Embed Size (px)
Citation preview
ETP 130 - Single (05/02/16) 1 of 6
RETRAINEE - JOB CREATION
Training Proposal for:
American Medical Response of Southern California
Agreement Number: ET17-0455
Panel Meeting of: March 24, 2017
ETP Regional Office: San Diego Analyst: H. Bernard
PROJECT PROFILE
Contract
Attributes: Medical Skills Training
Job Creation Initiative
SET
Priority Rate
Retrainee
HUA
Industry
Sector(s): Healthcare
Priority Industry: Yes No
Counties
Served:
Statewide Repeat
Contractor:
Yes No
Union(s): Yes No American Federation of State, County and Municipal Employees
(AFSCME), Local 4911; International Association of EMT's and Paramedics (IAEP),
Local 5000; International Association of Fire Fighters (IAFF), Local 4513
Number of Employees in: CA: 6,300 U.S.:50,000 Worldwide: 50,000
Turnover Rate: 3%
Managers/Supervisors: (% of total trainees)
0%
FUNDING DETAIL
Program Costs - (Substantial Contribution)
(High Earner Reduction)
= Total ETP Funding
$745,800
$0
$0
$745,800
In-Kind Contribution: 100% of Total ETP Funding Required $1,200,000
American Medical Response of Southern California March 24, 2017 ET17-0455
ETP 130 - Single (05/02/16) 2 of 6
TRAINING PLAN TABLE
2 Retrainee
Job Creation Initiative
Medical Skills Training
Priority Rate
SET
MS Clinical Preceptor,
MS Didactic, Continuous Impr.
60 8 - 200 0 $2,140 *$10.50
Weighted Avg: 107
*It will be made a condition of contract that the trainees will never be paid less than the State or local minimum wage rate as in effect at the end of retention regardless of the wage expressed in this table. The highest minimum wage rate will prevail.
Minimum Wage by County: All Retrainees included in this project will be compensated in
accordance with the Collective Bargaining Agreements (CBA) for their respective county (See
Page 4 Union Representation).
Health Benefits: Yes No This is employer share of cost for healthcare premiums –
medical, dental, vision.
Used to meet the Post-Retention Wage?: Yes No Maybe
Although the employer provides health benefits (up to $5.22 per hour), they are not being used to
meet ETP’s Post-Retention Wage requirements per AMR’s Collective Bargaining Agreements.
Wage Range by Occupation
Occupation Titles Wage Range Estimated # of
Trainees
Job Number 1
Emergency Medical Technician (EMT) 409*
Paramedic 291*
Job Number 2
Emergency Medical Technician (EMT) 30*
Paramedic 30*
Collective Bargaining Agreement Wages by County
Location/County Occupations Collective Bargaining
Agreements Minimum Wage Maximum Wage
Redlands/San Bernardino
EMT AFSME
**
Paramedic
Job
No. Job Description Type of Training
Estimated
No. of
Trainees
Range of
Hours Average
Cost per
Trainee
Post-
Retention
Wage Class /
Lab CBT
1 Retrainee
Medical Skills Training
Priority Rate
SET
MS Clinical Preceptor,
MS Didactic, Continuous Impr.
700 8 - 200 0 $882 *$10.50
Weighted Avg: 49
American Medical Response of Southern California March 24, 2017 ET17-0455
ETP 130 - Single (05/02/16) 3 of 6
Riverside EMT
AFSME
Paramedic
San Diego EMT
IAEP
Paramedic
Burlingame/San Mateo
EMT AFSME
Paramedic
Concord/Contra Costa
EMT AFSME
Paramedic
Marina/Monterey EMT
IAFF
Paramedic
Modesto/Stanislaus EMT
AFSME
Paramedic
San Francisco EMT
AFSME
Paramedic
Stockton/San Joaquin
EMT AFSME
Paramedic *Approximately 4 planned trainees in San Bernardino County are at the $10.50 wage (two in Job Number1 and two in Job Number 2).
