HomeMy WebLinkAboutFD Ground Emergency Medical Transportation Program Cost Reporting ServicesAGREEMENT FOR PROFESSIONAL SERVICES FOR
GROUND EMERGENCY MEDICAL TRANSPORTATION PROGRAM COST
REPORTING SERVICES 0e
This Agreement is made and entered into this 4 day of 0eJ U�" , 20AA,by
and between the CITY OF SAN RAFAEL (hereinafter "CITY"), and PUBLIC CONSULTING
GROUP LLC (hereinafter "CONSULTANT").
RECITALS
WHEREAS, the CITY has determined that professional services are required for support in
preparing Ground Emergency Medical Transportation (GEMT) Program cost reports for fiscal years
2018-19, 2019-20, 2020-21, 2021-22, and half of 2022-23; and
WHEREAS, the CONSULTANT has agreed to render such services.
AGREEMENT
NOW, THEREFORE, the parties hereby agree as follows:
PROJECT COORDINATION.
A. CITY'S Project Manager. The City Manager is hereby designated the PROJECT
MANAGER for the CITY and said PROJECT MANAGER shall supervise all aspects of the progress
and execution of this Agreement.
B. CONSULTANT'S Project Director. CONSULTANT shall assign a single
PROJECT DIRECTOR to have overall responsibility for the progress and execution of this
Agreement for CONSULTANT. Marc Staubley is hereby designated as the PROJECT DIRECTOR
for CONSULTANT. Should circumstances or conditions subsequent to the execution of this
Agreement require a substitute PROJECT DIRECTOR, for any reason, the CONSULTANT shall
notify the CITY within ten (10) business days of the substitution.
2. DUTIES OF CONSULTANT.
CONSULTANT shall perform the duties and/or provide services as follows:
As requested by the PROJECT MANAGER, CONSULTANT shall provide support in preparing the
GEMT annual cost report, collect information, address feedback, and provide ongoing support as
outlined in the CONSULTANT's "Ground Emergency Medical Transportation (GEMT) Program"
proposal, dated July 21, 2022, marked as Exhibit "A," attached hereto, and incorporated herein.
3. DUTIES OF CITY.
CITY shall compensate CONSULTANT as provided in Paragraph 4.
4. COMPENSATION.
For the full performance of the services described herein by CONSULTANT, CITY shall
pay CONSULTANT a contingency fee at a rate of fifteen percent (15%) of the total Medi -Cal Fee -
For -Service revenues collected by the CITY based on CONSULTANT's cost reports prepared
under this Agreement, as further described in CONSULTANT's "5. Pricing" included in Exhibit
"A" attached; but in no event shall the total amount paid to CONSULTANT for services rendered
under this Agreement exceed $75,000.
CONSULTANT shall not invoice CITY until the CITY receives its Medi -Cal Fee -For -
Service revenues that are collected based on CONSULTANT's cost reports, and CONSULTANT
submits invoice(s) to the CITY's PROJECT MANAGER detailing the 15% fee contingency
calculation.
If, as a result of a government audit, a refund is required by CITY, CONSULTANT
agrees to return the portion of the compensation fee that was paid on the amount being refunded
and will otherwise not be liable for any other costs, fees, expenses, damages, or amounts.
If CITY terminates this Agreement for convenience prior to the completion or submission
of a cost report, CONSULTANT shall invoice, and CITY shall compensate CONSULTANT, at
an hourly rate of $225, in 15 minute increments, for the time CONSULTANT expended in
preparing such cost report, provided that CONSULTANT submits invoices documenting actual
hours performed on the cost report together with a description of work performed for each hour
or portion thereof. If CITY terminates this Agreement for convenience after the submission of a
cost report, but prior to payment being received by CITY, the parties agree that the compensation
provisions, shall survive termination of the Agreement, and CITY shall timely compensate
CONSULTANT pursuant to those provisions set forth herein.
TERM OF AGREEMENT.
The term of this Agreement shall be for 42 months commencing on the date this Agreement
was made and entered into by the parties. Upon mutual agreement of the parties, and subject to the
approval of the City Manager the term of this Agreement may be extended for an additional period
of up to 12 months.
6. TERMINATION.
A. Discretionary. Either party may terminate this Agreement without cause upon thirty
(30) days written notice mailed or personally delivered to the other party.
B. Cause. Either party may terminate this Agreement for cause upon fifteen (15) days
written notice mailed or personally delivered to the other party, and the notified party's failure to cure
or correct the cause of the termination, to the reasonable satisfaction of the party giving such notice,
within such fifteen (15) day time period.
C. Effect of Termination. Upon receipt of notice of termination, neither party shall
Revised 7/13/2021
incur additional obligations under any provision of this Agreement without the prior written consent
of the other.
D. Return of Documents. Upon termination, any and all CITY documents or materials
provided to CONSULTANT and any and all of CONSULTANT's documents and materials
prepared for or relating to the performance of its duties under this Agreement, shall be delivered to
CITY as soon as possible, but not later than thirty (30) days after termination.
7. OWNERSHIP OF DOCUMENTS.
The written documents and materials prepared by the CONSULTANT in connection with
the performance of its duties under this Agreement, shall be the sole property of CITY. CITY may
use said property for any purpose, including projects not contemplated by this Agreement.
INSPECTION AND AUDIT.
Upon reasonable notice, CONSULTANT shall make available to CITY, or its agent, for
inspection and audit, all documents and materials maintained by CONSULTANT in connection with
its performance of its duties under this Agreement. CONSULTANT shall fully cooperate with CITY
or its agent in any such audit or inspection.
