A D D E N D U M # 7 October 17, 2017 Address all questions to: Kathi Braeme-Burr, Sr. Procurement Analyst Multnomah County Purchasing 501 SE Hawthorne Blvd. Portland, OR 97214 503-988-7550 E-mail: Kathi.braeme-burr@multco.us RFP NO: 4000005894 TITLE: Emergency Ambulance Services CLOSING DATE: November 6, 2017 / NOT LATER THAN 4:00 p.m. This Addendum is issued to the above referenced to RFP make the following changes, additions, deletions, and/or clarifications: 1. Delete and Add: Section 5, Attachments List, Attachment 5.5, Communications Interface and Equipment Information, Page 136. Delete: Attachment 5.5, Communications Interface and Equipment Information, dated August 4, 2017. Add: Attachment 5.5, Communications Interface and Equipment Information, dated October 13, 2017 labeled as Addendum 7, Attachment 1. 2. Clarification: General QUESTIONS RECEIVED REGARDING TECHNICAL INTERFACE WITH Versaterm CAD AND COUNTY RESPONSES Call reception and dispatch. BOEC will continue to serve as PSAP, but ceases EMD and ambulance dispatch services. Is there space and facilities for the ambulance contractor to base its Communication Center at the BOEC facility? The County does not anticipate that Ambulance Contractor personnel will be located at BOEC. Can you provide specifics about the IT infrastructure and software for the BOEC, for purposes of planning interface development with contractor Communication Center? Can you provide technical contacts to discuss in depth? 4000005894 Emergency Ambulance Services Page 1 of 11
Attachment 5.5 of the RFP identified two distinct technology options to achieve integration of the Emergency Ambulance Contractor s communication functions - i.e., caller interrogation, and unit assignment - with the communication functions of the City Bureau of Emergency Communications Public Safety Answering Point (BOEC PSAP) - i.e., call-taking, dispatch of ambulances and other responders, and related communications activities: 1. The first option was for the Contractor to supply its own Computer Aided Dispatch system (CAD). 2. The second option was for the Contractor to use the BOEC Versaterm CAD (VCAD). After further consultation with BOEC and the City Bureau of Technology Services (BTS), option 1 - the option for the County s Emergency Ambulance Service Contractor (Contractor) to use its own stand-alone CAD system - has been eliminated. The Contractor must utilize the VCAD to perform call interrogation and ambulance unit assignment. The following is a narrative description of the contemplated approach: The County s Emergency Ambulance Service Contractor (Contractor) will use the City s Versaterm Computer Aided Dispatch application software (VCAD) to facilitate provision of emergency medical call phone triage and assignment of ambulance resources to these calls. This will occur in a center located at a Contractor facility physically separate from the BOEC Primary Public Safety Answer Point (PPSAP). The Contractor s site must be approved by both the City s Bureau of Technology Services (BTS) and Multnomah County EMS. The Contractor will be responsible for covering the City s reasonable costs related to setup, testing, and enabling of live operations at the Contractor s EMS medical phone triage and communications center. These costs include, but are not limited to, expenses and fees for: enabling Contractor s remote use of VCAD; adding Medical Priority Dispatch System (MPDS) software to VCAD; using BOEC s Motorola radio system and logging recorder equipment; providing operator training for VCAD and MPDS applications; and modifying the Century-Link 9-1-1 telephone system if necessary to support bidirectional call hand-offs, three-party conversations and voice logging. A Performance Agreement between the City of Portland BOEC and Multnomah County EMS will be required to define service levels, various terms and conditions, and roles and responsibilities of the City and the County. The County will incorporate applicable elements into the final agreement between the County and the Contractor. Such performance agreements are standard under Section 5 of the BOEC Intergovernmental Agreement which serves as the framework for the BOEC PSAP. The existing contract between Versaterm, Inc. and the City of Portland will need to be amended to include software licenses for all VCAD software required for Contractor operations. This may include licenses for Full CAD, Remote CAD, EMS Mobile CAD, as well as other CAD modules. Amendments to the contract may require City Council approval. Any additional costs associated with amending the existing agreement will be reimbursed to the City by the contractor. 4000005894 Emergency Ambulance Services Page 2 of 11
