Board of Supervisors — 2022-05-31

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CEO Miyasato, do you have a report for us today? No report this morning chair. And clerk announcements

Chair Hartman and members of the board, I just have one quick announcement this morning. I'd like to remind the public who are participating in our meeting today of the board's updated methods of public participation for the Board of Supervisors methods of public participation and to provide public comment on general public comment or an item on the board's agenda please see page two of the agenda.

Members of the public can attend meetings in person both in the Santa Barbara board hearing room chambers as well as the Santa Maria board hearing room Please note the board is following all local and state guidelines and are no longer requiring face coverings indoors. If you attend the board meeting in person, you will no longer be required to wear a face covering but please be advised that the Public Health Department is still strongly encouraging all county staff and members of the public to mask and socially distance themselves in crowded areas.

I would also like to remind the public that if you require any special accommodations please contact the clerk at the board to make that request preferably on the Friday prior to the board meeting Individuals that would like to provide verbal public comment virtually may do so via Zoom by registering in advance via the link available on page 2. After registering you will receive a confirmation email containing important information about joining the virtual meeting.

Once the chair has announced the item you want to comment on, please join the meeting with the information provided in the registration confirmation email. You will be placed on mute until it is your turn to speak. The clerk will call you by name and when removed from mute, you will hear a notification that your line has been unmuted. If you are using a touchtone phone, you may need to press star six to unmute yourself. Again if you're using a touchtone phone, you may need to press star 6 to unmute yourself.

Each person may address the board for up to three minutes, and this is at the discretion of the chair. If you have any questions please contact the clerk's office at area code 805-568-2240 Again that's 805-568-2240. That concludes my announcements today.

Thank you, Madam Clerk. Turning to our administrative agenda do any board members have any items you'd like to pull? Seeing none, Madam Clerk, do any members of the public ask to pull any item on the administrative agenda? Chair Hartman

and members of the Board we have no requests to speak on the administrative agenda from the public.

So may I have a motion to approve A1 through A14 on our administrative agenda?

So moved.

May I get a second? All in favor, please say aye. Aye. Any opposed? Passes unanimously. Now for general public comment items not on today's agenda but within the purview of this board. Do we have any general commenters today, Madam Clerk?

Chair Hartman and members of the Board, we have no request to speak on general public comment today.

Alright turning to departmental item number one Would you read that into the record, please?

Chair Hardman and members of the Board. Departmental item number one is from the Public Health Department. It is a hearing to consider recommendations regarding an ambulance service contract policy resolution and ambulance services update.

Madam Chair, members of the Board. Before we start with the staff presentation I am going to give a brief overview but before we start that I did want to say that because we have potential private and public bidders for the request for proposal To ensure procurement integrity, we recommended that all County Departments wall off county staff that have been advising and or supervising the LMSA on the ambulance service procurement from any county staff advising or supervising the County Fire District. And so just to take a deep, just a short break and allow C.O. Miyasato to leave the room because Assistant CEO Terry Mosnisch is the CEO's representative for the RFP.

Thank you. Ms. Van Molen, would you like to now while you have the floor just give us a brief overview of some of the issues that we must bear in mind as we consider this RFP? Thank you Madam Chair. And just to reiterate, we've had a wall to separate people on one side or another and so now that's on the record. It's been awkward but we've nonetheless

followed your advice. Thank you Madam Chair and members of the board. So I'm going to talk briefly about the Board's role and LMSA's role in this process. So the Board of Supervisors serves as the LMSA's awarding agency for ambulance services procurement. So, as the awarding agency, the County Board of Supervisors awards the contract resulting from the competitive process.

In addition, the state recently enacted AB 389 which does a few things. But one of the items it does is requires the Board of Supervisors to adopt by ordinance or resolution a written policy which sets forth issues to be considered for inclusion And the emergency ambulance prior to awarding any contract or renewing a contract. So that's something that's before your board for consideration today.

So in sum, the Board's actions include approving the Ambulance RFP for public release which is before your board today. Providing feedback on the request for proposal which you'll also be doing today The policy required by AB 389, which is also on your agenda. And then the final step after the request for proposal is complete would be awarding the emergency services contract.

