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Tuesday, May 19, 2015 – 6:30 p.m.
Courthouse Annex, 79 Jackson Street, Zebulon, Georgia
[Note from the Editor: Read more about the budget by clicking here to read notes from the Wednesday, May 13, 2015 Board of Commissioners meeting.]
UDATE 5.18.15: I spent part of my time today on the phone with representatives from the three ambulance companies. Here is the info that I learned today as well as the info gleaned from the three proposals to provide ambulance service here in Pike County.
Spalding Regional made a bid for a three year contract only that would provide two Advanced Life Support ambulances within the county limits 24 hours a day/7 days a week for $350,000 per year. (The contract requests that this only be awarded for three years because of the capital investment by this company for the citizens of the county.) The contract goes further to say that they "will base two reserve back up ambulances within Pike County as well as provide a back-up ambulance to Pike County territory until the two primary ambulances are available for service in Pike County," they will offer a one for one medical supply exchange and one for one medical equipment exchange for Pike County First Responders, and will provide continuing education and joint training programs for local first reponders in our county. They will provide the Ghost Out for local high school students (as Mid Georgia Ambulance is doing now), will provide ambulance demonstrations for the public, and give a commitment to maintain current ambulance personnel who meet Spalding Regional EMS standards including a drug panel screen, background check, 3 years MVR and insurance approval, peer interviews, oral interview with the director, a 40 hour classroom orientation, and successful completion of clinical rides. The rep from Spalding Regional is going to call me back tomorrow with the answer to a question about how/whether an buy out of the parent association of Tenet would affect an ambulance contract here in Pike if they were awarded the contract. I am assuming that the answer is no, but you never know until you ask. (Update 5.20.15: I received a return call on my question--which is a moot point since Pike County went with Grady EMS already--but I appreciated the call back never the less. Kathleen Smith advised that since Tenet (the parent company of Spalding Regional) is in the process of being sold, Spalding Regional could not obtain any information to answer my question.)
Mid Georgia Ambulance, our current provider for the past eight years, provided a bid of $370,000 annually for one year, three year, or five year contracts with the county which is a reduced rate from the current $395,000 that we are paying annually now. This would provide two ambulances in Pike County on a 24 hour per day/7 days per week/365 days per year basis with "the provision of a back-up ambulance to remain in service within the territorial limits of Pike County until such time as the two primary ambulances are available for service in Pike County." According to the contract, Mid Georgia will continue to comply with requirements that all employees receive mandatory training and that this training is available to Pike County personnel at no cost except for expenses related to travel, meals, necessary equipment, and supplies, and it will continue to keep the upkeep for all housing and facilities for the ambulance service. Mid Georgia Ambulance has contracts in Upson, Lamar, Bibb, and Crawford to they can used regionalization to ensure that there is adequate coverage in all participating counties. According to Darrell Riggins from Mid Georgia Ambulance, there have been 52 instances of mutual aid over the past year which is about once per week.
Grady EMS proposed a one year, three year and five year contract at a cost of $275,000 per year. This would include operation and staffing of two ambulances 24 hours per day/7 days a week/365 days per year with "an additional ambulance that will be available Monday-Friday for 12 hours per day to manage non-emergency inter-hospital transports. This additional ambulance will meet the County's specification for a back-up ambulance stationed within Pike County." Training will also be available for county personnel including law enforcement, fire fighters, and first responders at no cost excluding expenses like travel, equipment and training related supplies. There will be no costs for transporting Pike County employees, personnel and prisoners, constitutional officers and staff or volunteer fire fighters if needed and "EMS rates shall not exceed 250% of the current year's Medicare Fee Schedule rural base rate for the duration of the contract" along with a sliding scale for the uninsured that is spelled out in the contract. I had a LOT of questions after reading the RFP (request for proposal) and asked Pete Richey about service on the phone today. He told me that they build and service all of their ambulances and work to streamline the company so that this proposal for $275,000 is a good number for the company. He said that they are profitable in Decatur County (south Georgia) and that if the need arose for a third truck to be on standby 24/7 to avoid constant mutual aid then they would look at doing that because if it was needed, it would be profitable for them to keep it here and run it. I keep coming back to the requirement of a truck to be on site 24/7/365 because headquarters for Grady is 50 miles away and there is no way that they would be able to send another ambulance here so it would be dependent upon mutual aid with neighboring counties which they would respond to I am sure. However, I am looking for more clarification about that back up ambulance requirement between the two other bidders and this 12 hour per day ambulance back up. It is hard to compare apples to apples until everything is laid out on the table.
