Collection Specialists 1 & 2, basic knowledge of the patient accounting Charge Clerks 1 & 2); review PCRs and PCS for system; familiarity with EOBs; analytical and accuracy and completion; receive payments from problem-solving skills; ability to type 45 the Cashier's representatives throughout the WPM; ten key by touch hospital, third party payer lockbox and mail Minimum Position Qualifications correspondence; accurately post payments and High School Diploma or GED; one to two adjustments to accounts in the patient accounting years health care business office experience or system on a daily basis (including unidentified related field required payments); research and respond by telephone and Preferred Position Qualifications in writing to patient inquiries regarding billing AA Business/Management; MS Office— issues and problems, and other duties as assigned Intermediate Level experience Payment Poster: TBD/Agency* (one at 100%) Essential Functions Knowledge/Skills/Abilities Receive payments; accurately post payments and Basic math skills; basic money handling skills; adjustments to accounts on a daily basis basic knowledge of the patient accounting (including unidentified payments); balance all system; familiarity with EOBs; analytical and payments and transactions on a daily basis; problem-solving skills; ability to type 45 process billings to patients and third party WPM; ten key by touch reimbursement claims; process patient statements, Minimum Position Qualifications key data,post transactions, and verify accuracy of High School Diploma or GED; one to two input to reports generated; resubmit claims as years medical billing & accounting experience necessary; D; y of South Sain I�'ir ndsco )epai tirn en L� IIrrrNm ll nce Seiivuces 1 acto r 6 of 25 28 OVAT Staff Report - Exhibit C NOVATO FIRE PROTECTION DISTRICT Essential Functions, Cont'd Preferred Position Qualifications receive and receipt cash items and third party AA Accounting; MS Office—Intermediate level reimbursements;post and reconcile payments to experience patient ledgers; duties as assigned Charge Clerk: TBD/Agency* (two at 100% each) Essential Functions Knowledge/Skills/Abilities Bill all primary third party claims on the Effective written and verbal communication electronic billing system, or,print to paper if skills; knowledge of computer software appropriate, with necessary edits to ensure programs and use of basic office equipment; compliant billing practices; report any variances analytical and problem-solving skills; ten key in workload to the Supervisor; review claims for by touch required; type 45 WPM; current accuracy and completeness and provide medical terminology, medical documentation, documentation required for complete billing; CPT/HCPCS coding, hospital billing, and accurately document claim mail date to reflect insurance processing requirements;prior certified vs. overnight delivery (for manual experience with charge entry, charge and chart claims) on the collection audit trail of each auditing and other services in the hospital account to initiate follow-up process; identify setting is a plus; it is necessary to be a good recurring errors and corrections being made to problem solver, be detail oriented and possess claims and report these to the Supervisor; make the ability to multi-task is necessary recommendations to resolve problems; complete Minimum Position Qualifications all secondary billing and rebilling; ensure required High School Diploma or GED; one to two attachments, such as remittance advices or years' health care business office experience explanation of benefit forms, are appropriately or related field required; medical management attached, if required; assist staff members and computer applications patients in addressing patient inquiries or billing Preferred Position Qualifications inconsistencies; other duties as assigned Five years ambulance billing and medical terminology preferred; bilingual English/Spanish; coursework in health information management, medical coding, or health care operations is a plus; Collections Specialist: TBD/Agency* (two at 100% each) Essential Functions Knowledge/Skills/Abilities Perform telephone collections based on work files Working knowledge of insurances -PPO, assigned for self-pay accounts; verify and update EPOS, HMO, Medicare, Medi-Cal, Indemnity, patient demographics and insurance on existing Workers' Compensation; must possess patient accounts (if appropriate); file claims for excellent customer service and communication rebilling and follow-up with insurance companies; skills along with good math skills; ability to resolve inquiries, complaints