9. ASSIGNABILITY.
The parties agree that they shall not assign or transfer any interest in this Agreement nor the
performance of any of their respective obligations hereunder, without the prior written consent of the
other party, and any attempt to so assign this Agreement or any rights, duties or obligations arising
hereunder shall be void and of no effect.
10. INSURANCE.
A. Scope of Coverage. During the term of this Agreement, CONSULTANT shall
maintain, at no expense to CITY, the following insurance policies:
1. A commercial general liability insurance policy in the minimum amount of
one million dollars ($1,000,000) per occurrence/two million dollars ($2,000,000) aggregate, for death,
bodily injury, personal injury, or property damage.
2. An automobile liability (owned, non -owned, and hired vehicles) insurance
policy in the minimum amount of one million dollars ($1,000,000) per occurrence.
3. If any licensed professional performs any of the services required to be
performed under this Agreement, a professional liability insurance policy in the minimum amount of
one million dollars ($1,000,000) per occurrence/two million dollars ($2,000,000) aggregate, to cover
any claims arising out of the CONSULTANT's performance of services under this Agreement.
Where CONSULTANT is a professional not required to have a professional license, CITY reserves
the right to require CONSULTANT to provide professional liability insurance pursuant to this
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section.
4. If it employs any person, CONSULTANT shall maintain worker's
compensation insurance, as required by the State of California, with statutory limits, and
employer's liability insurance with limits of no less than one million dollars ($1,000,000) per
accident for bodily injury or disease. CONSULTANT's worker's compensation insurance shall
be specifically endorsed to waive any right of subrogation against CITY.
B. Other Insurance Requirements. The insurance coverage required of the
CONSULTANT in subparagraph A of this section above shall also meet the following requirements:
1. Except for professional liability insurance or worker's compensation
insurance, the insurance policies shall be specifically endorsed to include the CITY, its officers,
agents, employees, and volunteers, as additional insureds (for both ongoing and completed
operations) under the policies.
2. The additional insured coverage under CONSULTANT'S insurance policies
shall be "primary and noncontributory" with respect to any insurance or coverage maintained by
CITY and shall not call upon CITY's insurance or self-insurance coverage for any contribution. The
"primary and noncontributory" coverage in CONSULTANT'S policies shall be at least as broad as
ISO form CG20 0104 13.
3. Except for professional liability insurance or worker's compensation
insurance, the insurance policies shall include, in their text or by endorsement, coverage for
contractual liability and personal injury.
4. By execution of this Agreement, CONSULTANT hereby grants to CITY
a waiver of any right to subrogation which any insurer of CONSULTANT may acquire against
CITY by virtue of the payment of any loss under such insurance. CONSULTANT agrees to
obtain any endorsement that may be necessary to effect this waiver of subrogation, but this
provision applies regardless of whether or not CITY has received a waiver of subrogation
endorsement from the insurer.
5. If the insurance is written on a Claims Made Form, then, following termination
of this Agreement, said insurance coverage shall survive for a period of not less than five years.
6. The insurance policies shall provide for a retroactive date of placement
coinciding with the effective date of this Agreement.
7. The limits of insurance required in this Agreement may be satisfied by a
combination of primary and umbrella or excess insurance. Any umbrella or excess insurance shall
contain or be endorsed to contain a provision that such coverage shall also apply on a primary and
noncontributory basis for the benefit of CITY (if agreed to in a written contract or agreement) before
CITY'S own insurance or self-insurance shall be called upon to protect it as a named insured.
8. It shall be a requirement under this Agreement that any available insurance
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proceeds broader than or in excess of the specified minimum insurance coverage requirements and/or
limits shall be available to CITY or any other additional insured party. Furthermore, the requirements
for coverage and limits shall be: (1) the minimum coverage and limits specified in this Agreement; or
(2) the broader coverage and maximum limits of coverage of any insurance policy or proceeds
available to the named insured; whichever is greater. No representation is made that the minimum
Insurance requirements of this agreement are sufficient to cover the obligations of the
CONSULTANT under this agreement.
C. Deductibles and SIR'S. Any deductibles or self-insured retentions in
CONSULTANT's insurance policies must be declared to and approved by the PROJECT
MANAGER and City Attorney and shall not reduce the limits of liability. Policies containing any
self-insured retention (SIR) provision shall provide or be endorsed to provide that the SIR may be
satisfied by either the named insured or CITY or other additional insured party. At CITY's option,
the deductibles or self-insured retentions with respect to CITY shall be reduced or eliminated to
CITY's satisfaction, or CONSULTANT shall procure a bond guaranteeing payment of losses and
related investigations, claims administration, attorney's fees and defense expenses.
D. Proof of Insurance. CONSULTANT shall provide to the PROJECT MANAGER
or CITY'S City Attorney all of the following: (1) Certificates of Insurance evidencing the insurance
coverage required in this Agreement; (2) a copy of the policy declaration page and/or endorsement
page listing all policy endorsements for the commercial general liability policy, and (3) excerpts of
policy language or specific endorsements evidencing the other insurance requirements set forth in this
Agreement. CITY reserves the right to obtain a full certified copy of any insurance policy and
endorsements from CONSULTANT. Failure to exercise this right shall not constitute a waiver of
the right to exercise it later. The insurance shall be approved as to form and sufficiency by PROJECT
MANAGER and the City Attorney.