All five commissioners are present along with County Clerk Jo Ann Wrye, County Manger (CM) John Hanson, and County Attorney Rob Morton. The meeting room was pretty full tonight.
1. CALL TO ORDER................................................................................Chairman Briar Johnson
2. INVOCATION……………………………………………………………………...Ben Maxedon
3. PLEDGE OF ALLEGIANCE..............................................................Chairman Briar Johnson
4. APPROVAL OF THE AGENDA - (O.C.G A. 50-14-1 (e) (1))
5. INVITED GUESTS
a. Darrell Riggins with Mid GA Ambulance
Joe Robinson, president of Mid Georgia, is in his 29th year with Mid Georgia which has spent the past 8 years with the county. [Note from the Editor: Robinson was allowed to speak in Riggins' place.] He said that there have been no issues, no complaints, and no concerns with our service. The cost is what the cost is. For a service delivery model to work, you have to know what your cost is. He said that people cannot get over the vast difference between the low bidder and the top two that are within 5% of each other. Both are part of a not for profit health system. He said that his health system is willing kick in $105,000 to make it $265,000 to subsidize services and make this work. (That is an amount that is below Grady’s sealed bid.) He then said that he would answer any questions whatsoever.
He said that they charge base rate plus mileage, but that the subsidy would allow Mid Georgia to go down to $265,000. He said that there may be 4 transports a day here so rural Georgia transport is different than that of Atlanta which would allow Grady to lower their costs. He said that there is no guarantee of reimbursement and that Mid Georgia charges about $900 plus mileage for a transport and that Medicare and Medicaid and reimbursement overall are not always guaranteed. He said that there is fear that cost will be passed onto citizens because of a lower cost overall to the county, but that this will not happen with Mid Georgia. A question was asked about Grady’s bid having a sliding scale for poverty level. What about Mid Georgia? Mid Georgia doesn’t have something like this, but he said that Mid Georgia has written off some bills if people absolutely could not pay so that citizens are not always getting a full bill for transport.
Pike County currently has 2 ambulances 24 hours a day now. Mid Georgia has a regional system with Pike, Upson, Lamar, Crawford, and Bibb Counties. If the two crews in Pike are on transport, our mutual aid comes from Lamar or Upson Counties with a regional system. He said that this is what Grady does in Atlanta too. If Lamar needs help, resources are moved from Upson County in a rural county deliver system. This is under the premise of mutual aid though Mid Georgia is covering the other counties so they can do this.
How does Mid Georgia cover local events? For high school football events, there is a crew that works that game outside of the standard two buses in the county. There is no additional charge for this. He said that they have brought on more than one additional ambulance if that was needed for some of our events and said that it is typical for rural Georgia to have a dedicated ambulance at a football game.
b. Grady EMS
Rep. Johnnie Caldwell came to speak to commissioners again. [Note from the Editor: This didn't sit well with me tonight either. And while I am confident that the commissioners made their decision on the extensive homework that was done to verify Grady's service in Decatur County, I have to say one more time that a sitting representative who represents our county on a state level should not be sitting in front of commissioners and asking them to vote for any company that is putting in a bid for a county project. Ever. It doesn't smell good. And the Vice-President of the company did a great job all by himself of speaking for the company and answering a LOT of questions.]