This process is governed by the State Emergency Medical Services System Act and it was pre-hospital emergency medical care personnel act we call it the EMS Act Which was adopted in 1980. And so that's what's governing our process today and in order for the board to award an exclusive contract there's two ways to do that, two mechanisms in state law one is a competitive procurement which is what your board has directed the process to be or grandfathering of the existing provider.

And so we are in the midst of this competitive process as part of that, the board has discretion to provide input on contractual matters related to the RFP. As far as the LIMSA's role, in order for the county to have a local emergency medical systems program, the county must designate a local EMS agency And the county has designated County Public Health as the local EMS agency, which we refer to as the LMSA.

And on the RFP, matters that are within the medical control of the EMS system are within the jurisdiction of the LMSA. I'm happy to address any other questions.

While we have you, will you talk a bit about direct assignment?

Madam Chair, members of the board. Sure I'm happy to do that. As I said we are governed by state law so the only way under state law to establish an exclusive contract and exclusive operating area is through either grandfathering the existing provider or a competitive process. So that's the path we're going down now is the competitive process in order to establish this exclusive contract In order to do any kind of direct contracting, you either need to do that at the end of your competitive process or the contract that you end up with is non-exclusive.

And would you just describe what non-exclusive might lead to?

Sure, Madam Chair. I can start with that and then we might want to have either our consultant or county staff explain. But when you develop an exclusive operating area, it allows the county to contract with one provider to serve that area so that you don't have competition or any misunderstanding of who's providing the services. So that's just a general overview, but I'm happy for Fitch & Associates or for county staff to add to that.

So yes, and I just think it's important to understand we're working on the RFP. We're doing that because it's required if we want an exclusive contract. We've explored other options and those aren't available to us or aren't a good way to go so just if you would talk about what happens if there is a non-exclusive operating area?

Sure, so thank you Madam Chair. My name is Steve Knight with Fitch and Associates. I'm a partner with the firm that's been assisting in the procurement and RFP process all along but I think council did a good job of describing what a non-exclusive area would include and there are some unintended potentialities about different services competing, you may erode some of the service level and professionalism that you currently enjoy through the setup that you have. So I think overall the best practice is usually to have an exclusive area in a competitive process.

Because otherwise you might have too many people or too many ambulances in one area that's more lucrative and you may not have enough in other areas that are less so. Is that correct?

Yes, socioeconomic other factors that influence a capital environment for sure would erode some of that. So some of the protections that are built in that the county currently enjoys certainly goes a long way to normalize some of those to ensure there's a commensurate level service based on the population density.

And Mr. Knight just one other preface question this is a very unusual RFP could you elaborate on that?

Sure. So again, this is unique from the standpoint that the board's initial direction to start the competitive bid process was to make sure that the bid was open and inclusive enough to allow a public entity bidder in the process rather than with a more traditional private only that California's pretty much lived on for a very long time. So, a lot of the process was from a high level was worked on under that pillar if you will, that tenant that it had to be able to accommodate public potential bidder so the way we approached it not knowing what that potential bid would look like we tried to keep things broad enough to handle An all-public bid, a public private partnership bid and a typical more traditional private potentiality for bids. So from that perspective what it hasn't really materially occurred in the state of California yet so this is quite unique you know there's been some attempts that haven't gone in the right direction for various reasons.

You know, one county did an alliance model with a public-private partnership that did have a couple bumps in the road that they're having to go back out for bid in the not too distant future. But it's certainly what you're doing here in the County of Santa Barbara is what we believe is the future at least for California to be able to accommodate the nuance that you have by your EMS Act. In other states, the county board would have authority To award you know to a public agency if they wanted to so it is quite unique.

So this is the first of a kind in California.

Yes. To my knowledge, yes.

Thank you. So Dr. Del Reynoso now starting with you.

