DATE: September 23, 2025
TO: Board of Supervisors
SUBMITTED BY: Joe Prado, Interim Director, Department of Public Health
SUBJECT: Agreement with ImageTrend, LLC
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute a Master Subscription Agreement with ImageTrend, LLC for installation, maintenance, support, and software hosting services for the License Management System, a licensing management software for Emergency Medical Services certification, effective upon execution, not to exceed five consecutive years, which includes a three-year base contract and two optional one-year extensions, total not to exceed $423,371.
REPORT
There is no additional Net County Cost associated with the recommended action. Approval of the recommended action would allow the Department of Public Health to transition to a cloud-based software for Emergency Medical Services (EMS) certification and accreditations for Emergency Medical Technicians (EMTs), paramedics, base hospital physicians, and mobile intensive care nurses (MICNs) with the License Management System (LMS) with ImageTrend, LLC. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended action, the County and EMS would continue to use the EPISUITE software hosted on County servers, requiring continued maintenance through the Information Technology Services Department (ITSD), which does not fully capture all data required as part of the certification or accreditation process.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The recommended Agreement includes up to $20,000 in one-time installation costs and $73,000 in subscription costs for the first year with a 5% increase year over year through the five years of the recommended Agreement for a total of $423,371. All costs are covered by fees charged by the Department to applicants for certification/recertification and accreditation. Sufficient appropriations and estimated revenues are included in the Department’s Org 5620 FY 2025-26 Adopted Budget and will be included in subsequent budget requests for the duration of the contract term.
DISCUSSION:
On October 31, 2024, the Department released Request for Proposal (RFP) #25-020 for a qualified vendor to implement a cloud-based certification software and continuous quality improvement (CQI) system. The RFP closed on December 2, 2024, with two proposals being received From Ignyte Group, Inc. and ImageTrend, LLC. The proposal from Ignyte Group, Inc. included $555,243 in installation and training costs, and first year software and maintenance costs of $203,685, for a total of $1,805,256 over 5 years. The proposal from ImageTrend, LLC included $31,550 in installation costs and first year software costs of $116,750 for the LMS and Elite Repository System, for a total of $148,300 for one year.
An RFP evaluation panel was convened with five members consisting of a Senior EMS Specialist, Senior Staff Analyst, Staff Analyst, Program Technician, and Information Technology Analyst. ImageTrend, LLC was selected as the optimal candidate for the Department due to their competitive bid and demonstrated extensive experience working with other California counties in relation to the LMS for EMS certification. The RFP Evaluation Panel determined that the Elite Repository System included in proposal from ImageTrend was outside of the scope of the RFP and is not included in the contract. The bid from Ignyte Group, Inc. surpassed both the financial threshold and the scope of the system.
The Department is the designated EMS Agency for Fresno, Kings, Madera, and Tulare counties, pursuant to Health and Safety Code, section 1797.200, acting as the Central California EMS Agency (CCEMSA). As the CCEMSA, the Department is the certifying body for the four-county region.
The License Management System operated by ImageTrend, LLC is in use by many counties throughout the State and will assist EMTs, paramedics, base hospital physicians, and MICNs to apply online, and allow Department staff to easily access all submitted documents, verify all information, and process certifications more efficiently. The current software is hosted by the County’s ITSD. It was developed during COVID-19 when in-person applications were no longer feasible and lacks many of the necessary features that the recommended Agreement will provide.
The recommended Agreement differs from the County’s model contract in that it includes mutual indemnification, and the insurance language does not contain the ‘County’s Entitlement to Greater Coverage’ clause. The County’s Human Resources - Risk Management department recommended that this clause be included; however, ImageTrend, LLC opposed its inclusion as they disagree that any increases to their insurance should automatically extend to the County, and stated that the County has the right to review any contract terms on an annual basis if an increase in insurance requirements is desired. The Department believes that any risk associated with the recommended agreement is extremely minimal and accepts this change as a business decision.
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk – Agreement with ImageTrend, LLC
CAO ANALYST:
Ronald Alexander