Caldwell said that Grady gave a specification based on a sealed bid and said that it’s “not proper or fair” to allow Mid Georgia to go outside of the process. [Note from the Editor: Caldwell is right on this. You can't change your bid after sealed bids are accepted.] The question was asked how can Grady bid like it did? They are a not for profit entity. They don’t have a board of directors or other requirements to make a certain amount of money to pay investors or stockholders. He said that the current bid is in line with Decatur County and that you will find that their service there is excellent. He advised that Grady has an agreement with Tenet (Spalding Regional) to use ambulances for mutual aid if needed, and that Grady will also cover events in Pike County as well. Grady is looking to hire local people to work in Pike County just like they did when they won the bid in Decatur County and hired local people there. He said that if current workers meet the qualifications, they will be hired and will be allowed to keep their tenure and pay that they currently hold. This bid will save the county $475,000 over a 5 year period without seeing anyone else’s bid. We played by the rules and did what you asked us to do.
Vice-President Bill Compton is here to discuss this as well. He said that he has been at Grady for 7 years and worked to improve what was a “broken” and “broke” system when he came in. He said that Grady is working on outreaching with a rural delivery system. He said that Decatur County and their employees are happy. He said that $275,000 gives Grady enough cushion to put back into their system. The concern in South Georgia was that Grady would take over the hospital so it was put into their contract. He said that we need to break even and we need to replace our equipment and we don’t have to make a whole lot of money over. We remount and refabricate our trucks and are remounting for Henry and Effingham Counties. Two trucks will be stationed here 24 hours a day every day during the week. We are the largest event provider in the state of Georgia. We handle professional sporting events. We will have that event business to help here too. He said that Grady is trying to provide the highest level of care to Pike County, and we hire locally rather than bringing in Atlanta based physicians, etc.
Rate structure for ambulance service is based on a rural margin here and it is less than what is charged in Atlanta. $400 to $800 is charged for a transport. He then said that if someone can demonstrate that they can’t pay the bill, we write it off. The citizens won’t pay any higher at the end of the day with Grady than any other company. 100% of the employees who applied in Decatur County who passed the background check and had a clean driving record were hired. It was stressed again that there will be a local manager in Pike County and that employees will keep their seniority, pay, and benefits.
There was a question about reduction from the current service. Grady will provide 2 ambulances plus a 3rd that will be available 12 hours a day, 5 days a week for staff and transports, etc. On the weekends and evenings, how will you handle mutual aid? There will an on call unit on the weekend. He also pointed out that counties work together already with response to mutual aid. He said that Grady would examine the demands for the weekend and decide whether to bring in additional resources. Grady will also have medics on golf carts who can help with event coverage so people can be treated and the ambulance can come and pick them up.
Tim Daniel asked about the Fulton County government tags on the vehicles that they drove tonight to the meeting. He said that they use a Fin code as a not for profit entity so they buy their vehicles through the county because of tax dollars that they get through Fulton County as a subsidy.
How soon can they begin working? He said that Grady is flexible even though they like 60 days notice to come into a county. Grady would begin by talking with Mid Georgia to find out about people to fill the trucks. He wanted to assure commissioners that people won’t get charged double or anything like that despite their low bid.
Chairman Briar Johnson asked if the 12 hour transport could be flipped from day to night if needed based on 911 stats. If our peak was a different hour, the 3rd ambulance can be adjusted. He was then asked about football games, Relay for Life, etc. and it was clarified that these would be covered by their Event Coverage crew rather than Grady. Mid Georgia has attended all fire calls. Will you do the same? Yes. [Note from the Editor: Kudos to our County Manager and commissioners for some outstanding questions about Grady service tonight! You can read more about Grady in the past Commission meeting where Grady asked to be on the agenda prior to the opening of the bids on the May 13, 2015 meeting by clicking here.]
6. NEW BUSINESS
a. Award of bid on the Ambulance Service for Pike County
Tommy Powers asked about the legality of the $265,000 against the $275,000 bid. County Attorney Rob Morton said that the bid given tonight cannot be received because it was given after the bid was closed.