INTRODUCTION
Founded in 1992, American Medical Response of Southern California (AMR SoCal) (www.amr.net) is headquartered in Riverside. AMR SoCal will be the lead employer with affiliate American Medical Response West (AMR West). Both AMR SoCal and AMR West are holdings of Envision Healthcare Holdings, Inc. AMR SoCal and AMR West provide an array of services including both emergency and non-emergency response transportation services and disaster response and event medical services. Both AMR SoCal and AMR West are eligible for funding under Special Employment Training (SET) for frontline workers. The Company’s customers include hospitals, healthcare systems, and local, state and national government entities. This will be the second project between AMR SoCal and ETP. The first project (ET15-0269) included only AMR of SoCal and trained 481 trainees at 4 locations statewide. The inclusion of AMR West in this proposal expands the scope to 9 locations and 760 trainees statewide. AMR SoCal trainees will be located in Riverside, Redlands and San Diego. AMR West trainees will be located in Burlingame, Concord, Marina, Modesto, Stockton and San Francisco. (Redlands and Riverside did not participate in the previous Agreement.)
PROJECT DETAILS
Training will ensure compliance with the evolving healthcare industry, including staying up-to-date with government regulations and advances in equipment. Advanced training will allow EMT staff the opportunity to promote to Paramedics. Moreover, changes in corporate structure over the past year will require significant training.
American Medical Response of Southern California March 24, 2017 ET17-0455
ETP 130 - Single (05/02/16) 4 of 6
In late 2015, AMR acquired Rural Metro, one of the largest emergency responder providers in the nation. The acquisition added 7,500 employees and $600 Million in additional revenue (1,500 employees in CA). This has created a greater need for incumbent worker training in Southern California, specifically AMR SoCal’s San Diego location, as the Company works to integrate Rural Metro staff into AMR’s procedures, processes and continual training environment. Just last year, AMR West entered into a large-scale emergency transportation services agreement with Sutter Health (Sutter), a nonprofit healthcare provider in California, and the California Shock Trauma Air Rescue (CALSTAR), a nonprofit air ambulance service. The partnership with Sutter and CALSTAR seeks to minimize response and transportation times for patients in both rural and urban areas and will become one of the largest air-ground transport networks by serving up to 17,000 patients per year. Staff must be fully trained on administrative processes of both CALSTAR and Sutter. For example, having Sutter as a client requires transportation services for critical care patients who are being moved between healthcare facilities. Typically, paramedics and EMTs only serve trauma patients for a short period of time. However, critical care transportation requires more extensive treatment. This training will enable EMTs and paramedics to serve critical care patients who have vastly different needs than trauma patients. AMR West will focus most of its training on ensuring incumbent and new staff is adequately trained in transportation and treatment of critical care patients. Retrainee - Job Creation The Panel offers incentives to companies that commit to hiring new employees. Training for newly-hired employees will be reimbursed at a higher rate, and trainees will be subject to a lower post-retention wage. The recent partnership with Sutter will require AMR West to expand existing business capacity by hiring 60 new positions, 30 EMT’s and 30 Paramedics, during the term of the Agreement. The date-of-hire for trainees will be within the three-month period before contract approval or within the term-of-contract. These trainees will be hired into “net new jobs” as a condition of contract. Training Plan Medical Skills training is crucial in supporting AMR West’s new partnership with Sutter as well as the increase in staff transitioning in from Rural Metro. Additionally, incumbent staff need ongoing training in response to changing regulations and standards. In this proposal, 439 EMT’s and 321 Paramedics will participate in Didactic and Clinical Preceptor training classes. This training will target specific skills by occupation to ensure that trainees are competent in advanced medical transportation procedures and treatment protocol. Medical Skills Training will be performed at a rate of $22 per hour and will apply to both the Didactic and Preceptor modes of delivery. The standard class/lab Job Creation reimbursement rate of $20 per hour will apply to Continuous Improvement training for Job Creation trainees in Job Number 1. The $18 per hour reimbursement rate will apply to the Continuous Improvement for incumbent workers in Job Number 2.
Medical Skills (90%): Training will be provided to EMT’s and Paramedics via didactic and preceptor training which will occur in emergency vehicles in the following topics: Prehospital Care including pharmacology, medication administration, Patient Assessment, physical exam techniques, clinical decision making, trauma Emergencies and Medical Emergencies. More
American Medical Response of Southern California March 24, 2017 ET17-0455
ETP 130 - Single (05/02/16) 5 of 6
advanced training topics will be delivered to Paramedics to function independently at optimum levels.
