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Ad Hoc EMS Advisory Committee - Agenda - 3/28/2024
1 Bayfield County Clerk Lynn M. Divine, County Clerk Jeran Delaine Deputy Clerk Alannah Belanger Clerk I Ph: 715.373.6100 Fax: 715.373.6153 Email: Lynn.Divine@bayfieldcounty.wi.gov ● 117 E. Fifth Street, PO Box 878, Washburn, WI 54891 BAYFIELD COUNTY AD HOC EMS ADVISORY COMMITTEE Meagan Quaderer, Jonathan Shultz, Colleen Beagan, Scott Kluver, Clyde Clauson, Kellie Pederson, Lynn Divine, Tam Hofman, Adam Olson, Chris Pribek, Michael Lang, Tony Lang, David Trudeau, Jan Victorson, Larry Fickbohm, Steve Sandstrom, Beverly Steele, Sandy Raspotnik, Eric Neff, Dan Vaillancourt, Jeff Byerhof Dear Committee Members: Please be advised that first meeting of the reinstated Ad Hoc EMS Advisory Committee will held on Thursday, March 28, 2024, at 5:00 p.m. in the Bayfield County Boardroom and virtually. The Bayfield County Board Room is located at 117 E 5th St., Washburn, WI. Committee members and the public will be able to participate in the meeting in-person or remotely via voice by using either the internet link or phone number below. Microsoft Teams Need help? Join the meeting now Meeting ID: 271 700 746 759 Passcode: iXzJoL Dial-in by phone +1 715-318-2087,,454136586# United States, Eau Claire Find a local number Phone conference ID: 454 136 586# For organizers: Meeting options | Reset dial-in PIN 1. Call to Order 2. Introductions 3. Discussion and Possible Action, Minutes from February 26, 2024 4. Discussion Increases to FAP funding for 2024 (Jan) 5. Discussion and Possible Action, EMS Study RFP Responses, Recommendation for Choosing a Firm Notes: Bayfield County received six (6) responses to the EMS Study RFP Any person wishing to attend who, because of a disability, requires special accommodations, should contact the County Clerk’s office at 715-373-6100, at least 24 hours before the scheduled meeting time, so appropriate arrangements can be made. 2 Scott Kluver, Jan Victorson, and Meagan Quaderer have narrowed down the six to the top two which are: The Riseling Group Strategic Management & Consulting LLC The top two proposals clearly understood the goals of the project, met the project objectives, and came in at budget. Scott, Jan, and I will fill out the scorecard and provide a recommendation to the Ad Hoc EMS Advisory Committee 6. Update on Previous Committee Final Report and What Initiatives Have Been Met or are in Process of Being Met Adjourn Sincerely, LYNN M. DIVINE Bayfield County Clerk LMD/amb Bayfield County Clerk Lynn M. Divine Jeran Delaine, Deputy Clerk Alannah Belanger, Clerk I Ph: 715.373.6100 ● Email: Lynn.Divine@bayfieldcounty.wi.gov ● 117 E. Fifth Street, PO Box 878, Washburn, WI 54891 BAYFIELD COUNTY AD HOC EMS ADVISORY COMMITTEE February 26, 2024 MINUTES CALL TO ORDER: Meagan Quaderer called the initial meeting to order at 5:03 p.m. INTRODUCTIONS: Those present introduced themselves. Those present in-person were: Meagan Quaderer, Bayfield County EMS Director; Jeff Byerhof, South Shore Ambulance; Clyde Clauson, Clerk, Town of Orienta; Dan Vaillancourt, Supervisor, Town of Lincoln; Mark Abeles-Allison, Bayfield County Administrator; Beverly Steele, Chairperson, Town of Clover; Sandy Raspotnik, Chairperson, Town of Washburn; Jan Victorson, EMT and Asst. Administrator for Mason and Iron River ambulance services; Lynn Divine, Bayfield County Clerk; Tony Lang, Operations Manager, Great Divide Ambulance Service; Christopher Pribek, Captain, Ashland Fire Dept.; Michael Lang, Red Cliff Ambulance Service; Adam Olson, Service Director, Iron River Ambulance; David Trudeau, citizen, South Shore Ambulance Service; Stuart Matthias, Chief, Ashland Fire Dept.; Tam Hofman, past EMS President and citizen of South Shore Ambulance Service; Larry Fickbohm and Steve Sandstrom, Bayfield County Supervisors. ABSENT: Eric Neff and Colleen Beagan. ELECTION OF COMMITTEE CHAIRPERSON: Raspotnik nominated Jan Victorson as Chairperson. No other nominations were made. All those present were in agreement to elect Jan Victorson as Chairperson. Victorson continued the meeting as Chairperson. ELECTION OF VICE CHAIRPERSON: Quaderer nominated Scott Kluver as Vice Chairperson. No other nominations were made. Raspotnik made a motion to cast a unanimous ballot for Scott Kluver as Vice Chairperson, seconded by Abeles-Allison. Motion carried. OVERVIEW OF CURRENT STATUS OF EMS IN BAYFIELD COUNTY: Quaderer stated that the high-level goal from the past committee’s recommendation is “to ensure continued and successful operations over the next 10 years and establish an action plan to carry out those activities.” The members agreed that this is a good starting point moving forward. Raspotnik asked if there is a report of the goals created by the last committee. Quaderer stated that a report will be presented at the next meeting. She went on to say that one of the key barriers to success was mental health. Emergency Management has worked with a local mental health provider and is working on the Auxilia Initiative, an initiative provided by a non-profit organization that focuses on the prevention of PTSD. In addition, a Bayfield County EMS System was created. It is a non-transporting system that currently focuses on mass tragedy, but also allows the county to levy monies to assist the EMS agencies. Currently, each of the nine ambulance services receive $20,000 annually and those funds have been committed through 2026. Bayfield County also paid for the EMS appreciation dinner for directors and all members who chose to attend. Victorson added that there has been a substantial increase in funding at the state level. She will look into getting more details regarding this. Quaderer stated that future meetings will include the Bayfield County Medical Director, Dr. Jonathan Schultz, who has asked to be a part of the committee. Future invitations will also be extended to Chanz Green and Romaine Quinn, our current state representatives. Representatives from several of the services gave an update on the status of their agency. EMS STUDY RFP: The committee reviewed the RFP provided in the meeting packet. There was discussion regarding whether to invest in an RFP and what additions or changes should made. After lengthy discussion, Kluver made a motion to recommend proceeding with an RFP incorporating some of the adjustments that have been discussed. Clauson seconded the motion. Motion carried. Quaderer stated there is a timeline in getting the RFP completed by the time Bayfield County begins its budget process for 2025. It was agreed to proceed right away. Quaderer will make the adjustments discussed and will forward those changes to Victorson and Kluver for approval. The tentative timeline is to have the bids returned by the end of March. After that deadline, Quaderer, Victorson and Kluver will open the bids and score them. They will share the scores and their recommendations with all committee members and a final vote will be taken at that time. Abeles-Allison recommended that the bids be due before the next County Board of Supervisors Meeting so that the board can see the proposals and authorize the committee to make their selection. Then the committee can meet later that week to make their decision. It was agreed that the bids will be due on March 22nd. On March 25, they will be opened and scored to be presented at the March 26th County Board Meeting. The committee will meet on Thursday, March 28, 2024, to go over the proposals and choose the successful bidder. There being no further business to conduct, Victorson adjourned the meeting at 6:15 p.m. Respectfully submitted Lynn M. Divine Bayfield County Clerk lmd Bayfield County, Wisconsin EMS RFP Analysis RFP 2024-18-04 Prepared By: Chief (Retired) Sue Riseling Assistant Chief EMS Josh Wescott Assistant Chief (Retired) Lance Langer March 22, 2024 2EMS RFP Analysis Bayfield County, Wisconsin Overview On the shores of Lake Superior, Bayfield County is home to more than 16,000 residents and is the second largest Wisconsin county by land area at almost 2,042 square miles including 500 square miles of surface water which contributes to a vibrant tourism economy. Tourism in the county has a nearly $90 million annual economic impact and supports 700 full and part-time jobs. Tourism also results in higher numbers of visitors, creating an increased need for emergency service delivery beyond the county’s permanent population. Introduction Public safety services are a significant portion of a small community’s distinctive values. For many decades, rural local governments relied upon those willing to give their time to train and respond to emergency situa- tions. These individuals are a substantial portion of the fabric and identity of small communities. Over the years training requirements increased, making civic volunteerism impractical to cover these increasingly technical and complex services. As a result of many contributing factors, communities across Wisconsin are working to determine the most effective means of ensuring around the clock emergency medical on-scene response and care in the most cost-effective manner possible. Bayfield County is seeking consultation to assess its current EMS system and make recommendations for how to build upon its current strengths. The members of these services and operations are and must continue to be an integral component to any conversation in rural Wisconsin about how to best provide community-based emer- gency medical services. From elected officials to emergency responders, it’s imperative those who make up the Bayfield County Emergency Medical Services system have direct input and inform how its services progress and adapt in the years to come. Their knowledge, insight, participation and buy-in will be essential for any eventual outcomes or recommendations from this analysis to succeed. Recently adopted state legislation created incentives for communities to both explore and implement public safety service collaborations. EMS Analysis: Objectives 1. Evaluate and provide assessment of current EMS services that operate in Bayfield County. Assess re- sources – both personnel and infrastructure – along with response times and current working relation- ships between entities. 2. Develop short and long-term recommendations designed to improve response times and ensure sus- tainable service delivery in a cost-effective manner. 3. Explore viability of potential partnerships/collaborations to improve quality of patient care; examine feasibility of integrating existing services into a more cohesive countywide EMS system. 4. Review potential for state funding and additional revenue sources to support solutions and/or prospec- tive new collaborations. EMS Analysis: Methodology 1. Work with Bayfield County to obtain data for analysis. a. Review EMS call volumes and response time data for all Bayfield County EMS services. b. Analyze EMS transport times and incidents where agencies are unable to respond to inci- dents within their primary respective jurisdictions. c. Examine any trends among emergency medical calls with longest response times. d. Review Bayfield County EMS district response coverage maps over past 20 years. e. Evaluate existing recruitment/retention efforts within EMS agencies. 3EMS RFP Analysis Bayfield County, Wisconsin f. Review operating and capital budgets for all Bayfield County EMS agencies. g. Review current EMS billing practices and existing revenue sources. 2. Communicate and Meet a. Assist with initial communication with EMS community and local leaders. b. Communicate with elected officials and administrators about study objectives, stages, and timeline. c. Meet with/interview elected officials and administrators from Bayfield County to assess per- spective on current EMS service delivery. d. Meet with EMS leadership from agencies serving the county along with current and former EMS volunteer/paid on call/career providers. Where possible, these conversations should occur at EMS stations so facilities/resources can be assessed. e. Initiate conversations with community stakeholders – economic development/business, tourism, law enforcement, fire, other partner agencies – to obtain their perspective about current EMS services and opportunities for sustainability, growth, and increased collabora- tion. f. Initiate conversations with EMS medical directors and/or officials at primary transport hos- pitals to assess the current state of services. g. Meet with local technical colleges to assess workforce development trends, capacity for EMS training. EMS Analysis: Deliverables 1. Regular status updates on the project to Bayfield County study principles, as requested. 2. Draft final report that includes: a. Thorough assessment of current Bayfield County EMS strengths, opportunities, challenges. b. Analysis of response times, call volumes and trends (if data from multiple years is available). c. Data informed recommendations to inform future EMS district boundaries and/or sys- tem-wide integrated collaboration that prioritizes response time while offering highest quality of patient care. d. A roadmap of short, and long-term recommendations for policymakers and EMS leaders customized for the Bayfield County region and based on best practices focused on improv- ing patient outcomes. e. Analysis of current EMS expenditures and revenues and identification of sustainable finan- cial resources to support recommendations. f. Identified opportunities for partnership, with an outline as to how these can be achieved, barriers to their accomplishment, and suggestions for timelines and next steps in how to maximize any new collaborations. g. Recommendations for EMS staffing recruitment and retention strategies, including volun- teer staffing as the community desires. h. Summary of information sought by Bayfield County as identified in this RFP and further identified by County principles throughout the duration of this project. 4EMS RFP Analysis Bayfield County, Wisconsin 3. Communications strategy for findings of this analysis including presentations for Bayfield County Board of Supervisors and other study stakeholders. 4. As requested, the Riseling Group will assist Bayfield County with drafting and delivering initial com- munications to residents, EMS departments and responders, business leaders, and possibly the media about the study findings and recommendations. Bayfield County EMS Analysis: About the Team Sue Riseling Project Coordinator Sue led the University of Wisconsin-Madison Police Department as its Chief from 1991 to 2016 and also served as an Associate Vice Chancellor from 2003 until retiring from the University in 2016. She was appointed Vice Chair of the Governor’s Council on Radio Interoperability and to the State Homeland Security First Responder Group in 2006. Sue also served as a member of the U.S. Attorney General’s Western District Anti-Terrorism Task Force. Today, Sue is Presi- dent of The Riseling Group LLC, a consulting firm that offers a wide range of public safety, strategic planning, staffing analysis, resource deployment, crisis management and communications services. The Riseling Group has worked with the Verona Fire Department which has a combined EMS service with the Fitch- burg Fire/EMS department. TRG has also worked with the Poynette-Dekorra Fire District with EMS services. The fire district is a result of a collaboration and combination of the Village of Poynette, (pop. 2,598) the Town of Dekorra (pop. 2,328) and the Town of Lowville (pop. 1,022). The Riseling Group also worked with the Western Lakes Fire and EMS services. Western Lakes is a combination of The Towns of Merton, Oconomowoc, Ottawa,the city of Oconomowoc, the villages of Dousman, Lac La Belle and Summit. Josh Wescott Josh has served as an Emergency Medical Services provider for several rural Wisconsin agencies for nearly two and a half decades. He is an Assistant EMS Chief and is currently affiliated with and actively running as an Advanced level EMT for four departments serving rural Crawford, Green, and Dane Counties. In his various roles, he serves as a volun- teer and paid on call, for both standalone EMS and combined fire and EMS departments. He has experience leading EMS volunteer recruitment, retention and on-boarding efforts and has coordinated ambulance billing and fundrais- ing initiatives. Josh is a Wisconsin certified Emergency Medical Services instructor and currently teaches EMS in rural classroom settings for two Wisconsin Technical College Districts. In addition to his EMS work in the field, Josh has served as Chief of Staff for Dane County government for 13 years where he’s been the county’s lead public safety policy administrator for emergency management, emergency medical services, and public safety communications (911 Center). Josh developed public safety policy reforms that improved 911 dispatch and response times and oversaw development of a brand new $30 million interoperable county emer- gency communications’ network, linking communications capabilities between 61 cities, villages, and towns. Josh is currently working on an EMS study for two small communities in rural Walworth County. There he's meeting with lo- cal officials to evaluate current levels of service and explore potential new partnerships Josh has also overseen several internal and external reviews, studies, and analyses in his capacity as Dane County's Chief of Staff. Lance Langer Assistant Chief Langer retired from the Madison Fire Department after a distinguished career. During his time with the Madison Fire department, he was an operations leader as the City of Madison collaborated and then consolidated the fire and EMS services of the Village of Shorewood Hills. Additionally Assistant Chief Langer was a key part of the consolidation of the Town of Burke EMS services. He worked with the Town of Blooming Grove to consolidate their fire and EMS services as well. In the latter years as assistant chief he worked on the consolidation of the Town of Madison Fire and EMS with the City of Madison. Lance also served as a Division Chief for the City of Fitchburg combination fire service and EMS. Fitchburg has a combined EMS service with the City of Verona. The name of the service “Fitch-rona” notes the sharing of important paramedic level response to emergencies within the two cities. This combined effort and the training Lance has been engaged with, brings tremendous experience to the project. 5EMS RFP Analysis Bayfield County, Wisconsin Bayfield County EMS Analysis: Project Timeline The success of the timing of this project will hinge on the speed to which the County and EMS services can sup- ply the data needed for analysis. In addition, to stay on schedule, many individuals will need to make themselves available for meetings and information sessions. April 1 to April 30, 2024 Obtain and begin analysis of available call time/response data, operating and capital budget background, infor- mation about EMS billing and EMS coverage maps. Make introductions to interested stakeholders. May 1 to May 30, 2024 Conversations with Bayfield County EMS stakeholders identified in methodology section above. June 1 to June 20, 2024 Compile recommendations, conduct follow-up interviews as needed and begin drafting analysis/report. June 20 to June 28, 2024 Edit and review draft of report, review data, prepare final copy of report for Bayfield County Board. June 28, 2024 Release final report, including recommendations. Other Considerations: The County or other entity should select a individual to coordinate meetings, locations, invitations and commu- nications with the TRG team and stakeholders. TRG will require meeting and work locations while in Bayfield County. TRG has its own zoom account if the County would like some or all of the meetings conducted virtually. As much lead time as possible is requested for the consultants to appear on-site. Budget For EMS Review The budget cannot be finalized until the expectation for in-person and virtual meetings is known. This bud- get is the best estimate we can provide at this time. Visits to Bayfield County (5 total days – possibly 3 roundtrips) Madison to Bayfield: 648 miles round trip @ .67 per mile (fed rate) $434.16 $1,302.48 3 Consultants – 3 hotel rooms per night $397.80 $2,784.60 3 Consultants – Meals (incl travel days) $1,200.001 Incidentals $100.00 Report Preparation (to include Power Point) $1,000.00 Editor $250.00 Graphics $750.00 Consultant Compensation $26,512.00 TRG Overhead $2,100.00 Total Project Cost Estimate $34,999.08 1 If the hotel selected includes breakfast this total will be less. 6EMS RFP Analysis Bayfield County, Wisconsin Past Projects The Riseling Group conducts staffing studies for several types of public safety agencies to include police, secu- rity, and fire/EMS. Subject matter experts from the discipline are combined with a team coordinator who keeps the project on time and ensures deliverables are met. For this project the subject matter experts are current As- sistant Chief Josh Wescott and retired Assistant Chief Lance Langer. Between the two they have several projects of collaboration, consolidation, and partnerships within the fire, and EMS services. Currently Assistant Chief Wescott is working with the Village of Fontana (pop. 2772), analyzing the EMS services and the 24-hour nature of emergency calls in the jurisdiction. Contact is Theresa Loomer tloomer@vi.fontana. wi.gov Currently Assistant Chief Wescott is also working with the Village of Williams Bay (pop. 3001). The review is of their EMS services coverage in these times of fewer volunteers and consolidation. Contact is David Lothspeich admin@vi.williamsbay.wi.gov The Riseling Group worked with the Chief of the Western Lakes Fire and EMS services in July of 2022 and January of 2023. Western Lakes is a combination of The Towns of Merton, Oconomowoc, Ottawa, the city of Oconomo- woc, the villages of Dousman, Lac La Belle and Summit. The TRG work (Riseling and Bridges in 2022) involved personnel matters and the responsibilities of an Assistant Chief. In addition, TRG (Langer and Schutt 2023) con- ducted training and teambuilding sessions to strengthen the bonds amongst the fire and EMS staff. Contact Chief Brad Bowen 262 567-8282. TRG (Langer and Riseling) worked with the Poynette-Dekorra Fire District with EMS services. The fire district is a result of a collaboration and combination of the Village of Poynette, (pop. 2,598) the Town of Dekorra (pop.2,328) and the Town of Lowville (pop. 1,022). The project focused on the EMS and fire services working relationships, tensions, and the inability of the EMS to meet their call demand due to a lack of volunteers. There was a review, a change in department leadership and a new implementation plan for moving forward with greater profes- sionalism, efficiency, and improved training. July 2020 – March 2021. Contact Chris Varner – At the time of the Project she was the head of the Poynette Dekorra Fire Protection District Commission. She currently serves on the Commission until 2026. 