The City of Portland requires all Contractor personnel assigned to provide CAD workstation support at the Contractor s communications center must have the necessary knowledge and skills to perform troubleshooting and technical support of MS Windows based computers. BTS may require that these personnel have other technical competencies specific to the final system configuration and support agreements. The following resources and levels of support will be required for initial setup and successful ongoing operation of a dedicated Contractor communications center: VCAD Dispatch licensing, installation and support: City of Portland Bureau of Technology Services (BTS) will need to provide: Initial installation and testing of all Versaterm CAD software on Emergency Ambulance Contractor s computer hardware located at Contractor s communications center. VCAD servers located at BOEC and remote backup locations. No additional servers will be required to support the Contractor s communications center location. An FTP repository to enable software updates and data transfers as required. Documentation and consulting services for support as needed. Minimum specifications and requirements for hardware configuration, operating systems, physical and system security, network, firewalls, communications and peripheral equipment for BOEC s EMS VCAD dispatch and call-taking positions. A one-way push of data out of the City s VCAD system to the Emergency Ambulance Contractor s systems should it be necessary. Such a push could include data to support Electronic Patient Care Records (epcr), System Status Management, or other functions necessary to carry out the work required by the Contractor under its contract with the County. Any such push would be at Contractor s expense. Installation expenses as outlined in the RFP, including this attachment should be anticipated by the Contractor in preparing its response. City of Portland Bureau of Emergency Communications (BOEC) will need to provide: Support to develop and execute a Performance Agreement as previously described. Initial VCAD training of Emergency Ambulance Contractor s communications center personnel. All necessary Versaterm software licenses, to be assigned to the City of Portland, but specifically for the use in the Contractor s communication center. Contractor will be responsible for providing: CAD PC workstations, monitors, routers, switches, printers and all other devices required by Contractor's users of VCAD at its communications center. All equipment necessary to operate at a best-practice level, including the use of current Microsoft-supported Operating Systems and the latest antivirus/security software and associated libraries. For CAD workstations, the provider should provide at a minimum hardware and software that meets the following specifications: 4000005894 Emergency Ambulance Services Page 3 of 11
Dell model Optiplex 7010 Intel i3-3220 RAM 4GB Disk: 500GB Windows 7 Specifications may change during the course of the contract. Contractor is expected to maintain all equipment to minimum specifications necessary to continue to optimally run the software throughout the contract. MDT VCAD licensing, installation and support: BTS will provide: Initial installation and testing of all VCAD mobile data terminal (MDT) software in the Contractor s vehicles. Netmotion connectivity to each MDT needing access to the Versaterm CAD application. BOEC will provide: Support to develop and execute A Performance Agreement as previously described. All necessary VCAD MDT software licenses, to be assigned to the City of Portland, but specifically for the use of the Contractor as a contractor to the Multnomah County EMS. Contractor will provide: Necessary MDT hardware and peripheral equipment which meets City-compliance and Versaterm specifications for operating system, security, patching, network connectivity, and antivirus applications. For MDT workstations, the Contractor should provide at a minimum hardware and software that meets the following specifications: Getac model B300G6 Intel i5-6200u RAM 8GB Disk: 256GB Windows 7 Specifications may change during the course of the contract. Contractor is expected to maintain all equipment to minimum specifications necessary to continue to optimally run the software throughout the contract. Medical Priority Dispatch System (MPDS) BTS will provide: Infrastructure support for the MPDS environment. o This will include server hardware, installation, and network connectivity. o Collaboration with the Priority Dispatch Corp. vendor to install and test the MPDS application. o Secure access for ProQA support personnel for vendor-provided MPDS application support. City may require a secure access solution and the cost will be borne by the Contractor. 4000005894 Emergency Ambulance Services Page 4 of 11