Commissioner Jenkins made the motion to award the bid to the lowest bid per state law per bid requirements with a one year contract renewable up to five years to Grady. 2nd from Tim Guy based on information provided. Discussion: It is our duty to look out for the citizens the best that we know how. It is our duty to take care of the taxpayer dollars as we should. Johnson said that the County Manager and the Commissioners did their homework on this. Guy thanked Mid Georgia for their service over the past eight years.
Motion passed in a 3-2 vote with Powers and Daniel opposed.
b. Award of bid on the 2015 LMIG Project.
Option 1 was for patching and resurfacing from the City of Zebulon to Reidsboro Road. Williamson-Zebulon Road is our busiest road in the county with an average of 2,350 cars traveling on it every day. Option 2 is the full depth reclamation (milling of the current road and mixing it with concrete to fill the base of the road) and then resurfacing. County Manager John Hanson advised that the county has budgeted for Option #2 in next year's budget.
Here is a revamp of the sealed bids from the past meeting for the LMIG project of Williamson-Zebulon Road in which the county budgeted for Option 2 which is explained in depth at the top of the page. (I excluded the Option 1 bids in this meeting for reference, but you can read them by clicking here.) Bids were as follows:
1) Piedmont Paving Incorporated out of Newnan. $806,522.19.
2) CW Mathews out of Marietta. $786,155.32.
3) Blount Construction out of Marietta. $774,948.50.
4) Georgia Asphalt Inc. out of Macon. $736,370.98.
Hanson recommended the removal of Georgia Asphalt as low bidder based on our policy of prior performance. [Note from the Editor: Most of the room cleared out during this time because many were there for the ambulance contract only so it was hard to hear. However, I called the County Manager this morning (the day after the meeting) and asked what road Georgia Asphalt Inc. had worked on that was the basis of their renewal from the bids. (They did not say this in the meeting last night.) I was advised that they had received a LARP contract from the state of Georgia to resurface McKinley Road in North Pike County. My thoughts: Anyone who has driven that road even within a couple of weeks of that resurfacing will wholeheartedly agree with this decision. Slapping some pavement over the potholes and whatnot in that road might have satisfied the state contract, but the citizens of the county who spent tax dollars to fix that road deserved better than that. Kudos to our Public Works for working on this road since that time and correcting some things that go back to the first laying of the road. I will post pics from the Zipper Asphalt Machine work as soon as that section of the road is complete.] Recommendation to go with the second lowest bidder of Blount Construction because of their great track record with prior work. Their bid is $774,948.50. The time line is for October. Motion to award the LMIG project to Blount Construction. Approved 5-0.
c. Consider one appointment to the Workforce Investment Board.
We are mandated to have someone in this position. Mr. Kevin Hilton is CM Hanson’s recommendation. Motion to approve. 5-0.
d. Approve/deny Pike County assuming the operations of the Senior Center Program.
The county will be able to take over and run the Senior Center. The employees will become Pike County employees and we will have local control. Motion to assume the operation of the Senior Center. Approved 5-0.
7. SECOND READING OF THE FY 2015-16 BUDGET
Guardian ad litem is still an unsure amount because they’ve been averaging about $23,000 for the past 5 years but as high as $28,000 over the past couple of years. We are going to budget a little higher than $23,000 just to be sure that we are covered.
Further Discussion: Commissioner Powers said that we have just cut the budget $120,000 with the award of the Ambulance Service. Do you feel that we have enough money to operate on without having to borrow money in the upcoming year? Hanson said that he is comfortable with the budget. Powers said that he thinks that we need to deduct the $120,000 from the budget and give the taxpayers a break. Hanson agreed and said that he had planned to announce that during the 3rd and final reading of the budget. Hanson said that the savings on the ambulance contract will go to taxpayers including the reduction with the award of the LMIG project. These two reductions will come to about $140,000 in all.
Motion to accept the 2nd Reading. Second. Approved 5-0.
8. ADJOURNMENT
Motion to adjourn. 7:35 p.m.
Agenda subject to revision.
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