By JOEL PHELPS | arkadelphian.com
With a 90-day window for a Memorandum Of Agreement nearing its end and a decision approaching on which ambulance provider will handle 911 calls in Clark County, time is running out for officials to get their ducks in a row.
Two major steps in the process are publishing a Request for Qualifications and naming members of a Selection Committee, which will review the RFQs and make a recommendation to the panel responsible for the big decision: Clark County Quorum Court. With about one month left to go, neither step has been completed. Clark County Judge Troy Tucker said that, although an extension may be necessary, both actions are on go.
The Selection Committee
The county judge and the nine-member 911 board — which oversees the newly consolidated dispatch center — met for the first time Tuesday, June 3, to recommend names for the Selection Committee.
Tucker said told The Arkadelphian ahead of the meeting that the nomination process would be “treated just like a personnel issue” and would be held in executive session.
Tucker later said in a telephone interview that the 911 board, in a paper ballot-style process in which the board submitted and drew names, went through names of nominated prospects. The judge said the board is aiming for a total of seven members to serve on the Selection Committee, each of whom have a background in the business or medical aspect of the medical and/or first responder profession. As of Wednesday, the board was in the process of contacting the nominated parties to see which ones agree to serve on the committee. Tucker said he anticipates the committee will be finalized by the end of this week.
Once the committee is finalized, Tucker said, the names will be disclosed publicly.
RFQ not yet published
Another major aspect of the process is the Request for Qualifications, which interested providers will complete and submit for the Selection Committee’s review. To date, the RFQ has not yet been published in a local newspaper, the county’s website, or a trade publication. Tucker said the RFQ has been under review by the county and city attorneys, as well as an independent attorney, who is expected to green-light it for publication as soon as Wednesday, June 4. Its publication would be treated as any other bid a public entity is required to advertise.
Tucker said the busy schedules of those involved in the process are the main reason for the delay in finalizing the RFQ. Asked if the delay could extend the county’s 90-day MOA with Pafford and postpone the final decision, Tucker said he hopes it doesn’t come to that, but “if we need to extend it, we’ll extend it. We’re not going to rush the process.” The judge said he hopes the topic will be resolved within the 90-day timeframe.
Once the RFQ is published, licensed ambulance service providers will be able to submit their paperwork. Both of the two main frontrunners openly vying for the contract — Pafford and Valor EMS — are licensed in Arkansas, Tucker said.
Pafford emails to justices of the peace ahead of decision OK
One ambulance service vying for the 911 contract tested the limits of the county judge’s instructions not to lobby decision makers.
In an email sent separately in late May to justices of the peace, Jamie Pafford-Gresham introduced herself as the CEO of Pafford Medical Services, the Hope-based company that in April acquired Baptist Health’s ambulance service in a business transaction between two private entities. After the sale, county Judge Troy Tucker announced there would be a 90-day Memorandum of Agreement for Pafford to handle the county’s 911 Emergency Services until an ultimate decision is made.
During the selection process, Tucker pointed out that “lobbying of the Selection Committee will not be permitted by any proposer and could be grounds to reject the proposal. This would not prohibit contacting the County Judge’s Office or County Clerk for situations such as clarification and/or questions related to the procurement process.” Tucker, however, didn’t specify whether contacting members of the Quorum Court is fair game.
While no member of the Quorum Court is part of the Selection Committee, some justices said they feel there was a potential conflict in Pafford’s e-mail, which invited justices along for a “quick visit” to tour ambulances and equipment and “go into more detail of our operations in Clark County.”
District 5 Justice Jimmy King replied: “Given the fact the Quorum Court will vote on the committee’s recommendation for the ambulance services RFQ’s, I respectfully decline to meet with you at this time. I do not want to give the public any perception that there is any lobbying or unethical behavior between you and the Quorum Court with this process. If Pafford is successful in their bid to be the ambulance service for Clark County, I will gladly sit down and talk with you at that time. I hope you understand my desire that this process is honest, fair, and without any implications of impropriety on my part.”
District 7 Justice Jenna Scott denied the invitation on grounds that her time was consumed by Vacation Bible School preparations, and acknowledged that a committee would make a recommendation to the court. “As we move forward I’m sure you will hear if we need additional information,” Scott wrote to Pafford, who replied that she was “respectful and understanding of the process” and invited questions if issues arose before the committee convenes.
Pafford has since sent a follow-up email, acknowledging the concerns but assuring her intent was not to cause conflict. “Given that the [RFQ] or selection process has not yet begun, I felt it would be a good opportunity for an educational outreach to introduce myself and Pafford Medical Services,” she replied. “My aim is simply to ensure you are acquainted with our services and the dedicated individuals at Pafford who serve Clark County.”
Contacted by phone Tuesday afternoon, Pafford said she was aware of the county judge’s instructions, but was adamant that her intent was not to lobby.
“I didn’t mean [the initial email] any other way than, ‘If you have questions or concerns about our current services, call us to ask what’s going on,’” she said. Pafford said she was under the impression that the judge’s instructions were intended only for contacting members of the Selection Committee, and not the Quorum Court.
Pafford said that no Quorum Court member accepted the invitation to tour the facilities.
Michael Ankton, who represents District 2, said he didn’t respond to Pafford’s email, but also doesn’t view the approach as lobbying.
“They were just offering us to come see [their equipment] if we wanted to,” Ankton said. “If it was lobbying it would have been more of a direct invitation.” As for passing up the invitation, Ankton added, “I would rather my viewpoint be unbiased until I see every [ambulance service] at the same time.”