and concerns read, understand and follow verbal and/or regarding charges/account discrepancies; track written instructions; strong ability to interact and communicate collection issues within the and communicate with people over the patient account using standard abbreviations; bill telephone, often in stressful situations; medical appropriate insurance companies using electronic insurance claims procedures and and paper claim forms; make adjustments to documentation; type 40-50 WPM, accounts as necessary; D; y of South Sain I�'ir ndsco )epai Pornen L� IIrrrNm ll nce Seiivuces 1 acto r l of 25 29 OVAT Staff Report - Exhibit C NOVATO FIRE PROTECTION DISTRICT Essential Functions, Cont'd Knowledge/Shills/Abilities, Cont'd prepare lists of delinquent accounts for collection; possess computer skills: Internet Explorer, receive and handle telephone calls and walk-in Microsoft Outlook, Microsoft Word and public; compile information; prepare reports; Microsoft Excel; ability to navigate Health work bankruptcy accounts when applicable; file Plan websites; working knowledge of paperwork and monitor payment for deceased computerized registration, billing and patients with the patient's estate;prepare patient collection procedures; familiarity with ICD-9 refunds and adjustment requests, when applicable; and CPT coding prepare charge correction paperwork for account Additional Requirements charges/billing discrepancies, as needed; Excellent attendance record; work at additional tasks as assigned by maintaining a cooperative working supervisor/manager. relationship with staff and clinical departments; maintains organizational, employee and patient confidentiality at all times. Minimum Position Qualifications High School Diploma or GED; two to three years medical group practice or hospital billing and/or collection experience required The following apply to all applicable positions: Aye-Related Competencies: Human development knowledge/skills-ability to work with patients of all ages and provide an explanation of payer benefits; Age-specific patient needs that employee is required to understand and meet-patient may require voice elevation, repetitive information and require understanding Information Management: Treat all information and data within the scope of the position with appropriate confidentiality and security; respect the dignity, confidentiality and privacy of patients Risk Management: Cooperates fully in all risk management activities and investigations * These individuals will be sourced using a nationally recognized service provider (Agency) which specializes in providing temporary medical billing personnel for both short and long-term contracts. Individual requirements will be based on the scope of services for each position as noted above. The Agency will provide personnel with certifications and qualifications equivalent to our current EMS billing personnel; Agency employees are already trained and certified to current EMS billing practices and procedures. This eliminates the need for any District training prior to beginning of the contract with the District. District EMS Billing personnel will provide training specific to the use of our current EMS billing software. This training will be done "on the job" after the beginning of the contract with the District. D; y of South Sain I�'ir ndsco )epai tirn en L� IIrrrNm ll nce Seiivuces 1 acto r 8 of 25 30 OVAT Staff Report - Exhibit C NOVATO FIRE PROTECTION DISTRICT d. Relevant Experience: Ambulance Billing/Collection Reporting/Analytical Services In May 2005, the District created its own in-house ambulance billing division, under the direction of the Emergency Medical Services Director, Battalion Chief Ted Peterson. The ambulance billing division bills insurance companies, government medical coverage plans, and/or patients for ambulance transport, advanced life support and basic life support services. The rates that the District collects are federally regulated and adopted by the District's Board of Directors. In August of 2010, the District delivered a presentation on first responder billing to the Sacramento Metropolitan Fire Protection District (Sac Metro). That fire agency implemented the recommended District strategies and realized a six million dollar ($6,000,000)increase in ambulance revenue for fiscal year 2011/2012. To date, seven (7) fire service agencies have entered into a Joint Powers Agreement (JPA)with the District to collect their ambulance funds and for the past ten (10) years, the District has demonstrated that its ability to focus on process, and ability to structure rates has led to an increase in revenue of at