Medical_Direction_Services_for_Tucson_Public_Safety_(Addendum_#1_Revision).pdf

CITY OF TUCSON

REQUEST FOR PROPOSAL

240136

MEDICAL DIRECTION SERVICES FOR TUCSON PUBLIC SAFETY

Due Date: Tuesday, June 18, 2024

City of Tucson

255 W Alameda St

Tucson, AZ 85701

Procurement portal https://secure.procurenow.com/portal/tucson-az

Public Portal https://secure.procurenow.com/portal/tucson-az/projects/95141

PUBLISH DATE: May 22, 2024 https://secure.procurenow.com/portal/%7Bproject.government.code%7D https://secure.procurenow.com/portal/%7Bproject.government.code%7D/projects/%7Bproject.id%7D https://secure.procurenow.com/portal/%7Bproject.government.code%7D/projects/%7Bproject.id%7D

CITY OF TUCSON REQUEST FOR PROPOSAL NO. 240136

BUSINESS SERVICES DEPARTMENT Page 2 of 49 SHARED SERVICES PROCUREMENT DIVISION RESPONSIBLE CONTRACT OFFICER: Christopher Geoffroy

255 W. ALAMEDA, 6TH FLOOR, TUCSON, AZ 85701 PH: (520) 837-4469

Attachments:

A - Offer and Acceptance

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A. NOTICE

A.1. CITY OF TUCSON

NOTICE OF REQUEST FOR PROPOSAL NO 240136

TITLE: Medical Direction Services for Tucson Public Safety

SUBMITTAL DUE DATE: Tuesday, June 18, 2024 AT 2:00 P.M. LOCAL AZ TIME

PRE-SUBMITTAL CONFERENCE DATE: MICROSOFT TEAMS VIRTUAL MEETING

+1 213-293-2303,,585307161# United States, Los Angeles Find a local number Phone conference ID: 585 307 161# TIME: 11:00 am LOCAL AZ TIME

LOCATION: Microsoft Teams meeting

QUESTIONS SHALL BE DIRECTED TO: Christopher Geoffroy

(520) 837-4469 christopher.geoffroy@tucsonaz.gov

Posted Date: Wednesday, May 22, 2024

Competitive sealed offers for the material or service specified in this solicitation must be submitted through the City’s online bidding system. No late submitted offer will be accepted or considered.

Reponses submitted in physical form or by facsimile or email will not be considered. Offerors are cautioned to commence the submittal process sufficiently ahead of time to allow for unanticipated delays resulting from things like a slow internet connection, internet outage, difficulty uploading large documents, differing system requirements, etc.

Questions about this solicitation must be addressed to the responsible Contract Officer listed herein.

https://teams.microsoft.com/l/meetup-join/19%3ameeting_ZDc2ZDA4Y2EtOGFlOC00Mzk4LTkyNDUtNjg5MGNhNzgzYzU0%40thread.v2/0?context=%7b%22Tid%22%3a%22d21e59ec-c208-43eb-aaf1-cf06d9a196e0%22%2c%22Oid%22%3a%221dce1b86-387e-4e62-b197-798ed1fc7c55%22%7d tel:+12132932303,,585307161 https://dialin.teams.microsoft.com/2c60b41f-ade1-4bcb-8fa6-36d6e327015e?id=585307161

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B. INTRODUCTION

B.1. Summary

The Tucson Fire Department is seeking proposals for a dynamic medical direction contract to enhance emergency medical services (EMS) and public safety within the city. This multifaceted project aims to establish a robust partnership with a vendor who can provide comprehensive medical oversight, training, and support to our public safety personnel. In addition, the contract encompasses collaboration with the Public Safety Communications Department and the Tucson Police Department to ensure seamless coordination, oversight, direction, and communication in emergency response efforts, education, and community safety initiatives.

Key objectives of this contract include developing and implementing advanced medical protocols, ongoing medical oversight, quality assurance measures, and continuous education and training initiatives for public safety partners. The selected vendor will drive innovation and excellence in EMS, strongly emphasizing improving patient outcomes and bolstering public safety across Tucson. Vendors with a proven track record of effective collaboration, innovative solutions, and a commitment to public service are encouraged to submit proposals, as this project presents a unique opportunity to significantly impact emergency medical care and public safety within our community.

B.2. Contact Information

Christopher Geoffroy Contract Officer Email: christopher.geoffroy@tucsonaz.gov Phone: (520) 837-4469 Department:

Fire Department mailto:christopher.geoffroy@tucsonaz.gov tel:(520)837-4469

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C. SCOPE OF WORK

C.1. MEDICAL DIRECTION SERVICES FOR CITY OF TUCSON

A. The Contractor shall provide a qualified, licensed, Board certified emergency medical physician, hereinafter referred to as Medical Director, to provide Administrative Medical Direction to the City of Tucson’s (COT) Emergency Medical Service (EMS) providers – Tucson Fire Department (TFD), Tucson Police Department (TPD), and the Public Safety Communications Department (PSCD) – pursuant to Arizona Department of Health Services (ADHS) regulation under Title 9, Chapter 25 of the Arizona Administrative Code (A.A.C.) R9- 25-(201-205), Administrative Medical Director Requirements, Qualifications, and Responsibilities. Administrative Medical Direction will include evaluating and recommending all telecommunicator call determinant considerations and pre-arrival instruction, prehospital medical care and emergency medical communication provided by TFD, TPD, and PSCD personnel.