608 635-2122. As mentioned in his bio – Assistant Chief Langer served in the Madison Fire Department which had fire, EMS, hazardous materials, and lake rescue. He also was a Division Chief within a department of fire and EMS that shared EMS with another district (Fitchburg-Verona). While serving in the Madison Fire Department he was an active part of the study and subsequent consolidation of four departments. The Town of Burke fire and EMS consolidation into the Madison Fire Department (pop. 3284 in 2010). In 2013 the Village of Shorewood Hills fire and EMS (pop. 1798 in 2013). The Town of Blooming Grove fire and EMS consolidation (pop. 1692 in 2016). Prior to his retirement he worked on the consolidation of the Town of Madison fire and EMS (pop. 6236 in 2020). The Riseling Group (Burke and Riseling) have worked with the Verona Fire Department which has a combined EMS service with the Fitchburg Fire/EMS department. Human resource related work occurred prior to the five- year window. 7EMS RFP Analysis Bayfield County, Wisconsin SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED INACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. 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CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIREDAUTOS ONLY 3/4/2024 The Campbell Group4808BroadmoorAve SEKentwoodMI49512 Program Security 616-541-1425 800-847-3129 Security@thecampbellgrp.com Starstone National Insurance Company 25496 THERISE-01TheRiselingGroup,LLC1802MonroeStSuite201MadisonWI53711 1436674140 A X 1,000,000 X 50,000 1,000 1,000,000 3,000,000 X 5-PI-17633CIPI000012 3/1/2024 3/1/2025 1,000,000 PROFESSIONAL E&O Included Armed Coverage Included Verification of Insurance E9082 Oak Hill Road Wisconsin Dells, WI 53965 (608) 963-2380 Response to RFP for Study of County-wide Emergency Medical Services (EMS) In Bayfield County Prepared by: Page 2 of 17 Table of Contents Cover Letter………………..……………………………………………………………….……3 Company Background……………..………..............……………………………………....…...4 Methodology………………………………………………………………………………….4 – 6 Client Input………………………………………………………………………………4 Practical Recommendations…………………………………………………….………5 General Understanding………………………………………………………….………5 Specific Understanding…………………………………………………………………. 5 Project Management / Contact Information…………………….…...…….………..…6 Detailed Work Plan & Scope of Work…………………………………...……...……....….6 – 7 Citizen Engagement…………………………………………………………………………...…8 Analysis & Recommendations…………...………………….……………………..………..8 – 9 Deliverables....................…………………………………………………………………...…….9 Professional Summaries……………………………………………………..….………...10 – 13 References from Previous Projects……………………………………………………………14 Timeline…………………………………………………………………………………………15 Insurance………………………………………………………………………………………..15 Cost Quotation……………………………………………………………………….…………16 Options for Consideration for Future Projects………………………………………………17 Page 3 of 17 March 15, 2024 Bayfield County Emergency Management Attn: Meagan Quaderer, Director 117 E. 6th Street – P.O. Box 423 Washburn, WI 54891 RE: RFP 2024-18-04 Dear Meagan, Thank you for the opportunity to reply to the RFP to provide a Study for County-wide EMS in Bayfield County. We believe that the goal of the Study is to provide the best possible EMS delivery model to the greatest percentage of the population. Specifics of the processes to be used will be outlined in this RFP Response. Collectively, the Consultants picked for this Project—along with other staff—collectively have over 95 years in professional EMS & Fire experience, which provides you with the most qualified resources to walk you through the entire Study process. Our Reviews and Recommendations are based completely on facts and industry standards, and we strive to provide a comprehensive Final Report that can actually be implemented. With the Consultants selected for this Study, there is literally no area of EMS that has not been touched. Our involvement as providers, educators, EMS Directors, EMS & Fire Chiefs, State Officials, and most important—Leaders in EMS & Fire—eminently qualifies our Company for this important project. We look forward to working with you as we identify and determine the short-term and long-term EMS goals in a Final Report that will provide the options that are available to providing high quality County-wide Emergency Medical Services (EMS), to assure a viable and sustainable EMS Service in the Communities within the County for years to come. Respectfully submitted, Dana Sechler, President Strategic Management & Consulting, LLC Page 4 of 17 Proposal Company Background Strategic Management & Consulting, LLC is excited to provide the following proposal to conduct a Comprehensive Study to develop and evaluate options for Emergency Medical Services within Bayfield County. Strategic Management & Consulting, LLC is a Wisconsin-based Company that was co-founded by two EMS & Fire professionals that had been asked to fill a need in EMS Leadership training that had been lacking in the State. Since then, the Company has steadily grown in scope and size. We continue to teach numerous EMS Leadership classes each year. In addition to the Leadership training, the Company has been providing Comprehensive Studies and Reviews of various EMS & Fire entities across the State of Wisconsin in the areas of operations, structure, staffing, billing, and budgeting. Many of the Studies have helped rural volunteer, combination, and paid-on-call agencies identify their needs and create step-by-step solutions to help them be a successful department. Three of the Studies that have been previously performed are listed in the Reference Section of this Proposal. Additional references are also available upon request. The Mission of Strategic Management & Consulting LLC is to provide unique and out-of-the box ideas and solutions to issues affecting EMS & Fire Services in today’s complex environment. Methodology Our approach to this Project requires a clear understanding of the current intent and anticipated outcome. The key elements of this methodology include, but are not limited to: A clear understanding of the project background, complex issues involved, and the goals and objectives. A work plan that is comprehensive, well designed, practical, and provides ample opportunity for input from all stakeholders. Sufficient resources and a commitment to successfully complete the project within the desired time frame and at a reasonable cost. Client Input – In order to perform a comprehensive assessment and make specific recommendations, it is critical that we receive quality information from administration, staff, and partnering agencies. Accordingly, our approach includes interviews with individuals as defined by the Bayfield County Project Manager including outside agencies, supporting partners, and associated agencies if any, that would have valuable information to communicate to us. Page 5 of 17 Practical Recommendations – Our ultimate goal is to provide you with recommendations and guidance through every aspect of the project, which will provide you with the blueprint that will turn this project from “concept” to “operational”. We understand that recommendations need to be practical and based on sound National & State standards, NFPA standards, EMS State Statutes, Administrative Rules and legal considerations, as well as community capabilities. General Understanding – This proposal is designed to provide a Comprehensive Overview, based on the following Components / Topics: Analysis of current operations and service delivery Governance, service agreements, and contracts Staffing methodology, including current and future needs Salaries & wages Fiscal analysis and implications Planning for growth The following pages will summarize the proposal in detail, with the understanding that the analysis and evaluation will produce ideas and suggestions that will achieve the following benefits: Efficiency Effectiveness Cost control and containment Identification of the right-sized EMS entity to meet community need(s) Coordination and use of regional resources with elimination of artificial boundaries and duplication of resources Specific Understanding – We recognize the responsibility of municipalities in Wisconsin to provide Ambulance Service to its’ community. It therefore falls upon the elected officials to make decisions that will ensure that an ambulance service is staffed and ready to respond to an emergency call, when someone calls 9-1-1. We are also aware of the difficulties facing Ambulance Services as staffing levels decrease, as funding revenues decrease, as the availability of hospitals decreases—all the while expenses are increasing, transport distances and times are increasing, and now proposals are being made for training and education standards to increase. It is our understanding that this Comprehensive Study will explore alternative EMS models as compared to how EMS is currently being provided in the County. When the Study has been completed, we will provide a final document that will assist Elected officials in choosing the best model for EMS to be delivered in your area. Page 6 of 17 The expertise of our Company staff will guide the Recommendations regarding the options that are available. We understand that though some solutions have been enacted for Staffing purposes, that there are some short- and long-term solutions that need to be assessed comprehensively to ensure sustainability for a timely response in the event of an emergency for the ill and injured, as well as to provide confidence in the continuation of reliable EMS for area residents and visitors. We understand that volunteerism is dwindling in some areas and is strong in other areas. The goal of the Study is to solidify a sustainable solution for the future that will identify necessary resources based on current call volumes, response times, workforce utilization, and fiscal feasibility—in order to meet the needs of the community for generations to come. Project Management – A successful assessment and the provision of effective recommendations requires a special effort to ensure that all levels of the project receive adequate attention and those findings and recommendations are thoroughly coordinated. This is accomplished by the development and adherence to a project work plan, which is detailed in the next section. The Principal Consultant (Dana Sechler) will be the lead Consultant for this Comprehensive Study, and he will be the liaison with the Bayfield County Project Manager, Meagan Quader. Dana will work with Megan to obtain the various resources, contacts, and connections needed in performing the Study. His contact information is as follows: Strategic Management & Consulting, LLC C/O Dana Sechler, NREMT, CCP E9082 Oak Hill Road Wisconsin Dells, WI 53965 (608) 963-2380 (cell) dsechlerstrategic@gmail.com or danasechler@hotmail.com Detailed Work Plan & Scope of Work Strategic Management & Consulting, LLC will perform the following evaluations in conjunction with this Comprehensive Study: Comprehensive overview of how ambulance services are currently being provided and financed within the County including assessment of full costs The reliability and sustainability of the current EMS system Page 7 of 17 The feasibility, benefits, and drawbacks of various types / models of ambulance service that can be considered to provide sustainable EMS, including consolidation / merger / regionalization; Ambulance District(s); and/or County-wide Service Addition of part-time / full-time staff in various response areas, to support volunteers Assuring Paramedic level coverage when needed Use of ALS Intercept vehicles Inter-facility Transports Community EMS The information gathered for this Comprehensive Study will be accomplished by performing a review of background information including: o Community population and demographics o Residential, commercial, industrial, and municipal features of the County o Standard Operating Guidelines (SOG’s) / Protocols o Coordinated Medical Direction o Mutual aid agreements o Additional Resources o Company ownership o By-laws o Current staffing o Municipal governance o Road maps of the Area o Review of training schedules o Review of any long-range plans o Review of budget(s) and capital equipment o Review of vehicle fleets, replacement plans, and future needs assessment We will gather input (via in-person interviews, group meetings, virtual conferencing, or surveys) from the following: o Elected/appointed officials from the County / Municipalities o Current Ambulance Service Directors o Medical Director(s) o General Public o Dispatch / communications staff o Selected Members/Officers of the current EMS agencies While performing the Comprehensive Study, there may be other areas not listed above that will be identified, in which follow-up will be needed to evaluate the item(s) as they relate to the overall purpose of the Study. Page 8 of 17 Citizen Engagement Strategic Management & Consulting, LLC proposes the following options to consider, to involve citizens in participating in commenting on any of the items mentioned in the Detailed Work Plan. 1. Host a meeting to listen to, and document the comments of the citizens, which can be compiled into the Final Report. 2. Utilization of prior survey information received from the public. 3. Develop an online survey (such as Survey Monkey) to be hosted on a website, in which specific questions are asked, and the responses can be compiled in the Final Report. Analysis and Recommendations Strategic Management & Consulting, LLC will determine current system challenges, and future trends for public safety industry standards related to EMS operational requirements. During the development of all recommendations, we will consider many factors and industry standards as determined by the following: o National Highway Safety Traffic Administration (NHSTA) o Center for Public Safety Excellence (CPSE) o Journal of American Medical Association (JAMA) o Commission on Accreditation of Ambulance Services (CAAS) o American Ambulance Association (AAA) o Office of the Inspector General (OIG) o Occupational Safety and Health Administration (OSHA) o State of Wisconsin Statutes 256 and Administrative Code (DHS 110) o Wisconsin Ambulance Inspection Administrative Rule (Trans 309) o Wisconsin Department of Safety and Professional Services (SPS 330 & 332) The Final Report of the Study will detail many of the findings from the initial Analysis. As well, recommendations will be given with the intent to improve effectiveness and efficiencies in the delivery of EMS. Recommendations in the Final Report may include any or all of the following: The current capabilities, strengths, weaknesses, coverage gaps, and workforce shortfalls System reliability (including the ability / inability to respond to current / future 9-1-1 calls) Response times statistics Call Volumes Coverage areas, including recommendations for shared services, and/or the creation of Districts/County-wide EMS Staffing (Full-time, part-time, paid-on-call, combination, and/or volunteer) Page 9 of 17 Staffing Training Levels including Paramedic, AEMT, EMT, EMR Pay and Benefits Governance/Management (municipal / private / District / County, etc.) Interfacility transfers vs. Emergent 9-1-1 calls Review of Budgets Review of Billing Company services Review of succession planning Vehicle and Equipment needs Vehicles and staffing/run assignments Review of vehicle fleets, replacement plans and future needs assessment Other areas identified in the Analysis Deliverables In addition to all of the items listed above, the Final Report will include a number of Recommendations that can be implemented in two (2) phases: short-term (3 – 5 years) and long- term (5 – 10 years) in which the Community Leaders should be able to do the following: Determine best practice methods / models to deliver cost effective and efficient Emergency Medical Services (EMS) to the citizens and visitors in Bayfield County. o Three (3) options will be provided, along with financial comparisons. Understand short-term and long-term recommendations regarding facilities, personnel, equipment, financials, and project needs for EMS for the next 20 years. Compare the value in dollars of donated labor (volunteers) vs. the full and total cost of providing EMS in Bayfield County, and the gap between current financial resources and what will be needed for long-term sustainability. Page 10 of 17 Professional Summaries The following EMS Professionals will be utilized to work together on this Study. Chief Dana Sechler, (ret.) President & Co-Founder, Principal Consultant Mr. Sechler has been actively involved in Emergency Medical Services (EMS) and the Fire Service for over 32 years in a variety of capacities. He participated in both EMS and Fire departments that were volunteer, paid-on-call, combination, resident program, and career Services. During his tenure in EMS & Fire Services, Mr. Sechler gained valuable exerience working at a number of dfferent types and models of Services, including Fire-, Hospital-, and County-based EMS, a Third party Service, a Municipal Service, and a District Service. Mr. Sechler also founded and co-owned a Private ambulance service. His experience as an EMS provider, Officer, Supervisor, Manager, and Administrator stems across Wisconsin, Iowa, and Illinois, which has allowed him to learn many different ways to provide, lead, and manage Fire & EMS in a variety of different setitngs. Mr. Sechler has held (and still maintains) a number of EMS & Fire credentials including: ~Nationally Registered EMT, Intermediate, Paramedic, Critical Care Paramedic ~Firefighter I & II, Driver/Operator/Pumper, Fire Officer I ~Instructor certifications for EMS, Fire, and AHA, including BLS, ACLS, and PALS. Mr. Sechler has worked in Adminsitrative positons as a Fire Chief, an EMS Service Director, a Billing Services Manager, and a Wisconsin State EMS Office official—as the ALS / Paramedic Program Coordinator at Wisconsin DHS. In addition to the Field work associated with EMS and Fire, Mr. Sechler has also worked (and continues to work) at several Colleges / Training Centers, in various capacities including EMS & Fire Instructor, Adjunct Faculty, Educator, and Administrator for initial and continuing education classes—for all the levels of EMS (including EMR, EMT, Intermediate, and Paramedic) as well as a number of Fire and Rescue classes. In the educational setting, Mr. Sechler was a contributing author on several different curriculum that were adopted at the State level, for use in training EMS providers, including: ~Wisconsin Communuty EMS (CEMS) Curriculum ~Wisconsin Critical Care Transport Paramedic Curriculum ~EMT-Paramedic to Paramedic Specialist Bridge Curriculum ~EMS Leadership and Operations Management Curriculum Page 11 of 17 Over the last several years, Mr. Sechler has become quite active in the Legislative process— advocating for Fire & EMS with elected officials—both at the State and Federal level. Dana is a respected resource in the Public Service community and is often asked to speak on a number of current and critical issues at local, State, and Regional conferences for Fire & EMS. He has been a valued member on various Fire & EMS projects, Committees, Boards, and Associations at the local, State, and National levels, including: ~American Ambulance Association ~National Association of EMT’s ~National Association of EMS Physicians WI Chapter Board member ~Past-President & Board Member of the Professional Ambulance Association of Wisconsin ~Wisconsin EMS Advisory Board, Systems Development sub-committee member ~Wisconsin Legislative Council Study Committee member on Volunteer Firefighter and Emergency Medical Technician shortages As one of the co-founding Principals of Strategic Management & Consulting, LLC, Dana has conducted a number of EMS Leadership courses across the State (on behalf of the Wisconsin Office of Rural Health) utilizing a course curriculum that he co-wrote and developed. In short, Mr. Sechler has gained a wide variety of experience in almost every possible aspect of Emergency Medical Services and the Fire Service, which can be drawn upon for some unique and out-of-the box ideas and solutions to issues affecting Fire & EMS in today’s complex environment. Andy Ney, BA, CCP, FFI Consultant Andy Ney brings over 13 years of active involvement in Emergency Medical Services (EMS) showcasing a diverse and accomplished career. His journey includes roles as an EMT, Paramedic, and Critical Care Paramedic, holding licenses in Iowa, Wisconsin, and Illinois. Notable administrative positions include serving as the Director of Operations at Paramount EMS in Dubuque, Iowa, as well as the Paramedic Program Director at Northeast Iowa Community College in Peosta, Iowa. Complementing his professional commitments, Andy has devoted over a decade as a volunteer Firefighter / Paramedic with the Centralia-Peosta Fire Department, underscoring his dedication to community well-being. A key figure in the Iowa EMS Association (IEMSA) since 2018, Mr. Ney has held pivotal roles as President, Treasurer, and Board Member. His insights into EMS operations span all ownership types, and he has been particularly impactful in the Legislative Committee, contributing to Page 12 of 17 significant victories in Iowa, including the GEMT Supplemental Medicaid Payment and the passage of the Essential Service bill in 2021. Additionally, Andy holds a position on