least 25% for each fire service agency to which it has provided EMS Billing Services. For the past ten years the District has been successfully providing billing services for its own EMS Division as well as for those of other fire service agencies. As such, the District has gained a competitive edge in the business of EMS billing services with strategically priced bill rates, honed skills in conducting the billing process, and the provision of excellent customer service to its current fire service agency clientele. It will continue to utilize its current EMS Billing policies, procedures and strategies which have proven to be effective and successful. In addition, the District maintains awareness of emerging trends regarding State and Federal reimbursement opportunities via daily newsletters, as well as webinars, seminars and conferences. The District has the unique experience of being one of only two fire agencies that have negotiated with both the State Department of Health Care Services and the Federal Centers for Medicare/Medicaid Services on items of reimbursement to fire service agencies. With a strong focus on attention to detail, excellent communication skills, and ongoing maintenance of experienced billing staff, the team dedicated to the District for EMS Billing Services will become a strong resource for the District's management team. D; y of South Sain I�'ir ndsco )epai tirn en L� IIrrrNm ll nce Seiirvuzce 1:r age 9 of 25 31 OVAT Staff Report - Exhibit C NOVATO FIRE PROTECTION DISTRICT d. Relevant Experience: Ambulance Billing/Collection Reporting/Analytical Services References Client Name: Corte Madera Fire Department Address: 342 Tamalpais Drive, Corte Madera, CA 94925 Contact Information: Roger Sprehn, Fire Chief 415-927-5197 /rsprehnaummail.om To/From: 2007 -Present Service Type; Size: Ambulance; 1200 transport All Service Deadlines Met: Yes Gross Collection Rates: 45.55% Net Collection Rates: 93.39% Extras Added After the Contract: None Client Name: City of Albany Fire Department Address: 1000 San Pablo Ave, Albany, CA 94706 Contact Information: Lance Calkins, Fire Chief 510-528-5770 /lcalkinsa,alban cog To/From: 2008 -Present Service Type; Size: Ambulance/First Responder; 1200 transport All Service Deadlines Met: Yes Gross Collection Rates: 40.30% Net Collection Rates: 88.21% Extras Added After the Contract: None Client Name: City of Sanger Fire Department Address: 17007 1h Street, Sanger, CA 93657 Contact Information: Greg Tarascou, Fire Chief 559-875-6568 / ue�zta,ci.sanzer.ca.us To/From: 2014 -Present Service Type; Size: Ambulance/First Responder; 2400 transports All Service Deadlines Met: Yes Gross Collection Rates: 23.32% Net Collection Rates: 69.32% Extras Added After the Contract: None Client Name: Kingsburg Fire Department Address: 1460 Marion Ave, Kingsburg, CA 93631 Contact Information: Tim Ray, Fire Chief 559-897-6531/ FireChiefa.cityofkin s �z-ca.gov To/From: 2015 -Present Service Type; Size: Ambulance/First Responder; 1500 transports All Service Deadlines Met: Yes Gross Collection Rates: 44.97% Net Collection Rates: 92.53% Extras Added After the Contract: None D; y of South Sain I�'ir ndsco )epai tirn en L� IIrrrNm ll nce I[pl'lllhng Seiirvuzce ge 1I of 25 32 OVAT Staff Report - Exhibit C NOVATO FIRE PROTECTION DISTRICT B DETAILED PRESENTATION OF TASKS* The Novato Fire Protection District (District) exists to care for, protect and serve its communities. This is its Mission Statement and the philosophy that governs its actions. The California fire service is one of the communities it belongs to, and serves; as a result, the District's EMS Billing Services Division is always interested in assisting other fellow fire agencies to maximize revenues and provide excellent customer service without losing sight of the fact that the patients served are people, not numbers on a page. The City's requirements will be translated into a"complete and accurate design document" with the creation of a Standard Operating Procedures Manual specific to the City's project needs and goals; the final product will include the required scope of services as identified in the RFP document, as well as any other requirements discussed during the contractual negotiation process. EMS Billing Services Process (Proprietary and Confidential) A flowchart outlining the District's EMS Billing Services process may be found in the Appendix, Exhibit 2; note that this information is not to be copied and/or distributed for any reason. Account Write Off Procedure (Proprietary and Confidential) 1. District identifies accounts with no activity for 90 days i.e. returned mail, Patient or Insurance