11. INDEMNIFICATION.
A. CONSULTANT shall, to the fullest extent permitted by law, indemnify, release,
defend with counsel approved by CITY, and hold harmless CITY, its officers, agents, employees
and volunteers (collectively, the "City Indemnitees"), from and against any claim, demand, suit,
judgment, loss, liability or expense of any kind, including but not limited to attorney's fees, expert
fees and all other costs and fees of litigation, (collectively "CLAIMS"), arising out of
CONSULTANT'S performance of its obligations or conduct of its operations under this
Agreement. The CONSULTANT's obligations apply regardless of whether or not a liability is
caused or contributed to by the active or passive negligence of the City Indemnitees. However,
to the extent that liability is caused by the active negligence or willful misconduct of the City
Indemnitees, the CONSULTANT's indemnification obligation shall be reduced in proportion to
the City Indemnitees' share of liability for the active negligence or willful misconduct. In
addition, the acceptance or approval of the CONSULTANT's work or work product by the CITY
or any of its directors, officers or employees shall not relieve or reduce the CONSULTANT's
indemnification obligations. In the event the City Indemnitees are made a party to any action,
lawsuit, or other adversarial proceeding arising from CONSULTANT'S performance of or
operations under this Agreement, CONSULTANT shall provide a defense to the City
Indemnitees or at CITY'S option reimburse the City Indemnitees their costs of defense,
including reasonable attorneys' fees, incurred in defense of such claims.
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B. The defense and indemnification obligations of this Agreement are undertaken in
addition to, and shall not in any way be limited by, the insurance obligations contained in this
Agreement, and shall survive the termination or completion of this Agreement for the full period
of time allowed by law.
12. NONDISCRIMINATION.
CONSULTANT shall not discriminate, in any way, against any person on the basis of age,
sex, race, color, religion, ancestry, national origin or disability in connection with or related to the
performance of its duties and obligations under this Agreement.
13. COMPLIANCE WITH ALL LAWS.
CONSULTANT shall observe and comply with all applicable federal, state and local laws,
ordinances, codes and regulations, in the performance of its duties and obligations under this
Agreement. CONSULTANT shall perform all services under this Agreement in accordance with
these laws, ordinances, codes and regulations. CONSULTANT shall release, defend, indemnify and
hold harmless CITY, its officers, agents and employees from any and all damages, liabilities,
penalties, fines and all other consequences from any noncompliance or violation of any laws,
ordinances, codes or regulations.
14. NO THIRD PARTY BENEFICIARIES.
CITY and CONSULTANT do not intend, by any provision of this Agreement, to create in
any third party, any benefit or right owed by one party, under the terms and conditions of this
Agreement, to the other party.
15. NOTICES.
All notices and other communications required or permitted to be given under this Agreement,
including any notice of change of address, shall be in writing and given by personal delivery, or by
email, addressed to the parties intended to be notified. Notice shall be deemed given as of the date of
personal delivery, or if emailed, upon the date of sending the email. Notice shall be given as follows:
TO CITY's Project Manager:
TO CONSULTANT's Project Director:
Revised 7/13/2021
Jim Schutz
City of San Rafael
1400 Fifth Avenue
San Rafael, CA 94901
Email: Jim.schutz@cityofsanrafael.org
cityofsanrafael.org
Marc Staubley
Public Consulting Group LLC
148 State Street
Boston, MA 02109
Email: mstaubley@pcgus.com
16. 1NDEPENDENT CONTRACTOR.
For the purposes, and for the duration, of this Agreement, CONSULTANT, its officers,
agents and employees shall act in the capacity of an Independent Contractor, and not as employees of
the CITY. CONSULTANT and CITY expressly intend and agree that the status of
CONSULTANT, its officers, agents and employees be that of an Independent Contractor and not
that of an employee of CITY.
17. ENTIRE AGREEMENT -- AMENDMENTS.
A. The terms and conditions of this Agreement, all exhibits attached, and all documents
expressly incorporated by reference, represent the entire Agreement of the parties with respect to the
subject matter of this Agreement.
B. This written Agreement shall supersede any and all prior agreements, oral or written,
regarding the subject matter between the CONSULTANT and the CITY.
C. No other agreement, promise or statement, written or oral, relating to the subject
matter of this Agreement, shall be valid or binding, except by way of a written amendment to this
Agreement.
D. The terms and conditions of this Agreement shall not be altered or modified except
by a written amendment to this Agreement signed by the CONSULTANT and the CITY.
E. If any conflicts arise between the terms and conditions of this Agreement, and the
terms and conditions of the attached exhibits or the documents expressly incorporated by reference,
the terms and conditions of this Agreement shall control.
18. SET-OFF AGAINST DEBTS.
CONSULTANT agrees that CITY may deduct from any payment due to CONSULTANT
under this Agreement, any monies which CONSULTANT owes CITY under any ordinance,
agreement, contract or resolution for any unpaid taxes, fees, licenses, assessments, unpaid checks or
other amounts.
19. WAIVERS.
The waiver by either party of any breach or violation of any term, covenant or condition of
this Agreement, or of any ordinance, law or regulation, shall not be deemed to be a waiver of any
other term, covenant, condition, ordinance, law or regulation, or of any subsequent breach or violation
of the same or other term, covenant, condition, ordinance, law or regulation. The subsequent
acceptance by either party of any fee, performance, or other consideration which may become due or
owing under this Agreement, shall not be deemed to be a waiver of any preceding breach or violation
by the other party of any term, condition, covenant of this Agreement or any applicable law, ordinance
or regulation.
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20. LIMITATIONS ON LIABILITY; COSTS AND ATTORNEY'S FEES.
