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TWIN CITY MOBILE INTEGRATED HEALTH
4200 SION FARM, SUITE 25
CHRISTIANSTED, VIRGIN ISLANDS 00820
321-633-8005 or 321-432-2912
Business Expansion Portfolio and Prospectus
Twin City Care of The Virgin Islands
1
Dear Mr. Jeffrey Edward Epstein
“Twin City; For Today, for the Future, and for Our Community”. Twin City Makes Connections
for Life.
Twin City Mobile Integrated Health Services (TCMIH) is a private, non-profit, non-emergency,
certified, advance and basic life support interfacility ambulance provider, specialized transport and
mobile phlebotomy service. Our staff are trained professionals who have the experience of
transporting thousands of patients to and from various healthcare facilities and playing a key role
in the Virgin Islands Prehospital Care.
TCMIH provides patient centered, compassionate care in an atmosphere of safety and
professionalism, serving hospitals, clinics, nursing homes, air ambulance and private medical
facilities in the Virgin Islands.
As a provider of mobile medical service, we bring to the community a company that is committed
to excellence in medical transportation and patient care. From our team of highly skilled
Phlebotomist, EMR’s, EMT’s, Advanced EMT’s, Nurses and Paramedics ready to care for their
patient’s needs, to the professional management team our focus remains patient centered and safety
driven from start to finish. TCMIH is guided by the vision of experienced healthcare providers
from our local EMS, Florida EMS and a Certificate of Need/Necessity (CON) awarded by the
Virgin Islands Department of Health. Twin City invests heavily in itself through its personnel,
equipment, vehicle and training to maintain the highest level of quality and professionalism. We
also invest back into the community through donations and community service projects.
While no one anticipates or favors an injury or crisis, mental crisis, illness or the aging process
you can rest assured that your medical needs will be met professionally by a team of caring
individuals focused on making the most comfortable and compassionate experience possible.
Sincerely!
Eugene Phipps, TNT EMR
President
Twin City Care, Inc.
Jeffery D. Gilliard, BS, NRP/CCEMTP/FPM
CEO
Twin City Care, Inc.
Jerry Galloway, NRP, CCEMTP
Chief Operations Officer
Twin City Care, Inc.
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Twin City Care of The Virgin Islands
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Mission, Vision, Values
It is our goal, as a community non-profit service organization, to provide expedient, reliable, costefficient
non-emergency ambulance service, mobile phlebotomy and affordable specialized
transportation to the citizens of the Virgin Islands. In the pursuit of this goal, we pledge to furnish
superior, quality equipment, vehicle, personal, and service, dedicated to the needs and demands of
both the public and the local health care agencies. We strive to develop and promote a positive and
rewarding work environment. As a team, we inspire a professional, compassionate attitude,
knowing that without each other, we would not succeed. The company shall draw its strength from
the skill and dedication of its personnel and in turn, inspire the team to provide quality service of
which all would be proud.
Vision Statement
Twin City Mobile Integrated Health vision is to deliver service in a manner that sets the standard
for professional, compassionate, cost effective and safety oriented non-emergency ambulance
service, mobile phlebotomy and specialized transportation. Through our employees, our peers and
our patients we understand that we are not making connections for a moment, Twin City makes
connections for life.
Values
Patient Centered Care
Compassionate/Dignified Services
Health and Safety Focused
Compliance Motivated
Educationally Driven
Business Expansion Portfolio and Prospectus
Twin City Care of The Virgin Islands
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Commission on Accreditation of Ambulance Services (CAAS)
Any ambulance service can claim it is delivering quality service, but an accredited agency can
prove it through its written or documented procedures systems and reports. TCMIH demonstrates
full compliance with national ambulance standards of excellence to meet and maintain CAAS.
TCMIH will also maintain Health Insurance Portability and Accountability Act (HIPAA), Blood
Borne Pathogen (BBP), Vehicle Safety (EMD & CEVO), Virgin Islands Traffic Laws and VI Code
Tax Laws.
CAAS was established in 1990 as a not-for-profit national agency to uphold quality operating
standards for ambulance services. It is the gold standard for the ambulance industry, in as much as
JCAHO (Joint Commission of Accreditation of Healthcare Organizations) is the benchmark for
hospital excellence.