stopped making payments 2. District sends list to City to identify accounts to be placed elsewhere i.e. Collection Agency, County 3. City sends account list to District which identifies what account goes where (2-week turnaround) 4. District will forward all accounts that are deemed to go to the Collection Agency 5. District will note all other accounts as written off as bad debt in the billing system 6. Collection Agency will send list back to District which they can identify and District will verify balance owed 7. District will write off all Collection Agency accounts in the billing system Records Maintenance 1. Files The District maintains EMS Billing Services files using electronic and paper storage both on- and off-site. 2. Record Retention The District retains EMS Billing Services records for seven (7) years. None. Do of South Sain I�'ir nd sco )o pal tirn en L� IIrrrNm ll nc e �ueiivv c E ge II 1I d25 33 OVAT Staff Report - Exhibit C NOVATO FIRE PROTECTION DISTRICT The District would require the City to complete the Medicare packet; assist with connection of EPCR to District office, set up a lockbox account and assist with introductions to local hospital IT staff. Identify the accounts to be written off, sent to collections and process refund requests within 30 days of notice. The EMS Billing Manager is a Certified Ambulance Compliance Officer (CACO) by the National Academy of Ambulance Coding (NAAC). All ambulance billers are Certified Ambulance Coders (CAC) by NAAC as well. The EMS Billing Manager and Team Leads conduct audits of the coders to assure compliance to National standards. In addition, the District is audited on an annual basis by an independent outside agency; during the external audit the EMS Billing division participates. Of note it has received a CAFR award for the past seven (7)years. All audits would be open to the City; the District will partner with the City to make adjustments over the life of the agreement in order to maximize revenue for the City. The Novato Fire Protection District offers medical billing services only to Fire Agencies and does so at cost. The District process is not computer driven solely as some vendors are. The EPCRs are individually read by our subject matter experts to be sure to maximize and capture every procedure available. The City should not lose revenue because a Firefighter Paramedic forgot to check a box. The District truly looks at medical billing for Fire Agencies as a service we provide in the same manner as we look at mutual aid for fire suppression. We have developed an expertise and are willing to share the resources within the Fire community. The District is the recognized subject matter expert on the Ground Emergency Medical Transportation (GEMT) Program and has use both Certified Public Expenditures (CPE) and Intergovernmental Transfer (IGT) Programs to capture revenue for the Fire Service. The District is the only Consultant/Firm that negotiated with the California Department of Healthcare Services (DHCS), the Federal Centers for Medicare and Medicaid Services (CMS) as well as created legislation, lobbied at the State Capital, testified for legislation all to gain access to Federal monies for the California Fire Service. The District taught the classes throughout California during the role out of the GEMT Program. The District engages the Incident Command System (ICS) to manage enhanced and expanded EMS billing services. Utilization of this process for large scale projects has enabled the District to set industry standards in efficacy due to its implementation for project management. Using the ICS, separation of duties/tasks by subject matter expert, i.e. Payment Poster, Collections Specialist, Charge Clerk, Supervisor, etc. allows for the strategic completion of each part of the D; y of South Sain I�'ir ndsco )epai tirn en L� IIrrrNm ll nce Seiirvuzce ge 12 d25 34 OVAT Staff Report - Exhibit C NOVATO FIRE PROTECTION DISTRICT process. This allows the Manager and Director to step in only when needed should a routine issue require escalation to a higher level of authority and provides these individuals with more time for oversight and management of the project. The system is designed to review all needs of a project, with clear authority, tight controls and responsibilities, and specific timelines. For example, use of the ICS facilitated the District's ability to complete the accreditation process in nine (9) months; a task which usually takes at least two (2) years for other agencies. The software program used by the District offers the ability to run many types of reports in a standard format. All requirements