Continuous Improvement (10%): Training will be provided to EMT’s and Paramedics. Training will improve customer service and processes. Training will include Customer Service, Conflict Resolution, Critical Thinking, Communication Skills, Protocols and Standard Operating Procedures. Training will be provided in a classroom/laboratory setting. Commitment to Training
ETP funds will not displace the existing financial commitment to training. AMR’s budgeted training expenditures for the facilities included in this proposal are approximately $9.4 Million annually. Past training efforts include basic new hire orientation, county fire codes, continuing education courses, hazmat courses and mandatory compliance training required by Federal, state and local laws. Safety training will continue to be provided.
Training Infrastructure
AMR’s project will be overseen by AMR’s West Region CEO. In addition, the Company has designated the Manager of Clinical Education Services to oversee the project for AMR SoCal and the Director of Clinical Services, West Region to oversee the project for AMR West. The Company also retained Think LLP to assist with administrative services.
Retention Modification
AMR has requested the alternate retention period of at least 500 hours within 120 days. Due to the nature of the emergency responder industry, it is not customary for a paramedic or EMT to work a standard 35 hour (or more) work week. A full-time employee’s hours may vary from week to week depending upon demand. For example, an employee may work 60 hours one week and 32 hours the following week. Allowing AMR the flexibility to meet retention requirements through the alternate method will allow the Company to meet scheduling demands.
Special Employment Training Under SET, the participating employer is not required to demonstrate out-of-state competition. To qualify under SET, trainees must be earning at least the statewide average hourly wage at the end of the retention period. However, employees covered under a collective bargaining agreement do not need to meet the Post-Retention Wage requirements and may use collective bargaining wages to qualify. Union Representation All trainees are represented by the following collective bargaining agreements: American Federations of State, County and Municipal Employees (AFSME) Local 4911; International Association of EMT’s and Paramedics (IAEP), Local 5000; and International Association of Fire Fighters (IAFF), Local 4513. Union letters of support for the proposed training have been provided to ETP. High Unemployment Area
Although the Company’s facilities in Marina, Modesto and Stockton are located in a designated High Unemployment Area, a region with unemployment exceeding the State average by 25%, AMR is not requesting a wage modification.
American Medical Response of Southern California March 24, 2017 ET17-0455
ETP 130 - Single (05/02/16) 6 of 6
Substantial Contribution
For repeat contractors who earn in excess of $250,000 at one location within the past 5 years, a substantial contribution may apply. AMR’s last project (ET15-0269) earned $497,448, of which only $130,500 was earned in incumbent training. No one location earned over $250,000 in incumbent training, therefore no substantial contribution will be applied.
RECOMMENDATION
Staff recommends approval of this proposal.
PRIOR PROJECTS
The following table summarizes performance by AMR SoCal under an ETP Agreement that was completed within the last five years:
Agreement No. Location (City) Term Approved Amount
Payment Earned $ %
ET15-0269
San Diego, Victorville, Moorpark, Lancaster
09/02/2014–09/01/2016
$529,600 $497,448 (94%)
($130,500 incumbent)
DEVELOPMENT SERVICES
AMR SoCal retained Think, LLP in Costa Mesa to assist with development of this proposal for a flat fee of $25,000.
ADMINISTRATIVE SERVICES
AMR SoCal also retained Think, LLP to perform administrative services in connection with this proposal for a fee, not to exceed 13% of payment earned.