BTS desktop support to deploy the MPDS application to Medical Call- Taker workstations. BOEC and the Contractor will provide: Application-level support for the MPDS. Software licenses and installation of the MPDS application at Contractor communications center workstations. There is a performance requirement to accomplish MPDS triage and process the call to the assignment queue for life-threatening/time critical emergency requests within 90 seconds or less on not less than 90% of requests. However, in some cases there is a clinical need for longer telephone conversation (e.g., pre-arrival instructions). Can either the dispatch of EMS resources while still remaining on the telephone be the measure of time interval, or can the Contractor apply for an exemption for longer than 90-second cases due to complex pre-arrival instructions? The performance requirement of within 90 seconds/90% is the time interval from Contractor phone pick-up until movement of the call to the assignment queue - facilitating initial dispatch of first responders and the ambulance. There is no time limit involved to provide pre-arrival instructions. In the most critical cases (e.g. CPR in progress, childbirth, etc.) it is anticipated that pre-arrival instructions could continue until on-scene arrival of the first responding unit (ambulance or first responder). The proposal specifically mentions in Section 5.5 Communications Interface and Equipment Information, Enhanced System Descriptions. Is it the desire or intent of the RFP for the Contractor to act as a Secondary PSAP? If this is the intent would ANI (Automatic Number Information) and ALI (Automatic Location Information) be passed to the contractor either through a specifically designed interface or through the addition of 911 phone equipment consoles installed within the contractor s communication center? The County requires that the transactions involved in providing call triage, prioritization and initial assignment of the contractor ambulance resources will be done ONLY within the VCAD. There is no option to interface or utilize a Contractor CAD to prioritize calls or assign units. Operationally, initial call answering will be done by the BOEC PSAP call center; address validation and phone number confirmation will be done by the PSAP s primary intake call taker. The caller will be transferred via hook-flash (single number transfer), to the Contractor s communication center. Since the Contractor will be using the same VCAD as the PSAP, emergency dispatch staff (EMD) at the Contractor s center will have the caller information in front of them. Contractor s EMD will launch ProQA and continue with call interrogation and prioritization. Question What input will the Contractor have to the system set-up? 4000005894 Emergency Ambulance Services Page 5 of 11
Prior to contract start date, the Contractor will be responsible to work collaboratively with the County, its EMS Medical Director, first response agencies, BTS, and BOEC to set up and implement the new system. This will include finalizing technology requirements and mapping MPDS determinant codes to BOEC s first responder and Contractor operations plans. Can you clarify how the dispatch interface will work? When a request is received by the BOEC PSAP and determined to be a medical call, BOEC will electronically forward the caller to the Contractor s communication center. The Contractor s EMD staff will interrogate the caller and categorize the call in accordance with MPDS question algorithms programmed into the VCAD. Based upon the caller s responses to the questions, the VCAD assigns an MPDS determinant code. For assignment of ambulances, the Contractor will review the VCAD recommended unit assignment and either confirm or change the recommended unit assigned based on the Contractor s awareness of system status. For example, the EMD might assign a unit at a greater distance to a lower priority call in order to preserve a resource in an area where another (possibly higher priority) call may be anticipated. That said, once the unit assignment determination is made and confirmed by the contractor in the VCAD, the actual dispatch is made by BOEC. What is the County s desired connection type for the purpose of the desired Communications Interface, e.g. VPN (Virtual Private Network), MPLS point-to-point, etc.? A high-fidelity voice and data connection is required. Optimally, this would involve redundant fiber pathways. However, it is the Contractor's responsibility to determine what connectivity method it will use to provide uninterrupted service. If the contractor elects to pursue its own standalone Computer Aided Dispatch System, would the County be willing to provide remote access to BOEC s VCAD via a remote application server (i.e. Citrix or Remote Desktop)? As noted above, the option to use its own standalone CAD system has been eliminated. Contractor must utilize the BOEC VCAD to perform call interrogation and assignment. Section 5.5 Technology Requirements and Options Under heading Contractor/Service Provider CAD specifically mentions two distinct technology options that the contractor may elect to use/supply. Option one, Contractor supplies its own CAD. Option two, the Contractor uses the BOEC VCAD CAD. This section also describes the necessary interface requirements for the Service Provider to directly interface with Versaterm s Message Controller (VMC) should the provider elect to use option one. Under Addendum #3 Clarification 4 and Clarification 7 (respective answer section s): 4000005894 Emergency Ambulance Services Page 6 of 11