listed in the Scope of Services, Item 2. a. through m. with the exception of 1. (Meeting Attendance; see below) are standard to most, if not all, billing software programs. The District can offer customization of certain reports in-house and always has the option to order a customized report directly from the software program vendor. Meeting Attendance The District is a recognized leader in medical billing within the Fire Service and as such will assign a subject matter expert to attend all meetings with the City. iaa ii i o ii iii o 0 o is The District retains all records for a minimum of the required seven (7) years. They are kept on site and digitally in the `cloud' in two separate locations. The onsite materials are digitized and copies kept in an offsite location. A. The District asks for a 90-day window to migrate all billing and collection services. The cutover time allows also the ePCR to be mapped to our billing software. District recommends to the City to select a date to cutover and all new bills created from that date moving forward be sent to District. The current Consultant would retain all accounts prior to that date and be expected to work those accounts for 90 days. B. During the 90 days District would assist the City in completing a new Medicare packet which is needed any time billing companies are switched. The plan would be as stated in Item 8 above but reversed. The District has a good track record, up and down the state, of analyzing a Fire Agency's data and finding ways to be more efficient and to maximize revenue. Although software can run reports, it is more important to understand the `why' of an issue in order to change behaviors. The District understands the Fire Service culture because we live it on a daily basis. After analyzing and D; y of South Sain I�'ir ndsco )epai tirn en L� IIrrrNm ll nce Seiirvuzce ge II 3 of 25 35 OVAT Staff Report - Exhibit C NOVATO FIRE PROTECTION DISTRICT trending data we can see what changes can be made to the documentation process from the field and can, and do, come out and conduct training to the Firefighters as to the `why' this piece of data is important to them. We know that once the Firefighters understand or see the `why' compliance or behavior change comes much easier. *Proposal document missing Item 3 (l,2,4,5,6,7,8,9,10, 11); sections renumbered accordingly (l,2,3,4,5,6,7,8,9,10) Do y of South Sain I�'ir nd sco )o pai tirn en L� IIrrrNm ll nc e �ueiivv c E ge II 4 d25 36 OVAT Staff Report - Exhibit C NOVATO FIRE PROTECTION DISTRICT C Compensation Requirements Per the RFP submittal requirements, reference separate, sealed envelope plainly marked "Compensation Proposal for Ambulance Billing Services". D; y of South Sain I�'ir� ndsco )epai tirn en L� IIrrrNm ll nce Seiir�vuzce ge 1 5 of 25 37 OVAT Staff Report - Exhibit C NOVATO FIRE PROTECTION DISTRICT D Contract Exceptions None at this time D; y of South Sain I�'ir� ndsco )epai tirn en L� IIrrrNm ll nce Seiir�vuzce ge 1I of 25 38 OVAT Staff Report - Exhibit C NOVATO FIRE PROTECTION DISTRICT E Appendix - Exhibit 1: Personnel resumes - Exhibit 2: EMS Billing Process Flowchart; proprietary District information D; y of South Sain I�'ir� ndsco )epai tirn en L� IIrrrNm ll nce I[�pl,lllhng Seiir�vuzce ge II l of 25 39 OVAT Staff Report - Exhibit C NOVATO FIRE PROTECTION DISTRICT EXHIBIT 1 : Personnel Resumes Dty of South Sain I�'ir� ndsco )epai tirn en L� IIrrrNm ll nce I[�pl,lllhng Seiir�vuzce ge II 8 of 25 40 OVAT Staff Report - Exhibit C NOVATO FIRE PROTECTION DISTRICT RESUME Ted Peterson Battalion Chief Novato Fire Protection District(2003-Present) Director of Emergency Medical Services (EMS) Director of EMS Summary I am responsible for the planning, organizing, budgeting and strategy of the EMS Division while supporting the organizational priorities and values. As a member of a high performing Chief Officer team I model the Fire Chief's established mission, vision, goals and objectives. My main areas of responsibility where I hold overall medical oversight, supervision, and performance evaluation are as follows: - Ambulance Billing - EMS Education and Training - EMS System Delivery - Hiring - Physical Resources - Public Access Defibrillator Program - Public Education - Recruitment - Wellness Fitness Initiative - Workers Compensation The Novato Fire Protection District (NFPD) is an Internationally Accredited Agency by the Centers for Public Safety Excellence. The following are some of the aspects concerning the NFPD, - An annual budget of $30 million dollars with $13 million in reserves and is responsible for the life safety of 76,731 citizens over 72 square miles; an