Neither party shall be liable to the other any incidental, indirect, special, punitive or
consequential damages, including but not limited to, such damages arising from any type or
manner of commercial, business, or financial loss, even if the other party had actual or constructive
knowledge of the possibility of such damages and regardless of whether such damages for
foreseeable. Notwithstanding the forgoing, the prevailing party in any action brought to enforce the
terms and conditions of this Agreement, or arising out of the performance of this Agreement, may
recover its reasonable costs (including claims administration) and attorney's fees expended in
connection with such action.
Except as expressly provided in this agreement, CONSULTANT does not make any
warranty with respect to the contracted services, whether express or implied, and specifically
disclaims any implied warranties, whether of merchantability, suitability, fitness for a particular
purpose, or otherwise for said contracted services.
21. CITY BUSINESS LICENSE / OTHER TAXES.
CONSULTANT shall obtain and maintain during the duration of this Agreement, a CITY
business license as required by the San Rafael Municipal Code CONSULTANT shall pay any and
all state and federal taxes and any other applicable taxes. CITY shall not be required to pay for any
work performed under this Agreement, until CONSULTANT has provided CITY with a completed
Internal Revenue Service Form W-9 (Request for Taxpayer Identification Number and Certification).
22. SURVIVAL OF TERMS.
Any terms of this Agreement that by their nature extend beyond the term (or termination) of
this Agreement shall remain in effect until fulfilled and shall apply to both Parties' respective
successors and assigns.
23. APPLICABLE LAW.
The laws of the State of California shall govern this Agreement.
24. COUNTERPARTS AND ELECTRONIC SIGNATURE.
This Agreement may be executed by electronic signature and in any number of counterparts,
each of which shall be deemed an original, but all of which together shall constitute one document.
Counterpart signature pages may be delivered by telecopier, email or other means of electronic
transmission.
[Signatures are on the following page.]
Revised 7/13/2021
IN WITNESS WHEREOF, the parties have executed this Agreement as of the day, month
and year first above written.
CITY OF SAN RAFAEL
,Fim chug City Manag
ATTEST:
kwL,�;
LINDSAY LARA, City Clerk
APPROVED AS TO FORM:
ROBERT F. EPSTEIN,
Revised 7/13/2021
Attorney
CONSULTANT
By: 4"
Name: Marc Staubley, Health Practice Area
Director
[If CONSULTANT is a corporation, add signature of
second corporate officer]
By:_
Name:
Title:
Ej
Ground Emergency Medical
Transportation (GEMT)
Program
City of San Rafael
July 21, 2022
Attachment A
City of San Rafael
GEMT,Program and CMS Medicare Cost Survey. Services
1. INTRODUCTION
Public Consulting Group (PCG) understands that the City of San Rafael ("City") requests the assistance of
a qualified vendor to provide cost report preparation and consulting services for the Medi -Cal Ground
Emergency Medical Transportation (GEMT) program, operated by the California Department of Health Care
Services. As the leading firm in GEMT reimbursement programs, PCG is well-equipped to provide high--
quality cost reporting services which aim to take the administrative burden away from the provider, increase
provider reimbursement, and minimize audit risk.
PCG provides unmatched comprehensive cost reporting services
PCG's cost report preparation and cost settlement support will allow the City to generate maximum
allowable revenue while mitigating audit risk. Through our full-service delivery model, PCG offers cost
reporting expertise that optimizes revenue and eliminates the administrative burden on EMS providers.
PCG will provide full support to the City throughout the cost reporting process and all state and federal
and its.
PCG has the knowledge and resources to provide the City of San Rafael with services aimed at increasing
revenue forthe City. We provide the full lift associated with developing the cost report, from data collection
all the way through compilation of the final report. Additionally, we conduct comparative analyses to identify
significant trends in billing and financial data utilizing our web -based cost reporting tool. PCG is the only
vendor to offer an online EMS cost reporting system for the use of data aggregation, comprehensive
compliance reviews, automated edits checks, and advanced reporting. The use of a system through these
programs is vital to help ensure all potential reimbursement is captured and extensively reviewed.
PCG is the only vendor to contract directly with state Medicaid agencies to provide EMS supplemental
payment program development, oversight and administration, training, and audit support. This gives us a
unique advantage and understanding of how the state will be approaching the program and related audits,
allowing PCG to better serve our provider clients.
PCG is the right choice for the City of San Rafael
As a firm dedicated to serving the public sector, PCG understands the fiscal challenges that the City of San
Rafael Fire Department faces in serving Californians. We are confident that our team's knowledge,
combined with our deep experience and highly successful approach, uniquely qualifies PCG to be the firm
that will help the City generate incremental revenue to help alleviate some of the fiscal pressure it is
currently facing.
2. COMPANY BACKGROUND AND EXPERIENCE
PCG was founded in 1986 with a mission of helping public sector agencies improve operational and
managerial performance. Our firm provides industry-leading management consulting and technology to
public sectored ucation, health, human services, and other government clients to achieve their performance
goals and better serve populations in need.