Great. Good morning Chair Hartman and members of the board. With me today joining in person is Dr. Daniel Shepard our Emergency Medical Services Agency medical director. Joining me on Zoom is Nick Clay Our local emergency medical services agency director and as you have met, joining the county team is our consultants for the RFP from Fitch & Associates. We have Steve Knight, Thomas Moore and Guillermo Fuentes.

This morning, the county team will be presenting the policy for emergency ambulance services contract and the AMR agreement extension. The Fitch & Associates team will be presenting the key elements in the RFP. Recommendations for your board's consideration include to adopt the attached resolution attachment A, adopting a policy setting forth issues to be considered for the inclusion in contracts for the provision of emergency ambulance services entered into or renewed on or after January 1st 2022.

Also, to approve and authorize the chair to execute a fifth amendment to the professional services agreement with American Medical Response West or otherwise known as AMR. To update the vehicle maintenance program, to update the lame duck contract termination provision and to extend the termination date to March 1st 2024. To allow for the completion of the ambulance services requests for proposal process.

Also, to approve and authorize the public health department director or designee to authorize AMR's request in accordance with Agreement Section 11.1.G upon review and approval from the CAO's Auditor-Controller and County Council. With respect to the RFP for an exclusive ambulance services provider for the Santa Barbara County Exclusive Operating Area, to approve and authorize issuance of the RFP or to provide staff with other direction regarding further development of the RFP.

And lastly, to determine that the proposed actions do not constitute a project within CEQA. With that, I transition to Nick on Zoom.

So in an effort to ensure the ambulance RFP is able to be completed with enough time for a ramp up timeline or lead time for new provider to acquire ambulances, the EMS agency negotiated extension with American Medical Response AMR with the end date of the contract now being March 1st 2024 Additionally, the mileage cap or limit for the primary ambulances was brought in line with the current RFP as drafted to 250,000 miles.

Lastly, the lame duck language was given a little bit more structure to provide the ability for the public health department and EMS agency to address requests AMR may have in the event they do not win the RFP and become a lame duck. Next slide. So we were asked to provide a sort of policy crosswalk looking at the proposed policy and how those elements were introduced into BMO's RFP.

So in front of you, you have essentially a high-level overview of each element and where it can be found in the RFP. As we walk through just a couple of high level items, so treatment of the incumbent workforce, the contractor is encouraged to recruit from and preferentially hire the incumbent paramedic and EMT workforce And it was the LEMSA's goal to ensure that contractor initially and throughout the term of the agreement provides a financial benefit to encourage employee retention and recruitment.

There are provisions for disaster response, including a requirement to support mutual aid. There is establishment of minimum qualifications that allows or requires the potential bidders to demonstrate fiscal stability and prudence as well as a stable track record of emergency non-emergency and urgent ambulance service We've gone through a diversity, equity and inclusion requirements or suggestions. The contractor shall provide services without regard to race, color, national origin, religious affiliation, age, sex or ability to pay and ensure ready as professional and safe conduct of all their personnel.

There are financial requirements to ensure fiscal stability in depth within the system. There's a cost recovery consideration to ensure that the contractors has the mechanism to reimburse the county for its efforts There is public information education requirements that ensure there's an outreach element from the contractor to the community. And then there's ongoing workforce development requirements to ensure the proposer is required to document their commitment to have key personnel actively participating in a quality management system, and last but not least wage and benefit staffing protections Staff are paid in association with their, in line with their current payment if not and benefits package to ensure that there's no reduction in those elements either.

Thank you, Nick. And I'd like to transition and invite Fitch & Associates to give their presentation.

Madam Chair before we go to Fitch, I would like to introduce our consulting team just so folks are aware since they've already had a chance to speak. Dr. Steve Knight, who you've already met today, is a partner with Fitch Associates and he leads the firm's fire service practice. In that role he has led numerous assessments of major cities and other agencies. These often include standards of cover review including strategic planning services. And Dr. Knight also brings to the firm over 25 years of fire and EMS experience. He is the retired Assistant Fire Chief for the City of St. Petersburg, Florida and he's been a subject matter expert for both the National Fire Academy Center for Public Safety Excellence and he's also served as his team leader and assessor for the Commission on Fire Accreditation International and has held multiple faculty appointments in fire science and EMS.