The accreditation process entails a serious self-assessment, comparing us to the accreditation
standards. We work through a comprehensive application process with guidance, consultation and
mentorship from our CEO; Mr. Jeffery Gilliard former Director of Coastal Ambulance, Brevard
County Florida.
Within two years TCIMH hopes to achieve and maintain recertification requirements for CAAS
Accreditation and joins the 160 agencies in 37 U.S. State, Canada and the West Indies. This is our
steadfast commitment and dedication to quality healthcare for our community, each patient, each
transport, and each day.
Performance Requirements
As the premier non-emergency, interfacility, advanced and basic life support ambulance service
in the Virgin Islands. TCMIH will provide detailed performance parameters including on time
performance as outlined below.
Advanced and Basic Life Support
Definitions:
Pre-Schedule Requests
Urgent Requests
Non-Urgent Requests
Those requests scheduled 24 hours in advance.
Same day requests that are time sensitive in nature, such as transports
to emergency room.
Same day requests that are not time sensitive in nature such as hospital
discharges.
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Twin City Care of The Virgin Islands
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Performance Parameters:
Pre-Schedule Transports On time 90%
Non-Schedule Urgent On time within 1 hour of call time 90%
Non-Schedule Non-Urgent On time within 2 hours of call time 90%
Mental Health Transports
Definitions:
Priority 1
Priority 2
Priority 3
Priority 4
Law Enforcement with the patient.
Transport requests coming from the Emergency Room, include Air Ambulance
Transport request from Hospital rooms, Detention Centers, Exparte, voluntary
request, inpatient mental health units, other “stable” environments, and voluntary
requests. “Non- Air Ambulance”
Pre-Scheduled transports with a minimum of 24 hours’ notice.
Performance Parameters
Priority 1
Priority 2
Priority 3
Priority 4
On scene 45 minutes from time of call’s acceptance 90% on time
On scene 1 hour from time of call’s acceptance from receiving facility, 90% on time
On scene 2 hours from time of call’s acceptance from receiving facility, 90% on time
On scene at the agreed upon time, 90% on time
Fees for Service
Transport Rate Schedule
Ambulance Transportation
BLS Non-Emergency $290.00
ALS Non-Emergency $400.00
BLS Emergency $440.00
ALS Emergency $520.00
ALS-2 $775.00
All Mileage
$11.25 per mile
Stand-by or Waiting Time
$125.00 per hour or increment thereof*
Medical Coverage (First Aid Station) Contracts
$800.00 per day
In addition to TCMIH primarily non-emergency inter-facility services, TCMIH will routinely
render ambulance services in response to facility requests that fall into the Center for Medicare
and Medicaid Services (CMS) guidelines qualifying Twin City for reimbursement under the CMS
code for ALS or BLS Emergency based on the “Immediate Response” criteria. The current CMS
definition for Emergency is not based on “lights and sirens”, it is based on “immediate response”.
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Twin City Care of The Virgin Islands
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Ambulance Division and Definition
TCMIH provides Advanced Life Support services (ALS) 24/7, 365 days a year to our hospitals,
nursing facilities and various other health care providers in the Virgin Islands. Our entire fleet will
stand ready to provide consistent, high quality, patient centered care. Not only are we here for the
day-to-day needs of our community, but during times of need, for mutual aid support to the Virgin
Islands Department of Health EMS and the Virgin Islands Territorial Emergency Management
Agency.
All Paramedics, EMTs, Nurses and Emergency Medical Responders will be working under the
guidance of our Medical Director Dr. Christopher C. Hill DO, (Board License Emergency
Physician) in accordance with National Highway and Traffic Safety Administration (NHTSA).
As the premier interfacility non-emergency ambulance provider for the community, our role is as
diverse as the patients we serve. From providing critical care transports to monitoring the vital
signs and offering support for a Hospice patient, it is all about the connections we make, each day,
and each transport.
Advanced Life Support (ALS)
ALS care is provided by Advance EMTs, and Paramedics who are licensed in pre-hospital care,
having qualifications and equipment to provide BLS capabilities as well as advanced airway
management, cardiac monitoring and defibrillation, IV administration, administering of life saving
medications and capable of handling severe medical emergencies.
Specialty Care Transports (ALS-2)
Patients who require specialized monitoring of IV medication drips and ventilators. Care from Air
Ambulance services (Medivac).
