Jersey City has decided to re-issue bid requests for a three-year contract to supply ambulance service to residents who call 911, possibly avoiding a legal challenge from Jersey City Medical Center over the selection process.
Jennifer Morrill, spokesperson for the city, said after conversations with the two bidders – Jersey City Medical Center (JCMC) and McCabe Ambulance – the city has withdrawn its original proposal and both bidders have agreed to rebid.
“The RFP (request for proposals) is similar to last time and provides for flexibility,” Morrill said.
City officials would not comment on an alternative proposal from the Fulop administration that might have split the ambulance contract and allowed each firm to service a portion of the city. That idea got a negative reaction from a number of residents, who cited potential confusion that might result. Earlier this year, confusion between two street names resulted in a delay that may have been responsible for loss of life in a fire. Some people fear a split contract might lead to similar tragedies.
Mickey McCabe, founder of McCabe Ambulance, who was out of the state until early last week, said he had not been contacted about the rebidding. CarePoint Health, which owns Bayonne Medical Center, Christ Hospital in Jersey City, and Hoboken University Medical Center, and supports McCabe in their pursuit of the contract, has not responded to requests for comment.
Jersey City Medical Center, which has also not responded to requests for comment, has had the contract for more than 100 years. JCMC has a lot of popular support and some allies on the City Council, including Councilman Richard Boggiano, who has opposed awarding the bid to McCabe.
Initial bid requests encountered problems
Bid specifications were originally issued by the city on Sept. 27, 2013, with JCMC and McCabe as the only two bidders. The contract was supposed to be voted on in December to begin on Jan. 1, but the process stalled over in a number of questions about the criteria used for awarding the contract to McCabe over JCMC.
Although three of five members of a panel recommended McCabe over JCMC, the administration took the item off the council agenda, pending a review from the Inspector General, the results of which have not been announced. Representatives from CarePoint were confident at the time that the state would approve the bid.
Meanwhile, the council has voted monthly extensions of the old contract with JCMC until the matter is resolved.
Money, and how they make it
The contract proposals from both McCabe and JCMC offered to provide ambulance service free of charge to the city for the three years of the contract.
JCMC has provided service without charge to the city from 1998 to 2006 (patients were still charged as is the standard), but the hospital has charged the city $4 million annually from 2006 until last year.
JCMC officials said that during the previous contract, the hospital was in dire financial straits and needed to money to keep its doors open. This money also allowed JCMC to modernize its ambulance service. But since then, the hospital has rebounded and JCMC says it can offer the service for free.
McCabe/CarePoint officials believe that the emergence of their competing bid may have forced JCMC to bid at no charge.
Both ambulance companies make their money from transport of patients, whose insurance or other medical coverage pays for some or all of the service. Paramedics, which JCMC currently provides, are an additional cost and McCabe would have to subcontract for that service if the city awards them the contract.
First responders are an issue
One of the key provisions of the bid has to do with first responders. The Fire Department began first-responding duties in the 1990s to provide quicker attention to emergencies. At the time, fire companies were strategically located throughout the city, and trained firefighters would arrive first and provide initial care until medical units could arrive.
The bid specifications provided two options: a bidder could provide their own first responder team, or pay the city to cover the cost of firefighters who act as first responders to medical emergencies.
JCMC said it would provide its own first responders, then claimed that the panel, which voted to award the contract to McCabe, had held JCMC’s choice against the hospital because their proposal included the possible use of volunteer medical units as first responders.
McCabe offered to pay, which would have generated more than $2.6 million in revenue to the city. But JCMC claimed McCabe’s offer to pay the city would have been illegal under state bidding regulations. Had the contract gone to McCabe under those conditions, JCMC suggested in council caucus meetings that they would have begun legal action.
Boggiano objected to the panel’s decision, partly because he said he believed the choice was based on the revenue from McCabe’s financial payments to the city, not on the comparative performance of the two ambulance services.
JCMC also claimed that the bid specifications were modified and fundamentally changed after both services had submitted bids.
Residents who support JCMC said they wanted assurances that a change in ambulance provider would be “justified and reasonable,” and that the selection process will be “transparent.”
Currently, JCMC, which is the county’s official trauma center, provides ambulance service for the city and paramedic service for the entire county. It is also responsible for the medical 9-1-1 call service.
McCabe runs 9-1-1 service in Bayonne and Hoboken, and has operated an ambulance service in Bayonne for about 40 years and has provided officially designated service in Bayonne since the 1980s.
At question is whether or not McCabe’s smaller fleet of vehicles would be able to provide the service to Jersey City. As of December, McCabe had 16 vehicles, and JCMC had 35.
McCabe said its fleet had already expanded prior to Jan. 1, 2014, and the company has plans to expand more fully if the contract is award. JCMC has also been upgrading, including significant technology improvements.
CarePoint also involved
CarePoint is offering financial backing to McCabe, and appears to be getting involved because one of its hospitals is in Jersey City. As a for-profit hospital, a significant amount of revenue would come from patients who are admitted through its Emergency Room.
CarePoint claims they want to make sure Christ Hospital gets its fair share of patients, and fears that a JCMC monopoly over the transport may divert patients to JCMC instead.
JCMC officials said they deliver patients wherever they ask to go, although hospital officials acknowledged that as the county’s trauma center, people with life-threatening conditions or multiple injuries must go to JCMC.
Al Sullivan may be reached at email@example.com.