Also joining us today is Mr. Guillermo Fuentes, he leads the communications and technology practice for the firm. His experiences in public safety operations, communications, technology and senior administration is very wide ranging. He's a leading expert on the analysis design and deployment risk and risk management for public safety agencies And he supervises statistical and operational analyses, computer modeling and the development of deployment plans as well as major technology purchases in communication center installations.

And finally Mr. Thomas Moore who is a senior associate with Fitch & Associates He is the Director of Emergency Medical Services for the University Medical Center Health System in Lubbock, Texas. His professional healthcare experience includes designing, implementing and managing ground ambulance services, managing hospital emergency care system and trauma centers, and providing consulting and leadership for strategic planning, mergers and acquisitions as well as the development of RFPs.

So at this point in time I'd now like to turn it over to Mr. Moore who will walk us through the fundamentals of the RFP.

And thank you for all being here in person today.

Hello Board, it's a pleasure to be with you this morning. We prepared a brief presentation to discuss the salient points of the development of the RFP process. Can you hear me now? That's better, thank you. So briefly, give you just a little bit of background information about our organization. So we've been in business for 38 years and during that time, we've been fortunate enough to do business in 50 states, 10 Canadian provinces and 12 other countries. Our experience includes designing, developing and managing some of the world's most innovative EMS systems. From a procurement perspective, our organization has been involved in more than 70 procurements for health systems cities and counties including 12 in the state of California.

So briefly just to discuss the process design that went into this request for proposals document. First of all, we use a very deliberate, objective and structured method in all of our request for proposal and procurement processes. And as was mentioned previously this one was specific and unique in the sense that we wanted to ensure that all the tenants of a successful request for proposal process would stay at the core of the document and the process itself while also allowing a public entity, private entity or a public-private collaboration or partnership to exist and then bid on the scope of services. So our goal is to clearly profile the system, its administrative procedures and other requirements, and then develop along with feedback and input that we're able to solicit from the RFP AC committee stakeholders in the community a final document.

A developed RFP truly does allow the proposers to sharpen their pencils and propose ways that they can provide optimum value to the community while also mitigating risk So the final RFP document goes through a very iterative process. And many, many aspects within this specific document that we're discussing were considered and discussed both from the aspect of the feedback that we were able to yield from the phase one and phase two studies that our firm conducted in 2018 and 2019 as well as a stakeholder survey that was provided last September A draft comment period of the draft document at that time in November of last year to any potential proposers.

And that same document was also provided to the California EMS Authority. What's not listed here is that once the document itself is published and it's approved and we're in the midst of the process, a proposer's conference is a key tenant of the timeline itself. And during that session, it's essentially an all-day if not two day working session. Each page, each sentence and paragraph of the document are walked through with any potential proposers that have submitted a letter of intent so we can codify any questions.

Get additional feedback from stakeholders. And then if modifications need to be made or adjustments are needed, or if specific language or feature changes are identified we can table all of those elements provide those answers and feedback to all the potential proposers this body and the public at large So due to the uniqueness of this process, some specific considerations had to be made with respect to certain historic requirements that are typically and have been for say decades ambulance procurement processes. And those are as you can see here historical experience requirements Exclusive operating areas, response time standards, stop the clock agreements, bond and financial commitment thresholds, scoring methodology, the treatment of the incumbent workforce and then the system cost.

And so the remaining portion in this presentation I'm going to highlight these key areas. The first being historical experience requirements. Typically, in a private ambulance procurement process there would be historic experience requirements to ensure that potential proposers that were coming to the table with a bid would be able to demonstrate their experience in a similar arena and those requirements have ranged from having transport apparatus experience to a specific number of transports that could be 20,000 or 30,000 depending on the size of the locale It could be that you have a demonstrated history of meeting response time standards with a transport capable apparatus in a service area of a similar size. And the reason for that is we want to ensure that the individuals that are bringing a bid to the table have demonstrable experience in those areas.