States that the RFP requires the use of BOEC CAD Software for the purpose of this RFP There is a discrepancy between the original RFP document (Attachment 5.5) and Addendum #3 as to whether or not the Service Provider/Contractor will be able to use its own distinct CAD system separate of BOEC Versaterm. Please clarify if the contractor is required to use BOEC s existing Versaterm CAD or if they may elect to use another CAD system at their discretion. As noted above, the option to use its own standalone CAD system has been eliminated. Contractor must utilize the VCAD perform call interrogation and assignment. Is there additional Interface Control Document (ICD) and/or Data Type Definition (DTD) document available for review by the potential Contractor(s)? Is there any desire to have Contractor data returned to the Versaterm CAD (i.e. response time(s), unit responding/assigned, incident number, unit status(es) etc?) Please clarify the additional data element being transferred to the Contractor. Specifically mentioned are Unit Status and AVL Data. Is this information specific to Fire Department units that are dispatched by BOEC? As noted above, the option to use its own standalone CAD system has been eliminated. Contractor must utilize the VCAD to perform call interrogation and assignment. Therefore, the above listed interface documents are not required. c: D. Knott, A. Monnig K. Braeme-Burr, A. Blackmon, A. Hathorne File 4000005894 Emergency Ambulance Services Page 7 of 11
Addendum 7, Attachment 1 4000005894 Emergency Ambulance Services October 13, 2017 Attachment 5.5 Communications Interface and Equipment Information Proposals must be submitted based on the technical and operational assumptions presented in this attachment. Actual work will be performed based on agreements made between Multnomah County EMS and the City of Portland which is responsible to administer the PPSAP. Introduction This appendix provides a general description of the process flow and technology required to implement the Contractor s Communications Interface for emergency medical phone call triage and unit assignment responsibilities under the RFP. Each Proposer should fully evaluate the requirements and costs associated with fulfilling these responsibilities. Current System and Call Flow Described The process for call handling is based on the distinct steps in the anatomy of a 911 call. Calls typically enter the system at the Primary Public Safety Answering Point (PPSAP) center operated by the City of Portland s Bureau of Emergency Communications (BOEC). The center handles all three emergency services disciplines (police, Fire and EMS). EMS ambulance services are provided under contract by a contracted ambulance service (Contractor). In the current model, the Contractor has a single designated pod within the BOEC dispatch center. The pod s primary function is to carry out the Contractor s redeployment of resources. This pod does not have the role of initial assignment of vehicles but can adjust the assignment after BOEC personnel have assigned the call. 4000005894 Emergency Ambulance Services Page 8 of 11
Addendum 7, Attachment 1 Figure 1 Timelines The current system is fully integrated; the BOEC dispatch center performs both 911 call-taking activities and dispatch activities (see Figure 1 for 911 timeline and CAD timeline). The current call prioritization/triage tool is a manual proprietary paper-based tool that allows the same agent to handle both 911 call taking activities and call prioritization/triage activities ( record open on the CAD Timeline). The call is then sent to a primary dispatch desk to assign both Fire and EMS resources ( call transmitted on the CAD Timeline - also referred to as call enters Queue ). The call is then shifted to a call follow up channel; this channel follows the call from enroute" to call closed on the CAD Timeline. The current Contractor listens on the radio and follows cll progress on the BOEC CAD, but works off of its own CAD. This general work flow is depicted in Figure 2 below. Figure 2 Current Flow 4000005894 Emergency Ambulance Services Page 9 of 11