ethnically diverse community with a population that includes 4.60% Asian, 7.3% Hispanic, 2.7% African-American, 4% American Indian, and 84.9% Caucasian residents - 86 paid firefighters, paramedic/firefighters, civilians and sworn personnel in the Fire Loss Management Division - Other Employees; executive assistant, public information officer, a part time physician, human resource manager, IT analyst, and other non-sworn clerical and billing personnel - Operates five (5) Fire Stations capable of responding 5 Engine Companies, 3 Wildland Engines, 1 Truck Company, 1 Rescue Unit, 1 Hazardous Materials Unit, USAR Team and 3 All Risk Command Vehicles - Responds to approximately 4,800 emergency incidents annually; approximately 75% of these alarms are EMS in nature - Offers the community an engine-based ALS service from all five of our fire management zones along with ALS transportation D; y of South Sain I�'ir ndsco )epai tirn en L� IIrrrNm ll nce I[pl'lllhng Seiirvuzce ge 1I of 25 41 OVAT Staff Report - Exhibit C NOVATO FIRE PROTECTION DISTRICT Development of an EMS system which is supported by intensive training and the purchase of state of the art equipment; this has produced an environment were 60% of a certain type of cardiac arrests patients are brought to the hospital with pulses returned. Professional Background I have been in the fire service for 10 years; eight of which I have proudly been serving as Battalion Chief, Director of EMS. My strengths are in organizational vision, leadership, analysis, teamwork and seeking opportunities for partnership. I developed a recruitment program that when implemented increased the number of perspective employees applying to the NFPD 1000 percent. I am responsible for the Ambulance Billing Division that, since its inception in 2005, has increased ambulance revenue to the NFPD by $2.5 million dollars. The NFPD now offers billing services to six other fire departments who have all realized an increase in revenue. While responsible for Workers Compensation I put into place practices and actions that decreased the District's cost by $300,000.00. I co-authored a grant to the California Community College Chancellors' Office that was funded to create the first Paramedic to RN Bridge Program in California. I have presented classes on EMS Leadership, Workers Compensation, Ambulance Billing and Budgeting at both the California Fire Chief s Association and the International Association of Fire Chief s EMS Section Conferences. I have 20 years in the private sector, before joining the Fire Service, of EMS education and patient care. I held many positions with overall medical oversight of system performance evaluation, personnel performance evaluation, mentorship, recruitment and retention, new business development, supervision, management and ownership of two companies. EXPERIENCE Battalion Chief, Director of EMS, Novato Fire Protection District, (2003-present) EMS Educator/CQI Coordinator, Novato Fire Protection District, (2001-2003) Emergency Medical Services Specialist— Counties of Sacramento and Marin (2001) Vice President— CE3000.COM, Inc. 1999-2009 Vice President— Samaritan Training Center, Inc. (1996-1999) Program Director—Napa Valley College, EMS Program (2005-2010) Instructor— College of Marin (2005-present) Instructor—Napa Valley College (1988-present) Operations Supervisor/Paramedic—Piner Napa Ambulance Service(1980-1998) EDUCATION Bachelor of Arts, Business Administration, California Coast University, 2007 Paramedic Certification, Stanford University, 1984 EMT Certification, Napa Valley College, 1980 HONORS Novato Fire Protection District, Award of Excellence, 2010 Novato Fire Protection District, Award of Excellence, 2009 American Red Cross, Real Heroes Award, Education, 2009 Do of South Sain I�'ir nd sco )o pai tirn en L� IIrrrNm ll nc e �ueiivv c E ge 20 of 25 42 OVAT Staff Report - Exhibit C NOVATO FIRE PROTECTION DISTRICT HONORS Cont'd Piner Ambulance Employee of the Year, 1993 California Emergency Medical Services Employee of the Year, 1991 TRAINING, CERTIFICATES, MEMBERSHIPS Executive Board Member, California Fire Chiefs Association, EMS Section Member, Title 13 Taskforce, California EMS Authority Member, California State Trauma Advisory Committee Member, International Association of Fire Chiefs Member, American Ambulance Association Member, California Ambulance Association Member, National Association of EMS Educators Member, Marin County EMS System Committees: policy and procedure, trauma advisory, data taskforce, EMS Forum, CQI, STEMI California State Licensed Emergency Medical Technician—Paramedic Advanced Leadership Issues in