Since 2006, PCG has been working with the provider community to increase Medicaid reimbursement for
ambulatory services. Most notably, PCG assisted the State of Texas with the establishment of the first EMS
Certified Public Expenditure (CPE) Program in the country and subsequently supported the Commonwealth
of Massachusetts with the approval and implementation of an EMS Certified Public Expenditure (CPE)
Program in 2013. As the result of our work over the past thirteen years in this arena, PCG has acquired in-
depth experience working with fire departments and ambulance service providers to identify reimbursable
Public Consulting Group LLC Page 2
Attachment A
City of San Rafael
GEMT Program and CMS Medicare Cost Survey Services
costs and to complete or facilitate the completion of the required annual cost report. More recently, PCG
has worked with providers in Washington and Florida to navigate the process cost reporting, revenue
maximization, and audits. We currently work with over 550 providers across thirteen states, which provides
us with a wide range of experience. Please see Figure 1 below for specific details on PCG's experience in
key states.
3. APPROACH
PCG Methodology
Massachusetts Executive Office
of Health & Human Services
(EOHHS) appointed PCG to
design, obtain federal appra,ral.
and implement the CPE Program
In 2006, PCG partnered with
Austin -Travis County EMS and
the State of Texas Health and
Human Services Commission
(HHSC) to develop the Ambulance
Supplemental Payment Program_
,TEXAS
r' Heartliand Human Servkes
Floridas Public Emergency
Medical Transportation (PEMTi
Certified Public Expenditure
(CPE) Program vias approved far
implementation in 2016
The Washington State Health
Care Authority (HCA) gained
federal approval for their Ground
Emergency Medical
Transportation (GENT) Program in
July 2017
Washington State
Health Care Authority
-Developed and facilitated
federal approval of State Plan
A ni endment
-Conducted outreach and
facilitated workgroups to inform
program development
-Created the cost report
template, web -based reporting
system and training materials
-First federally -approved EMS
supplemental payment program
-Adopted 1115 Waiver that
expanded cost settlement to
Medicaid Managed Care and
the Uninsured
-Customized web -based EMS
cost reporting tool
-Developed web -based cost
reporting system for FL
-Conducted comprehensive
review of programmatic
components and developed data
request, data review, and QC
processes
-Created a web -based cost
reporting tool for data collection.
data review, and enhanced
reporting
-Shared fiscal impact studies
with individual providers to
demonstrate the benefits of
program participation
-Developed cost reporting
processes and data analysis
tools to ensure compliance and
revenue maximization
Figure 1: PCG Successes in Key States
-Nearly 107 participating
providers in FY21
-Generating over $100
million in additional funding
to providers since the
beginning of the program
-More than 70 participating
providers
-Generated nearly $676
million for Texas providers
-Conducted outreach and
supported more than 40
providers in the first year of
the program
-Currently provide service to
over 60 EMS providers
-Generated more than $190
million for Florida providers
since FY17
-Completed FY16 and FY17
cost reports on behalf of
more than 60 providers in
the program's first reporting
period
-Generated over $120
million in reimbursement to
90 providers
Public Consulting Group LLC Page 3
Attachment A
City of San Rafael
GEMT Program and CMS Medicare Cost Survey, Seryices
PCG's approach to this scope of work is described below. It includes
our project management approach, a timeline, milestones and
deliverables for the project. This approach is based not only on our
successful implementation with other GEMT projects, but also on
our process improvement analysis of our past GEMTwork.
Phase 1: Project Kickoff and Implementation process as seamless as
In this prel iminaryphase, the PCG willworkwith the City toestablish possible.
a stakeholder group that will be involved in the cost reporting
process. Once the key stakeholders are identified, we will schedule
a project kickoff meeting with the appropriate individuals to
understand and discuss project expectations and specific roles and responsibilities. This will allow us to
further develop our project statement of work and fully refinethe project plan. We will work with the City to
form a communication plan to establish protocols and timeframe for future status meetings based on the
City's preferences.
Lastly, we will provide a data request to the City to begin the process of completing the cost report. The
items requestwill include, but is not limited to:
• Provider -specific identifier numbers
• Computer Aided Dispatch (CAD) Data
• Capital Usage
• Expenditures for the provider
• Employee data
• Indirect Cost Rate Proposal
• Provider revenue received
• Depreciation detail
e Billing data
The purpose of collecting this data is to determine the allowable costs that are in excess of other Medk
Cal revenue that the eligible GEMT entity receives for providing Emergency Medical Transportation
services to Medi -Cal recipients. This data will be used to provide the content for the Medi -Cal costreport.
Data collection periods forthe f ive (5) cost reports thataredue in 2022/23 are outlined in thetable below.
Public Consulting Group LLC Page 4
(12 months)
(12 months)'
Cost Reporting
Period Begins
7/1/2018
7/1/2019
7/1/2020
7/1/2021
7/1/2022
Cost Reporting
Period Ends
6/30/2019
6/30/2020
6/30/2021
6/30/2022
12/31/2022
Cost Report
p
7/31/2022
7/31/2022
7/31/2022
5/23/2023
Due Date
9/1/2022"
9/15/2022*
10/1/2022
11/30/2022
Public Consulting Group LLC Page 4
Attachment A
City of San Rafael
GEM T.Pro.gram and CMS Medicare Cost Survey. Services
Figure 2: GEMT Cost Report Schedule
'Indicates the extension date grantedbyDHCS to the City of San Rafael
Phase 2: Cost Report Preparation
This phase will specifically focus on the preparation of the annual cost report as well as any necessary
supporting documentation to allow the City to receive supplemental payments. During this phase, we
document processes and identify strengths, weaknesses and mitigating controls, proactively offering
recommendations for strengthening compliance, especially in relation to California GEMT programmatic
regulations. We will leverage our knowledge of state and federal Medicaid billing and reimbursement
requirements to make recommendations to the City as the team learns aboutyour data. Additionally, our
staff constantly reviews regulations and legislation at both the state and federal levels to ensure its claiming
practices are current. Our legal and regulatory staff reviews the Office of Inspector General (OIG), Centers
for Medicare and Medicaid Services (CMS), and other audits throughout the nation, some of which result
in policy modifications. We will review if any of these reforms could impact the City and make suggestions
to enhance procedures, thus proactively addressing the concerns outlined in other audits.