the Professional Ambulance Association of Wisconsin (PAAW) Board in the For-Profit sector, further solidifying his influence in shaping ambulance services in Wisconsin. Beyond leadership and association roles, Andy is actively involved in Contract Paramedic positions with The Medic Rig and The Snocross Mobile Medical Team, providing his expertise to the national motocross and snocross circuit. Mr. Ney has the following Credentials: Bachelor of the Arts Degree in Management Critical Care Paramedic EMS Instructor Firefighter I HazMat Ops Various certifications from: American Heart Association (AHA) National Association of Emergency Medical Technicians (NAEMT) Chief Nick Siemens Consultant Chief Nick Siemens started his Fire & EMS career as a volunteer firefighter with Bettendorf Fire Rescue in 1998. He then took a full-time position with Cheyenne Fire Rescue, where he spent 19 years serving the community. He held the ranks of firefighter, paramedic, engineer, and company officer, before being promoted to the rank of Division Chief of Training. Duties associated with the Division Chief position included planning and coordinating an annual training program for all Operations level personnel; planning and coordinating the new-hire recruit academy; supervising and coordinating the activities of other instructors; developing a comprehensive training program for use by single or multiple organizations; conducting an organization needs analysis; developing training goals and implementation strategies; preparing a training budget; planning and coordinating a training program for the department Standard Operating Procedures, and developing and administering assessment center testing for promotional exams. During his time at Cheyenne Fire Rescue, Chief Siemens was also the Program Director for the Laramie County Community College Fire Science Program, and he was the past chair of the Laramie County Training Officers group. Page 13 of 17 In 2023, Nick joined Western Taney County Fire Protection District as the Division Chief of Training. The Fire Protection District is a combination department that utilizes a wide range of staff—from volunteers to full-time personnel. Nick’s duties include providing direct supervision to 20 fire district instructors during training evolutions and classes. He also coordinates the annual training program and assists in program delivery as needed. As a Division Chief he is integrated into the Incident Command System during emergencies of all types and has experience directing fire ground and other emergency operations. Chief Siemens has the following Credentials: Master of Science - Disaster Preparedness and Executive Fire Department Leadership Bachelor of Science - Public Safety and Emergency Management Associate of Applied Science - EMS - Paramedic Fire Officer I &II Fire Instructor I & II Fire Inspector I HazMat Ops Blue Card Incident Commander Program National Fire Academy (NFA): ~ Managing Officer Program ~ Leadership Strategies for Company Success ~ Training Program Management ~ Fire Service Course Design To sum up, Mr. Sechler, Mr. Ney, and Mr. Siemens, have a wide variety of experience in almost every possible aspect of Emergency Medical Services (EMS) which can be drawn upon for the best well-rounded results in this Comprehensive Study. They have assisted many Rural departments that are volunteer, combination, paid-on-call/paid-per-call, part-time, and full-time in becoming successful EMS agencies in the State. In addition, since the Principal Consultant for this Comprehensive Study was previously the ALS / Paramedic Program Coordinator for the State DHS EMS Office, he continues to maintain a very good working relationship with the staff at the EMS Office, which allows for a direct line of communication to be able to determine the best Recommendations for the delivery of EMS— as balanced by current Rules, Regulations, and Statutes. Page 14 of 17 References from Previous Projects In the Fall of 2022, Strategic Management & Consulting, LLC contracted with four Towns in Vilas County to perform a Study on Recommendations to Provide an Ambulance Service in a Viable and Sustainable EMS Model. The Report with Recommendations for a District-wide and a County-wide Ambulance was delivered in March 2023. The report included a step-by-step process to implement both the District-wide and County-wide options. In the Fall of 2023, Strategic Management & Consulting, LLC then contracted to provide implementation and consulting services for a District-wide Ambulance Service within the four Towns, of which the Project is currently underway. They are currently in the process of hiring their first full-time EMS Director. Contact: John Hanson, Town Chair Jessica Mabie, MWFD EMS Chief P.O. Box 267 13210 Cranberry Blvd Manitowish Waters, WI 54545 Manitowish Waters, WI 54545 (715) 543-8413 (715) 614-3032 townchair@mwtown.gov Emsmwfc@gmail.com Strategic Management & Consulting, LLC was awarded the contract for the development of a detailed step-by-step County-wide EMS Implementation Plan, along with supporting Budgets, to implement a proposed Model for EMS delivery in Florence County. The Document for the Project was completed in May 2022, and the County has since been in the process of following the steps of the Implementation Plan, with occasional assistance and advice from our Firm. Contact: Amanda Mulvey, Emergency Management Coordinator P.O. Box 410, 501 Lake Avenue Suite 266 Florence, WI 54121 (414) 296-1059 amulvey@florencecountywi.gov Strategic Management & Consulting, LLC was awarded the contract for the review and analysis of the Dodge County EMS delivery system. This included EMS coverage of 24 Towns, 11 Villages, and 9 cities by 10 volunteer EMR agencies, 10 volunteer ambulance services, and 2 career fire-based agencies. The project was completed on January 31, 2020. This project reviewed a number of aspects of EMS Delivery across the entire County. Contact: Amy Nehls, Emergency Management Director 210 W Center St. Juneau, WI 53039 (920) 386-3993 Page 15 of 17 Timeline Strategic Management & Consulting, LLC understands that the anticipated start date of the Project will be April 1, 2024, with the delivery of the Final Report by June 30, 2024. We are confident that we can successfully perform the Comprehensive Study and submit the Final Report within that timeframe. The list below shows the key dates. Date Task / Activity ☐ March 22, 2024 Due date for submittal of the Response to the RFP ☐ TBD Proposals reviewed, and Consulting Firm is chosen ☐ April 1, 2024 Start of the Comprehensive Review / Analysis Begin collection of data from the County Project Manager ☐ Month of April Set dates for Stakeholder Interviews / Community Engagement ☐ Month of May Begin Comprehensive review of information ☐ June 3, 2024 Begin drafting initial Report ☐ June 17, 2024 Preliminary Report provided to County Project Manager for review ☐ June 17 – June 28, 2024 Edits and updates to Report ☐ June 30, 2024 Final Report delivered to County Project Manager ☐ TBD Presentation of Final Report details Insurance Strategic Management & Consulting, LLC has insurance policies through the following entities: The Hartford Business Service Center General Liability = $1,000,000 / $2,000,000 Employment Practices Liability = $10,000 Hiscox, Inc. Professional Liability = $1,000,000 Certificates of Insurance are being provided, along with this Response to the RFP. Page 16 of 17 Cost Quotation Strategic Management & Consulting, LLC will provide a comprehensive Study of EMS in Bayfield County and will complete a Final Report to include short-term and long-term Goals, Recommendations and Suggestions—for the Elected Officials to utilize in the assurance of a viable and sustainable Ambulance Service to the Communities within the County. Included in the Final Report will be a step-by-step Implementation plan that can be utilized in bringing the Recommendations to fruition. Total Cost for the Project = $34,500.00 This bid includes all expenses related to the Project, including: a. Comprehensive Study of the scope of items listed within this proposal. b. Labor / Materials. c. Meeting costs, including travel, and lodging for two (2) in-person / face-to-face sessions. The first session will be to conduct initial interviews with selected stakeholders, as part of the discovery process for the Comprehensive Study. (Additional interviews can be performed via Zoom.) The second session will be to present the findings discussed in the Final Report to all interested parties, as well as to answer any questions from those that wish to participate. Payment Schedule will be as follows: $10,000.00 payment due within 10 days of signing contract $10,000.00 payment due on May 1, 2024 $10,000.00 payment due on June 1, 2024 $4,500.00 payment upon delivery of the Final Report Page 17 of 17 Options for Consideration for Future Projects 1. Strategic Management & Consulting, LLC can provide additional, future Consulting services via phone, email, and text that will focus on the individual steps needed to implement the various processes presented in the Final report. This may include the development of new documents that are needed for the implementation process, and/or the completion of applications, etc. that are required for that project. The fee for this service can be negotiated at a one-time flat rate, or at an on-going hourly rate. 2. After the completion of the Comprehensive Study, Strategic Management & Consulting, LLC can provide an EMS Operations Management & Leadership Course for up to 25 participants of your choosing. This class is 12 hours in length and will be based on the current EMS Operations Management & Leadership Course that is being taught by Strategic Management & Consulting, LLC through the Wisconsin Office of Rural Health—but it will be tailored to the Findings & Recommendations that will be included in the submitted Final Report. The Sessions for the EMS Operations Management & Leadership Course can be as follows: Held over six (6) Zoom sessions, on days / times of the week that are best for the participants. Or, Held in person, over a Friday evening through Saturday evening time period. 1 Bayfield County (Wisconsin) Request For Proposal (RFP) RFP 2024-18-04 Study for County-Wide Emergency Medical Services (EMS) In Bayfield County Issued: February 28th, 2024 Due Date: March 22nd, 2024 Bayfield County Emergency Management 117 E. 6th Street Washburn, WI 54891 2 Table of Contents RFP COVER SHEET ................................................................................................................................... 3 Purpose................................................................................................................................................... 4 Background ............................................................................................................................................. 4 Total Calls for Service: ............................................................................................................................. 5 Calls for Service by Jurisdiction: .............................................................................................................. 5 Bayfield County 2021 Expenditures: ....................................................................................................... 6 Project Deliverables and Objectives ........................................................................................................ 7 Qualifications .......................................................................................................................................... 8 Project Timeline ...................................................................................................................................... 8 Proposals should include: ....................................................................................................................... 8 Proposals Due: ........................................................................................................................................ 9 3 RFP COVER SHEET Issue Date: February 28th, 2024 RFP 2024-18-04 Title: Study for County-Wide Emergency Medical Services (EMS) in Bayfield County Issuer: Bayfield County Administrator 117 E. 5th Street Washburn, WI 54891 Due Date: Proposals will be received untfl March 22nd at 2:00 p.m. CST. Inquiries: All inquiries for informatfon should be directed to: Meagan Quaderer, Director Or Maria Renz, Assistant Bayfield County Emergency Management 117 E. 6th Street P.O. Box 423 Washburn, WI 54891 Office: 715-373-6113 Email: EM@bayfieldcounty.wi.gov 4 Purpose Bayfield County is seeking proposals for a consultant to perform an assessment of Emergency Medical Services throughout the county to help the community leadership understand the systems and how actfons and initfatfves may be developed and designed with the goal of long-term reliability, sustainability, and viability. Over the last several years, the current EMS structure has experienced an increase in requests for service while also experiencing a decrease in staffing, understanding EMS services are primarily staffed by volunteers. Leaders are concerned about their ability to sustain a reliable EMS system into the future. This concern stems from many potentfal causes such as the change in volunteerism within our communitfes, the increase in call volume, and the working relatfonships between EMS organizatfons, other healthcare organizatfons, and other key stakeholders, such as elected officials. Demands on EMS services have increased as a result of public expectatfons, changing demographics, expenses, transport distances and educatfon/licensing requirements. More is being expected of rural EMS as healthcare consolidates and trauma, cardiac and stroke care becomes regionalized in specialty care centers resultfng in longer transport and more transfers. The cost of running an ambulance service is increasing faster than funding sources and the need to find new sources of rural EMS funding contfnues to be a challenge. For all of these reasons, Community leaders within Bayfield County are seeking a comprehensive assessment of EMS within the county to provide a better understanding of the strengths and weaknesses of the current EMS structure. Background Bayfield County is located in Northwestern Wisconsin on the southern shore of Lake Superior. Bayfield County covers approximately 2,042 square miles and has a year-round populatfon of 16,608 which nearly doubles in the summer with seasonal residents. Nine (9) EMS independent transportfng EMS agencies serve Bayfield County; two (2) full-tfme paramedic level services; six (6) hybrid paid/volunteer services; and one (1) volunteer, paid-on-call EMS transportfng service. Additfonally, Bayfield County has a newly formed County-Wide EMS Service that is non- transportfng and focuses on Mass Casualty Incidents (MCI) only. All nine transportfng services respond with emergency vehicles from their local statfons. Calls for emergency services are dispatched by the County single PSAP (Public Safety Answering Point) located in Washburn at the Bayfield County Sheriff’s Office. A report created in 2022 by the Bayfield County Ad Hoc EMS Advisory Committee can be found here: https://www.bayfieldcounty.wi.gov/DocumentCenter/View/13776/EMS-Committee-Report 5 Total Calls for Service: Agency 2022 2023 Ashland 70 111 Barnes 104 108 Bayfield 185 222 Great Divide 428 341 Iron River 372 306 Mason 156 135 Red Cliff 336 325 South Shore 106 97 Washburn 438 499 Total 2,125 2,033 Calls for Service by Jurisdiction: Town 2022 2023 Barksdale 42 55 Barnes 97 86 Bayfield - Township 68 84 Bayfield – City 97 88 Bayview 33 28 Bell 33 23 Cable 113 108 Clover 15 16 Delta 33 26 Drummond 104 81 Eileen 3 1 Grand View 59 48 Hughes 29 38 Iron River 223 164 Kelly 45 24 Keystone 18 20 Lincoln 16 11 Mason - Township 25 17 Mason - Village 4 5 Namakagon 51 51 Orienta 6 10 Oulu 46 34 Pilsen 1 2 Port Wing 46 36 Red Cliff – Tribal Nation 313 295 Russell 11 14 Tripp 13 17 Washburn – Township 29 30 Washburn - City 307 333 6 Bayfield County 2021 Expenditures: Local Jurisdiction Population Annual Cost Per Capita Amount Barksdale 725 $33,188 $45.78 Barnes 772 $208,279 $269.79 Bayfield - Township 704 $90,180 $128.10 Bayfield – City 484 $209,700 $427.07 Bayview 484 $34,388 $71.05 Bell 281 $89,360 $318.01 Cable 829 $96,920 $116.91 Clover 218 $32,014 $146.85 Delta 275 $29,269 $106.43 Drummond 433 $102,994 $237.86 Eileen 691 $52,943 $76.62 Grand View 471 $28,815 $61.18 Hughes 394 $29,065 $73.77 Iron River 1,170 $132,173 $112.97 Kelly 472 $24,948 $52.86 Keystone 368 $24,808 $67.41 Lincoln 289 $15,000 $51.90 Mason - Township 324 $23,588 $72.80 Mason - Village 93 $8,156 $87.70 Namakagon 249 $65,725 $263.96 Orienta 121 $20,000 $165.29 Oulu 533 $11,208 $21.03 Pilsen 213 $17,439 $81.87 Port Wing 379 $71,732 $189.27 Russell 1,553 $22,817 $14.69 Tripp 239 $6,939 $29.03 Washburn – Township 556 $25,889 $46.56 Washburn - City 2,069 $205,193 $99.17 7 Project Deliverables and Objectives Create a report which details optfons of sustainable future EMS models, which may include regionalizatfon and/or shared services. The report should detail recommendatfons that can be implemented in 2 phases: short-term (3 – 5 years) and long-term (5 – 10 years). As a result of the study, Community Leaders would expect to be able to do the following: • Determine best practfce method to deliver cost effectfve and efficient EMS service to their citfzens. • Compare the value in dollars of donated labor (volunteers) vs. the full and total cost of providing EMS in the area, and the gap between current financial resources and what will be needed for long-term sustainability. • Establish processes for the development of short term (3 – 5 years) and long-term needs (5 – 10 years) for statfons, personnel, major equipment, and vehicles. • Understand vehicle and equipment needs for EMS, and Fire services over the course of the next 20 years. • Meet with the Bayfield County Ad Hoc EMS Advisory Committee during the study process and the Bayfield County Executfve Committee to present findings and recommendatfons. When compiling recommendatfons, the areas below should be reviewed and considered: • The current capabilitfes, strengths, weaknesses, coverage gaps and workforce shortialls. • System reliability including the ability or inability to respond to current and future requests for service • Response tfmes and statfstfcs • Call Volume • Coverage Areas, including recommendatfons for district creatfon or shared facilitfes • Staffing Time – Full-tfme, part-tfme, paid on call, volunteer • Staffing Training Levels - Paramedic, EMT-Advanced, EMT-Basic, Emergency Medical Responders (EMR) • Pay and Benefits - Governance/Management – municipal, private, county, etc. • Interfacility Transfers (in county from licensed facilitfes) versus Emergent Calls • Review of budgets • Review of billing company services • Review of succession planning • Vehicle and Equipment Needs • Vehicles and staffing/run assignments • Review of vehicle fleets, replacement plans and future needs assessment • Any other areas as needed 8 Qualifications Eligible bidders (Bidder) will be those individual consultants, companies and instftutfons that have the following qualificatfons: 1) A minimum of 8 years of experience and expertfse in regard to the operatfons, structure, staffing and other issues critfcal to the effectfve operatfon of a modern EMS department with a focus on volunteer, combinatfon and/or paid on call organizatfons. Experience studying and assessing rural Wisconsin EMS organizatfons required. 2) Bidder must possess a proven record of accomplishment of reviewing EMS department management and operatfons and making “attainable” recommendatfons that are legal, ethical, and take into consideratfon existfng service agreements and budgets and that can actually result in improving operatfons. 3) Knowledge of federal and state laws and regulatfons and generally accepted standards for similarly sized communitfes and EMS departments. Preference given for experience in assessing the challenges of rural EMS. Project Timeline • April 1, 2024 - Antfcipated project commencement. • August 9th, 2024 - Completfon of the study, along with recommendatfons for improvements Proposals should include: • Method to complete the project • Time Frame to complete key portfons of the project • Introductfon page for those that will be involved with the project • Three (3) references with contact informatfon from similar projects involving rural EMS agencies in the past 5 years. Wisconsin projects preferred. • List of Deliverables • Cost for the project plus the cost of an implementatfon plan 9 Proposal Evaluation 1. Mandatory Elements a. The firm has no conflict of interest regarding any other work performed by the firm for the County. b. The firm adheres to the instructfons in this request for proposal on preparing and submitting the proposal. c. The firm submits a copy of its insurance. 2. Technical Qualificatfons a. Demonstratfon of experience and qualificatfons of staff. b. Demonstratfon of experience and performance on comparable government engagements. c. Proposed methods and approach in serving Bayfield County. 