B. Medical Direction Services for TFD, TPD, and PSCD, the Medical Director will:

1. Advise and recommend to the TFD Chief, TPD Chief, and PSCD Director measures to ensure that TFD, TPD, and PSCD provide the highest quality of emergency medical services for the Tucson community.

2. Provide consultation on EMS related issues, including preparation for mass casualty, natural or human-caused disasters, and homeland security events.

3. Serve as a liaison to the local, regional, state, and national pre-hospital medical community, regulatory agencies, elected officials, law enforcement, and private individuals and groups regarding issues of interest to TFD, TPD, and PSCD.

4. Advise the City of Tucson Attorney's Office regarding legal issues specific to PSCD telecommunicator call coding and pre-arrival instruction and TFD and TPD EMS standards of care and scope of practice, as requested.

5. Attend regularly scheduled local and regional EMS committee meetings as a representative of the COT.

6. Assist in the creation, oversight, and sustainment of a comprehensive medical data retrieval system, including cardiac-related data and patient outcomes, as indicated for the requirements of the Quality Assurance Coordinator.

7. Coordinate, recommend, oversee, and evaluate any TFD pre-hospital medical research projects.

a. The medical direction group shall effectively take over the Pedidose, Pedipart, and Cavalier national research studies, ensuring a smooth and collaborative handover process utilizing the below transition plan. The Medical Director will complete the plan as described below:

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i. Orientation:

I. Conduct an orientation/transition session to introduce the medical direction group to the current study teams (Pedidose, Pedipart, and Cavalier).

II. Provide an overview of the transition plan, emphasizing key milestones and expectations.

ii. Study Overview Meetings:

I. Schedule individual meetings between the medical direction group and leaders of each research study to discuss study objectives, protocols, and ongoing activities.

iii. Study Review:

I. Conduct in-depth reviews of Pedidose, Pedipart, and Cavalier research studies, gaining a comprehensive understanding of the current status and challenges.

iv. Resource Identification:

I. Collaborate with existing study leaders to identify specific resource needs, including personnel, technology, and support staff.

v. Infrastructure Evaluation:

I. Assess the existing infrastructure supporting the studies and identify any required modifications for a seamless transition.

vi. Continuous Support:

I. Medical direction team will provide on-going support, training, and collaboration with research program coordinators.

8. Recommend changes in and improvements to PSCD annual call-coding and TFD and TPD EMS medical care protocols as per below guidelines and Medical Director’s Administrative Guidelines (AG) and Protocol Annual Calendar.

a. Solicitation of Changes (July - August):

i. The Medical Director will encourage EMS personnel, including frontline staff and administrative members, to submit proposed changes to the administrative guidelines.

ii. The Medical Director will create an on-line portal/link to accept submissions, open from July 1 to August 15.

b. Review Committee Formation (September):

i. The Medical Director will facilitate a review committee consisting of field providers, agency, leadership, and medical directors to review recommended AG, revisions, and updates.

ii. The committee evaluates the proposed changes and ensures they align with current industry standards and best practices.

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c. Review Process (October - November):

i. The committee thoroughly reviews all submitted proposals.

ii. The Medical Director will schedule regular meetings to discuss proposed changes, assess their impact on operations, and determine their feasibility and effectiveness.

iii. The Medical Director will seek input from relevant stakeholders to ensure a comprehensive perspective.

iv. The Medical Director will ensure revisions to the educational pearls page are listed on the back of each administrative guideline.

d. Protocol Implementation Planning (December):

i. Once changes are approved, the Medical Director will develop an implementation plan for new protocols and updated guidelines.

ii. The Medical Director will consider training requirements, resource allocation, and communication strategies to facilitate a smooth transition.

e. Training Preparation (December):

i. The Medical Director will develop training modules based on the approved changes.

ii. The Medical Director will outline a comprehensive training plan, detailing the scope of training, the target audience, and the delivery methods.

f. Training Sessions (December - January 1):

i. The Medical Director will conduct training sessions for EMS personnel using an online training module.

ii. The Medical Director will utilize the Learning Management System (LMS), tracking completion and ensuring that all staff members are adequately trained.

g. Implementation (January 1):

i. The updated guidelines and new protocols officially come into effect on January 1.

ii. All EMS personnel are expected to adhere to the revised administrative guidelines in their daily operations.

h. Throughout the year the Medical Director shall: maintain AG website, post FAQs and Medical Director responses as needed to assist with EMS provider and telecommunicator understanding of each guideline and protocol, review requests for urgent AG revisions to address new or urgent changes to call-coding, pre-arrival instructions and/ortho standards of care.

9. Review and amend TFD and TPD standards of care and scope of practice and PSCD call questioning, coding and pre-arrival instruction as needed, working in collaboration with TFD and TPD Medical Administration and PSCD leadership.

10. Recommend changes in and improvements to medical devices, techniques, medications, and other interventions considered for use by TFD and TPD personnel.

