EMS Study

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Scope of Work


  • 4.1. The County is seeking a contractor to conduct a comprehensive, thorough, and objective study of the emergency medical services system. The system includes the 911 center, first response services and transport delivery into a hospital (or other approved destination).
  • 4.2. The study should look at all aspects of EMS delivery including radio and cellular communications now and those planned for the future, 911 CAD, clinical care, response times throughout the County, ALS availability by time of day/day of week and geography.
  • 4.3. Madison County has 2 hospitals with varying degrees of surge capacity. This study shall look at each hospital's surge capacity and determine the impact on EMS and other public safety entities when a major patient driven incident occurs in our community.
  • 4.4. Additionally, the potential changes to NYS EMS regulations will need to be explored and the impact to Madison County EMS will need to be determined.
  • 4.5. The contractor shall propose and use industry recognized research methodologies to accomplish this scope of work.
  • 4.6. At a minimum the Contractor will provide:
  • 4.6.1. A description of each agency's service areas, this is to include population, geography, and demographics
  • 4.6.2. Examine deployment as compared to EMS call locations
  • 4.6.3. Provide an operational and administrative capability analysis of the providers within the current system. This to include staffing (volunteer and paid at each level of certification), budgets, governance, training levels, sources of funding and taxation, organization design, call volumes (requests, % of requests filled, and cause of no unit responding), transports, response times [chute times, travel times, scene times, total call times, calls by hour/calls by day of week (to the extent data is available)], destination analysis, facilities, volunteer incentive programs, and vehicles
  • 4.6.4. An operational analysis of the EMS E-911 call taking, call processing, pre-arrival instructions, staffing, and quality assurance
  • 4.6.5. Provide present and future community age demographics by service area and impending impacts on EMS
  • 4.6.6. Assess and identify opportunities for public/private partnership
  • 4.6.7. Define at least 3 options to improve service and enhance program sustainability, quality, efficiency, and affordability
  • 4.6.8. Quantify the costs, governance, and other features of the various options
  • 4.6.9. Review hospital surge capacity and "off-load" times and their impact to EMS and the community
  • 4.6.10. Determine the feasibility for EMS transporting low acuity patients to alternative destinations versus emergency departments
  • 4.6.11. Review opportunities for better patient continuity of care as it relates to EMS being part of the health care continuum
  • 4.6.12. Present the findings in a public forum to be designated by County EM Office
  • 4.6.13. Develop and produce ten copies of a draft version of the written report for review by the County to ensure adequate opportunity will be provided for review and discussion of the draft report prior to finalization
  • 4.6.14. Provide a final written report (10 copies) in printed and electronic format. The written report will include, but not be limited to:
  • 4.6.14.1. An executive summary describing the nature of the report, the method(s) of analysis, the primary findings, and critical recommendation(s)
  • 4.6.14.2. Detailed narrative analysis of each report component structured in easy-to-read sections and accompanied by explanatory support to encourage understanding by both EMS and civilian readers
  • 4.6.14.3. Clearly designated recommendations highlighted for easy reference and cataloged as necessary in a report appendix
  • 4.6.14.4. Supportive charts, graphs, and diagrams, where appropriate
  • 4.6.14.5. Supportive maps, utilizing GIS analysis, as necessary
  • 4.6.14.6. Appendices, exhibits, and attachments, as necessary
  • 4.6.15. The existing operations will be assessed to determine strengths and opportunities for improvement both immediate and in the future. Methodology shall include but not be limited to:
  • 4.6.15.1. On-site assessment
  • 4.6.15.2. Interviews with EMS agency leadership and staff, Fire Department leadership and staff, County / Town / Village Elected Officials, County Emergency Management, E-911, County GIS, County Health, Hospital leadership (including ED leadership), law enforcement agencies, NYS DOH EMS, and other identified parties to be determined
  • 4.6.15.3. Clinical care
  • 4.6.15.4. Operational performance
  • 4.6.15.5. Financial analysis and performance
  • 4.6.15.6. Legal issues including statutory roadblocks
  • 4.6.15.7. Community awareness
  • 4.6.15.8. System structure(s)
  • 4.6.15.9. Benchmark data