Addendum 7, Attachment 1 Description of the Enhanced System under the RFP The RFP requires the use of an electronically interfaced MPDS call prioritization tool that is fully integrated with the 911 Primary Public Safety Answering Point s existing Versaterm CAD system. This tool also offers agent performance monitoring and quality improvement functions. Requests for service are to be prioritized and pre-arrival instructions provided in strict accordance with MPDS protocols as approved by the County. Under the model required by the RFP, the Contractor is responsible for staffing the medical triage portion of the call processing function, utilizing MPDS. As illustrated in Figure 3 below, the red segments will be handled by the BOEC PPSAP, and the Contractor s communications center staff will handle the blue segments. In Figure 3, the call taking function refers to identifying what service is required e.g., 911 what is your emergency? and the location e.g., what is the address of your emergency? Once these two aspects of the call are carried out, and the call is identified as an EMS call, the caller will be transferred to the Contractor s communications center which will carry out medical phone triage and provide pre-arrival instructions. If the call is a request for Police or Fire services, the BOEC call taker will continue to manage the call (per the current approach). Figure 3 Revised Call Flow Technology Requirements and Options The Contractor must use the Versaterm CAD. This will require a working agreement between BOEC and the Contractor. The following section outlines standard requirements generally anticipated to be included in the contract between BOEC and the contractor: CONTRACTOR acknowledges and agrees that CONTRACTOR employees and subcontractors will only Access VCAD and the information available in or through VCAD for Authorized Use as outlined in this Agreement. Permission to Access VCAD or to use the information available in or through VCAD other than for Authorized Use shall be obtained in writing from the Portland Police Bureau prior to any such Access or use. CONTRACTOR is responsible for providing computers, routers, switches, printers, and other CONTRACTOR located devices required by CONTRACTOR s users of VCAD. 4000005894 Emergency Ambulance Services Page 10 of 11
Addendum 7, Attachment 1 CONTRACTOR is responsible for working with the Portland Bureau of Technology Services (BTS) to ensure compatibility as it installs, configures, and provides network access to devices located in CONTRACTOR s communication center location including, but not limited to, computers, routers, switches, and printers. CONTRACTOR is responsible for providing secure network access that meets BTS security requirements, and enables CONTRACTOR s technology to reach the VCAD network demarcation points. CONTRACTOR is responsible for providing all network communication devices, and for working with BTS to provide services between CONTRACTOR computers and City network demarcation points. CONTRACTOR is responsible for ensuring that all CONTRACTOR network infrastructure and workstations with Access to VCAD are properly protected by adequate technical, administrative, and physical safeguards as covered in the section titled SECURITY. CONTRACTOR is responsible for providing the BOEC CAD Coordinator with the most current contact information for the CONTRACTOR IT security personnel and any changes thereof within 7 days of any change. CONTRACTOR is responsible for ensuring that all CONTRACTOR Users that are granted Authorized Use of VCAD comply with the IT security requirements specified in this Agreement. SECURITY Physical Security CONTRACTOR shall be responsible for maintaining the physical security of all devices that are able to access VCAD, as well as any printed output or system documentation which might permit unauthorized access to, or use of VCAD from within the CONTRACTOR s location. Security Platform Contractor shall maintain a cyber-security platform that meets BTS requirements. Online Security VCAD contains procedures and tools to ensure that only authorized CONTRACTOR users and devices can access the information available in or through VCAD. CONTRACTOR users will be required to enter special identification codes and passwords before gaining access to VCAD and its functions and data. CONTRACTOR acknowledges and agrees that CONTRACTOR employees will not share VCAD user accounts or passwords. Contractor optional data push out from VCAD Should the Contractor propose a data push out from the Versaterm CAD, the following general specifications will apply: The Versaterm/Contractor CAD interface is a one-way transfer of data, with the exception of the Contractor CAD ACK transaction. Data that will be transmitted are: call-for-service, unit status, and AVL data. A heartbeat transaction is used to keep the interface alive and verify that it is still working. The heartbeat transaction contains an h wrapped around start-of-text (SOT) and end-of-text (EOT) characters. The Contractor CAD needs to sends an ACK transaction in response to the heartbeat transaction. 4000005894 Emergency Ambulance Services Page 11 of 11