The cost report preparation phase of the process involves managing the GEMT pre -cost report submittal
process forthe City. This includes:
• Collecting provider information securely via electronic submission
• Storage of data into ourweb-based cost reporting tool
• Reviewing all submitted data to determine eligible costs for reimbursement under the GEMT
program
• Gaining City sign off during pre -determined status meetings per the communication plan
established in the kickoff meeting
These items are further outlined below:
Collect Provider Information
The first step of this process is collecting provider information perthe data request discussed in the kickoff
meeting. The transmission, collection and storage of this data in an electronic format has increased the
focus and importance of creating appropriate protection and controls for data that is sensitive and/or
protected. As a hosted solution provider, we acknowledge and acceptthat itis incumbent on every service
provider to enable proper protection and control for the management and safe -keeping of our data, and
particularly for the data that we are entrusted to store on behalf of our clients.
PCG will take necessary steps to:
• Assure appropriate protections and controls are developed and followed;
■ Apply appropriate standards; and
• Comply with pertinent regulations governing the access to protected data such as the Health
Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information
Technology for Economic and Clinical Health (HITECH) Act.
We recognize that having a robust security program is critical in minimizing the impact of threats inherent
in today's computing environments. We are committed to maintaining a healthy process of periodic audit
and review of our program to assure that we are accomplishing our, and the City's goals and objectives in
Public Consulting Group LLC Page 5
Attachment A
City of San Rafael
GEMT Program and CMS Medicare Cost Survey, Services
protecting sensitive data, and to assure that the plan evolves to address an ever-changing environment
and threat landscape overtime.
Once the requested data is received, we will identify the need for any additional data and communicate
with the City to ensure a timely completion of the Medi -Cal cost report. When all of the required data is
submitted by the City we will provide the City of San Rafael a data summary for approval at a pre-
determined status meeting. Afterthe first yearof data collection, PCG will identify any shifts in the data
provided in years prior to further ensure the accuracy of the data provided.
Review Provider Information
Our web -based cost reporting tool is an invaluable resource in
performing data validation in real-time, as data is collected.
Immediately upon entry, ourteam will be able to identify variances
and discuss their acceptance with the City We have the ability to
change the allowable variance limits to be aligned with updated
guidance from DHCS or the City of San Rafael Fire Department
preferences. The web -based tool also allows the team to give the
City feedback on how their expenses compare to other providers for
benchmarking purposes. The paragraphs below describe this
process and further benefits of using this tool.
• Benchmarkdata
■ Create an audit trail
• Validate data in real-time
J
Figure 3: PCG's Web -Based Cost Reporting Tod.
Once all data is received from the City we will inputthe data into our online tool. As mentioned above, our
proprietary system will perform real-time validation checks for quality assurance and accuracy. No other
vendor in the country utiles a web -based reporting tool to compile, review, and audit all data components
included in the cost report prior to cost report submission. An automated compliance process is essential
to ensure the accuracy of all reported financial information. The information collected from the City and
stored in this system will be used to satisfy the reporting requirements for all components of the Ground
Emergency Medical Transportation (GEMT) Program.
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Attachment A
City of San Rafael
GENT Program. and CMS Medicare Cost Survey Services
PCG will communicate with the City of San Rafael Fire Department throughout the data review process
with status updates and any clarification questions regarding the data during status meetings for updates.
The cost reporting work will focus on compliance and audit risk minimization, ensuring that all included
costs meet OMB S u perC i rcu I ar (2 CFR Part 200) req uirem ents and be sufficiently accounted for in auditable
financials. After the data is reviewed, we will provide the City with a decision summary for sign off before
beginning the process of the cost report preparation. During this p hase, we will draw on our access to and
history with EMS providers across the country to provide guidance on necessary determinations such as
allowable and shared costs.
Our tool, combined with our book of clients across the country allows
us to provide the City of San Rafael Fire Department with blinded
benchmark data. The City may have an interest in seeing how their
cost per transport compares to departments of similar size or with a
comparable call volume.
We implement year-to-year comparisons of billing and expenditures
data and identify any areas in which significant changes occur.
Because all data is stored in this system, an audit trail is created as
the cost report is completed. In addition to the data trail created in the
system, the system captures and stores:
• Supporting documentation (including a crosswalk to external
files)
■ A crosswalk through allowable cost determination
• Notes for any variances identified
Because this is created as the cost report is completed, q uestions from D HCS or an audit request will not
be a causeforconcern. Wewill havethe information readyto respond to additional req uests without surplus
information needed from the City.
PCG looks forward to using theweb-based tool, as well as the vast cost report experience mentioned above
to assist the City of San Rafael Fire Department in the successful completion of the Medi -Cal Cost Report.
Phase 3: Cost Report Submission and Desk Review
We accept the full administrative burden of cost report preparation and will ensure the City of San Rafael
Fire Department staff is closely involved in the cost report review process before submission to DHCS. We
will work towards establishing protocols and processes that the City can easily replicate in generating the
information that will ultimately result in the transfer of funds from DHCS.