Mental Health Transport and Crisis Hotline
Specialized medical transport team, working with agencies such as law enforcement, mental
healthcare providers, hospital emergency rooms and nursing facilities to ensure the safe, efficient
and dignified transport of the mental health patient. In addition to the transport component, Twin
City will be a vested partner in the progress and wellbeing of our mental health community at
large. Attending and participating in many community forums such as local planning meetings,
any mental health taskforce meetings TCMIH will be committed to assisting with the best practices
for the providers for the patients that we serve.
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Our crews will be trained as Crisis Intervention Teams (CIT) which will include being a Behavioral
Health Technician (BHT) who will meet requirements in:
Crisis de-escalation, intervention and sensitivity training
Patient and crew safety
Documentation and patient confidentiality
Ethical and Professional Responsibilities
Crisis Hotline Response & Management
Intake Assessment Referrals
Residential Substance Abuse Treatment Referrals
Individual & Group Counseling Referrals
Male/Female Specific Support Groups
Relapse Prevention Education
Substance Abuse Education & Prevention
Educational/Vocational Counseling
Family Education
Parenting Skills and education
Children's Services Referrals
HIV/AIDS and Hepatitis prevention and education services
Women's Aftercare Program Referrals
Mutual Aid
TCMIH will be available and prepared to fulfill its mutual aid commitment to the Virgin Islands
Emergency Medical Services (VIEMS) under the directives of the Virgin Islands Territorial
Management Agency (VITEMA). When called upon we will assist in the evacuation of healthcare
facilities, special needs residents and nursing facilities to safety, only to return them home again
after the storms have passed.
Community Paramedicine
Community paramedicine (CP) is an emerging healthcare profession. It allows paramedics, Nurses
and emergency medical technicians (EMTs) to operate in expanded roles to provide healthcare
services to underserved populations. It is a way to improve rural emergency medical services
(EMS) as well as address the healthcare needs of the community.
Some rural patients lack access to primary care, and misuse 911 services in an attempt to access
emergency departments for routine healthcare. This is demanding on our EMS system and causes
strains on the workforce. Working in a primary care role, community paramedics can meet the
needs of such individuals, as well as others in the community, in a more efficient and proactive
way.
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Twin City Care of The Virgin Islands
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Mobile Phlebotomy
Our islands are moving toward new types of patient interactions and each year comes an influx of
organizations seeking in-home or direct patient (participants / customers) visits. TCMIH will
provide mobile phlebotomy and mobile examiner staffing services for island wide specimen
collections and one-on-one health testing.
Our Mobile Phlebotomy is a full-service staffing agency that works with organizations such as
specialty labs, doctors, health diagnostic and research companies to provide mobile phlebotomists
and mobile examiners directly to your patients around the island. We understand that many
organizations depend on reliable and experienced phlebotomists available specifically for short
term health screening assignments and specimen collections. Our technicians will collect blood,
urine, fecal, hair, nail samples and do Electrocardiograms.
Professional and reliable team members take pride in the quality of their work. They pride
themselves in their adherence to requirements for timely collection, delivery and handling of the
specimens. We will be the leader in the home blood draw services in the Virgin Islands. We deliver
the specimens to the labs so you don’t have to. All of our staff will be Certified Mobile Phlebotomy
Technicians and carry a mobile centrifuge in their vehicles. This helps assure we get quality
specimens.
Medical Oversight (Medical Director)
The American College of Emergency Physicians (ACEP) believes that all aspects of the
organization and provision of basic (including first responder) and advanced life support
emergency and non-emergency medical service, require the active involvement and participation
of physicians. The primary role of the medical director is to ensure quality patient care.
Responsibilities include involvement with the ongoing design, operation, evaluation and revision
of the system from initial patient access to definitive patient care.
The medical director has authority over patient care, authority to limit immediately the patient care
activities of those who deviate from established standards or do not meet training standards, and
the responsibility and authority to develop and implement medical policies and procedures. The
medical director's qualifications, responsibilities, and authority must be delineated in writing
within each system. Ideally, the medical director will be a board-certified emergency physician.
In order to meet requirements and CAAS compliance, TCMIH has already entered into contractual
agreement with Dr. Christopher C. Hill DO, ACEP, AAEP, ACOEP, AOA, AMA.