One of the public equivalencies that was modified and adjusted into this RFP is that if a proposer did not have experience in one of those areas that historically they would have had to demonstrate experience for, it reads if you do not have experience propose how you would meet this service provision. How would you meet the scope of work as it's written? And without modification, that traditional requirement would've eliminated any sort of public bidder.

We'll briefly talk about the service area. So this is a service area map of the current service areas that exist today, and there were four key areas that were considered by the RFP Advisory Committee. Option one was to bid the ESA, the Exclusive Operating Service Area under the current configuration. Option two is to bid each ESA separately. Option three was to combine all of ESA1 and ESA2. And then option four was bid a single ESA.

In December of 2021, the LMSA and the RFP Advisory Committee convened based on feedback that was yielded from some of the potential proposer comment period that took place in November as well as just concerns that were mentioned in general due to the nuances that exist in some of the ESA areas that we have in this county. And a letter was provided to the California EMS Authority seeking clarification regarding exclusive operating area boundaries. CalLIMSA responded back and essentially opined that based on the information that was presented, UCSB was not exclusive and so that was taken back to the committee and after significant discussion over the course of a few meetings it was determined that the final at least draft document would be finalized using option four, which is combining all of the ESAs into a single ESA.

Response time standards. So the intent here is to maintain an effective ambulance response time and create a neutral competitive bidding process. The response time standards, as you'll see in here in a moment as we talk about stop clock agreements It essentially exists somewhat in unison, in the sense that we wanted to ensure that there were no say private slash public better implications if we were to say wholly modify or change those structures as they exist today.

In this current RFP and so our goal was to codify the ambulance response time Which is, you know, 959, 90% of the time in urban areas. And where the fire service arrived and quote stopped the clock it was 759. Due to public better implications with stop-the-clock funding, the recommendation was to essentially codify and maintain the effective ambulance response times that exist today With a threshold of 959. In addition, a few additional changes that were made the categories that are in current agreement are different and nomenclature whereas we use the U.S. Census definitions to define those polygons and those boundaries.

For the stop-the-clock agreement aspect, the consideration that was given to this specific area Specifically deals with the potential financial benefit that an ambulance provider, let's say if it were a public entity would have. If indeed they were to say carve out or submit lower cost for work that is already being done by those organizations And so the policy considerations that were discussed with the RFPAC included the perception that a private entity would have what ostensibly would be real cost or actual cost and a public entity could elect, and I say could because we don't know.

Not to pay themselves to stop the clock for the first response agreement aspect that's currently existing today. And so a number of different options and solutions and considerations were tossed about, and that's still going to be kind of an ongoing conversation. Next, the bond and financial commitment threshold. So in typical ambulance procurements it's a key tenant is to have a performance security and that gives the municipality assets to cash and assets in the event of some sort of a default which has historically or would have been by a private provider We understood and consideration was given, and much discussion was had amongst the committee that typically governments are reticent to designate dollars for either things that are non-operating expenses such as salaries or benefits or capital outlay that would be vehicle and equipment.

And so a public equivalency that was developed was to allow government proposers to pledge receivables and assets in lieu of performance security And that could be set aside in a restricted fund that adheres to generally accepted accounting principles, where dollars are allocated and then simply reappropriated or rollover year over year. And this was to ensure once more that there was inclusivity and that there was no intent to exclude any potential provider type or model.

The next aspect that we want to touch on is the treatment of the incumbent workforce. So this is a historical tenet, and it's really geared towards removing or eliminating the potential for draconian measures that existed say decades ago where a provider could So, I'm going to talk a little bit about what we're looking at here. The second paragraph has a statement that says all incumbent personnel hired will retain seniority status. We wanted to clarify and ensure that the point was made, our intent was not to have any specific referential language in the document that potentially violated any sort of collective bargaining agreements or other laws, state, local, federal etc.