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11. Establish and monitor dashboard; and revise TFD and TPD pre-hospital medical care quality assurance standards.

a. Clearly document QA standards, including protocols, procedures, and key performance indicators.

i. Ensure documentation is accessible and understandable for all relevant personnel.

ii. Use the provided Smartsheet links to access the respective OHCA, TBI, Versed, Wrap, and Treat & Release Behavioral dashboards.

iii. Regularly review the dashboards to monitor ongoing performance.

iv. Monitor real-time or near-real-time data for immediate feedback.

v. Use insights from the dashboards to inform revisions to QA standards.

12. Serve as Chair of the TFD Medical Quality Improvement Committee. As Chair, the AMD will be responsible to:

a. Review index cases, benchmarks, & high-risk cases

b. Oversee Weekly meetings to identify ways in which the system might prevent future misses or near misses

c. Expected meeting attendees would include:

i. Medical Director

ii. Associate Medical Director

iii. Office of the Medical Director EMS Specialists

iv. On-shift ECs

v. Optional: Off-shift ECs and DCs

13. Provide input and oversight to TFD Basic Life Support (BLS) and Advanced Life Support (ALS) training programs and PSCD telecommunicator training.

14. Establish and maintain regular face-to-face communication with TFD and TPD field personnel and PSCD telecommunicators. This may be accomplished through continuing education class instruction, vehicular ride-alongs, sit-alongs, station visitation, emergency department interaction, personnel counseling, and other opportunities.

15. Reviewing A.R.S. Title 36, Chapter 21.1 and 9 A.A.C. 25 on an annual basis to ensure implementation of and annually review policies and procedures governing the administrative medical direction of EMCTs, including all prehospital policies, procedures, and protocols.

16. Approving, ensuring implementation of, and annually reviewing treatment protocols, triage protocols, and communication protocols governing EMCT practices that are consistent with A.R.S. Title 36, Chapter 21.1, 9 A.A.C. 25, and each EMCT’s scope of practice, as identified under Article 8 of 9 A.A.C. 25.

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17. Approving, ensuring implementation of, and annually reviewing policies and procedures governing medical record keeping, medical reporting, and completion and processing of prehospital incident history reports that are consistent with A.R.S. Title 36, Chapter 21.1, 9 A.A.C. 25, and each EMCT's scope of practice, as identified under Article 8 of A.A.C. Title 9, Chapter 25.

18. Providing consultation for advanced training for new EMCTs

19. Participating in ongoing EMS quality assurance/system improvement meetings with TFD and TPD.

20. Ensuring that code reviews are completed on appropriate encounters.

21. Oversee drug box discrepancies for Tucson Fire and ensure security policies are in place.

22. Instituting Arizona Department of Health Services (“ADHS”) protocol changes.

23. Ensuring prehospital protocols, policies, and procedures are up-to-date and are reviewed annually by each EMCT.

24. Overseeing Tucson Fire’s medication replacement program and reviewing medication storage and dispensing policies to ensure compliance with DEA regulations.

25. Providing direction for the Tucson Fire BLS Training Center, as ADHS requires for emergency medical technician training.

26. Coordinate with COT and other first responder agencies' Administrative Medical Directors.

27. Providing administrative medical direction to Tucson Fire’s Community Integrated Health Paramedic program and/or other future community paramedic programs or initiatives as needed, including medical oversight, education, and quality improvement.

28. Providing administrative medical direction, review, and oversight to COT’s telehealth program and/or future alternative resourcing options as implemented, including medical oversight, education, and quality improvement.

29. Providing input into the development and utilization of the Tucson Fire immunization program, as needed; and when requested by the Tucson Fire leadership team, being available to participate in public relations meetings and EMS outreach and operations, participating as liaison/communications with other hospitals, dispatch centers, and/or other agencies, and being available to respond to select facilities to facilitate positive interactions between emergency medicine physicians and ALS/BLS providers.

C. TFD will provide:

1. Office Space: Adequate office space to accommodate the incoming medical direction group. The space should be well-designed and equipped to facilitate a productive and collaborative work environment. Comfortable and ergonomically designed workspaces contribute to the well-being and productivity of the medical direction group. This includes ergonomic furniture, adjustable workstations, and proper lighting to create a conducive and healthy working environment.

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2. Clerical Support: Clerical support is needed to assist with administrative tasks, including meeting arrangement, document preparation, and coordination of schedules. This support ensures smooth operations and allows the medical direction group to focus on their core responsibilities.

3. Conference Rooms: Multiple conference rooms of varying sizes are required for meetings, presentations, and discussions. These rooms should have audiovisual facilities, comfortable seating, and appropriate lighting to ensure effective communication.

4. Technological Infrastructure: Technological infrastructure for efficient communication and data management. This includes high-speed internet access, secure networks, and up-to-date hardware and software to support the medical direction group's work.

5. Collaboration Tools: Implementing collaboration tools such as video conferencing platforms, project management software, and communication apps for remote collaboration and seamless communication within the medical direction group.

D. Medical Direction Services for Tucson Police Department:

1. Serve as Medical Director to the Tucson Police Department's Emergency Medical Care Technician (EMCT) certified personnel.

2. Provide medical oversight for Tucson Police Department, including the regular review of:

a. post-basic academy / Advance Officer Training (AOT) first responder medical training,

b. emergency medical protocols used by police officers,

c. implementation and reporting on quality improvement project(s) related to medical emergencies encountered by police officers, and

d. review of cases as needed on behalf of Tucson Police Department.