Dr. Hill serves as the Medical Director for EMETS, a paramedic/EMT education/training company
in Brevard County and for EMETSEEI Institute Inc in Rockledge, Florida. He is concurrently
working at Rockledge Regional Medical Center Emergency Department and enjoys teaching in
the clinical setting.
Dr. Hill is currently a member of the American Academy of Emergency Physicians, American
College of Osteopathic Emergency Physicians, and American Osteopathic Association.
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Twin City Care of The Virgin Islands
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Training
Ohio University College of Osteopathic Medicine/Doctors Hospital Emergency Medicine
Residency and Track Internship
Education
Nova Southeastern University, Doctor of Osteopathic Medicine, Florida Atlantic University, BS
Biology
Accreditations/Affiliations
ACEP, AAEP, ACOEP, AOA, AMA
Communications
TCMIH will staff a 24 hour a day dispatch center with dispatchers who are professional, caring
and multi-task oriented. They will be responsible for making sure all requests for service are
handled in a prompt and courteous manner. The dispatchers handle and maintain all internal and
external communication between TCMIH and those agencies requesting ambulance transportation.
They are responsible for accepting, coordinating, and screening all requests for service and will
remain in radio contact with the crew from start to finish in each transport.
Equipment
As a private Non- profit service organization, a significant portion of our capital will be utilized in
the purchase of equipment. Our equipment selection will be based upon the latest advances in the
ambulance industry.
Ambulance
Currently we have one unit serving St. Croix with future operational plans to staff four Quick
Response Vehicles, and four additional ALS ambulances typically Type III models allowing for
additional room for complex equipment and staffing needs for more critical patients. Our
expansion intent will cover all of the USVI to include St. Thomas and St. John.
EPCR
To safeguard patient care documentation and best comply with the continuing regulations set forth
by Medicare/Medicaid for comprehensive medical necessity documentation TCMIH will be using
electronic run reports documentation.
Quality Assurance
In the dictionary the word Quality is defined as “an inherent or distinguishing characteristic; or a
degree or grade of excellence”.
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At TCMIH “Quality” will be the benchmark for our day to day performance. We believe quality
can be measured in many ways, from customer service surveys, on time performance measures, to
clinical indicator reviews and run report accuracy just to name a few. To ensure that TCMIH
remains focused on providing exceptional patient care from the request for service on through to
the reimbursement cycle, we have established quality assurance processes to create a culture in
which quality, excellence and accuracy is our focus. To achieve this, each day we will look at the
transports from the previous day and review how we performed. We will measure our on-time
performance, looking at each run report line-by-line to ensure we have met our protocol
requirements. We will make certain the crews have gathered the appropriate information allowing
us to properly bill on behalf of the patients while maintaining compliance with all Medicare,
Medicaid and other healthcare regulations.
Medical Necessity
Health Insurance providers and Medicare in particular, have strict guidelines on what they will
cover and what is deemed as “medically necessary”.
For the service to be determined medically necessary, the patient’s medical condition at the time
of transport must be such that any other means of transportation would have placed the patient at
risk for harm or deterioration.
In addition, Medicare and Medicaid have guidelines requiring all non-emergency ambulance
transports from a hospital, nursing home, physician’s office, out-patient facility or clinic to obtain
a Physician’s Certification statement (PCS). We will collect this statement at the time the request
for service is received as part of our normal practice.
Stand By / Special Events
TCMIH will provide both committed and non-committed ambulance standby / first aid station
support during sporting events, community gatherings, concerts, fairs, parades, and other public
and private events.
Code of Conduct
TCMIH will attribute its success and reputation to the ethical standards that our employees will
set forth in their day-to-day actions. Healthcare is a challenging field of endeavor, yet we know
we must meet each challenge with the highest level of integrity and resolve, not with shortcuts.
Operational Code of Professional Conduct
The primary goal of TCMIH is to ensure that all employees provide competent, safe and ethical
specialized transportation to the citizens of the Virgin Islands. TCMIH has adapted this Code of
Professional Conduct to define a set of professional standards that will augment the technical and
clinical aspects of our duties.
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Twin City Care of The Virgin Islands
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Twin City Care, Inc.
Three Year Expansion Prospectus.
March 10, 2018
Dear Mr. Epstein:
In the ever-changing world of reimbursements for patient transportation, a means of cost effective
non-emergency medical transportation has emerged. It is the birth of this cost effective nonemergency
Ambulance Transportation business that has shown the most growth since President
Clinton signed the Medicare Reform Act. In this proposal, we will provide information on our
proposed expansion of our non-emergency Medical Ambulance service to include the following.