Prepare Cost Report Submission Package
We will complete all ten (10) schedules outlined in the Medi -Cal Cost Report in compliance with the format
provided by DHCS. This includes using the web -based tool described above to complete the required
schedules. A demonstration of the web -based tool will be presented to the City and we will provide a
preliminary cost report with anticipated settlement results.
Review Cost Report to Identify and Address Audit Risk
We will review the cost report and identify all outstanding potential audit risks with the City. Wewill suggest
potential remed ies to reduce audit risk and update the cost report accordingly as needed. During this stage,
Public Consulting Group LLC Page 7
Attachment A
City of San Rafael
GEMT Program and CMS Medicare Cost Survey Services
we will anticipate any possible question of the cost reported by finalizing notes addressing potential
questions or clarifications on the cost report. In addition, we will provide the City with supporting
documentation linking the reported data to the documentation delivered during the data collection process.
Submit Completed Cost Report Package to DHCS
We will supply the City of San Rafael Fire Department with a cost report submission package that includes
the completed cost report, supporting documentation of financials, and any additional documentation
requested by DHCS. In addition, we will provide an in-depth final report review before submission. This
ensures all stakeholders and the individual certifying the report agree with the data as reported and sign off
on the cost report before submission.
Address Feedback of DHCS Review of Cost Report
DHCS's questions and findings will be addressed during the desk review process. This includes d rafting
responses, providing supporting documentation and conducting comprehensive billing reconciliations
should there be questions regarding the billing data. Leveraging experience responding to agency inquiries
regarding EMS Medicaid cost reports in multiple states, we will be able to assist the City of San Rafael Fire
Department in swiftly resolving any issues that may arise during D HCS's review of the cost report. We will
also be responsible for providing supporting documentation, drafting responses, and undertaking financial
accountability during a potential federal audit. We build and maintain a strong collection of supporting files
that is well -organized and readily accessible in the event of an audit.
We will work closely with the City of San Rafael Fire Department to help maintain the highest levels of
compliance and program integrity while maximizing the City's revenue to the greatest extent possible.
Ongoing in-depth assessments will be performed and we will work with the City of San Rafael staff to
provide status updates and written reports for internal stakeholders.
Phase 4: Ongoing Support
We will continue to provide ongoing support to the City of San Rafael Fire Department after the completion
of the cost report and subsequent reviews. These ongoing tasks include.
• Continuing to provide policy updates from DHCS and Centers for Medicare and Medicaid Services
(CMS) regarding any updates or changes to the program
Communicating any updates f rom DHCS relating to the date of anticipated reimbursement from the
GEMT prog ram
•
Providing auditsupportin theevent of an aud itbythe state, CMS, orthe Officeof Inspector General
(OIG)
We will also provide the City with additional services aimed at increasing ambulance service revenues. In
addition, we provide charge master review services to ensure that the City of San Rafael Fire Department
is optimizing charges to drive revenue generation. We understand the political complexities associated with
increasing charges and provide the necessary support and analysis to present to stakeholders.
4. PROPOSED STAFF
Public Consulting Group's GEMT team includes a qualified and experienced staff of subject matter experts.
All members of the PCG team have direct experience with EMS Medicaid reimbursement. No other vendor
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Attachment A
City of San Rafael
GEMT Program and CMS Medicare_Cost Survey Services
offers a team with more knowledgeable staff, cost reporting experience and Medicaid experience. We will
bring these resources to the full benefit of the City of San Rafael Fire Department cost reporting services.
Proposed Staff Bios
James Dachos has over 15 years of health care policy and analysis experience and has led PCGs
Ambulance Supplemental Payment Program data collection and cost recovery efforts for over 10 years.
Mr. Dachos serves as the program director for 11 active Ambulance Supplemental Payment Program
initiatives across the country, including Texas, Florida, Washington, Colorado, Oregon, Oklahoma,
Maryland, Missouri, Iowa, Illinois, and the District of Columbia. As the program director, Mr. Dachos is
directly responsible for the development, design, implementation, cost reporting, and ongoing
administration of EMS reimbursement programs. He currently oversees ambulance supplemental
payment services for over 550 ambulance providers. Mr. Dachos also oversees the project team
dedicated to providing statewide EMS consulting, cost collection, and auditing services on behalf of the
State of Colorado.
Mr. Dachos has worked closely with state Medicaid departments to design, develop, and gain federal
approval for cost -based EMS and school-based services (SBS) programs. He has worked with CMS on
behalf of numerous states responding to requests for information pertaining to the State Plan
Amendment and other related program components. He has also led comprehensive SBS and Local
Health Jurisdiction (LHJ) assessments on behalf of state health departments.
Ms. Narode has extensive experience managing statewide projects and comprehensive knowledge on
rate setting and rate study projects. Sincejoining PCG, Ms. Narode has supported and led several key
initiatives. For the New York State Department of Health School Supportive Health Services Program,
Ms. Narode serves as the project manager and assists in reviewing completed Medicaid cost reports to
identify possible reporting errors and works closely with Local Education Agencies (LEAs) to ensure that
finalized reports are completed accurately and in compliance with all reporting requirements. Ms. Narode
serves as the Project Manager on the Florida Public Emergency Medical Transportation (PEMT) program
working with over 60 providers on their Medicaid cost reports and also is the Project Director for the Iowa
Ground Emergency Medical Transportation (GEMT) program where she oversees a team to assist
multiple EMS providers in completing Medicaid cost reports. On behalf of the Wisconsin Department of
Health Services, Ms. Narode works hand-in-hand with county -based health service providers to ensure
the accuracy and completeness of annual Medicaid cost reports, including conducting trainings and
completing comprehensive desk reviews on completed cost reports. Ms. Narode will be the Project
Advisor for this program, utilizing her prior experience working in multiple states to maximize Chula Vista
Fire Department reimbursement opportunity.