TRAINING VENDORS
To Be Determined
American Medical Response of Southern California ET17-0455
ETP 100 Exhibit B Menu Curriculum (07/07/14) 1 of 3
Exhibit B: Menu Curriculum
Class/Lab Hours 8 - 200 Trainees may receive any of the following:
MEDICAL SKILLS - PRECEPTOR
Prehospital Care o Advanced Prehospital Care o Anatomy and Physiology o Pathophysiology o Life-Span Development o Pharmacology o Medication Administration o Airway Management Ventilation o Therapeutic Communication
Patient Assessment o History Taking o Physical Exam Techniques o Patient Assessment o Clinical Decision Making o Communications o Documentation
Trauma Emergencies o Trauma and Trauma Systems o Blunt Trauma o Penetrating Trauma o Hemorrhage and Shock o Soft-Tissue Trauma o Burns o Musculoskeletal Trauma o Head, Facial and Neck Trauma o Spinal Trauma o Thoracic Trauma o Abdominal Trauma
Medical Emergencies o Pulmonology o Cardiology o Neurology o Endocrinology o Allergies and Anaphylaxis o Gastroenterology o Urology and Nephrology o Toxicology and Substance Abuse o Hematology o Environmental Emergencies o Infectious Disease o Psychiatric and Behavioral Disorders o Gynecology o Obstetrics o Special Operations o Neonatology o Pediatrics o Geriatric Emergencies
American Medical Response of Southern California ET17-0455
ETP 100 Exhibit B Menu Curriculum (07/07/14) 2 of 3
o Abuse and Assault o The Challenged Patient o Acute Interventions for the Chronic-Car Patient o Assessment-Based Management
MEDICAL SKILLS - DIDACTIC
Prehospital Care o Advanced Prehospital Care o Anatomy and Physiology o Pathophysiology o Life-Span Development o Pharmacology o Medication Administration o Airway Management Ventilation o Therapeutic Communication
Patient Assessment o History Taking o Physical Exam Techniques o Patient Assessment o Clinical Decision Making o Communications o Documentation
Trauma Emergencies o Trauma and Trauma Systems o Blunt Trauma o Penetrating Trauma o Hemorrhage and Shock o Soft-Tissue Trauma o Burns o Musculoskeletal Trauma o Head, Facial and Neck Trauma o Spinal Trauma o Thoracic Trauma o Abdominal Trauma
Medical Emergencies o Pulmonology o Cardiology o Neurology o Endocrinology o Allergies and Anaphylaxis o Gastroenterology o Urology and Nephrology o Toxicology and Substance Abuse o Hematology o Environmental Emergencies o Infectious Disease o Psychiatric and Behavioral Disorders o Gynecology o Obstetrics
Special Operations o Neonatology o Pediatrics o Geriatric Emergencies
American Medical Response of Southern California ET17-0455
ETP 100 Exhibit B Menu Curriculum (07/07/14) 3 of 3
o Abuse and Assault o The Challenged Patient o Acute Interventions for the Chronic-Care Patient o Assessment-Based Management
CONTINUOUS IMPROVEMENT
Ambulance Operations Skills
Customer Service
Documentation Skills
Conflict Resolution
Critical Thinking
EMS Communications & Protocols
Standard Operating Procedures
Note: Reimbursement for retraining is capped at 200 total training hours per trainee, regardless of the method of delivery.
United EMS Workers Local 4911 AFSCME AFL-CIO 7275 National Drive Unit F
Livermore, California 94550 www.uemsw.org*www.facebook.com/unitedemsworkers
January 12, 2017
Ms. Suzanne M. Godin ETP Contract Specialist 5353 Mission Center Rd. Suite 110 San Diego, CA 92108-1350 Re: United EMS Workers support of AMR’s application for funding from the Employment Training Panel.
Dear Ms. Godin,
As the President of the largest labor organization representing over 3500 Paramedics, Emergency Medical Technicians, Registered Nurses, Dispatchers and support staff of private sector Emergency Medical Services, I would like to take this opportunity to express our support for AMR’s application for funding from the Employment Training Panel.
A robust and continuing training program allows for my members to develop the necessary knowledge and skillsets to increase their operational readiness, improve the EMS system resiliency, and increase interagency operability.
For these reasons, United EMS Workers supports this application and is looking forward to working collaboratively with all healthcare providers on this initiative. Your kind attention to this letter of support is greatly appreciated. Sincerely,
Jason Brollini, President United EMS Workers Local 4911 AFSCME
International Association of Fire Fighters; Local 4513
36 Quail Run Cir, Ste K. Salinas, CA 93901
1
March 23, 2016
Ms. Suzanne M. Godin
ETP Contract Specialist
5353 Mission Center Rd. Suite 110
San Diego, CA 92108-1350
Dear Ms. Godin,
I am the President of the International Association of Fire Fighters, Local 4513 and as the exclusive
representative for employees working at the American Medical Response, in Monterey California; we
strongly support American Medical Response’s application for funding from the Employment Trainin g
Panel.
Training for the workforce that can add to the skill and knowledge of the workers we represent builds
a stronger workforce who can apply their development to the betterment of all the communities
American Medical Response serves.
Your kind attention to this letter of support is greatly appreciated.
Sincerely,
Ben Hitchcock
President
IAFF, Local 4513