‣ Definition
‣ Competition
‣ Launch Strategies
‣ Public Relations
‣ Success Metrics and Rates
‣ Funding
Thank you for allowing us to provide you this information. As you will see an opportunity is
available to assist in funding this ever-growing business demand in the USVI.
Sincerely,
Jeffery D. Gilliard, BS NRP/CCEMTP/FPM
CEO
Twin City Care, Inc.
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Past
Prior to TCMIH there were no Advance Life Support Ambulance providing interfacility service
on St. Croix and the Governor Juan F. Luis Hospital was left on numerous occasions with patients
who were discharged tying up beds. Transports for Patients who need stretcher services were being
transported by the 911 emergency ambulances after no alternatives were provided. The research
show that an overwhelming number of patients that need stretcher transportation and medical
monitoring could not be provided by the current services on St. Croix.
Present
Presently, the competitor, Wheel Coach Services, hasn’t the ability or the authorization to bill the
customers insurance and in many cases the patients and family members will have to pay for their
own ambulance / stretcher transportation home. The request for Non-emergency ambulance
services has experienced an increase on St. Croix 88-92% and has been channeled through the 911
system. Today we also find a lack of Non-emergency ambulance services to provide timely
transportation. This constantly creates a multi-tiered domino effect when patients cannot be moved
out of the hospital. Discharged patients are tying up valuable beds, family members are angry and
receiving facilities are not going to accept late patients. Current reimbursements of ambulance
services that are medically necessary are at 100% if filed correctly.
Future
With the present situation of the Governor Juan F. Luis & Lester Schneider Hospital the need to
mobilize patients frequently, has caused a growth spurt within the district of St. Croix, St. Thomas,
St. John and will continue to grow. This growth will be perpetuated by the hospitals need to
transport patients from its facility to either a nursing home or home healthcare. Twin City will
currently fill part of the void by providing non-emergency and urgent advance life support
ambulance transport to and from JFLH, nursing homes and other health facilities / organizations
which would avoid much needed bed delays.
Service Definition
Non-Medical Stretcher service is stretcher patient transportation that requires no medical attention
or treatment. The service is provided by utilizing a high-top van with a stretcher mounted in the
back or transport of a patient in an ambulance without providing basic medical care / monitoring
and is being provided by Wheel Coach Services locally. Twin City will provide Ambulance
services which are categorized in the following manner and staffing patterns:
1. ALS ambulance services – One (1) AEMT and One (1) EMR or EMT
2. ALS 2 ambulance services – One (1) Paramedic and One (1) AEMT or EMT
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Twin City Care of The Virgin Islands
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Competition
Presently, there is no competition for Twin City. All non-emergency ambulance and non-medial
stretchers are regulated through the Virgin Islands Department of Health and Wheel Coach
Services that are currently the only provider of the non-medical stretcher. Since 2003 to this date
Wheel Coach is unable to provide non-emergency ambulance service on the island of St. Croix. It
is very feasible to conduct successful non-emergency ambulance operations with the local
hospitals (JFLH), fee for service (Medicare, Medicaid, Private Insurance, self-pay).
Positioning
It is the goal of Twin City Care, Inc. to operate a Mobile Integrated Health Service which consist
of; non-emergency and emergency ambulance, specialized transport, community health and
mobile phlebotomy service within the USVI. Contracts for fees for service, and subscription
service, shall be sought with the major Hospitals, Skilled Nursing Facilities, Casino’s, Tourist
Bureau and the Community at large. It is our contention to provide excellent customer service.
Considering the numerous complaints of the lack of current service we feel that by instituting a
policy that provides performance parameters that meets the customers’ needs we will be highly
successful in our goal. It is our intention to provide a two-hour window and true scheduled pick
up times. According to customer surveys, they desire performance and reliability. Ambulance rates
are payable by Medicare at $221.00 base rate and $7.31 per mile, the average ambulance call per
day at Twin City is four. We expect to double that within the first month. We will also work with
the local physicians to transport all qualifiable patients by ambulance, such as those who are on
oxygen or those who need non-emergency and urgent transportation to the hospital. We shall also
offer to the people of St. Croix a subscription service for ground ambulance, where if they need an
ambulance they receive no bill.