It's essentially to ensure that those draconian measures Existed in days past or not a part of this RFP process. And then the other note to this specific point is that it's not an associated scoring value, it's not a criterion that has a score assigned. It's more so a specific element within the RFP itself. And then lastly here, the scoring methodology. So there's been much discussion about the scoring methodology. The state requires that the minimum qualifications be on a pass-fail basis and obviously they're the four elements that minimum qualifications must be established and those are experience in managing a clinically sophisticated emergency ambulance service, response time performance, financial depth and stability, and then regulatory compliance In addition to those minimum qualifications, there are clinical operational and administrative criterion within those specific categories that are assigned an integer value and then scored based on a good exceptional acceptable or unsatisfactory basis as you can see in the table example here.

And really the goal here is to make it a very transparent process, to highlight the areas that we want to have the potential proposers or the proposers once they've decided to submit a letter and bid. Go through the process of asking themselves and pontificating how they would meet the specific criteria that exist There's a sample document that's provided in the appendix. I say sample because that's, in essence, what it is. It's there to give the proposers something to pontificate as they work to develop specific answers and responses to those criterion as they exist and are written in the RFP.

So with that, I will turn it over to Dr. De Niroso.

Thank you, Thomas. Before we go through the timeline I believe Dr. Shepard has additional comments on the RFP.

I just want to make a quick comment from the, good morning chair and members of the board. Just wanted to make a quick comment from the LAMSA perspective. I appreciate the time. I think when I'm in the emergency department seeing patients we see all comers so it could be criminals people who are physically verbally threatening and then we set that aside and treat them as individuals and I would never compromise my integrity or you know Reputation to participate in a process that isn't you know fair and thorough, and I know that goes for everyone in my office Yes some worked for AMR. I was the medical director for County Fire in the Carpinteria fire Summerland Fire Protection District I trained in a system that has a fire based transport system But we have a singular focus in Alamsa And that's to create a system that It's who is providing the service, but how well they're doing it.

I think that's really what we're concerned with and we take the direction from the board and the public health department and the constraints or the boundaries provided by the statute and regulations to every day advance our AMS system and we want innovation in clinical excellence.

Thank you Dr. Shepard. And now Nick if you can walk us through the timeline

Absolutely. So should your board approve the RFP for release today, the timeline for the RFP intent to award would occur in mid-September with a presentation of a contract before Thanksgiving and about a 15 to 17 month ramp up time. Next slide. Should there be I would like to start with the need for additional, should your board have recommendations changes to the RFP staff may need time to review any potential impacts of the recommended changes and suggest returning to your board on June 28th to present a hopefully final RFP prior to sending the RFP to the state for review and approval. This would mean the intent to award would likely occur in early December That would then allow for a approximately 11 to 13 month ramp up time should we maintain this estimated timeline.

That concludes our presentations and both Fitch & Associates team as well as the county team were available for your questions

Thank you. So it's back to the board and the first thing I want to ask is whether there were any additional ex parte communications to report since our last meeting? Supervisor Nelson?

Yes, thank you Chairman. Last week met with the LMSA staff for the first time on this issue. I

have nothing to report since last meeting.

And I did meet with the LEMSA staff and with our consultants, Steve Knight, Thomas Moore and Guillermo Fuentes. And I did speak briefly to the Fire Chief Hartwig at a press conference but very few remarks. Supervisor Hart?

Last Friday, I met or spoke by telephone with Elizabeth Barnett who's the executive director of the California EMS Authority to talk about the timeline that they would require to review our RFP and she was very encouraging and said that her staff Was well aware of our RFP and would be assigning their appropriate staff as soon as they received it to turn around that document very quickly

Great. Thank you supervisor Williams

I also met with our consultants last Friday and our staff earlier in the week on Wednesday, and did exchange text messages with Kevin Taylor and one phone call with Mr. Taylor clarifying the points that they have made in their letter about different elements of the RFP.

So we're going to open it up for board questions, but before we do that.

Chair Harmon?

Yes. Yeah

I forgot there was two other additional contacts that I had. I also met with Fitch & Associates on Friday and I did meet with Molly Culver who is a consultant for AMR.

Thank you. So before we just open it up to board questions, I thought it might be helpful to structure our conversation by listing issues that we think are important ones and staff is prepared to actually write it down. And some of these issues were already covered at least briefly in the presentation But the first one I have is exclusive operating areas and the status of UCSB.