Ms. DiCicco has over 12 years of experience working with public sector clients at the federal, state and
local levels. She uses innovative ideas, collaborative approaches and change management skills to
manage projectsand developnew programs. Ms. DiCicco currently serves as project director for seven
Emergency Medical Services (EMS) cost recovery and revenue maximization initiatives which allows her
the opportunity to work closely with Medicaid state agencies, lobbyists, state industry associations, and
ambulance providers of all sizes. Ms. DiCicco has acquired extensive knowledge of the operations and
f inancial health of fire and departments, and is ab leto apply it towards q ualitative and quantitative analysis
in orderto create impact solutions for her clients. Additionally, Ms. DiCicco serves as PCG's program
director and subject matter expert on CMS' Medicare Ground Ambulance Data Collection System
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Attachment A
City of San Rafael
GEMT Program and CMS Medicare Cost Survey Services
ProposedBios
(MGADC). Ms. DiCicco will be the Project Manager for this program, utilizing her prior experience working
in multiple states to maximize Chula Vista Fire Department reimbursement opportunity.
Ms. McDonald has worked with Medicaid and EMS reimbursement for4 years. She has worked as an
analyst in Florida, Oklahoma, Missouri, and Texas focusing on Cost Report Compilation and Data
Analysis. In these states, she works with fire departments and ambulance providers to design, gain
approval for, and implementthe EMS Supplemental Payment Program, a federally approved program that
provides additional reimbursement for governmental providers that serve Medicaid patients. She also
prepares the annual cost reports, data analysis, and provide comprehensive support throughout the
State's desk reviews. Additionally, Ms. McDonald has led and contributed to project initiatives in federal
and state compliance, Medicaid billing analysis, Medicaid cost reporting, statewide school-based cost
settlement operations and training, process improvement and program management best practices in the
state of Wisconsin. Ms. McDonald will utilize her prior experience with completing GEMT cost reports, to
compile data and complete the cost report for the Chula Vista Fire Department.
Ms. Ray has over four years of experience working with both public and private sector clients and
managing portfolios, analyzing provider and client data, and supporting the development of state
supplemental payment programs. Ms. Ray currently serves as a business analyst working with
governmental ambulance service providers to maximize their fiscal return on Medicaid Fee For Service
transports. On each project, she provides detailed cost reporting, data analysis, organization, outreach
and stakeholder engagement, implementation planning, and more. Ms. Ray will utilize her prior
experience to provide project support in completing the cost reports for Chula Vista Fire Department.
5. PRICING
PCG is pleased to offer the above scope of GEMT program services to the City of San Rafael Fire
Department at a contingency rate of fifteen percent (15%) per cost report with a total do not exceed
of seventy-five thousand dollars ($75,000). This pricing is based off five (5) supplemental payment
reimbursement cycles pertaining to additional Medi -Cal Fee -For -Service revenues generated as a result of
the program. The City of San Rafael Fire Department will compensate PCG within thirty (30) days of receipt
of an invoice. Invoicing will occur only after the City receives its settlement payment(s).
Public Consulting Group LLC Page 10
RAP
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WITH E'
CONTRACT ROUTING FORM
INSTRUCTIONS: Use this cover sheet to circulate all contracts for review and approval in the order shown below.
TO BE COMPLETED BY INITIATING DEPARTMENT PROJECT MANAGER:
Contracting Department: Fire
Project Manager: Thomas Wong Extension: 5360
Contractor Name: Public Consulting Group
Contractor's Contact: Sarah Dicicco Contact's Email: sdicicco@pcgus.com
❑ FPPC: Check if Contractor/Consultant must file Form 700
Step
RESPONSIBLE
DESCRIPTION
COMPLETED
REVIEWER
DEPARTMENT
DATE
Check/Initial
1
Project Manager
a. Email PINS Introductory Notice to Contractor
N/A
7/22/2022
b. Email contract (in Word) and attachments to City
TW
Attorney c/o Laraine.Gittens@cityofsanrafael.org
2
City Attorney
a. Review, revise, and comment on draft agreement
7/25/2022
and return to Project Manager
7/25/2022
0 GC
b. Confirm insurance requirements, create Job on
Department Director
PINS, send PINS insurance notice to contractor
9/22/2022
0 _GC_
3
Approval of final agreement form to send to
0 —DW—
Project Manager
contractor
4
Forward three (3) originals of final agreement to
10/3/2022
0
contractor for their signature
5
Project Manager
When necessary, contractor -signed agreement
0 N/A
agendized for City Council approval *
*City Council approval required for Professional Services
Agreements and purchases of goods and services that exceed
Or
$75,000; and for Public Works Contracts that exceed $175,000
Click here to
Date of City Council approval
enter a date.
PRINT
CONTINUE ROUTING PROCESS WITH HARD COPY
6
Project Manager Forward signed original agreements to City
10/5/22
Attorney with printed copy of this routing form
TW
7
City Attorney
Review and approve hard copy of signed
10/6/2022
/i►
agreement
(5��
8
City Attorney
Review and approve insurance in PINS, and bonds
10/6/2022
(for Public Works Contracts)
9
City Manager/ Mayor
Agreement executed by City Council authorized
/d L
official
10
City Clerk
Attest signatures, retains original agreement and
/ ��
forwards copies to Project Manager
OEM