3. Have working knowledge and understanding of current Arizona Peace Officer Standards & Training (AZPOST) First-Aid curriculum to include:

a. Basic First Aid/Cardiopulmonary Resuscitation (CPR)

b. Automated External Defibrillator (AED),

c. Individual First Aid Kit (IFAK) equipment and application,

d. Tactical Emergency Casualty Care (TECC), and

e. Narcan for Tucson Police Department.

4. Assist with development of response plans and care of individuals with behavioral health emergencies and substance use disorder.

5. Serve as Medical Director to the Tucson Police Department (TPD) SWAT Tactical Emergency Medical Support (TEMS) program. The TEMS program consists of Tucson Fire paramedics and Tucson Police EMCTs. Recommend and provide a five (5) hour quarterly training block of instruction/training to maintain and improve the current skill level of TPD's medics. The type and method of training shall be agreed upon between the parties.

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6. Facilitate scheduling of training of TEMS EMCTs and TEMS paramedics with local hospitals and other emergency medical providers. Each TEMS EMCT or paramedic will receive no more than 20 hours per quarter of training not conducted by the Contractor. This does not include initial EMCT certification.

E. The Medical Director shall select and appoint a Deputy Medical Director to assist with his/her duties. The Deputy Medical Director will serve at the direction of the Medical Director upon approval by the Fire Chief. In the event that he/she is temporarily unable to serve, the Deputy Medical Director may serve as acting Medical Director until he/she resumes the position or until a replacement Medical Director can be selected. The Deputy Medical Director shall have and maintain the same training and experience requirements as the Medical Director.

F. If the appointed Medical Director cannot serve, the Contractor shall provide an alternate qualified and licensed, board-certified emergency medicine physician who meets the requirements of A.A.C. R9-25-204, Administrative Medical Director Qualifications and Responsibilities. The Fire Chief or his/her designee shall approve the replacement Medical Director from among the qualified physicians the Contractor offers to make available for the position.

C.2. EMERGENCY MEDICAL SERVICES (EMS) SPECIALIST

A. The Contractor shall provide an EMS Specialist(s) with experience in pre-hospital medical practice to facilitate Medical Director duties.

B. The EMS Specialist(s) shall:

1. Coordinate, delivery, and oversight of EMS provider maintenance of Emergency Medical Care Technician (EMCT) certification including:

a. Prepare and conduct pre-hospital continuing education classes as authorized and approved by TFD and the Medical Director.

b. Review EMCT documentation pertaining to maintenance of certification such that:

i. EMCTs and TFD administration are aware of any training deficits that would prevent the Medical Director's approval of recertification before individual EMCT recertification date and lapses in EMCT certification.

ii. The Medical Director has approved any necessary recertification documents before EMCT recertification date and lapses in EMCT certification.

c. Assist with the planning and organization of any skills training or skill competency testing program as authorized and approved by TFD and the Medical Director.

d. Attend no less than fifty (50%) TFD internal committee meetings in a calendar year, including Medical Administration Section and EMS Captain meetings.

2. Will assist the medical director in the oversight of EMS operations including:

a. Ensuring compliance with the Medical Director led TFD medication and controlled substance program.

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b. Assisting with policy, protocol and standing order/administrative guideline review to ensure compliance with Arizona Statutes pertaining to EMS Medical Direction.

c. Facilitating Medical Director oversight of Tucson Fire Department EMS operations, special operations, and dispatch by coordinating meetings and collecting background information and data.

d. Monitor, coordinate, and provide recommendations for a TFD EMS quality assurance program to include review of TFD documentation through electronic patient care forms (ePCRs), patient outcomes, hospital telemetry and radio communication, and documentation.

C. TFD will provide:

1. Computer access to all necessary software programs.

2. Appropriate workspace to facilitate on-site work.

3. Access to TFD stations and TFD EMS provider drug logs and drug boxes to facilitate the auditing process.

4. Background check for individuals responsible for the handling of any scheduled II medications.

C.3. QUALITY ASSURANCE COORDINATOR

The Contractor shall provide a Quality Assurance Coordinator with experience in medical data retrieval, compilation, and interpretation. The individual in this position shall possess significant skills and abilities with management information systems, database management, data analysis, familiarization of regional, state, and national data collection sites and requirements for reporting, and a thorough understanding of the local EMS system.

The Quality Assurance Coordinator shall:

A. Obtain from server data downloads from TFD's cardiac monitors, including the ability to manage and convert the data into reports using standard or specialized software as needed.

B. Assist in developing a comprehensive data retrieval system for TFD medical responses specific to cardiac incidents and cardiac arrest. Develop and maintain cardiac-related databases. Assist with a systematic review of data retrieval methodology at frequent and regular intervals.

C. Provide data, including patient outcome data, to the TFD Medical Administration Section and Medical Director as requested.

D. Assist in designing and implementing medical research studies as directed by the Medical Director and TFD Medical Administration.

E. Provide data and EMS reports applicable for use in the training and continuing education of TFD EMS personnel.

F. Provide information to the Medical Director and TFD Medical Administration regarding medical complaints.

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G. Collaborate with the Medical Director and TFD Medical Administration in gathering data specific to quality assurance information related to evaluating pre hospital care and emergency medical dispatch.