Expansion Launch Strategies
It is our intent to expand Twin City Mobile Integrated Health with two ambulances operating per
day, Mon-Fri and one on the weekends, by salaried personnel on St. Croix and St. Thomas. Once
these units are at 85% capacitance, a third unit will be added. Along with the third unit, a marketing
strategy should be launched in the St. Johns area. Under this expansion project employees and
starting salary ranges would consist of the following:
4 fulltime Receptionist / Secretary / Dispatcher, $25k/year each
1 Salaried Chief Executive Officer / Paramedic, $100k/year
1 Salaried Medical Director, $125k/year
1 Salaried Human Resource Director, $75k/year
1 Salaried Chief Operations Officer (Paramedic) $85k/year
1 Salaried Supervisor / Customer Care Advocate (Paramedic or Advance EMT) $75k/year
12 Fulltime Emergency Medical Technician (EMT) $45k/year each = $450k/year
9 Part time Advance Emergency Medical Technician $55k/year each = $495k/year
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All calls received after hours, will be answered by the COO / Director and / or Supervisor and
immediately ran by the two of them if it cannot be scheduled.
A billing / collection Director will handle all billing. This employee will be paid a salary and a
percentage of the daily collections with accurate billings. This will be the driving incentive to do
a superior job and keep the revenues high.
Public Relations / Advertising
Through research, it has been recognized many organizations fail to realize that there are three (3)
customers in this business. The customer that rides on the stretcher deservers friendly and efficient
service. The second customer is the facility requesting patient transport. The third customers are
the staff that transports the clients in a timely, professional and courteous atmosphere. These
customers deserve prompt quality service as well as friendly and efficient service.
It has been found through research, that the company that makes public relations Priority One has
been very successful. With the healthcare profession being a tight circle of professionals, the word
will quickly spread of the fast, friendly, and efficient service that is being provided. Once this
reputation is established, and maintained, the advertising will be a part of each associates daily
activities and duties.
Twin City Mobile Integrated Health Services will also align itself with organizations, whose
clients will utilize our service. Such organizations would be local Hospice, Rehabilitation, Casino,
Hotels, Cruise Lines and Retirement Groups. The company would also be joining other
professional organizations such as the Chamber of Commerce, American Ambulance Association,
National Association of EMTs and Rotary Club.
Twin City Mobile Integrated Health Services will also provide Community paramedicine (CP)
which is an emerging healthcare profession. It allows paramedics and emergency medical
technicians (EMTs) to operate in expanded roles to provide healthcare services to underserved
populations. It is a way to improve rural emergency medical services (EMS) as well as address the
healthcare needs of the community.
Some rural patients lack access to primary care, and misuse 911 services in an attempt to access
emergency departments for routine healthcare. This is demanding on EMS personnel in rural areas
and causes strains on the workforce. Working in a primary care role, our community paramedics
can meet the needs of such individuals, as well as others in the community, in a more efficient and
proactive way.
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1.0 Executive Summary
The purpose of this business plan is to raise $10,000,000.00 for the expansion of our Mobile
integrated health service while showcasing the expected financials and operations over the next
five years. Twin City Care, Inc. is a US Virgin Islands based corporation that will provide nonemergency
ambulance, mobile phlebotomy, Community Health and specialized medical
transportation services to people in its targeted market.
1.1 Products and Service
Twin City intends to provide non-emergency medical transportation of people to hospital,
physicians, physical Therapy clinics, and outpatient centers. TCMIH will be able to attend
both urgent and non-urgent call. The business will receive a majority of its income from
publicly funded healthcare systems and private insurance companies.
1.2 The Financing
Twin City is seeking to raise $10,000,000.00. This funding is primarily for expansion cost,
relocation and current office maintenance / repairs. During the storm (Hurricane Maria) we
suffered severe damage to our current place of operations. The funding requested should assist
our organization to:
1. Make repairs to our interior walls, purchase furniture
2. Replenish radio communication
3. Purchase additional communication equipment (Dispatch Computers)
4. Purchase additional ambulances, 2 Quick Response Units and 2 Supervisors Units
5. 2 years Operational Funds
6. Office supplies
7. Medical supplies
8. General Operational Costs
Twin City has already purchased its first ambulance and will have it in comission by April
2018.