The second I have is response time and stop the clock, those work together. The next financial security and bonds, that was listed. I'm not sure if we have any more questions about that or not. The fifth, the incumbent workforce. The sixth scoring methodology. And so we'll get those, I think so they're up and we can see them. And what I thought is that if board members have additional ones to add, we could do that as we go along or and then if the public has additional ones that they want to add or want to frame their remarks in light of those, that makes it easier for us to assimilate what the information is.

So Ms. Mocenich, will we be able to get a screen with those listed?

Yes, Madam Chair. We have a member of staff taking notes and I believe we're going to work together on this screen so that we can take down comments as they come.

Can I just add one that's really significant just from the onset is that you know, I believe the language Reiterates the board's full discretion to accept one or deny both or any number of parts, actions that could take place after the RFP returns.

Supervisor Nelson?

Yeah, two additional ones. I may have been covered on what you were thinking Chair Hartman but scoring criteria. I think there's something that I want to discuss as far as something might not be on there that I think should be integrated into the RFP and as well as the review panel. I think that's a big part of the discussion.

Okay, the review panel. The community public education programs and the fleet requirements those are additional ones? Okay, so do we have any questions now about the RFP or about the presentation or about the context within which we're operating? Supervisor Lavinino.

Thank you I just want to make sure I'm getting this right. So we're going to post all these, we're gonna hear public comment then we're gonna come back and discuss each one as we go through okay makes sense

And I'm sort of eager to see our list up there of issues just so we can be sure whether it embraces everything that we have in mind or as we hear things, we may want to add to it.

So Madam Chair what I have thus far is the EOA and the status of UCSB specifically response time and stop the clock. Financial Security and Bonds, Incumbent Workforce, Scoring Criteria, Review Panel. I'm letting Vaughn catch up with me. Community Education and Outreach, Fleet Requirements, and then Board Authority Discretion.

That is my list but will we have it up to look at it soon? Okay, all right. Supervisor Hart?

Yeah I also would like to have staff work doesn't need to be immediate but a new timeline with the dates that you know would reflect today's action changes to the RFP going through the EMSA process so we'd understand where how this the timeline that we have on slide 19 changes.

All right Supervisor Nelson, did you have anything additionally? Okay. So I don't see any more lights up here for questions of staff on the presentation so I guess we're ready. Madam Clerk how many public speakers do we have?

Chair Hartman and members of the board we currently have 20 requests to speak on this item.

Okay let's get started And three minutes each. If you can make it, if it's repetitive we would encourage you strongly to shorten it. Oh yes and at this point I close public comment so no additional speakers.

Chair Hartman and members of the board we are going to begin on Zoom with Philip Petit to be followed by Shelly Hendelson back here in Santa Barbara.

Good morning, my name is Phil Petit and I'm National Director of the International Association of EMTs and Paramedics. And we proudly represent EMS professionals all around the state of California including those in Local 70 employed by American Medical Response in Santa Barbara. As a proud partner with AMR in Santa Barbara County for over a decade, we've cooperated to improve the working lives of these first responders and to ensure your constituents receive the best emergency care possible. Today I am here to speak in favor of the incumbent workforce language including the RFP. I know in recent extensive remarks by fire department representatives, the applause worthy protections for incumbent employees were derided as a barrier to success on the contrary these protections are critical to the stability of Santa Barbara's emergency services system.

A committed cohesive and experienced workforce with intimate knowledge of the area and the patients they serve is an invaluable resource worth of years of careful cultivation. So thank you very much for your time and I urge you to support the inclusion of that in common workforce language.

We will now return to Santa Barbara with Shelly Hendelson, to be followed by Heather Vanderlinden. Shelly?

Good afternoon. My name is Shelly Huddleston, and I represent the EMS professionals for the IAEP Local 70 employed by American Medical Response in Santa Barbara. As it has come to our attention, the Board of County Commissioners in Santa Barbara is entertaining the possibility of opening an EMS provider RFP. While we recognize that it's their right to do so having built a productive and cooperative relationship with AMR in this region, we believe the right provider already has the job.