3. Proposed Schedule of Compensatfon Proposals Due: Proposals are due to Meagan Quaderer by March 22nd, 2024, at 4:00 pm (CST). Proposals may be delivered via email or in person to: Bayfield County Emergency Management Attn: Meagan Quaderer, Director 117 E. 6th Street P.O. Box 423 Washburn, WI 54891 EM@bayfieldcounty.wi.gov Questfons regarding this RFP should be directed to the Project Manager, Meagan Quaderer, Director of Emergency Management, at meagan.quaderer@bayfieldcounty.wi.gov or 715-373-6113. Bayfield County reserves the right to waive any informalitfes or technicalitfes and to reject any and all proposals or parts thereof deemed to be unsatfsfactory or not in the County’s best interest. Furthermore, Bayfield County reserves the right to cancel any order or contract for failure of the successful firm(s) to comply with the terms, conditfons, and specificatfons of this request and/or contract. Bayfield County reserves the right to award this request to the firm or firm’s whose proposal is overall the most advantageous to the County in the County’s sole determinatfon. PAGE 1 CONSULTING SERVICES PROPOSAL Study for County-Wide Emergency Medical Services (EMS) In Bayfield County PO Box 170, 2901 Williamsburg Terrace, Suite G, Platte City, Missouri 64079 (816) 431-2600 (816) 431-2653 www.fitchassoc.com CONSULTING SERVICE PROPOSAL Bayfield County Emergency Medical Management PAGE 2 CONSULTING SERVICES PROPOSAL Study for County-Wide Emergency Medical Services (EMS) In Bayfield County TABLE OF CONTENTS ORGANIZATIONAL HISTORY ............................................................................................... ERROR! BOOKMARK NOT DEFINED. QUALIFICATIONS OF THE TEAM ......................................................................................... ERROR! BOOKMARK NOT DEFINED. PROJECT TEAM ..................................................................................................................................................................6 WORK PLAN ...................................................................................................................... ERROR! BOOKMARK NOT DEFINED. METHODOLOGY ............................................................................................................................................................... 11 CLINICAL CARE ................................................................................................................................................................................................. 12 OPERATIONAL PERFORMANCE ANALYSIS .............................................................................................................................................................. 13 FISCAL ANALYSIS ............................................................................................................................................................................................... 13 REGULATORY/LEGAL ENVIRONMENT EXAMINATION ............................................................................................................................................... 13 COMMUNITY ISSUES .......................................................................................................................................................................................... 13 ORGANIZATION STRUCTURE AND EFFECTIVENESS ................................................................................................................................................. 13 APPROACH TO DATA COLLECTION .................................................................................................................................... 14 QUESTIONNAIRE ............................................................................................................................................................................................... 14 EXAMINATION OF RECORDS AND REPORTS ............................................................................................................................................................ 14 INTERVIEWS ...................................................................................................................................................................................................... 14 DIRECT OBSERVATION........................................................................................................................................................................................ 15 REFERENCE ...................................................................................................................... ERROR! BOOKMARK NOT DEFINED. WAYNE COUNTY, NEW YORK .............................................................................................................................................................................. 15 BRADFORD COUNTY, PENNSYLVANIA ................................................................................................................................................................... 16 NEW BEDFORD, MASSACHUSETTS ...................................................................................................................... ERROR! BOOKMARK NOT DEFINED. PROPOSED PROJECT COST ............................................................................................... ERROR! BOOKMARK NOT DEFINED. CONSULTING SERVICE PROPOSAL Bayfield County Emergency Medical Management PAGE 3 March 15, 2024 Meagan Quaderer, Director of Emergency Management Bayfield County Emergency Management 117 E. 6th Street Washburn, WI 54891 Dear Meagan Quaderer, Thank you for considering Fitch & Associates LLC (FITCH) as a consulting firm for the Bayfield County Emergency Medical Management agency. We understand the need for a report detailing options for sustainable future Emergency Medical Services (EMS) models, covering short-term (3 – 5 years) and long-term (5 – 10 years) recommendations. Our firm is uniquely qualified to submit this proposal and perform the work required. FITCH has designed, developed, and managed some of the world’s most innovative EMS systems. The study aims to help community leaders determine the best method(s) to deliver cost-effective and efficient EMS service to Bayfield County residents. It should include the development of short and long-term financials and project needs for EMS for the next 20 years and compare the value in dollars of donated labor (volunteers) vs. the complete and total cost of providing EMS in the area. When compiling recommendations, we will review and consider the following areas: • Current capabilities, strengths, weaknesses, coverage gaps, and workforce shortfalls. • System reliability, including the ability or inability to respond to current and future requests for service. • Response time statistics, call volumes, and coverage areas. • Staffing time, training levels, pay, benefits, and governance/management. • Interfacility transfers, review of budgets, billing company services, and succession planning. • Vehicle and equipment needs, review of vehicle fleets, replacement plans, and future needs assessment. We appreciate the opportunity to provide this proposal for your consideration. Please do not hesitate to contact us with any questions or additional information. Thank you. Warm Regards, J. Todd Sheridan, NRP, MBA Junior Partner CONSULTING SERVICE PROPOSAL Bayfield County Emergency Medical Management PAGE 4 Organizational History FITCH is a Limited Liability Company initially established as a corporation in 1984. The Firm is located in Platte City, Missouri, a suburb of Kansas City. Our physical mailing address and office contact information are as follows: PO Box 170, 2901 Williamsburg Terrace, Suite G, Platte City, Missouri 64079 (816) 431-2600 (816) 431-2653 FITCH has earned credibility for nearly forty years by implementing innovative, customized solutions in the public safety and healthcare arenas. The Firm has consulted with over 1,500 communities in 50 U.S. states, most Canadian Provinces, and 12 other countries. Projects have ranged from objective reviews, analysis and system design issues, productivity, consolidation, mergers, strategic partnership designs, and enhancement studies to detailed operational, financial, and transition management services. In addition to review and design services, FITCH has developed and managed some of the world’s most innovative emergency service systems. In addition to its partners, FITCH has full-time Senior Associates, research, and support staff members. These combined resources provide expertise on matters as diverse as organizational psychology, accounting, economics, healthcare administration, public information and education, marketing research, emergency medicine, fire service administration, law enforcement, safety management, and “Just Culture” concepts. The Firm's success is attributable to its experience, credibility, and the solid consulting methodologies it develops and applies to reflect individual situations. System stakeholders are typically deeply involved in the consultation process. Our collaborative approach facilitates support for implementation and long-term system stability. Project research outcomes are data-driven and identified within a community-specific, comprehensive, objective, and accurate framework. The firm seeks out opportunities to partner with agencies and communities willing to ask the tough questions, seek transparency and public input, and are interested in planning for the future in a sustainable manner aligned with community expectations and unique community risks. We approach every decision as a collaboration because we CONSULTING SERVICE PROPOSAL Bayfield County Emergency Medical Management PAGE 5 understand the value of successful partnerships. We provide our clients with a team and approach to clarify project goals, make informed choices, obtain stakeholder buy-in, and take command of their projects from concept development through implementation. Finally, we bring the energy, focus, and credentials that drive decision-making and action. The firm’s consultants have direct Private EMS, municipal EMS, and fire‐based EMS leadership experience. In addition, one distinctive added value is that FITCH manages EMS programs across the country as part of our management services. In this manner, our expert consulting informs our real-world service models, and our direct management services provide information to our expert consulting. We can provide and validate recommendations and alternatives because we are utilizing and refining our operational and fiscal analytics to ensure that all recommendations are implementable and highly accurate. In other words, we practice what we preach and can assist municipal clients in understanding the market space, profit margins, and inherent capacity to perform. Qualifications Of The Team FITCH’s specific strengths for this project are centered on objectively conducting research, managing multiple project priorities, and blending expert and local resources while building support for the outcome(s). Our key strengths include talented and experienced consultants who are leaders in their field, time-tested methods, quality teamwork, timeliness, and the ability to provide tangible results. Talent Team members are all subject matter experts and leaders in their fields and have been selected for their particular areas of expertise that match the requirements of this project. Time-Tested Methodologies FITCH’s experience represents an unparalleled base for the tasks at hand; we have worked with local, state, and federal government agencies, municipal and volunteer fire departments, ambulance services, and hospitals. Teamwork FITCH has stayed true to its core values by accomplishing projects using a collaborative approach offering high level involvement for system participants without compromising the independent or objective nature of the project. CONSULTING SERVICE PROPOSAL Bayfield County Emergency Medical Management PAGE 6 FITCH has real-world experience managing extensive urban and rural services nationwide and a track record of content- specific consulting. Each of the firm’s partners and associates, including the project director proposed for this project, have extensive emergency services management experience. The commitment of top-level resources underscores the importance FITCH places on this project team. Project Team A project with this level of complexity requires a focused approach by each member of its team. Therefore, consulting staff involved in the review will include a targeted deployment of our partners and senior associates with specific expertise. The following will serve as the primary consulting staff for this project. Todd Sheridan will be the project director and primary consultant, while other key team members will support the comprehensive and timely completion of project objectives. Guillermo Fuentes – COO/Partner: Guillermo Fuentes, MBA, has 25 years of emergency services experience that spans multiple public safety services and jurisdictions. He has held executive positions for more than a decade being named Deputy Chief of Montreal (Canada) EMS in 1999. Montreal EMS is the 5th largest municipal ambulance service in North America answering over 300,000 calls for service, while in Montreal he was responsible for overseeing 1100 field employees. One of his core duties was to manage a 118-person communication center. He subsequently served as Deputy Chief of EMS for Niagara EMS and was responsible for building and staffing a new communications center. He led both centers through their NAED accreditation process. Mr. Fuentes subsequently served as the Chief Administrative Officer for the Niagara Regional Police Service. In this role he was responsible for Information Technology, Human Resources, Records, Communication Center, Fleet, and other administrative duties including the finance function. As CAO he also served as the CFO overseeing a 150-million-dollar operating budget. Timeliness FITCH is known for consultant access, responsiveness, producing its work on or before the scheduled completion date and within budget. Tangibles FITCH is known for developing innovative solutions to complex issues, and our recommendations and tangible work products have been implemented more frequently than any national public- safety consulting firm. CONSULTING SERVICE PROPOSAL Bayfield County Emergency Medical Management PAGE 7 Mr. Fuentes has worked with FITCH on a part-time basis for eight years and joined the firm full-time in 2012. He routinely engages in complex projects. His ability to move between field operations, dispatch centers and administrative functions - applying statistical analysis to real life situations makes his contribution to projects both complete and practical. He holds a Masters Certificate in Management from Tulane University and a Masters in Business Administration from Aspen University. J. Todd Sheridan, MBA – Junior Partner: J. “Todd” Sheridan is a seasoned EMS leader with expertise in operations, finance, and strategic planning. He has held senior leadership roles within EMS agencies developing optimized strategies to meet expected performance and financial goals. He has functioned as an executive through the firm’s on-site management services for both major university medical centers and County EMS programs. In those multi-year projects, he was responsible for enhancing efficiency and financial performance, designing, and leading mergers, and providing day-to-day leadership guidance during times of transition. Mr. Sheridan specializes in “right-sizing” organizations. His modeling is centered around knowledge transfer which focuses on return-on-investment strategies, so the employees learn how to create and maintain sustainable EMS systems. Mr. Sheridan’s consulting projects have ranged in size from smaller community initiatives to large urban high- performance EMS systems. His skills include assessment and strategic planning, data analysis, operational performance improvement, financial modeling, and staff development. In larger system projects, he has been responsible for implementing major system changes. He implemented new resource management and deployment systems for an EMS system that annually answered more than 100,000 requests for service, and improved processes for a communications center that annually handled more than 250,000 requests, to significantly improve the center’s performance. Mr. Sheridan previously served with multiple EMS and Fire agencies including roles as a senior operations leader with the Richmond Ambulance Authority and the Central Virginia All Hazards Incident Management Team. He holds a Masters in Business Administration and a Bachelor of Science degree in Emergency Services. Mr. Sheridan continues to maintain his national registry certification as a Paramedic. Frank Gresh – Senior Consultant: Frank Gresh has been involved in Emergency Medical Services for nearly 40 years. In that time, he has served in many roles including EMT, Paramedic, dispatcher and has served in a variety of management roles in communications, operations, and technology. Most recently, Frank was the Chief Information Officer (CIO) for the Emergency Medical Services Authority in Tulsa and Oklahoma City, Oklahoma. In that role Frank was responsible for all aspects of technology including computer systems, radio systems, clinical technology and both physical and cyber security. Frank has a bachelor’s degree in business management and a master’s degree in computer information systems. CONSULTING SERVICE PROPOSAL Bayfield County Emergency Medical Management PAGE 8 Frank is a faculty member for the FITCH Ambulance Service Manager Program (ASM) and the Communications Center Manager Program (CCM). Frank has consulted nationally and internationally on wide-ranging topics from system assessment and improvement projects to implementation of System Status Management. He is a sought-after speaker on topics including the use of technology in public safety, performance improvement, and leadership. Fred Wurster III, MS, NRP – Senior Consultant: Fred Wurster has nearly 25 years of career and volunteer fire and EMS experience. He brings over 15 years of experience in progressive leadership roles in emergency services organizations that span multiple hospitals, volunteer, and career public safety services. He most recently served as EMS Chief for a 7- hospital health system in southeastern Pennsylvania, where his responsibilities included merging 3 EMS systems spanning four counties of 911 ALS/BLS service. Prior to this role, he served as EMS Chief for a fire-department-based EMS agency in Downingtown, PA. In addition to his responsibilities at FITCH, he also serves as the Pre-Hospital Training Programs Manager for the University of Pennsylvania, Perlman School of Medicine in Philadelphia and continues to maintain active status as a paramedic and Critical Care Transport/Flight Paramedic. Fred has published several peer-reviewed articles and spoken at multiple national and regional conferences. Chad Premo, BS - Associate: Mr. Premo brings 30 years of EMS experience with over a decade of progressive leadership experience. He has experience in 911 operations, hospital-based and private ambulance services. Chad also has an extensive critical care and aeromedical background. He most recently served as the Field Operations Director for a sizeable catholic hospital air and ground transportation system. Chad’s areas of expertise include operations, risk management, stakeholder relations, financial analysis, system design, strategic planning, and public affairs. Brian McGrath – Senior Consultant: Brian McGrath serves as President of CAD North Inc. His responsibilities include Administration, Marketing, Software Development, and Business Analysis/Requirements Documentation. He brings over 18 years of experience in Information Systems management and development in the public safety industry, including 10+ years of Business and Systems Analysis in public safety software development. He has exceptional ability at requirements capture, analysis, and documentation. He is fully conversant with all aspects of the software product development and implementation life cycle. He is an experienced software developer of public safety dispatch applications, including software development using TriTech’s RAPTOR API. He possesses excellent communication and interpersonal skills is comfortable at all organizational levels and has a solid base of operational experience in public safety communications. Gang Wang – Senior Consultant: Dr. Wang is an expert in analyzing fire department, emergency medical service (EMS) agency, and private ambulance service workload, deployment, and response time. Dr. Wang has completed more than seventy fire and EMS studies in thirty states. He specializes in managing large-scale data sets and applying advanced mathematical models to design the most efficient system to provide fire and EMS services. CONSULTING SERVICE PROPOSAL Bayfield County Emergency Medical Management PAGE 9 Dr. Wang holds a Ph.D. degree in industrial engineering from Wayne State University. Dr. Wang has conducted research in areas of cross-cultural decision making, supply chain management, and revenue management. He has presented at national and international conferences and has published several peer-reviewed journal articles and a book chapter. Work Plan Our project management methodology is a disciplined and structured approach to managing projects. This approach will provide a framework for effective management and completion of this project while providing ample flexibility to meet your organization's unique needs. Key activities are clearly outlined and logically organized to produce specific deliverables within the period. We will review our progress against our work plan regularly to ensure that we are progressing according to plan. Any deviations will be flagged immediately, and appropriate action will be taken, through discussion with you, to address any potential issues. The following figure graphically illustrates the project approach. Figure 1 - Project Approach Each phase of our project approach is described below including Assessment initiation, Baseline information development, Components and Models, Development of responses, and Evaluation of options and decisions to implement. CONSULTING SERVICE PROPOSAL Bayfield County Emergency Medical Management PAGE 10 A A kick-off meeting to finalize the work plan and timeline is paramount to a successful study and the ability of FITCH to maximize the effectiveness of its team. At the kick-off meeting, an overview of the project’s approach will be provided to stakeholders. Any final scheduling and logistics issues will be resolved during this phase. B Baseline information is collected and typically includes the following: Previous studies and planning documents. Annual reports and records. Available response and deployment planning data. Budgets and expenditure reports. Relevant performance documentation Additional documentation and other performance measures based on our experience conducting similar reviews. Baseline data is