The justices who spoke to The Arkadelphian said they had not been approached by any other prospective ambulance provider.
The county judge said he was made aware of the emails, but had no qualms with a provider approaching elected officials. “The difference [between members of the Selection Committee and the Quorum Court] is that [Quorum Court members] are public officials,” Tucker said. “If someone wanted to have a conversation with me, as a public official I can’t avoid the conversation.” The judge added that, once the RFQs are out, there could be a time when all interested providers want to approach elected officials — but not the Selection Committee.
Asked if Pafford’s correspondence with Quorum Court members was ethical, Tucker said, “I don’t believe that it would be inappropriate, but it would be in everyone’s best interest to wait until the RFQs come in — if that’s what they want to do.”
Pafford CEO statement
Pafford’s CEO provided the following statement addressing multiple questions and concerns about its service:
Given the very short timeframe, Pafford worked closely with the previous provider to ensure a smooth handover in Clark and Hot Spring Counties. We successfully onboarded a significant number of their team members, between 11 and 14 individuals, and have since welcomed additional personnel to our Pafford family. This has allowed us to enhance service availability from the outset, including upgrading the Bismarck truck to operate on a 24-hour basis.
At Pafford, we believe in providing comprehensive advanced life support healthcare, not just transportation. Our approach to pre-hospital emergency medical services goes beyond simply arriving at a residence after a 911 call. As an innovator in this field, our care begins the moment someone calls 911. Our certified emergency medical dispatchers provide crucial pre-arrival instructions while our paramedic ambulances are en route.
It’s important to understand that our service involves healthcare professionals who arrive on the scene equipped with protocols, advanced equipment, essential medications, and the backing of a team of doctors offering online medical direction. This comprehensive approach is what truly makes a difference in patient outcomes.
Pafford has made a substantial investment in Clark County’s ambulance service. Each of our ambulances is equipped with state-of-the-art technology to ensure we can deliver the highest quality care to our patients. In just the 60 days since we began serving the community, we have invested over $1.4 million in new equipment.
We operate a 24-hour communication center that is the 299 medical ACE accredited dispatch center in the world with direct connectivity to many of the counties we serve.
Furthermore, our MedLink service offers physician-directed treatment-in-place protocols for patients who do not wish to be transported to the hospital. We are proud to offer 24-hour access to nurse triage and physician providers to patients within our service areas.
While anyone has the right to refuse care or transport, our new process ensures that patients who choose to receive care at home under the direction of a physician through EMS have this option available, with thorough documentation to address the liability associated with non-transport decisions.
Pafford has been a pioneer in offering these types of healthcare services in Arkansas and recently, the legislature in Arkansas recognize the importance of treatment in place and now requires both insurance companies and Medicaid to cover the services when a physician is involved.
We often receive inquiries about our in-network status with specific insurance companies. While Pafford does participate in numerous insurance networks, recent legislation has altered this landscape. Historically, ambulance providers, representing a small fraction of insurance carriers’ overall business, were not typically asked to be in-network.
To address this, the Arkansas Ambulance Association proposed and successfully passed legislation (Acts 836 and 867) to ensure fair and proper reimbursement for all ambulance providers across Arkansas. This legislation aims to protect patients from claim disputes by establishing payment floors and guidelines for how carriers should process claims for mandated emergency services, ensuring that only co-pays, deductibles, and denials are billed to the patient. This means that you can generally expect your claim to be treated as an in-network claim, provided you are not under an ERISA plan. This is positive news for our community.
Pafford holds a unique geographical position that allows us to provide unparalleled back-up ambulance service and mutual aid. We currently serve Nevada, Pike, Hot Spring, and soon, Garland County.
Regarding our expansion into Garland County, Pafford was selected through a competitive process to provide ambulance service under contract. The selection committee, which included county officials, emergency management, fire chiefs, and hospital representatives, consistently ranked Pafford highest among the responding providers. We are scheduled to begin service in Garland County on July 15th.
Radio/Communications
We have been aware of comments regarding Pafford’s communication with first responders. Upon assuming service in Clark County, we requested and received permission from the previous provider to use their existing radio channels to ensure familiarity for first responders. Unfortunately, the landowner of the radio tower unexpectedly took it down on the day of the transition. Since then, Pafford and Baptist have jointly purchased the radio equipment and are working to transfer the FCC licenses. The new radio antenna has been ordered and is currently in transit. Our radio shop understands the urgency of this situation and is prepared to install the equipment as soon as it arrives.
Pafford primarily utilizes the AWIN statewide radio system. While this is a reliable system, we recognize the importance of restoring the specific VHF radio channels for Clark County and are working diligently to do so.
Additionally, Pafford typically employs software that integrates CAD systems to expedite the sharing of information and call details. This software also provides dispatchers with real-time location data for all in-service Clark County ambulances. Clark County 911 has expressed concerns about the timeline for setting up this software, particularly with an upcoming RFP/RFQ process, which has put this implementation on hold.
Finally, community engagement is a core value at Pafford. We actively participate in community events, offering CPR education, first aid training, Stop the Bleed courses, and general attendance at local gatherings. We are committed to being an integral part of the communities we serve and fostering strong relationships. Although at the current time, it seems like there are a lot of people standing on the sidelines, holding their elbows in their phones waiting to see what happens we plan to continue to seek opportunities to build these connections and offer valuable resources to benefit the community.
At the end of the day, We are still taking care of patients right now, regardless of any RFP process so the need to work together and ensure proper patient care until what time a long-term contract is awarded is paramount.