H. Work a minimum of 20 hours per week for the TFD Medical Section office. TFD will provide office space, computer equipment, and computer access to necessary TFD and COT software programs. Work schedule shall be agreed upon between TFD and the Contractor.

I. Attend no fewer than three quarters (75%) of TFD internal committee meetings in a calendar year including Medical Administration Section and EMS Captain meetings. There are approximately three (3) one-hour meetings per week.

C.4. QUALITY ASSURANCE

A. TFD will collaborate with the Contractor to collect, review, and analyze emergency medical response information for quality assurance. The Contractor will ensure patient, physician, hospital, COT, Fire Department, and budgetary privacy by disseminating data related to patient care and outcome.

B. TFD and the Contractor shall jointly address complaints and concerns regarding the performance issues or working relationships between Tucson Fire EMS and Hospital Emergency Department personnel.

C. The process shall be centralized, trackable, and have a standardized format for addressing complaints, concerns, and performance issues.

D. All responses, actions, and findings shall be logged and reviewed through a retrievable system.

C.5. ON-LINE MEDICAL DIRECTION

A. The Contractor shall provide on-line Administrative Medical Direction as required by A.A.C.

R9-25-201C, 203, and 205 for TFD EMS responses.

B. The Contractor shall provide 24 hour per day, 7 days per week on-line medical direction capability between TFD EMS field providers and the Public Safety Communications Department as defined in A.R.S. 36-2201-10 and regulated under A.A.C. R9-25-206C.

C. Online medical direction may be delegated to a qualified base hospital emergency physician, consistent with A.A.C. R9-25-205D, Online Medical Director Qualifications, and Responsibilities. On-line medical direction will be conveyed through the Public Safety Communications Department as a qualified medical direction authority and TFD EMS providers via electronic telemetry, two-way radio, and/or cellular or wired telephonic communication.

1. Contractor will have an Emergency Medicine Physician, physically present in the Emergency Department, and will provide on-line medical direction as needed. The Emergency Medicine Physician will be knowledgeable regarding the capabilities and limitations of BLS and ALS personnel, the established standing orders, and the applicable treatment, triage, and communication protocols. The Emergency Medicine Physician will

BUSINESS SERVICES DEPARTMENT Page 14 of 49 also be board-certified by the American Board of Emergency Medicine or have successfully completed an emergency medicine residency training program.

2. Contractor will provide a mechanism through which to provide on-scene medical oversight for a subset of patients when requested by TFD.

C.6. MEDICAL DATA

A. Authorization of the Fire Chief is required for any use of TFD data by the Contractor in publications, or shared with any outside agency, group, individual, or organization.

C.7. Director Experience Requirements beyond the AAC requirements

A. Remain board eligible or board certified in the specialty of emergency medicine, having completed a residency in emergency medicine in a program approved by the Accreditation Council for Graduate Medical Education (“ACGME”).

1. Remain board eligible or board certified in the subspecialty of emergency medical services (“EMS”) and/or have at least five years of experience in the State of Arizona as an administrative EMS medical director of multiple fire/EMS agencies.

2. Possess and maintain a current, valid, and unrestricted Drug Enforcement Administration (“DEA”) registration certificate.

B. A physician with experience in hazardous materials management and special teams responders.

C. Maintaining active membership and/or participation in state and regional EMS committees.

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D. INSTRUCTIONS TO OFFERORS

D.1. DEFINITION OF KEY WORDS USED IN THE SOLICITATION

For purposes of this solicitation and any subsequent contract, the following terms have the meanings set forth below:

City:The City of Tucson, Arizona

Contract:The legal agreement(s) executed between City and the Successful Offeror(s). The Contract will be deemed to include all the conditions and requirements set forth in this solicitation and any Addenda to the solicitation, all the Special Terms and Conditions and Standard Terms and Conditions, and all the terms of the Offer submitted by Offeror as finally negotiated and accepted by the City.

Contractor/Consultant:A Successful Offeror that enters into a Contract with the City.

Contract Representative:The City employee or employees who have been designated to act as the City contact for this solicitation process and who are responsible for monitoring and overseeing the Contractor's performance under the Contract.

Business Services Director:The contracting authority for the City, authorized to sign contracts and addenda thereto on behalf of the City.

May: Indicates something that is not mandatory but permissible.

May not:The indicated party is prohibited from taking the action.

Must: The action or condition is required.

Offer:Any proposal, statement of qualifications, bid, or other submission provided by an Offeror in response to this Solicitation.

Offeror: Each individual or entity that submits an Offer in response to this solicitation.

Successful Offeror: An Offeror who received a Notice of Award or a Notice of Intent to Award from the City.

Will:The indicated party is promising to take the action or abide by the condition.

D.2. PRE-SUBMITTAL MEETING

A Pre-Submittal Meeting will be held at the date and time stated on the cover page of this solicitation, if such a date and time is provided. Attendance at this meeting is not mandatory, but written minutes and/or notes regarding the meeting will NOT be provided, so attendance is encouraged. The purpose of this meeting will be to clarify the contents of this solicitation in order to prevent any misunderstanding of the City's position.