collected utilizing an Information and Data Request (IDR) instrument to collect detailed information from the providers, communications center, and stakeholders. The IDR will be modified and targeted to meet the specific objectives of this project. Included in this document will be a Geo-Spatial Data request to allow us to conduct a comprehensive demand analysis. The IDR data is essential for shaping initial questions, guiding onsite planning, and shortening follow up requests for materials. C Comparing performance to internal and external benchmarks provides a useful framework for objectively evaluating the system. FITCH compares agencies along 50 unique benchmarks in eight broad categories aligned with the Institute for Healthcare Improvement’s Triple Aim goal to enhance the experience of care, understand costs, and improve outcomes. This FITCH analysis includes: Clinical Care Operational Performance & Metrics Fiscal Analysis Regulatory / Legal Environment Examination Community Issues Organizational Structure and Effectiveness CONSULTING SERVICE PROPOSAL Bayfield County Emergency Medical Management PAGE 11 D Development of Future Options is an iterative process based upon the review of the current situation, organizational capabilities, and the service mandate. There is no cookie cutter approach. Options are developed based on the quantitative and qualitative research completed by the consultants. Findings and recommendations are summarized in a slide deck style report supported by additional data tables and materials. E Evaluation of Options and Decisions is the stage where the final two-page executive report with a supporting slide deck, Data Reports, Benchmarking Tables, and Presentation material are presented in a briefing. This provides a framework to discuss the findings, recommendations, implementation strategies, and timeframes. Figure 2 TIMEFRAME Month One Month One/Two Month Two/Three Month Three/Four ACTIVITIES Virtual Kickoff Data Request Tool provided and reviewed. Information Data Request (IDR) Survey completed by key stakeholders. Call Data Received Steering Meeting 1 & 2 (Virtual Meeting) Observations, Interviews, Confirm IDR & Data, Stakeholder Meetings Steering Meeting 3 (Virtual Meeting) Options Development Listing of advantages and disadvantages for options. Site visit if applicable Steering Meeting 3 (Virtual and Site, if desired, Meeting) Briefing for Local Officials & Stakeholder Briefing, Executive Summary and PPT Submitted Steering Meeting 4 (Virtual Meeting) DELIVERABLES Final Scope Confirmation IDR Complete & Site Schedule (if applicable) Issues & Opportunities listing GIS mapping, draft data report, and initial findings. Briefing and Recommendations Completed (Virtual meeting) Draft & Final Executive summary and PPT provided to include phase 3 and financial analysis and modeling, and final presentation to stakeholders (Virtual) PROJECT PHASES Phase 1 Phase 2 Phase 3 Phase 4 Cannot guarantee timeframe as requested in RFP, unless 100% clean and useable data is obtained during first week of project. Figure 2 – Project Phases and Timeline CONSULTING SERVICE PROPOSAL Bayfield County Emergency Medical Management PAGE 12 Methodolody Our project management methodology is a disciplined and structured approach to managing projects. The ultimate purpose of this methodology is to make defining, planning, and controlling of projects a repeatable, consistent, and successful process. All phases of project management are addressed from inception to completion. This approach will be used to provide a framework for effective management and completion of this project, while providing sufficient flexibility to meet the unique needs of your project and organization. Our proposed work plan reflects the key elements of the process. Key activities are clearly outlined and logically organized to produce specific deliverables within the defined timeframe. We will review our progress against our work plan on a two-week basis to ensure that we are progressing according to the plan. Any deviations will be flagged immediately, and appropriate action taken through discussion with you to address challenges. To develop an optimal future state, a broad understanding of what exists and how it benchmarks to best practices is a foundational step. The assessment model we utilize is an objective process that engages stakeholders. Our industry specific framework incorporates a snapshot of six major areas of inquiry including clinical care, operational performance analysis, fiscal analysis, regulatory/legal environment examination, community issues, and organizational structure and effectiveness. The framework acknowledges that state, regional, and local government entities; medical facilities; physicians; nurses; paramedics and EMTs; insurers; and many others must work together to provide the highest possible level of quality within available resources. The following points present the elements that are typically covered within the course of a review such as this. The specific criteria utilized in this project will be reviewed to ensure the scope is effectively captured. Clinical Care Protocol adherence Quality of clinical care (e.g., as measured by reasonable conformance to protocol) Scopes of practice Quality improvement and measurement systems Medical direction and control interaction. Certification and licensure requirements. CONSULTING SERVICE PROPOSAL Bayfield County Emergency Medical Management PAGE 13 Operational Performance Analysis Response times. Performance requirements and compliance. Organizational structure and human resource leadership. Dispatch and Utilization review. Logistical supply chain. Vehicles. Fiscal Analysis System funding. Reimbursement issues. Budget review. Technology upgrade costs. Liability issues. Cost-benefit analysis of various functions. Equipment capitalization. Funding sources. Industry financial reports and models. Regulatory/Legal Environment Examination Contracts. State legislation and regulations. Current ambulance plans. Mutual Aid Agreements. Municipal regulations and ordinances. Other communities’ experience. Community Issues Community involvement. Expectations. Awareness. Historical satisfaction levels. Organization Structure and Effectiveness Legislative issues. System management and services. Inter-agency coordination. Organizational structure option. Service description and relationships. Potential enhancements inventory. System design issues. Leadership and organizational structure. CONSULTING SERVICE PROPOSAL Bayfield County Emergency Medical Management PAGE 14 Approach To Data Collection The consultants utilize four distinct approaches for the collection of data for the review (we understand some of these may not be available): Questionnaire An Information Data Request (IDR) will be provided to the designated providers and completed during visits. This will provide the consultants with key data and information and will also identify the records and reports which they require. Examination of records and reports This begins with a review of any supporting documents for the provision of ground ambulance and communications services. It will include: Review of any previous studies and planning documents. Review of annual reports and records. Review and analysis of available response data. Budgets and expenditure reports. Detailed review of relevant performance documentation, much of which will be identified and collected during the questionnaire stage. Additional documentation and other performance measures based on our experience conducting similar reviews. Interviews Potential interviewees can include: Service Directors and Staff Agency Medical Directors Hospital Representatives Other Stakeholders that are mutually beneficial CONSULTING SERVICE PROPOSAL Bayfield County Emergency Medical Management PAGE 15 Direct observation This approach will be used in at least four areas: Communications/Dispatch Center, where processes and systems, both formal and informal, will be observed. Operations, where the same processes and systems will be observed from a crew perspective. Fleet & Logistics, where direct observation and discussion will be held gather their viewpoints. Administrative, reviewing of daily actives that support operations. References Clark County, Illinois Clark County NY, consulted with FITCH to complete a countywide EMS assessment for the system. This plan included assessing the current county ambulance operations as well as the only remaining non-county ambulance organization. The County and the independent ambulance entity have been attempting to merge for over 10 years without success. FITCH reviewed and recommended operational changes proposed in a phased-in method, with financial and performance implications. Additionally, FITCH aided in completing and managing the merger between the two entities. FITCH responded and was awarded the contract for this position. FITCH worked with local and state legislators to work through taxation issues. FITCH continues to provide both on and off-site management services to aid in the oversight of the county-wide EMS system. Point of Contact: Rex Goble – Chairman Board Email: lionrex1958@yahoo.com Phone Number: 217-218-5686 Wayne County, New York Wayne County NY, consulted with FITCH to complete an EMS countywide strategic plan for the system. This plan included operational changes proposed in a phased-in method, with financial and performance implications. Additionally, Wayne County opened an RFP process in mid-2022 for the purpose of awarding an EMS Project Implementer. FITCH responded and was awarded the contract for this position. This contract is in place for 1 year with the option to extend as needed and provides for both on and off-site management services to aid in the implementation of a county-wide EMS system. CONSULTING SERVICE PROPOSAL Bayfield County Emergency Medical Management PAGE 16 Point of Contact: Jim Lee – EMS County Coordinator, Wayne County NY Email: jlee@co.wayne.ny.us Phone Number: 315-945-0895 Bradford County, Pennsylvania Bradford County, PA engaged FITCH to conduct a comprehensive study of the current EMS system and to assess whether current operations were in line with generally accepted standards and benchmarks used by comparable EMS departments in similar communities and based on “best practices” for local, community-based EMS systems. The outcome of the study was to provide Bradford County with an evaluation of its existing operations and to work closely with Bradford County’s EMS partners, to ensure long-term success, viability, and sustainability of the EMS operations. FITCH provided numerous recommendations including the formation of an EMS Authority, merging numerous agencies together, having the community hospital take over EMS, and having the County form its own EMS service. Point of Contact: Matthew Williams – Director of Planning and Public Safety, Bradford County PA Email: williamsm@bradfordco.org CONSULTING SERVICE PROPOSAL Bayfield County Emergency Medical Management PAGE 17 Proposed Project Cost FITCH recognizes the importance of meeting deadlines and completing the project. Demonstrated performance in achieving our commitment can be derived from our references. Project fees are billed based on attaining milestone events as specific project phases are completed. We propose a fixed fee arrangement for this consultancy. The professional services fee for the consultancy is $49,500. If desired an all-virtual consultancy can be completed with the same deliverables and would reflect a $5,000 discount from the professional services fee as listed above. Travel, expenses, and any payment processing costs incurred will be billed at cost. This fee encompasses the development and delivery of the agency study, including all elements described in this proposal and the deliverables. This ensures that the cost of the project will remain manageable. Payments will be made based on the completion of Phases outlined in Figure 3 – Project Phases and Timeline. Project Activity Professional fee Report detailing options for sustainable future Emergency Medical Services (EMS) models, covering short-term (3 – 5 years) and long-term (5 – 10 years) recommendation. $49,500.00 Payment by Phases of the Project Phase 1: 50% $24,750.00 Phase 2: 30% $14,850.00 Phase 4: 20% $9,900.00 FITCH provides a slide deck (PowerPoint) and two-page project summary. During our review, clients also request a Claims Audit to ensure Medicare and Medicaid billing practices compliance. This review would be separate from the initial study, and FITCH would charge an additional $5,000.00. Following the consultancy, we propose a management services agreement through MedServ, our management services division, at a rate of $350.00 per hour to support any implementation efforts. Thank you for considering our proposal. Our team at FITCH is excited to help you make informed EMS decisions that will improve the quality of care provided by Bayfield County Emergency Medical Management agency. CONSULTING SERVICE PROPOSAL Bayfield County Emergency Medical Management PAGE 18 148 State Street, 10th Floor, Boston, Massachusetts 02109 | (617) 426-2026 | www.publicconsultinggroup.com nor Bayfield County, Wisconsin REQUEST FOR PROPOSAL Study for County-Wide Emergency Medical Services (EMS) in Bayfield County RFP 2024-18-04 March 22, 2024 Bayfield County Emergency Management Attn: Meagan Quaderer, Director P.O. Box 423 117 E. 6th Street Washburn, WI 54891 EM@bayfieldcounty.wi.gov TECHNICAL PROPOSAL 148 State Street, 10th Floor, Boston, Massachusetts 02109 | (617) 426-2026 | www.publicconsultinggroup.com PROPOSAL COVER LETTER March 22, 2024 Bayfield County Emergency Management Attn: Meagan Quaderer, Director 117 E. 6th Street P.O. Box 423 Washburn, WI 54891 Director Quaderer: Public Consulting Group LLC (PCG) is pleased to present this proposal for a Study of County-Wide Emergency Medical Services (EMS) in Bayfield County (RFP 2024-18-04). Our Public Safety Consulting Services (PSCS) team brings direct Wisconsin, Midwest, and national experience to this project and is eager to begin working with you to help shape the framework for your County’s EMS system, both in the short-term and long-term future. Our experience and expertise are supported by a companywide network of EMS cost report analysts who work with EMS agencies throughout the country and an internal team of project managers who have experience managing projects large and small. As a prospective partner with your County, its communities, and its local EMS agencies, our professional consulting team brings the following expertise to this project: ► Extensive Wisconsin EMS Experience – One of our team’s Lead Subject Matter Experts is an experienced EMS provider in Wisconsin, having been affiliated with volunteer/rural through career/urban EMS agencies within the state, represented on statewide and regional EMS association/committee executive boards, and participated in a state EMS office subcommittee on EMS system data & design. ► Project Experience in Wisconsin, the Upper Peninsula, and the Midwest – Our team has assisted a prior Wisconsin fire/EMS client transition from a non-profit fire/EMS agency into a municipal department, developed a ground-up EMS feasibility study for a nearby Upper Peninsula county government, assisted another Upper Peninsula EMS authority take shape, and provided technical support through operational analysis services for additional EMS agencies in Iowa, Indiana, and Ohio. ► Rural EMS Proficiency – Our team has conducted multiple rural fire/EMS studies for clients throughout the country and brings additional experience in statewide rural EMS research, whitepaper development, and healthcare-related system initiatives. ► Statewide and Industry Compliance Understanding – Our team is directly aware of Wisconsin EMS administrative codes, is operationally familiar with the U.S. Department of Labor and Fair Labor Standards Act (FLSA) regulations pertaining to EMS volunteers and employees, and has referenced all such sources with prior clients within the state and nationwide. We believe that projects like this require special attention to data, details, and dynamics in order for respective EMS systems to remain (or become) reliable, sustainable, and viable. We are confident that our specific expertise and direct Wisconsin connection position our firm as a prime partner for your County. As highlighted in your RFP, you are looking for “RECOMMENDATIONS FOR FUTURE ACTION,” and that is exactly what we are prepared to offer as your partner along the way. PCG appreciates the opportunity to submit our proposal for your consideration and we encourage you to reach out to Chief Tim Nowak, in Green Bay, at tnowak@pcgus.com / 920-621-9838 with any direct questions. Thank you for your time and we look forward to your consideration and reply. Respectfully, Alina Coffman, Associate Manager Public Consulting Group LLC March 22, 2024 Bayfield County, WI Study for County-Wide EMS in Bayfield County RFP 2024-18-04 Public Consulting Group LLC iii TABLE OF CONTENTS PROPOSAL COVER LETTER .......................................................................................................... III SECTION 1. PROJECT METHODOLOGY, TIMELINE, AND DELIVERABLES .................................. 1 SECTION 2. PROJECT TEAM & COMPANY PROFILE ..................................................................... 3 SECTION 3. REFERENCES & PROJECT EXPERIENCE .................................................................. 5 SECTION 4. COST PROPOSAL ........................................................................................................ 7 APPENDIX ........................................................................................................................................ 8 March 22, 2024 Bayfield County, WI Study for County-Wide EMS in Bayfield County RFP 2024-18-04 Public Consulting Group LLC Page 1 SECTION 1. PROJECT METHODOLOGY, TIMELINE, AND DELIVERABLES 1.1. Key Components Considering the data you have provided in your RFP and combining it with our extensive understanding of the dynamics of Wisconsin’s communities and its EMS system, our consulting team appreciates the up-front effort you have put into setting the stage for this project and your County’s challenges. At the forefront, we have identified three focal elements we intend to direct our attention toward if selected as your partner in this project: ► Posing difficult questions to community stakeholders, such as whether immediate Paramedic (advanced life support) service is a local want or need, if dynamic staffing and deployment models are favorable within their community, and whether or not stakeholders have faith in the viability of volunteer staffing structures within the Countywide EMS system. Addressing these challenge points will ultimately allow our team to help the County identify its existing strengths/challenges and tackle its future opportunities/risks. ► Expediting the short-term (3-5 year) and long-term (5-10 year) proposed recommendation timeline into a 1-3 year and 3-5 year respective timeline to facilitate the immediate actions that need to occur to stabilize the County’s EMS system in order to promote long-term sustainability. Doing so will set the stage for 5-10 year operational planning and 10-20 year capital planning to occur. Without expediting this timeline, our team is concerned that missed opportunities for stabilization may result in system jeopardy, degradation, or even collapse, as this is a strong reality for many rural, Northern Wisconsin EMS agencies (and fire departments). ► Developing calculated and actionable EMS organizational model/system recommendations that can be scaled up, transitioned over time, and/or expanded beyond just the arena of emergency medical services within Bayfield County. 1.2. Preliminary Analysis Entering into this proposal with full transparency, our consulting team’s preliminary analysis of the data provided in your RFP reveals the following findings and notes: ► Countywide consolidation is the most sustainable solution for the County’s EMS agencies. There is also a potential for consolidated system expansion on a larger, regional platform. ► There is enough cumulative EMS call volume to warrant Paramedic-level services, within some capacity, throughout the County if a dynamic staffing and deployment approach is utilized. ► Further collaborative or contracted services potential exists with nearby EMS agencies for Paramedic-level services, if not maintained within the County. ► Sufficient geographic (equitable) coverage could feasibly be maintained from four locations throughout the County. ► The likely primary staffing mechanism needed within the County to maintain reliable (equal) system response would come from daytime paid/scheduled EMT and Advanced EMT staff, with the potential for paid-on-call/scheduled to be utilized either Countywide or within particular low-volume regions. Dynamic staffing options for Paramedic-level staffing is possible within the County. ► The future of volunteerism within the County for EMS (and fire services, for that matter) is bleak. ► The outlined annual cost by each jurisdiction/municipality (based on provided 2021 data) is sufficient to maintain some level of paid EMS staffing but is not near the full cost to maintain a complete full-time system (if so desired). ► Opportunities may exist for local operational competition in terms of providing contracted interfacility transfer services from local hospitals to outside hospital/care facilities or residences (if so desired). ► Significant countywide opportunities exist for a combined fire/EMS (emergency service) department or special taxing district in the future (if so desired). March 22, 2024 Bayfield County, WI Study for County-Wide EMS in Bayfield County RFP 2024-18-04 Public Consulting Group LLC Page 2 1.3. Methodology and Deliverables As both a constructive challenge to our team and a means of validating these preliminary analysis points, we will meet the needs of your outlined Project Deliverables and Objectives by: ► Further analyzing available call volume data (including time-of-day, month-to-month, etc.). ► Further analyze provided budgetary data and formulate projected personnel, operational, and capital expense budgets for any forthcoming organizational model recommendations. ► Conduct a pay scale analysis to correspond with any recommended staffing models and positions as a part of subsequent organizational models/systems highlighted. ► Virtually interviewing ten (10) stakeholders identified by the County. ► Conducting one, multi-day on-site visit to meet with local EMS agency representatives, view their stations/equipment, and conduct up to two (2) in-person townhall-style meetings (if requested). ► Reference applicable state EMS regulations to address any potential compliance-related concerns. ► Produce a draft report (electronic) for the County to review for factual validity. Due to the short timeline of this project, only one week may be available to facilitate the County’s review. ► Produce a final report (electronic) for the County by the project’s deadline and deliver a virtual presentation of the report at a later date. If requested, an in-person presentation may also be negotiated. The final report will include an implementation plan to meet respective benchmarks or elements for each/any organizational model recommendations. 