1.3 Management Team
Twin City Care, Inc. was co-founded by Eugene Phipps, Jeffery D. Gilliard, and Jerry
Galloway together we have a combined experience of over 90 years in the emergency medical
field and 31 years’ experience in Non-emergency medical transportation (see Curriculum
Vitae’s). Through our expertise and knowledge, we will be able to bring the services of this
business to profitability with its first year of operations.
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TWIN CITY CURRENT FINANCIAL SHEET:
Radio Communications
Radio Service $250.00
Dispatch Center $2,500.00
Annual Total $30,250.00
Radio Communications
Mobile Radio 4 $2200.00 ea. $8,800.00
Port. Radio 5 $1800.00 ea. $9,000.00
Tablets/ mounts 4 $3,000.00 ea. $12,000.00
Total Cost $29,800.00
Tele- Communications
Telephone Office $220.00
Fax Office $110.00
Cell Operations X 3 AT & T
$100.00/
month
$300.00
Internet Office Broad Band
$400.00
Month
/
$400.00
Internet Mobile AT& T
$500.00
Month
/
$500.00
Annual Total $6,730.00
Facility Rental
$3,500.00
Annual Total $42,000.00
Utilities
WAPA $1,200.00
Annual Total $28,800.00
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Office Supplies
Printing Advertising $125.00/week $500.00
Direct Mail $20.00/week $80.00
Brochure $375.00/week $1,500.00
Advertising $150.00/week $600.00
Website Advertising / Hosting $150.00/week $600.00
Promotional Materials $375.00/Month $1,500.00
Annual Total $57,360.00
Business License Expenses
Bus. License $500.00
Vehicle License $500.00
Vehicle Ins. $3,000.00
Annual Total $4,000.00
Staff Education
Monthly $3,000.00 $3,000.00
Annual Total $36,000.00
Staff Uniform
$2,500.00 $2,500.00
Annual Total $2,500.00
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Ambulance Medical/Equipment Supplies
ITEM Amount Cost Total
ALS Medical Bag (BLUE) $462.00 ea. $462.00 X 2 $924.00
Trauma Bag (RED) $277.00 ea. $277.00 X 2 $554.00
Pelican Drug Box $510.00 ea. $510.00 X 2 $1,020.00
Power Stair Chair (RED)
Ferno
$6800.00 ea. $6800.00 X 1 $6,800.00
Combination
Backboard/Scoop
$950.00 ea. $950.00 X 2 $1,900.00
Head Immobilizer $130.00 ea. $130.00 X 4 $520.00
Pedi Board $180.00 ea. $180.00 X 2 $360.00
LifePak 15 Defib/ Monitor
$27000.00
ea.
$27000.00 X 2 $54,000.00
Multi-system BP Cuff $160.00 ea. $160.00 X 4 $640.00
Reeves Heavy Duty Stretcher $378.00 ea. $378.00 X 2 $756.00
Reeves First call bag $90.00 ea. $90.00 X 2 $180.00
IO Drill Kit (Hard case) $450.00 ea. $450.00 X 2 $900.00
CPAP Kit (MACS) $2500.00 ea. $2000.00 X 2 $4,000.00
Thomas EMS Pedi Braslow
Bag
$1320.00 ea. $1320.00 X 2 $2,640.00
Total $75,194.00
Ambulance 2017
Chassis Cost ea. Amt. TOTAL
Sprinter Ambulance 2018 $245,617.74 1 $245,617.74
Including Shipping
Including Graphics
Stretcher (Ferno)
Total $245,617.74
Intial
Cost
Project
$558,251.74
Business Expansion Portfolio and Prospectus
Twin City Care of The Virgin Islands
18
1.4 Current Assets
Twin City Care, Inc. has current assets consisting of training equipment, 1-2017 Ambulance,
EMS Equipment, office furniture and supplies for a total of $358,811.74.