D.3. INQUIRIES

Any questions about this solicitation or the proposed Contract must be presented at the Pre-Submittal Meeting, if there is one (see above), or submitted in writing, via email, or through the online bidding system, to the Contract Officer by the Question Submission Deadline. The email must refer to the solicitation number and the paragraph number of the provision that the question concerns. The Contract

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Officer may respond by email or may, if they deem it appropriate, address the question in a solicitation addendum or response through the question and answer portal in the online bidding system. Offeror may not rely on oral interpretations or clarifications about the solicitation; only questions answered in an email by the Contract Officer, posted through the online bidding system, or posted as a formal solicitation addendum will be binding.

D.4. ADDENDUM OF SOLICITATION

Solicitation Addenda will be posted on the City’s link to the online bidding website. Offeror is responsible for checking the webpage regularly for new solicitation addenda and must acknowledge each addendum to this solicitation in its submittal. Please note that vendors who have registered with the Business Services Department at https://procurement.opengov.com/portal/tucson-az and follow the City of Tucson will receive email notifications of solicitation addenda.

D.5. UNDERSTANDING SCOPE OF WORK

Before submitting an Offer to this solicitation, Offeror must familiarize itself with the Scope of Work, laws, regulations, physical conditions, and other factors affecting the obligations – including the expense and difficulty of fulfilling those obligations – that Offeror will have under the Contract if awarded to Offeror. No adjustment to the financial or other terms of the Contract will be justified by Offeror’s failure to fully understand or appreciate the Contract requirements or other factors affecting Contract performance.

D.6. PREPARATION OF OFFER

A. Form and Organization. If Offer forms are included in this Solicitation, Offeror’s Submittal must be on those forms. Supporting documentation must be arranged in a manner that follows and clearly refers to corresponding sections of the solicitation. Offeror may copy the submittal forms in order to complete them electronically but may not alter or rearrange them or change any paragraph designations.

B. Confidential Information. Any information in its submittal that Offeror wishes to be treated as confidential must be clearly marked “CONFIDENTIAL.”

C. Offer Contents. Offeror’s submittal must contain responses to all sections of this solicitation, any Offer forms provided must be completed and any requested supporting documentation must be attached.

D. Signatures. Offeror must include in their submittal signed copies of the Offer and Acceptance page. Any cover letter accompanying the proposal documents must be signed. Offeror must initial each erasure, interlineation or other modification in the submittal. The person signing and initialing on behalf of Offeror must be a person authorized to legally bind Offeror.

E. Prices. Where a unit price is provided it will govern over any erroneous extension of the price.

F. Time Periods. Periods of time, stated as a number of days, will be calendar days unless specifically stated otherwise.

G. Accuracy. Mistakes in preparation of its submittal confers on Offeror no right to modify or withdraw its submittal after the Submittal Deadline.

https://procurement.opengov.com/portal/tucson-az

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H. Cost of Preparation. The City will not reimburse Offeror for the cost of developing, presenting, submitting or providing any response to this solicitation.

I. Subcontractors. Offeror must, in their submittal, list any subcontractors that it will utilize in the performance of the Contract if they are awarded the Contract and must describe their qualifications in detail.

J. Incomplete Information. Failure to include all requested information may have a negative impact on the evaluation of Offeror’s submittal.

D.7. PAYMENT DISCOUNTS

Payment discount periods shall be computed from the date of receipt of the material/service or correct invoice, whichever is later, to the date City’s payment warrant is mailed. Unless freight and other charges are itemized, any discount provided shall be taken on full amount of invoice. Payment discounts of twenty-one calendar days or more shall be deducted from the proposed price in determining the price points. However, the City shall be entitled to take advantage of any payment discount offered by a vendor provided payment is made within the discount period. The payment discount shall apply to all purchases and to all payment methods.

D.8. TAXES

The City is exempt from federal excise tax, including the federal transportation tax, but is not exempt from any other taxes, including state and local sales and excise taxes.

D.9. EXCEPTIONS TO CONTRACT PROVISIONS

By submitting an offer in response to this solicitation, Offeror is offering to enter into the Contract with the City. If Offeror wishes to modify any Contract terms and conditions, Offeror must, in its Offer, clearly identify the changes it is requesting. No requested modification will be deemed accepted by the City unless and until the City’s Business Services Director or their designee expressly accepts it in writing.

D.10. PUBLIC RECORD

Any documents submitted by Offeror in response to this solicitation will become the property of the City.

Except as set forth below with respect to Confidential Information, the Submittal will be deemed to be a public record available for review by the public after the award notification.

D.11. CONFIDENTIAL INFORMATION

The City is obligated to abide by the Arizona Public Records Law, A.R.S. §§ 39-101 through 39-161. If Offeror believes that any portion of its Offer, specification, protest or correspondence contains information that is confidential and subject to being withheld from disclosure in the event that the City receives a public records request to which the record is responsive, Offeror must, when the record is submitted, provide the Contract Officer written notification of that fact. The records or portions of records that Offeror wishes to be treated as confidential must also be clearly marked “CONFIDENTIAL” on their face. Pricing will not be treated as confidential.

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If the City, after award notification, receives a public-records request the scope of which includes a document submitted by Offeror and marked "CONFIDENTIAL", the Contract Officer will make a written determination regarding whether the document will be provided to the requestor. If the Contract Officer determines that the document should be released, City will notify Offeror in writing. Unless Offeror, within 10 days after the date of that notice, obtains and provides to City an order from a court of competent jurisdiction prohibiting the City from releasing the documents, the City may release the documents without any liability to Offeror.