1.4. Project Timeline Corresponding the RFP’s outlined Project Timeline (three months, April 1 – June 30), our consulting team will be able to meet the needs of the County for this project, however, we believe it is fair to express that many similar projects typically consume a six-month timeline. Much of this necessary additional time is spent to ensure sufficient data is shared in a timely manner and to ensure that sufficient report drafting, internal editing, client editing, and final revisions are completed over an un-stressed period of time. At any rate, our team is confident that we will be able to complete this project effectively and efficiently within the requested timeline, however, this is presuming that client data and stakeholder interview timeline benchmarks are met. Our team will make every effort possible to streamline and facilitate up-front data and information requests in order to maintain this abbreviated timeline. Outlined below is our anticipated timeline for this project. 4/1 4/15 4/29 5/13 5/27 6/10 6/24 July 2024 Project Kick-Off, Data Request Data Analysis, Begin Key Interviews On-Site Visit, Townhall Meetings (optional) Follow-Up Interviews, Data Analysis PCG Report Drafting, PCG Editing County Draft Report Review PCG Final Report Editing Post-Project Presentation (optional) March 22, 2024 Bayfield County, WI Study for County-Wide EMS in Bayfield County RFP 2024-18-04 Public Consulting Group LLC Page 3 SECTION 2. PROJECT TEAM & COMPANY PROFILE 2.1. Project Team PCG’s Public Safety Consulting Services (PSCS) team is comprised of experienced subject matter experts (SMEs) with direct fire and EMS industry experience from throughout the country, and within a variety of service delivery models. As former/retired chief officers, each SME brings insight related to administration, finance, logistics, operations, and planning within the EMS, fire, hazardous materials response, and special operations/rescue disciplines. They offer data- and compliance-minded solutions that are realistic and reasonable for our clients to implement and maintain a progressive edge within the industry by attending and presenting at various state/national conferences and events, providing industry-focused articles and subject matter content for various sources, and through continuing their passion within the industry as continuous learners of their trade. Complimented by a support network of project management professionals and EMS/healthcare finance SMEs, the PSCS team brings a strong focus to each of its projects through providing a credible, reliable, and professionally sound final product for each of its clients. Shared below is a brief biography of our team members. Chief Tim Nowak is a full-time Project Manager and Fire/EMS Consultant with PCG and is remotely based in Green Bay, WI. He serves as a fire/EMS subject matter expert with PCG and brings over 20 years of fire/EMS experience and an expansive background within the EMS industry, spanning over the disciplines of education/training, quality, data management, operations, clinical care, special operations, logistics, community risk reduction, and industry content development. He has prior working experience in rural through metropolitan environments, spanning throughout four states, and was most recently an Assistant Chief of a large, county-based EMS agency. The majority of Chief Nowak’s career has also been spent in Wisconsin working along both its eastern and western borders, in addition to providing continued education training throughout the state for EMT through Paramedic-level providers, sitting on multiple regional/statewide EMS committee/association boards, and leading multiple consulting projects in Wisconsin and Michigan. Chief Ken Riddle is a full-time Senior Advisor and Fire/EMS Consultant with PCG and is remotely based in Las Vegas, NV. He serves as a technical advisor on all consulting projects, bringing more than four decades of fire and EMS industry experience to the team. In this role, he oversees contract negotiations, project progress and completion, and subject matter expertise and recommendations related to all forms of public safety consulting projects. Previously, Chief Riddle served 28 years with the City of Las Vegas Fire & Rescue and managed every division in the department. Chief Steve Noble is a full-time Senior Project Specialist and Fire/EMS Consultant with PCG and is remotely based in Tucson, AZ. He serves as a fire/EMS subject matter expert with PCG, bringing over 25 years of fire/EMS experience with an operational, supervisory, and management background with an urban/suburban fire department. Chief Noble also has extensive operational and teaching experience in the all-hazards disciplines of specialty rescue and hazardous material response. Ms. Alina Coffman is an Associate Manager and Project Director with PCG and is remotely located in Austin, TX. She serves as a team leader and project manager with PCG, bringing over 15 years of project- related experience including contract management, program oversight, and certification as a Project Management Professional, to her work. Ms. Kaitlynn Edwards is a full-time Senior Operations Analyst and Project Manager with PCG and is remotely located in Harlingen, TX. She serves as a project manager with PCG, bringing over five years project-related experience in contract management, technical writing, and copy editing to her work. Subject Matter Expert Subcontractors – PCG assigns full-time staff to all projects in its administrative functions and includes at least one full-time subject matter expert/consultant within each project’s operational functions. On occasion, we find it beneficial to utilize one of our vetted subcontractors to fill a specific subject matter expertise role. March 22, 2024 Bayfield County, WI Study for County-Wide EMS in Bayfield County RFP 2024-18-04 Public Consulting Group LLC Page 4 2.2. Company Profile Public Consulting Group LLC (PCG) believes in the power of the public sector. We provide local and county entities and state agencies with practical and cost-effective recommendations and Solutions that Matter within multiple disciplines of government. We empower public-sector health, fire/EMS, education, and human services organizations to make measurable improvements to their performances and processes. Our public-sector focus means we have a deep understanding of the challenges our clients face – from economic constraints to demographic shifts, to regulatory changes – and what it takes to surmount those challenges. For more than 35 years, our firm has helped clients maximize resources, contain or cut costs, optimize outcomes, make better management decisions, improve compliance, streamline business processes, and implement and improve technology solutions. Our firm’s global footprint offers an expansive service line, at the same time offering a local, customized, and client-focused approach toward our work. PCG Snapshot ► Founded in 1986 ► Headquartered in Boston, MA ► Privately held Delaware Limited Liability Company (LLC) ► Over 2,000 employees working remotely or within any of our 30+ worldwide offices PCG Experience ► Four practice areas: Health, Human Services, Education, and Technology Consulting ► Contract experience in 50 states, six Canadian providences, and the EU ► 2,000 open contracts at any point in time PCG’s greater Health practice area and its Financial & Strategic Solutions (FSS) center of excellence help both state and municipal health agencies (including EMS agencies) respond optimally to reform initiatives, restructure service delivery systems to best respond to regulatory change, maximize program revenue, and achieve regulatory compliance. We use industry best practices to help organizations deliver quality services with constrained resources, offering expertise in strategy and finance, revenue cycle management, and payer support services. PCG’s Health practice area is a recognized leader in health care reform and health benefits exchange consulting, and is a leading provider of revenue enhancement, rate setting, cost settlement services, and health care expense management services. The FSS team directly provides industry-leading services including Medicare Ground Ambulance Data Collection (MGADC) and Ambulance Supplemental Payment Program (ASPP) services for hundreds of clients throughout the country. In addition, we provide direct oversight for many statewide ASPP services on behalf of individual states, of which PCG is at the forefront of Wisconsin’s anticipated GEMT program. Our Genuine Approach … We DON’T Use Artificial Solutions Generated Through Artificial Intelligence. We DON’T Have a Hidden Agenda or Affiliation Allegiance. We DON’T Claim to Have “Written the Book.” We DON’T Claim to “Be the Best, with No Other Comparison.” We DO Use Our Professional Experiences, Insight, and Knowledge to Craft Achievable & Actionable Solutions. We DO Believe in Doing What is Right by Our Client and Their Community, Taking into Account Their Data and Local Context. We DO Tackle Tough Questions, Conduct Research, and Validate Our Work as a Team of Diverse Professionals. We DO Strive to Produce Quality Work and Prepare Our Clients, Their Communities, and Their Stakeholders for Continued Success. March 22, 2024 Bayfield County, WI Study for County-Wide EMS in Bayfield County RFP 2024-18-04 Public Consulting Group LLC Page 5 SECTION 3. REFERENCES & PROJECT EXPERIENCE 3.1. References We are pleased to refer you to three project references, as requested, for similar projects to the one proposed in Bayfield County. While only one is from Wisconsin, the two references from Michigan are from the state’s Upper Peninsula and perfectly align with your project’s objectives. Renee Gray Director, Kinross EMS (MI) EMS System Feasibility Study (2024) 906-495-6062 kctems17@gmail.com Heidi DeRosso Emergency Management/911 Coordinator, Gogebic County (MI) County Ambulance Service Feasibility Study (2023) 906-667-1118 hderosso@gogebic.gov Ashley Vickers EMS Chief (Former), City of Whitewater Fire & EMS Department (WI) Fire & EMS Non-Profit to Municipal Transition of Services Technical Assistance 920-723-1724 ashmvickers@gmail.com 3.2. Project Experience Forthcoming is a complete listing of our consulting team’s active and completed projects since 2020. Specific projects noted in bold text align with the primary objectives and scope of work respective to your own Study. In summary, projects similar to yours are growing in necessity both in Wisconsin and throughout the country. As such, our consulting team has remained very active in the industry to remain aware of the challenges, trends, local context, best practices, and sustainable solutions to address such projects head-on and as a leading resource within the emergency services arena. March 22, 2024 Bayfield County, WI Study for County-Wide EMS in Bayfield County RFP 2024-18-04 Public Consulting Group LLC Page 6 PCG Public Safety Consulting Services (PSCS) Recent Projects (2020-Present) National Projects • U.S. Fire Administration Response to Active Shooter Incidents Report Revision (National, Repeat Client) • U.S. Fire Administration Rural Fire Mitigation Report Revision (National, Repeat Client) • U.S. Fire Administration EMS Burn Care Report (National, Repeat Client) • U.S. Fire Administration Civil Unrest Report (National) • NFPA Public Safety Call Answering Time Study (National) Northwest • Fire/EMS Funding Study (WA, Repeat Client) • Statewide EMS Resource Assessment (ID) • Fire/EMS Cost of Services Study (WA) • Ambulance Transporting Services Analysis (OR) • Consulting Services for County Fire Protection (OR) • Fire/EMS Cost of Services Study (WA) Southwest • Fire Department Study (UT) • Fire Service Staffing and Operational Analysis (CO) • Countywide EMS and Hospital Base Station & Trauma Catchment Area Evaluation (CA) • New Fire Station Technical Assistance (CA, Repeat Client) • Fire Department Strategic and Master Plan (CA) • Fire CAD and RMS Solution Consultant (AZ) • Fire Department Funding and Governance Analysis (UT) • Fire & EMS Analysis and Study (UT) • Fire/EMS Feasibility Study (NM) • Fire and Life Safety Department Implementation Study (CA) Midwest Projects • Fire/EMS Shared Services & Consolidation Feasibility Study (OH) • EMS System Feasibility Study (MI) • EMS Agency Analysis (IN) • EMS Agency Facility Assessment (IA) • EMS Non-Profit to County-Operated Transition of Services Study and Technical Assistance (IA) • Countywide Ambulance Service Feasibility Study (MI) • Fire & EMS Non-Profit to Municipal Transition of Services Technical Assistance (WI) • Fire Department Strategic and Master Plan (IN) South Central Projects • CAAS Accreditation Technical Assistance (TX, Repeat Client) • Fire Department Strategic Plan (TX, Repeat Client) • Countywide EMS Feasibility Study (LA) • Fire Department Dispatch Optimization and Feasibility Study (TX) • Dispatch Equity and Operational Efficiency Study (TX) Atlantic & Northeast Projects • Paramedic Staffing Study (MD) • EMS Analysis (SC) • Annual Report & Community Focus Report (PA) • EMS System Analysis (NC) • EMS Organizational Model Study (NY) • Transitional Study for Fire & EMS Services (FL) March 22, 2024 Bayfield County, WI Study for County-Wide EMS in Bayfield County RFP 2024-18-04 Public Consulting Group LLC Page 7 SECTION 4. COST PROPOSAL Public Consulting Group LLC is pleased to offer an all-inclusive, flat fee of $33,500 to complete your full Study, including all identified elements within the RFP, before June 30, 2024. This cost includes one, multi-day site visit (up to three calendar days, including travel days). It is also understood that a subsequent virtual presentation may be completed as a part of this all-inclusive fee up to three calendar months beyond the June 30th completion date. An additional flat fee of $1,500 may also be applied – if requested – to conduct any subsequent (non- sequential) multi-day on-site visits up to three total calendar days (including travel days) within the time period of this project. An additional $500 fee may be applied – if requested – for any sequential days beyond the three calendar days for any one, multi-day visit. Our consulting team is also open to discussing the potential of offering a discounted rate for continued fire/EMS consulting or technical advisory services in conjunction with, or following after, this project. Examples of such services may include technical assistance to facilitate EMS agency consolidation or new agency development, an analysis of current fire services provided within the County, or a feasibility study to combine all fire and EMS services within the County. Additional EMS financial cost reporting services may also be available to the County if a County-operated or special taxing district ambulance service is formed. March 22, 2024 Bayfield County, WI Study for County-Wide EMS in Bayfield County RFP 2024-18-04 Public Consulting Group LLC Page 8 APPENDIX Located in the Appendix is PCG’s Certificate of Insurance (COI). 3/18/2024 Hays Companies, Inc. 980 Washington St., Suite 325 Dedham MA 02026 Adrienne Kisonas Adrienne.Kisonas@bbrown.com Public Consulting Group LLC Attn: Michael Marotta 148 State St., 10th Floor Boston MA 02109 Great Northern Insurance Company 20303 Federal Insurance Company 20281 Allied World National Assurance Company 10690 ACE American Insurance Company 22667 23-24 GL Auto WC UMB A X X X 35855036 4/1/2023 4/1/2024 1,000,000 1,000,000 10,000 1,000,000 2,000,000 Included Employee Benefits 1,000,000 B X X 73540440 4/1/2023 4/1/2024 1,000,000 C X X X 10,000 0311-2674 4/1/2023 4/1/2024 10,000,000 10,000,000 D N 71724811 4/1/2023 4/1/2024 X 1,000,000 1,000,000 1,000,000 D Professional/Cyber Liability/D97157753 4/1/2023 4/1/2024 Each Claim/Aggregate:$10,000,000 Technology E&O: Claims Made Retention:$500,000 Bayfield County Emergency Management 117 E. 6th Street P.O. Box 423 Washburn, WI 54891 James Hays/MYLANA The ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25 (2014/01) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE LOCJECTPRO-POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence)$DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person)$ PERSONAL &ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTIONDED CLAIMS-MADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $UMBRELLA LIAB EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) INSRLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS PERSTATUTE OTH-ER E.L.EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. 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INSD ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) OTHER: THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: INSURED PHONE(A/C, No, Ext): PRODUCER ADDRESS:E-MAIL FAX(A/C, No): CONTACTNAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S)AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INS025 (201401) PUBLIC ADMINISTRATION ASSOCIATES, LLC Bayfield County 2024 EMS Study Devils Island sea caves and light Source: NPS photo/G M Spoto Public Administration Associates, LLC 2024 Bayfield County EMS Study 1 Table of Contents ¡ Statement of Qualifications (p.2) ¡ PAA Past Studies (p.3-4) ¡ Objectives (p.5) ¡ Methodology and Timeline (p.6-8) ¡ About the Team (p. 9–10) ¡ Project Deliverables (p. 11-12) Report prepared by: Public Administration Associates (PAA), LLC David Bretl: 414.350.3328 • bretld.paa@gmail.com 1155 W. South Street, Whitewater, WI 53190 http://public-administration.com Public Administration Associates, LLC 2024 Bayfield County EMS Study 2 Statement of Qualifications Introduction Public Administration Associates (PAA), LLC is a consulting firm specializing in local government recruitment and management studies. Founded in 1998, its current owners, Kevin Brunner, Chris Swartz and Dave Bretl are former county and municipal administrators and understand the challenges of local government. PAA is based in Whitewater, Wisconsin. PAA is recognized among the most trusted, skilled, and effective local government consultants in Wisconsin. Our consultants are highly skilled professionals who get the job done through diligence, unparalleled commitment to the highest standards of client service, and efficient use of client’s time and resources. It is a reputation earned from decades of public sector management. PAA Services: Comprehensive government consulting services ¡ Executive Recruitment Assisting municipalities in the recruitment and selection of management personnel including managers, administrators and department/division heads. ¡ Organization & Management Studies Analyzing municipal organizations, operations, and management structure and procedures using best practice standards. Specializing in organizational assessments, public works, and public safety. ¡ Interim Management Services Providing skilled and experienced administrators on a full-time or part-time basis for a limited period of time. ¡ Strategic Planning & Implementation Services Performing community needs assessments, preparation of plans, strategies for implementation of community plans, site planning/development review assistance, and assisting communities in development of boundary agreements and cooperative plans. ¡ Economic Development Services Assisting communities establish and implement economic development projects and programs, including downtown revitalization initiatives, redevelopment and tax incremental financing, business improvement district plans, brownfields initiatives, and business and industrial park planning and development. ¡ Classification & Compensation Studies Analyzing and developing of classification and compensation plans using internal and external equity standards. Return to Table of Contents Public Administration Associates, LLC 2024 Bayfield County EMS Study 3 Wisconsin Organization & Management Studies Performed by PAA Fire and/or EMS Related Studies: o Village Jackson, Wisconsin Fire Study, 2022 o Cottage Grove, Wisconsin Fire and EMS Study, 2022 o Village of Butternut Fire Study, 2022 o Fire/EMS Organizational Study, Village of Little Chute, 2019-2020 o Lodi Fire/EMS District Organization and New Station Location Study, 2019 o Sturgeon Bay-South Door County Fire Service Study, 2017 o Town of Sevastapol Fire Study, 2016 o Oconto Towns EMS and Fire Study, 2016 o Town of Buchanan Fire Study, 2013 o Organizational Assessment, Village of Pulaski, 2009 o Organizational Assessment, Village of Ashwaubenon, 2009 o Organization and Administrative Study, Verona WI Fire District, 2008 o Personnel Study of Fire/Rescue Department, Somerset, 2005 o Organization and Administrative Study, Chippewa Falls, 2004 o Management Study of the Village of Howard, 2002 o Management Study of the Village of Oregon, 1998 o Organization and Administration Study of the Village of Denmark, 1997 Related Municipality Studies: o DPW Organizational Analysis; Village of Waunakee, 2020 o DPW Organizational Analysis/Staffing Study; Village of Germantown, 2020 o Classification/Compensation