TWIN CITY EXPANSION NEEDS FINANCIAL PROPOSAL:
Additional Radio Communications
Radio Service $250.00
Dispatch Center $2,500.00
Annual Total $30,250.00
Additional Portable Communications
Mobile Radio 4 $2200.00 ea. $8,800.00
Port. Radio 5 $1800.00 ea. $9,000.00
Tablets/ mounts 4 $3,000.00 ea. $12,000.00
Total Cost $29,800.00
Tele- Communications
Telephone Office $220.00
Fax Office $110.00
Cell Operations X 3 AT & T
Internet Office Broad Band
Internet Mobile AT& T
$100.00/
month
$400.00 /
Month
$500.00 /
Month
$300.00
$400.00
$500.00
Annual Total $6,730.00
Facility Purchase
10000 Sqft Building $2,350,000.00
Annual Total $2,350,000.00
Business Expansion Portfolio and Prospectus
Twin City Care of The Virgin Islands
19
Utilities
WAPA $2,400.00
Annual Total $28,800.00
Office Supplies
Printing Advertising $125.00/week $500.00
Direct Mail $20.00/week $80.00
Brochure $375.00/week $1,500.00
Advertising $150.00/week $600.00
Website Advertising / Hosting $150.00/week $600.00
Promotional Materials $375.00/Month $1,500.00
Annual Total $57,360.00
Annual Total $172,080.00
Business License Expenses
Bus. License $500.00
Vehicle License x 6 $3,500.00
Vehicle Ins. X 6 $18,000.00
Annual Total x 3 years $328,000.00
Staff
Education/Month
Wage/Taxes/Benefits/Month
$
6,000.00
$
1,430,000.00
Annual Total x 3 years
$ 6,000.00
$
1,430,000.00
$
4,296,000.00
Staff Uniform
$ 10,000.00 $ 10,000.00
Annual Total x 3 years
$
30,000.00
Business Expansion Portfolio and Prospectus
Twin City Care of The Virgin Islands
20
Ambulance & QRV Medical/Equipment Supplies
ITEM Amount Cost Total
ALS Medical Bag (BLUE) $462.00 ea. $462.00 X 2 $924.00
Trauma Bag (RED) $277.00 ea. $277.00 X 2 $554.00
Pelican Drug Box $510.00 ea. $510.00 X 2 $1,020.00
Power Stair Chair (RED) Ferno $6800.00 ea. $6800.00 X 1 $6,800.00
Combination Backboard/Scoop $950.00 ea. $950.00 X 2 $1,900.00
Head Immobilizer $130.00 ea. $130.00 X 4 $520.00
Pedi Board $180.00 ea. $180.00 X 2 $360.00
LifePak 15 Defib/ Monitor $27000.00 ea. $27000.00 X 2 $54,000.00
Multi-system BP Cuff $160.00 ea. $160.00 X 4 $640.00
Reeves Heavy Duty Stretcher $378.00 ea. $378.00 X 2 $756.00
Reeves First call bag $90.00 ea. $90.00 X 2 $180.00
IO Drill Kit (Hard case) $450.00 ea. $450.00 X 2 $900.00
CPAP Kit (MACS) $2500.00 ea. $2000.00 X 2 $4,000.00
Thomas EMS Pedi Braslow Bag $1320.00 ea. $1320.00 X 2 $2,640.00
Total $75,194.00
Total x 6 units $451,164.00
Ambulance 2018
Chassis Cost ea. Amt. TOTAL
Sprinter Ambulance 2018 $245,617.74 1 $245,617.74
Including Shipping
Including Graphics
Stretcher (Ferno)
Total for 4 additional units $982,470.96
QRV Units 2018
Chassis Cost ea. Amt. TOTAL
Ford F350 2018 $145,266.88 1 $145,266.88
Including Shipping
Including Graphics
Equipment Box
Total for 2 units $290,533.76
Business Expansion Portfolio and Prospectus
Twin City Care of The Virgin Islands
21
Supervisor/Community Paramedicine Units 2018
Chassis Cost ea. Amt. TOTAL
Sprinter Ambulance 2018 $245,617.74 1 $245,617.74
Including Shipping
Including Graphics
Stretcher (Ferno)
Total for 2 units $982,470.96
Total Funding Needed
Expansion $9,978,299.68
$
Total Funding Requested
10,000,000.00
1.5 Summary
With your donation of $10,000,000.00, Twin City commits to aggressively expand during the
next three (3) years of operation. The intentions are to purchase an operations facility, set up a
mental health crisis hotline, purchase additional equipment and hire additional personnel. We
also intend to implement marketing campaigns that will effectively target individual new
customers within the territory. Due to our unique inside and immediate access to the market in
which we are involved with, on a daily basis, we will be able to assist and provide guidance to
the needs of our patients, constituents and future customers.