D.12. WHEN AND HOW TO SUBMIT OFFERS

In order to be considered, Offeror must, no later than the Offer Submittal Deadline, submit its Offer electronically through the City’s online bidding system:

https://procurement.opengov.com/portal/tucson-az

NOTE: THE ENTIRE OFFER MUST BE IN "“SUBMITTED"” STATUS IN THE CITY’S ONLINE

BIDDING SYSTEM IN ORDER TO BE CONSIDERED. RESPONSES THAT HAVE BEEN CREATED

IN THE SYSTEM, BUT THAT ARE NOT IN "“SUBMITTED"” STATUS BY THE OFFER SUBMITTAL

DEADLINE WILL NOT BE CONSIDERED.

D.13. CERTIFICATION OF NONCOLLUSION; CONFLICTS OF INTEREST

Offeror will not communicate, orally or in writing, with any member of the Mayor and Council, or with any City staff outside the Procurement Division of the Business Services Department, regarding this Solicitation. By submitting an Offer, Offeror warrants that:

A. Preparation and submission of the submittal did not involve collusion or other anti-competitive practices.

B. Offeror has not given, offered to give, nor intends to give at any time hereafter, any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, meal or service to a public servant in connection with this solicitation.

C. No person has been employed or retained to solicit or secure a Contract under this solicitation upon a promise of a commission, percentage, brokerage, or contingent fee.

D. No employee of the City involved in this Solicitation process, or any family member of such an employee, has any substantial financial interest in Offeror’s firm. No member of the City of Tucson Mayor and Council who has, or whose family member has, any substantial financial interest in Offeror’s firm will participate in any action taken by the Mayor and Council with respect to this Contract. The terms “relative” and “substantial interest” have the meanings assigned in A.R.S. § 38-502

The City may disqualify Offeror from further participation in the solicitation process if the City determines that any City employee or official involved in this Solicitation process has an actual or apparent conflict of interest or if Offeror has engaged in any collusion or anti-competitive practices.

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D.14. WITHDRAWAL OF OFFER; BINDING OFFER

By submitting an Offer in response to this Solicitation, Offeror is offering to enter into the Contract with the City. Offeror may withdraw a submitted Offer at any time prior to the Offer Submittal Deadline.

Telephonic or oral withdrawals are not effective.

Offeror cannot withdraw an Offer that is in “submitted” status as of the Offer Submittal Deadline unless the Director of the Business Services Department consents in writing to the withdrawal. The Offer will be irrevocable for 90 days after the Offer Submittal Deadline.

D.15. DISCUSSIONS

The City may, at its discretion, conduct discussions with Offeror for the purpose of eliminating minor irregularities, informalities, or apparent clerical mistakes in Offeror’s submittal in order to clarify the offer and assure full understanding of, and responsiveness to, solicitation requirements.

D.16. VENDOR REGISTRATION; BUSINESS LICENSE

In order to be eligible for award of a Contract, Offeror must:

A. Register with the City’s Business Services Department. Registration can be completed at https://procurement.opengov.com/portal/tucson-az

B. Obtain a City of Tucson Business License or a written determination from the City's Business License Section that a license is not required. For questions contact the City's Business License Section at

(520) 791-4566 or email at license@tucsonaz.gov mailto:license@tucsonaz.gov

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E. OFFER EVALUATION AND CONTRACT AWARD

E.1. PROPOSAL EVALUATION CRITERIA – (listed in relative order of importance)

A. Method of Approach

B. Qualifications & Experience

C. Price Proposal

E.2. INTERVIEWS

The City may interview some or all of the offerors at any point during the evaluation process. If interviews are conducted, information provided during the interview process will be taken into consideration in the evaluation process. The City will not reimburse the Offeror for any costs Offeror incurs during its participation in the interview process.

E.3. ADDITIONAL INVESTIGATIONS

The City may undertake any additional investigations it deems appropriate to evaluate the competence and financial stability of any offeror.

E.4. OTHER INFORMATION

Information that evaluation committee members have about an offeror beyond what is provided in the offeror’s Offer may be taken into consideration during the evaluation process.

E.5. PRICE

A. Tax Offset Policy. If applicable under Section 28-18(6) or Section 28-17(7)(d) of the Tucson Procurement Code, the City will include the amount of all business privilege taxes other than the City’s in evaluating the pricing component of each Offer.

B. Payment Discounts. Any discounts offered by Offeror for payments made within 21 calendar days or more will be deducted from the proposed price in evaluating an offeror’s pricing.

However, the City may take advantage of any early- or timely-payment discounts offered by a vendor. Any proposed payment discount will apply to all purchases and to all payment methods

E.6. CITY’S RIGHT TO WAIVE DEFECTS OR REJECT OFFERS

Notwithstanding any other provision of this solicitation, the City may:

A. Waive any immaterial defect or informality; or

B. Reject any or all submittals, or portions thereof; or

C. Reissue the solicitation.

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E.7. CONTRACT NEGOTIATIONS

At the City’s discretion, it may negotiate with one or more responsible offerors to agree upon the final conditions, terms and price of the Contract. In doing so, the City will treat offerors fairly and will not disclose to any offeror information from responses submitted by other offerors. Exclusive or concurrent negotiations do not constitute a contract award and do not confer any rights to the offerors participating in such negotiations. In the event the City deems that negotiations are not progressing, the City may formally terminate these negotiations and may enter into concurrent or exclusive negotiations with the next most qualified firm(s).