Study; City of Park Falls, 2020 o Organizational Audit/Staffing Study and Employee Personnel Policies. City of Park Falls, 2020 o City of Marinette Legal Services Study/Reorganization, 2019 o Organizational Audit/Staffing Study, Village of Port Edwards, 2019 o Organizational Audit/Staffing Study and Employee Personnel Policies. Village of Merton, 2019 o Organizational Audit/.Staffing Study, Town of Osceola, 2019 o Organizational Audit/Feasibility Study for Creation of City Administrator Position, City of Mineral Point, 2019 o Streetlighting Fee Feasibility Study, City of Oak Creek, 2019 o Classification/Compensation Study, City of Sturgeon Bay, 2019 Public Administration Associates, LLC 2024 Bayfield County EMS Study 4 o Organizational Audit/Feasibility Study for Creation of City Administrator Position, City of Park Falls, 2019 o Organizational Audit and Classification Study, Town and Village of Somers, 2019 o Employee Personnel Manual Development, Village of Williams Bay, 2019 o Community Collaboration Planning Project-Cities of Marinette and Menominee, MI and Marinette and Menominee, MI School Districts, 2018 o Organizational Analysis and Classification/Compensation Study, City of Clintonville, 2018 o Town of Buchanan Organizational Study, 2014 o Organization and Administrative Study, City of Lodi, 2013 o Organizational Analysis and Compensation Study, Town of Ledgeview, 2011 o Organizational Review, Town of Grand Chute WI Police Department, 2007 o Organization and Administrative Study, Village of Bonduel, 2006 o Organization and Administrative Study, Weyauwega, 2005 o Organization and Administrative Study, Turtle Lake, 2004 o Organization and Administrative Study of Clerks and Treasurers Offices, City of Racine, 2004 o Management Study of the Village of Hammond, 2002 o Analysis of Public Works Department for the City of Antigo, 2002 o Management Study of the City of Omro, 2001 o Management Study of the City of Chilton, 2000 o Management Study of the City of Oconto, 2000 o Management Study of the Town of Empire, 2000 o Management Study of the Village of Egg Harbor, 1999 o Administrative Study of the Village of Ephraim, 1999 o Organization and Management Study of the Police Department, City of Horicon, 1998 o Management Study of Public Works Department, City of New London, 1998 Return to Table of Contents Public Administration Associates, LLC 2024 Bayfield County EMS Study 5 Objectives ¡ Evaluate and provide assessment of current EMS service levels. Assess resource capacity (personnel and infrastructure) of system in place, response times, and current coordination and collaboration among services ¡ Develop short-and medium-term recommendations With the goals of improving response times and ensuring sustainable service delivery in a cost-effective manner, including but not limited to recruitment and retention strategies ¡ Explore viability of potential partnerships/collaborations to improve quality of patient care ¡ Review potential for additional revenue Complete a full evaluation of state and grant funding to support solutions and/or prospective new collaborations. Public Administration Associates, LLC 2024 Bayfield County EMS Study 6 Methodology & Timeline Early April ¡ Initial Communication Work with Bayfield County staff to develop initial communication with EMS community and local leaders and create framework for primary data collection to be launched in mid and late April. ¡ Data Review Retrieve and review all available data for each EMS agency to help inform subsequent survey Mid-April ¡ Stakeholder Engagement Communicate in advance to all stakeholders (elected officials and administrators) that the study will begin, sharing high level goals and timeline ¡ Obtain and Review Available Data Review EMS data already collected by Bayfield County in order to direct initial survey and online interviews to be as effective and efficient as possible, including but not limited to: l Call volumes by agency over past five years and identify trends, seasonal or otherwise l Response time data for all EMS services that provide emergency medical care in Bayfield County l Incidents with a response time more than 15 minutes l All incidents in which primary response jurisdiction was unable to respond and call was "dropped" or assigned to neighboring agency l Transport times from the scenes of incidents to hospitals l Review existing EMS response coverage/district maps. If possible, obtain historical perspective of how coverage maps have changed (and why) l Review operating and capital budgets for Bayfield County EMS agencies over past five years. Review expenses and revenues for possible efficiencies and identify additional sources of funding l Review current EMS billing practices and compare with those of similar sized agencies ¡ Initial Survey (online) Prepare and distribute an online survey to collect basic, quantitative, objective information about each EMS service. The responses to this survey will set comparable context across services. This survey allows the in-person interviews to focus on the harder to describe and nuanced answers to the strengths and weaknesses of the current Bayfield County EMS system Public Administration Associates, LLC 2024 Bayfield County EMS Study 7 ¡ Prepare for In-Person Interviews Schedule in person interviews with stakeholders, and logistics ¡ Analyze Online Survey Analyze and visualize survey responses, send reminders for those who have not responded. Evaluate in-person interview questions for necessary modifications based on online survey. May ¡ Hold One-On-One In-Person Interviews l Meet with/interview elected officials (Bayfield County Board Supervisors along with town, village, and city officials) and administrators from Bayfield County to assess strengths, weaknesses, opportunities and challenges with current EMS service delivery. l Initiate conversations with EMS agency medical directors to provide health care/hospital perspective on current state of services. l Meet with EMS program staff at area technical colleges to evaluate workforce development capacity, trends, opportunities l Meet with local economic development directors, chambers of commerce, business leaders to evaluate their perspective on current EMS services and explore how system improvements may provide opportunities for partnership related to tourism ¡ Small Group Meetings and Roundtable Discussions l Conduct individual and small group meetings with directors, chiefs, boards and/or appropriate leadership of EMS agencies serving the county. l Hold roundtable discussions/forums with current and former EMS volunteers/providers to evaluate their perspective of "state of EMS in Bayfield County” and explore any themes that emerge offering opportunities to improve retention. l Visit EMS stations across Bayfield County to evaluate current resource capacity and identify/consider future needs June ¡ Follow-ups Follow-up with those who did not have an opportunity to participate in May, analyze any gaps in the data collection process, and pursue those for a thorough review ¡ Analyze and Visualize Collate information from all surveys, budget and documentation reviews, interviews, and focus groups. Combine the unique needs of Bayfield County with best practices for customized recommendations ¡ Final Report and Visuals Draft final report will include sustainable future models for regionalization and/or shared services, with short and long-term phases. The report will include methods to deliver cost effective services to Bayfield County, with financial comparisons that Public Administration Associates, LLC 2024 Bayfield County EMS Study 8 include the following variables: facilities, personnel, equipment, and project needs. It will evaluate current strengths and weakness, future opportunities and threats, including models of response times, call volumes, coverage areas, staffing and qualifications, compensation, inter-agency cooperation, succession, equipment and fleet age and replacement schedules, untapped revenue. Final report will include a suite of products (graphics, easy to understand visuals) for elected officials use as they implement the changes following the study, and an in-person presentation. Return to Table of Contents Public Administration Associates, LLC 2024 Bayfield County EMS Study 9 About the Team Our team is uniquely situated to evaluate and make recommendations for Bayfield County, experts in both strategic and tactical next steps. We have experience in leading Wisconsin County governments, maximizing opportunities for State dollars and policy. In addition to our first-hand tactical experience in recruitment strategies for rural Wisconsin EMS districts, and technical colleges for educating the next generation of first responders. Dave Bretl, Vice President Public Administration Associates, LLC Dave Bretl has served local governments in various roles across Wisconsin for over three decades. He retired in 2020 as County Administrator and Corporation Counsel for Walworth County, Wisconsin, after 17 years of service in that combined role. Through his tenure, Dave replaced most of the county’s facilities and helped consolidate six departments. He helped organize the Walworth County Intergovernmental Cooperation Council, a collaborative effort where the county, its municipalities and townships all come together to work. In 2005 he helped organize a countywide private-public economic development initiative known as the Walworth County Economic Development Alliance, Inc. Dave has served as an Interim County Administrator and Interim Village Administrator. He earned his master’s degree in public administration and a law degree from the University of Wisconsin-Madison. Josh Wescott, Project Lead Josh has served as an Emergency Medical Services provider for several rural Wisconsin agencies for nearly two and a half decades. He is an Assistant EMS Chief and is currently affiliated with and actively running as an Advanced level EMT for four departments serving rural Crawford, Green, and Dane Counties. In his various roles, he serves as a volunteer and paid on call, for both standalone EMS and combined fire and EMS departments. He has experience leading EMS volunteer recruitment, retention and on-boarding efforts and has coordinated ambulance billing and fundraising initiatives. In addition to his EMS work in the field, Josh has served as Chief of Staff for Dane County government for 13 years where he’s been the county’s lead public safety policy administrator for emergency management, emergency medical services, and public safety communications (911 Center). Josh developed public safety policy reforms that improved 911 dispatch and response times and oversaw development of a brand new $30 million interoperable county emergency communications’ network, linking communications capabilities between 61 cities, villages, and towns. Josh is a Wisconsin certified Emergency Medical Services instructor and currently teaches EMS in rural classroom settings for two Wisconsin Technical College Districts. James Austad, EMS Consultant James is an instructor in the Fire Protection Program at Fox Valley Technical College. He is a 28- year veteran of the fire service, spending 22 years with the Oshkosh Fire Department. He was the battalion chief in charge of emergency medical services division of the Oshkosh Fire Department. Austad received an associate degree in fire protection from Fox Valley Technical College, a bachelor’s degree in business management from Silver Lake College and a master’s Public Administration Associates, LLC 2024 Bayfield County EMS Study 10 degree in public administration from the University of Wisconsin-Oshkosh. He also is a graduate of the National Fire Academy Executive Officer Program. In recent years Austad has worked on the PAA Sevastopol, Door County, Buchanan, Oconto Township, and Sturgeon Bay Fire Department studies. Tanya Buckingham Andersen, Project Assistant Tanya has over 20 years of experience in communications including graphic design and data visualization. She has held leadership roles in small and large organizations, that include both volunteer and paid labor, and has helped teams navigate and build buy-in for necessary change. Through experience and training, she has managed, created, and implemented findings from focus group studies, surveys, and one-on-one interviews. Return to Table of Contents Public Administration Associates, LLC 2024 Bayfield County EMS Study 11 Project Deliverables Full report, with text and graphics, that will layout recommendations for a sustainable future for Bayfield County EMS, customized to the unique needs of region, combined with the best practices and models of success from other counties facing similar challenges. Report Content ¡ Goals specified in this request for proposals, as well as any that emerge during the survey and interview stage, scheduled to take place in May. ¡ Actionable recommendations that can guide policymakers and EMS agency stakeholders into the future in a phased implementation (short, medium, and long term), accompanied by budgetary considerations for each phase ¡ An analysis of current strengths and weakness, future opportunities and threats for the following: l EMS district boundaries, with recommendations on how to improve response times, shared facilities, and staffing l EMS service levels, resource capacity (personnel and infrastructure), response times, call volumes, patient care, and current coordination and collaboration among services; evaluated for sustainable and cost-effective service delivery l Overview of current funding, and opportunities for policymakers to pursue increase in revenue, including, but not limited to, state funding, large and small dollar fundraising, review of billing practices to ensure it is maximized. l Recruitment and retention strategy review and recommendations for sustained, varied approach for ongoing success l Evaluation of overall system reliability, and measurable goals and ways to measure changes going forward. l Suggested partnerships/collaborations to improve quality of patient care that integrate consistent and regular training where first responders feel supported and provide the highest quality patient care across Bayfield County, including licensure recommendations. l Review of current capital expenses, infrastructure with a replacement schedule recommendation based on a regional, county-wide, model that balances the most budgetarily efficient and high-quality equipment, ensuring sustainability and safety are the best in the field. l Evaluation of current operating expenses that includes an analysis of the value of labor (both volunteer and paid), benefits, pay structure. l Exploration of possible partnerships, evaluation of how to create a solution that considers all solutions of municipal, county, state, and private participation. Community Leaders should expect ¡ A professionally drafted, thorough, authoritative report that they, and their constituents can trust. Public Administration Associates, LLC 2024 Bayfield County EMS Study 12 ¡ A slate of recommendations, customized to the way of life in Bayfield County, based on models of success that our team has led state-wide to deliver cost effective and high quality of patient care, that sets Bayfield EMS on a successful path for the next generations. ¡ A communications strategy -- including customized graphics and text -- for policymakers to educate Bayfield County residents and EMS community, and potential donors/funders, to build buy-in, and support for any recommended changes identified throughout the project Budget PAA will provide the above described scope of services at a total cost of $34,900 including direct costs. This proposal includes a total of three in-person visits: two, multi-day stays in Bayfield County to conduct interviews in May, and one visit to present the results at the close of the study. This proposal would be subject to the successful negotiation of a service agreement by and between PAA and Bayfield County. MissionCIT Qualifications for Bayfield Co., WI EMS Study RFP MISSIONCIT, LLC 3 Enterprise Drive Suite 409, Shelton, CT 06484 info@missioncit.com | +1 203.649.5090 | www.missioncit.com Page 1 of 15 Qualifications to Conduct an Emergency Medical Services Study for Bayfield Co., WI 3.12.24 Contact Information MissionCIT, LLC is headquartered in Shelton, Connecticut. Our team of consultants are located throughout the United States. Founder, Testing & Strategy Practice: Jason Decremer, PhD Website: www.missioncit.com Email: jdecremer@missioncit.com Direct Phone Number: 203-232-6035 Company Phone: 203-649-5090 MissionCIT Qualifications for Bayfield Co., WI EMS Study RFP MISSIONCIT, LLC 3 Enterprise Drive Suite 409, Shelton, CT 06484 info@missioncit.com | +1 203.649.5090 | www.missioncit.com Page 2 of 15 Cover Letter Please accept the enclosed submittal from MissionCIT, LLC for your solicitation to provide an Emergency Medical Services Study for Bayfield Co., WI. We are excited about this opportunity and will outline our skills and abilities to meet your requirements. We are an innovative and passionate firm that, to date, has completed multiple projects for other fire and emergency services organizations, such as yours, including organizational assessments, staffing studies, strategic planning services, and management consulting assistance. The size and the quality of our team members allow us to strive for excellence in all that we do for an organization. We do not provide sterile, cookie-cutter services, but we truly look for real and practical solutions to the issues facing emergency services organizations today through relationships and communication. We are dedicated to meeting your needs and the needs of the request. The size of our company allows for dedicated focus on your needs and the needs of the project and to meet the project timelines responsibly. Our team cares about your team. MissionCIT, LLC is uniquely qualified to meet and exceed the expectations that the county has requested. All of the team members who will be assigned to this project are current or immediate past fire and emergency medical services officers or staff with vast experience. The specific team members are included in the proposal. They have managed or served in dynamic organizations, volunteer, career, and combination, of various sizes (rural, suburban, and urban) and demographics. They have managed or served in departments with varying populations providing both fire and emergency medical services. They are experienced practitioners in the field who take the provision of emergency services personally and desire excellence in all areas. Our project submittal is based on beginning work in April 2024, with completion of the project in August 2024. This timeline is negotiable, if necessary. We look forward to hearing from you and being able to provide you with the services you desire and help you improve your organization. MissionCIT Qualifications for Bayfield Co., WI EMS Study RFP MISSIONCIT, LLC 3 Enterprise Drive Suite 409, Shelton, CT 06484 info@missioncit.com | +1 203.649.5090 | www.missioncit.com Page 3 of 15 Company Overview With a collective experience of practical and technical expertise, MissionCIT, LLC is uniquely positioned to offer custom services to developing and established fire and EMS organizations. Our company has seen phenomenal growth and interest from many emergency services agencies. We specialize in providing custom services to organizations through our dedicated team of experienced professionals. These services include such things as organizational assessments; community risk assessments; strategic planning; master planning; staffing studies and recruitment and retention plans. We have been providing such services since 2019. We have already completed multiple projects and look forward to our continued growth in 2024. Below is a list of our past clients for similar projects: • Clear Creek County, CO Fire Authority – Organizational Analysis • Burlington, VT Fire Department – Fire and EMS Staffing Study • Telluride, CO Fire Protection/EMS District – Strategic and Master Plan • Greenwich, CT Fire Department - Strategic Plan • Watch Hill, RI Fire Department – Recruitment & Retention Plan/Staffing Study • Nitro, WV Fire Department – Strategic Plan and Organizational Assessment • Southbury, CT Fire Department – Strategic Plan • Prospect, CT Fire Department – Apparatus Replacement Plan • Hampden Township, PA - Volunteer Fire Service Study We are also currently engaged in the following additional projects; • Warren Co., KY – Review of Volunteer Fire and EMS Services • Kutztown, PA Fire and Rescue Company – Strategic Plan MissionCIT Qualifications for Bayfield Co., WI EMS Study RFP MISSIONCIT, LLC 3 Enterprise Drive Suite 409, Shelton, CT 06484 info@missioncit.com | +1 203.649.5090 | www.missioncit.com Page 4 of 15 Project Understanding MissionCIT, LLC understands that Bayfield County desires to retain a qualified and experienced consulting firm to conduct an Emergency Medical Services Study. The study will focus on a review of the current state of the EMS system, the governance structure, organization and staffing of the EMS agencies, what are the future growth/service and staffing trends and the future workload and needs of the EMS system will be. The study will focus on the current and future community medical risks and we will also benchmark with other like EMS systems to obtain statistical data and learn of best staffing and response practices. The study will also gather feedback from internal and external stakeholders of the organization to gain direct perspective of the issues facing the system. From the data collection and analysis, we will make recommendations for organizational governance, structure, staffing and deployment options in which greater efficiencies and effectiveness can be realized by the system, along with any improved services to enhance public safety for the citizens. As part of this comprehensive review, the study will look to examine the following; • The current structure, operations, training, and staffing of the EMS system • A review of the facilities, equipment and financial aspects for the system • An evaluation of the current, daily, shift