Emergency Medical Services S404-Safety Officer Fire Management 2-1) FEMA EMI ICS 100, 200, 300 Introduction to Emergency Management Earthquake Pediatric Advanced Life Support Provider and Instructor Advanced Cardiac Life Support Provider and Instructor EMT 1 Certified Instructor, Napa Valley College and College of Marin D; y of South Sain I�'ir ndsco )epai tirn en L� IIrrrNm ll nce I[pl'lllhng Seiirvuzce ge 2 II d25 43 OVAT Staff Report - Exhibit C NOVATO FIRE PROTECTION DISTRICT RESUME Shannon Wager WORK EXPERIENCE: May 2005 to Present EMS BILLING SPECIALIST Novato Fire Protection District, Novato, California Duties: Responsible for 2 temporary employees; overseeing and/or completing all Ambulance billing for five fire agencies, medical collections, accounts receivable, medical records, refunds, customer service, monthly reports to the board, Medicare packets, HIPPA, internal auditing and mailing of claims and statements. July 2003 to May 2005 ACCT/ADMIN CLERK III Novato Fire Protection District, Novato, California Duties: Responsible for all parts of accounts payable,payroll, and monthly cash disbursements reports to the board. May 2002 to July 2003 TEAM LEADER Marin Medical Practice Concepts, Novato, California Duties: Responsible for 7 employees, 12 clients, and all aspects of medical billing for primary care. April 1998 to October 2002 MEDICAL 'BILLING AN OFFICE MANAGER Santa Rosa Medical Group, Santa Rosa, California Duties: Responsible-for all medical billing, medical collections, accounts payable, accounts receivable, medical records, and office operations. February 1996 to May 2000 ER TECH Petaluma Valley Hospital, Petaluma, California Duties: Responsible-for stocking, cleaning patient beds and areas, answering phones,putting orders in the computer, doing patient assessments, and working with the public. EDUCATION: - Ambulance Coding Recertification: 2010, 2011, 2012, 2013 and 2014; National Academy of Ambulance Coding - Ambulance Coding Certification: 2009, National Academy of Ambulance Coding - Medical Assisting- Coding and Reimbursement Certification: 2008, Santa Rosa Junior College, Santa Rosa, California - Associates Degree in Art and Science, 2000, Santa Rosa Junior College, Santa Rosa, California - High School Diploma, 1994, Ursuline High School, Santa Rosa, California. D; y of South Sain I�'ir ndsco )epai tirn en L� IIrrrNm ll nce I[pl'lllhng Seiirvuzce ge 22 d25 44 OVAT Staff Report - Exhibit C NOVATO FIRE PROTECTION DISTRICT RESUME Cont'd Shannon Wager AREAS OF KNOWLEDGE: Medical Billing; Phones; Organizing; Accounts Payable; Accounts Receivable; Collections; Payroll; Deposits; Filing; Scheduling; Office Operations; CPR; First Aid; Spread Sheets REFRENCES: Available upon request D; y of South Sain I�'ir ndsco )epai tirn en L� IIrrrNm ll nce I[pl,lllhng Seiirvuzce ge 23 of 25 45 OVAT Staff Report - Exhibit C NOVATO FIRE PROTECTION DISTRICT EXHIBIT 2: EMS Billing Process Dty of South Sain I�'ir� ndsco )epai tirn en L� IIrrrNm ll nce I[�pl,lllhng Seiir�vuzce ge 24 od�25 46 OVAT Staff Report - Exhibit C NOVATO FIRE PROTECTION DISTRICT EMS Billing Process CONFIDENTIAL INFORMATION Receipt of PCR from Client Missing data Yes No Yes Resolved purl, � url, No No Payment Yes Resolved No 11uu � I III � 47 i aiu . Staff Report - Exhibit D VA NOVATO FIRE PROTECTION DISTRICT EMS Ambulance Billing Services RFP SUBMITTAL SAW F'"J� r +' ,o "y7rr 'Swu %'� w FIRE REQUEST FOR PROPOSAL (RFP) EMS Ambulance Billing Services City of South San Francisco Fire Department Administration Attn: Management Analyst, Bertha Aguilar Compensation Proposal For Ambulance Billing Services DISTRICT COPY 48 OVAT 1/ Staff NOVA NOVATO FIRE PROTECTION DISTRICT Fee Options Initial 1St Renewal 2nd Renewal A or B Term Term Term (2 Years) (2 Years) (2 Years) A. Percent Percentage of Actual Collected Revenue 4.6% 4.6% 4.6% B. Flat Rate Per Call Fee for Transport $18.00 $18.00 Up to $19.80 Per Call Fee for Treat and No Transport $18.00 $18.00 Up to $19.80 D; y of South Sain I�'ir ndsco )epai tirn en L� irnb 4 ice I[pl,lllhng Seiirvuc e cge II of ll Staff Report - Exhibit E Resolution - Exhibit A AMBULANCE SERVICES COST BREAKDOWN Q1 - Q3 Q4 Total ADPI $52,303 $18,919 $25,000 $2,625 $98,847 NFPD* $0 $21,024 $75,600 $56,700 $153,324 Successor** $0 $0 $0 $18,900 $18,900 Lockbox*** $0 $5,225 $8,900 $8,900 $23,025 Subtotal $52,303 $45,168 $109,500 $87,125 Grand Total $97,471 $109,500 $87,125 $294,096 * 1168 transports estimated for Q4. FY 16-17 and 17-18 calculation based on 4,200 transports per fiscal year. ** Funding allocated to ensure continuity into next contract. *** Includes initial setup fee in Q4 for lockbox. 50