E.8. AWARD OF CONTRACT

A Contract is created when, and only when, it is formally awarded, which occurs when the Business Services Director and the City Attorney sign the Offer and Acceptance page of the Successful Offeror’s submittal. When a Contract is awarded, the City will send the Contractor a Notice of Award.

The City may first issue a Notice of Intent to Award to the Successful Offeror(s). Offeror, if it receives a Notice of Intent to Award from the City, must sign and file with the City, within ten (10) days after receipt of the Notice, all documents necessary for execution of the Contract. A Notice of Intent to Award does not create a contract. Only a subsequent formal award, as described above, creates a Contract.

E.9. MULTIPLE AWARDS

The City, at its sole discretion, may award multiple Contracts.

E.10. SUBMITTAL RESULTS

After the City issues a Notice of Award, the City will post the name(s) of the Successful Offeror(s) on the Business Services Department’s Internet site at https://procurement.opengov.com/portalucson-az/contracts

E.11. PROTESTS

Any interested party, may, in accordance with Article IX of the Tucson Procurement Code, protest either this solicitation or the award of a Contract under this solicitation. A protest based on alleged improprieties in this solicitation must be filed no later than five (5) working days before the Proposal Submittal Deadline. A protest of a proposed or actual award must be filed no later than ten (10) calendar days after the City issues a Notice of Intent to Award or, if no Notice of Intent to Award is issued, after the City issues a Notice of Award.

A protest must be made in writing and filed with the Contract Officer. It must include:

A. The name, address, and telephone number of the protestant;

B. The signature of the protestant or its representative;

C. The solicitation or Contract number;

D. A detailed statement of the legal and factual grounds for the protest along with copies of all relevant documents; and https://procurement.opengov.com/portalucson-az/contracts https://procurement.opengov.com/portalucson-az/contracts

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E. The form of relief requested.

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F. EVALUATION PHASES

No. Evaluation Criteria Scoring Method Weight (Points)

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1. Method of Approach

1. The Offeror will provide a detailed description of the Offeror’s proposed timeline approach to the Scope of Work. Including but not limited to, a list of milestones and proposed deliverables for each milestone, a schedule of work, an estimate of the Offeror’s staff time for each major step, and a list and description of needs on-site such as office space, conference rooms, clerical support for meeting arrangement, beyond what the City has already indicated it will provide in the Scope of Work.

2. The Offeror will provide a detailed description of the proposed level of participation by City staff.

The Offeror will include, type of staff experience, level of staff authority, and approximate investment of time by City staff by activity and other assignments.

3. The Offeror will provide a detailed description of its plan for customer support and its ability to assist the City of Tucson. The Offeror will include:

1. Information on its staffing, experience, and ability to offer on-site staff as needed.

2. Customer support available to the City.

4. The Offeror will identify potential problem areas and suggest solutions to those problems.

5. If there are additional tasks that the Offeror feels have been overlooked by the

N/A N/A

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Scope of Work, thoroughly describe them.

6. Offeror must explain how their administrative process will ensure that appropriate levels of attention are given and that work is properly performed.

7. The Offeror will describe the approach and delineate the steps involved in assisting in creating, overseeing, and sustaining a comprehensive medical data retrieval system, including cardiac-related data and patient outcomes, as indicated for the requirements of the Quality Assurance Coordinator. The Offeror will provide a detailed description of the proposed level of participation by City staff.

Including, but not limited to:

Requirement analysis, System design and development, Data retrieval and integration, Quality assurance and data validation, Security and compliance, Training and support, and Continuous improvement.

8. The Offeror will describe the approach and processes used to recommend changes in and improvements to medical devices, techniques, medications, and other interventions considered for use by TFD personnel. The Offeror will include: A needs assessment process; Describe research and analysis; Stakeholder engagement; Evaluation and recommendation process; Testing, validation and documentation; Field training and implementation;

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9. The Offeror will describe and explain the system approach to establishing, monitoring the dashboard, and revising TFD pre-hospital medical care quality assurance standards. The Offeror will include:

1. Quality Assurance Standards evaluation

2. Description of Monitoring and dashboards

3. A Revision process for Quality Assurance Standards

10. Describe the process and mechanisms to amend TFD standards of care, scope of practice, and PSCD call questioning, coding, and pre-arrival instruction as needed, working in collaboration with TFD Medical Administration and PSCD leadership.

11. Transitioning into the role of Administrative Medical Director for Tucson Public Safety involves a comprehensive process to integrate smoothly into current operations while assuming leadership responsibilities in several areas and maintaining the continuity of existing services. The Offeror will describe the approach and integration to include:

1. Initial assessment and planning

2. Communications with stakeholders

3. Integration and training

4. Implementation and oversight

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5. Expectations and support

6. Timelines

12. The Offeror will describe the approach and delineate the steps to effectively facilitate the takeover of the Pedidoe, Pedipart, and Cavalier research studies, ensuring a smooth transition process.

The Offeror will include:

1. Orientation

2. Study Review and Overview Meetings

3. Resource Identification

4. Infrastructure Evaluation

5. Continuous Support

6. Provide a detailed explanation as to how the offeror will meet the time line as indicated in the method of…