staffing levels and response performance • An evaluation of the efficiency and effectiveness of current staffing practices, including recruitment and retention • A review of the existing levels of service delivered by the EMS system with identified recommended improvements • Current and future impacts on the EMS system’s operations from growth and increases in workload • Options for operational improvements, staffing models, and other changes to improve service delivery • Recommendations that are based on real-world models, costs, and impacts • The financial impacts of all options and the future financial view for the ultimate EMS delivery system • Organizational/administrative structures/governance models that may be necessary for improvements • The current community medical risks in the county and response area and recommendations for a holistic approach to managing these risks MissionCIT Qualifications for Bayfield Co., WI EMS Study RFP MISSIONCIT, LLC 3 Enterprise Drive Suite 409, Shelton, CT 06484 info@missioncit.com | +1 203.649.5090 | www.missioncit.com Page 5 of 15 All data collection, analysis, and staffing plan development will be based on current emergency services nationally recognized guidelines and criteria. The baseline criteria used will include those generated by the American Ambulance Association (AAA). The evaluation will take into account the risk/benefit for various options/scenarios for both the public, members of the EMS system and the county. The evaluation will also include financial impacts and options for the implementation of recommendations with consideration of fiscal prudence. MissionCIT, LLC will provide a quality document that will meet and exceed the expectations of the county. The document will include, at a minimum, the following components; • General summary of the community, demographics and response area served by the current EMS system • Analysis and summary of the services provided by the EMS agencies, including current staffing, unit workloads, the condition of equipment and facilities • Review of historical EMS service system performance to include GIS analysis • Summary of the Community Medical Risks within the response area • Limited organizational SWOC (Strengths, Weaknesses, Opportunities and Challenges) sessions with both internal members and external stakeholders to help identify the issues within the system • Benchmark organization best practices • Review of the current staffing, equipment condition and service delivery performance for the EMS agency and the development of a plan to address future needs and issues MissionCIT, LLC has a complete understanding of each of these elements. Our firm has experience in analyzing and evaluating the components described above in fire/EMS agencies. Our Approach to Your Scope of Service Our approach to the successful completion of your RFP will revolve around the following key components/processes: • Open communications at all phases of the project with the key County and EMS agency contacts, various stakeholders, including discussion during stakeholder sessions MissionCIT Qualifications for Bayfield Co., WI EMS Study RFP MISSIONCIT, LLC 3 Enterprise Drive Suite 409, Shelton, CT 06484 info@missioncit.com | +1 203.649.5090 | www.missioncit.com Page 6 of 15 • The collection of all relevant and critical data from the EMS agencies, including an online survey instrument distributed to internal and external stakeholders • A complete and thorough review and analysis of the data to see trends and opportunities, considering all options for system improvements • Development of future deployment and organizational models, structures and service delivery outcomes, with budget parameters taken into consideration More specifically, we envision the project having eight phases for successful completion. These will include the following; Phase I – Project Orientation We will immediately open communications with key stakeholders upon award of the contract for the project. This will include determining the main points of contact for the county and EMS agencies, as well as learning of the key external stakeholders that we will need to interact with for identification of the community expectations, including benchmark partners. Phase II – Initial Data Collection We will work with the identified project contact personnel to identify and provide a listing of key data needs for collection and review of the current operations. We will also work with key personnel to develop an online organizational assessment survey for current and future service delivery expectations that can be forwarded to key stakeholders. Phase III – Onsite Preparation and Focus Group Scheduling We will work with the key stakeholders to identify and establish a focus group meeting schedule for an onsite visit in order to determine community and department needs and expectations for the future. Phase IV – Onsite Visit MissionCIT, LLC will provide an onsite visit by the consulting team. The team will meet with all key internal and external stakeholders, review the various EMS system operations, staffing, equipment and facility conditions and hold the focus group meetings with identified department and community partners to identify Strengths, Weaknesses, Opportunities and Challenges (SWOC) of the EMS system, including service expectations, future services provided, and options for future organizational structures. MissionCIT Qualifications for Bayfield Co., WI EMS Study RFP MISSIONCIT, LLC 3 Enterprise Drive Suite 409, Shelton, CT 06484 info@missioncit.com | +1 203.649.5090 | www.missioncit.com Page 7 of 15 Phase V – Data Analysis We will begin a review of the current response and deployment data information received from the EMS agencies. Phase VI – Report Preparation After collection, review and analysis of all relevant data from the county, EMS agencies, focus groups and the online surveys, recommendations for consideration will be developed to identify the potential organizational governance, deployment and staffing methods, equipment and facility needs for the future delivery of EMS services in the county. This information will include; - Projection of future response area growth, demographic changes, service delivery methodologies, and risks - Future organizational staffing and deployment options, as well as performance measures - Development of a realistic financial models/plans and impacts for meeting recommendations - Recommendations for future improvements to meet demands - Community Medical Risk Reduction strategies within the area Phase VII – Draft Report Submitted and Reviewed by County and EMS Agency Officials Project report preparations. Draft final report presented to the county and EMS Agencies for review and comment. Phase VIII – Virtual Final Report Presentation Virtual presentation of our final results and recommendations after revisions from Phase VII to the designated county and EMS agency representatives. Our commitment is that we will work openly and collaboratively with all parties and stakeholders (internal and external) to ensure that the resulting recommendations and plan are realistic and meet the expectations of the county, the EMS agencies and the community. Our process involves comprehensive interviews with EMS agency leadership, county leadership, organizational personnel, and other community stakeholders. We understand that organizations interact and depend on external stakeholder groups to be successful. Having explicit knowledge of what the community expects of its EMS services is critically important to developing a long-range perspective. MissionCIT Qualifications for Bayfield Co., WI EMS Study RFP MISSIONCIT, LLC 3 Enterprise Drive Suite 409, Shelton, CT 06484 info@missioncit.com | +1 203.649.5090 | www.missioncit.com Page 8 of 15 MissionCIT, LLC knows that none of the recommendations can be implemented or result in improvements without a realistic funding and implementation strategy. Realistic funding strategies will be important to ensure that the county and EMS leaders and the community are clear on the approach, costs and timeframe. Scope of Work and Timeline The following section details the proposed project timeline prepared by MissionCIT, LLC for Bayfield County. This section is designed to provide detail on a proposed timeframe for MissionCIT, LLC to complete and present the study results and recommendations. We understand that the timeline may need to be adjusted based on a number of factors not known at the time this proposal was created. This is not a contractual timeline and can be changed as needed based on input from the department. The overall timeframe for work by MissionCIT, LLC will include the following. This timeline is subject to the actual contract award date and will be finalized during the initial stakeholder meeting; Phase Approximate Time Period Task Summary April Contract Execution Phase I April Project Orientation w/Stakeholders Phase II April Initial Data Element Identification and Collection Phase III May On-site visit preparation Focus Group agenda developed Continued data collection Phase IV End of May or Early June On-site visit with multiple stakeholder meetings Continued data collection Phase V May - June Data analysis and synthesis Phase VI June - July Future system/model development Draft Report preparation Phase VII Early July Draft Report sent to County/EMS Agencies for review Draft Report revisions Phase VIII End of July/First week of August Virtual presentation of final report MissionCIT Qualifications for Bayfield Co., WI EMS Study RFP MISSIONCIT, LLC 3 Enterprise Drive Suite 409, Shelton, CT 06484 info@missioncit.com | +1 203.649.5090 | www.missioncit.com Page 9 of 15 Additional Zoom or phone meetings may be held between the team members and key personnel as needed during the term of the project to answer questions or gather data. During our data collection process, MissionCIT, LLC will be asking for relevant information and data that will be used for the review of the EMS system, and development of recommendations. The following documents/electronic data that are requested will provide relevant information; this includes but is not limited to the following; - Current fire call loads, response areas, organizational staffing, response, deployment, and performance measures to include data elements such as; o EMS Apparatus turnout times o EMS Apparatus arrival times o EMS Call concentration areas o EMS Concurrent call loads o EMS Unit availability - Review of current response area demographics and risk assessment - Review of current EMS agency organizational structures - EMS agency current career and volunteer recruitment and retention strategies and issues - Inventories of emergency response apparatus and station facilities - Any future EMS agency staffing and facility plans - Any county comprehensive plans detailing land use information and future population, transportation, and planning information - Past or current staffing/deployment studies completed for the EMS agency - County census demographics - Zoning maps and zones - Financial data, current budgets, budget projections, and any long-range capital budget plans - Administrative SOP's/SOG's - EMS agency organizational/structure ordinances/regulations - Automatic or mutual aid EMS agreements with surrounding communities and response numbers into and outside of each department's response area - CAD/Call Response records to include call processing, unit turnout, and response times for the initial unit MissionCIT Qualifications for Bayfield Co., WI EMS Study RFP MISSIONCIT, LLC 3 Enterprise Drive Suite 409, Shelton, CT 06484 info@missioncit.com | +1 203.649.5090 | www.missioncit.com Page 10 of 15 - Current EMS performance measure data to include any benchmark data on response call types - GIS layer data for the EMS agency response areas - Patient Care Report and incident data, including treatment records (following HIPPA regulations) for the departments and for each response apparatus - Other documents, information, and data deemed necessary for project completion Our GIS analyst will conduct a complete analysis of the EMS system, examining population growth and service demand projections, including population density and response time statistics. This will include but is not limited to mapping for the following: EMS response times, call hot spots, and other critical coverage information. These maps will be done for both current and projected future deployment of resources. It is assumed that all data and information elements indicated in the RFP necessary for this project are available from the county or the EMS agencies for collection, transfer, and analysis by the consulting team. Project Deliverables MissionCIT, LLC will provide the following deliverables; • A draft report for review by Bayfield County and the EMS agencies officials • A final report, as an electronic PDF version to the county • One site visit, to include; an initial project meeting, EMS system tour and assessment and in-person assessment sessions with stakeholders with a final virtual presentation of the results, recommendations and discussion with stakeholders MissionCIT Qualifications for Bayfield Co., WI EMS Study RFP MISSIONCIT, LLC 3 Enterprise Drive Suite 409, Shelton, CT 06484 info@missioncit.com | +1 203.649.5090 | www.missioncit.com Page 11 of 15 Proposed Project Cost MissionCIT, LLC is pleased to present this proposal with the total project costs of the following; Consultant Work Time @ $110/hour - - Project planning, data collection, meeting facilitation, data - analysis, GIS work, plan development and plan presentation 220 hours, 2 Consultants and GIS Analyst - Site Visits – 60 hours $30,800 Travel - Consultant Team Members - 3-Day Site Visit (2 consultants) - Includes all related travel, lodging, and meal expenses $5,090 Total Project Costs $35,890 Desired additional work for this project will be negotiated with a consultant billing rate of $135 per hour and actual cost for materials and travel. Payment Schedule - 1/3 due upon signing of the contract. - 1/3 due upon completion of the first draft - 1/3 due upon acceptance of the final plan This price quotation is good for 90 days from the bid opening. MissionCIT Qualifications for Bayfield Co., WI EMS Study RFP MISSIONCIT, LLC 3 Enterprise Drive Suite 409, Shelton, CT 06484 info@missioncit.com | +1 203.649.5090 | www.missioncit.com Page 12 of 15 Project Team Members Each of our primary team members has at least 20 years of professional experience with combination and career fire and EMS agencies. All have been directly involved in managing and improving staffing conditions within their departments. All team members will be fully available to complete the project in the proposed timeline. Below is a list of projected team members for this project. Team Leader – Chief Frank Edwards BS, MPA (ret.) Chief Edwards has more than 35 years of experience in the emergency services field. He has held the positions of firefighter up to fire chief in both career and combination (paid/volunteer) fire/EMS departments serving 30,000 up to 250,000 population. He most recently served as the Director of Emergency Services/Fire Chief for Jasper County, SC. He started his career in Chesterfield County, Virginia, where he retired as a Deputy Chief. He has also served as Fire Chief in several organizations in Florida. He has experience in managing and leading all aspects of emergency services, including fire services, emergency medical services, emergency management, and 911 dispatch centers, with an emphasis in the areas of capital and operational budgeting, recruitment and retention, strategic planning, officer development, grant writing, and performance measurement. While in Jasper County, SC, he was successful in writing and being awarded a $911,000 Assistance to Firefighter Grant for Volunteer Recruitment and Retention. He holds a Master's Degree in Public Administration, a BS in Fire Science, and is a graduate of the Executive Fire Officer Program at the National Fire Academy. He is a Life Member of the International Association of Fire Chiefs, where he served on several committees and workgroups and is a Life Member of the Virginia Fire Chiefs Association. He was in the inaugural group of Chief Fire Officers designated by the Center for Public Safety Excellence in 2000. Team Member - Chief Scott Martus (ret.) BS, MS, Critical Care Paramedic Chief Martus has over 20 years of municipal fire/EMS experience as well as hospital- oriented EMS experience. He currently manages the education and ambulance operations division for the largest bed size hospital in the US. He oversees operations and statutory requirements for over 380 paramedics, 1350 EMT’s across 12 towns and 27 EMS services. He has assisted in developing a transportation logistics and tracking system for the Yale Health System. He has served on the faculty for Yale-New Haven Hospital teaching advanced life support classes. MissionCIT Qualifications for Bayfield Co., WI EMS Study RFP MISSIONCIT, LLC 3 Enterprise Drive Suite 409, Shelton, CT 06484 info@missioncit.com | +1 203.649.5090 | www.missioncit.com Page 13 of 15 Previously, Chief Martus served as the Deputy Chief of Operations for the North Haven Fire Department. While there, he assisted in implementing a priority emergency medical dispatch system. He managed the field operations of a 100-person combination department. He facilitated improvements in the city’s EMS services through a change in commercial providers and integrating ALS services into the fire rescue department’s operations. Chief Martus previously worked for another national consulting firm and participated on several emergency services consulting projects across the United States. He has a BS Degree in Public Safety Administration and a Masters Degree in Emergency Management and Disaster Preparedness from the University of New Haven in CT. Team Member - (GIS Data Analyst) – Jered Pritchett BS Jered has an extensive background in GIS mapping work, analytical displays of data and working with the Center for Public Safety Excellence Accreditation systems and Community Risk programs. He currently works as a Data and GIS Analyst with the Bluffton Township, SC Fire District. Prior to that, he served as the GIS Analyst for Liberty County, GA. He currently serves as an officer in the Georgia Army National Guard. He holds a BS Degree in Geography/GIS from Wright State University. MissionCIT Qualifications for Bayfield Co., WI EMS Study RFP MISSIONCIT, LLC 3 Enterprise Drive Suite 409, Shelton, CT 06484 info@missioncit.com | +1 203.649.5090 | www.missioncit.com Page 14 of 15 Prior Projects and References Telluride, CO Fire Protection/EMS District – Strategic Plan and Master Plan MissionCIT, LLC recently completed work for the TFPD through the development of a strategic plan and master plan. The district covers 350 square miles and operates with 4 fire stations through a combination (paid/volunteer) system. They provide full service, Fire and EMS, to approximately 5,900 full time residents and a 20,000 peak time population. MissionCIT, LLC conducted an online organizational assessment, benchmark surveys and an onsite visit. We developed a 5 year strategic plan with 9 goals and multiple objectives for the organization. In addition, MissionCIT, LLC created a master plan for the future needs of the organization centered around Community Risk Reduction; Facilities and Apparatus; Health, Safety and Wellness; and Organizational Personnel and Staffing Needs. Contact Information: Chief John Bennett jbennett@telluridefire.com 970-729-2411 Clear Creek, CO Fire Authority – Organizational Assessment MissionCIT conducted a thorough review and assessment of the Clear Creek Fire Authority in Colorado. The district covers 360 square miles and protects a population of 9,500 with 8 fire stations. MissionCIT reviewed the entire operations of the fire authority to include their staffing, facilities, apparatus, response deployment, training and policies and procedures. We also looked at the best models of structural governance for the fire authority and developed a long term financial plan to sustain their operations. The project involved an online external and internal member survey, SWOC sessions, focus group meetings, benchmark organization surveys and a significant data collection/analysis process. Contact Information: County Manager Brian Bosshardt bbosshardt@clearcreekcounty.us 303-679-2312 MissionCIT Qualifications for Bayfield Co., WI EMS Study RFP MISSIONCIT, LLC 3 Enterprise Drive Suite 409, Shelton, CT 06484 info@missioncit.com | +1 203.649.5090 | www.missioncit.com Page 15 of 15 Burlington, Vermont – Fire and EMS Staffing Study MissionCIT completed a staffing study for the Burlington, VT fire department. The study examined their current staffing levels as well as their hiring and staffing processes and overtime trends. The department operates out of 5 stations with approximately 98 career personnel protecting a population of 45,000. The project involved an online external and internal member survey, SWOC sessions, focus group meetings, benchmark organization surveys and a significant data collection/analysis process. Contact Information: Fire Chief Michael LaChance mlachance@burlingtonvt.gov (802) 864-4553 X1 Greenwich, CT Fire Department – Strategic Plan This is a combination fire department of approximately 106 career fire fighters supplemented by approximately 70 volunteers that serves an area of over 60 square miles. The town is a mix of suburban and rural, with a current ISO rating of 5 in the suburban section and 8 in the rural section. The population as of 2018 was 62,727. Our team created a survey that was distributed to the fire department members and external town officials. The results of this survey helped us identify strengths and weaknesses, along with short and long-term goals. We conducted on-site interviews and toured facilities for three days. Our team created (7) overall goals for the fire department, along with several objectives for each goal. The final version of the plan was presented to fire and town administrative officials. Contact Information: Chief Joseph McHugh jmhugh@greenwichct.org 203-622-3952