36C24122Q0380 0001.docx

36C24122Q0380

5. PROJECT NUMBER (if applicable)

CODE

7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office.

is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO:

Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER

16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30

PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer) 689-23-2-7061-0019 None Department of Veterans Affairs Network Contracting Office 1 (NCO 1) Contracting Officer (90C) 940 Belmont Street Brockton MA 02301 Jeffrey S. Fleming Jeffrey.Fleming@va.gov Department of Veterans Affairs VA Boston Healthcare System Contracting Officer (90C) 940 Belmont Street Brockton MA 02301 To all Offerors/Bidders

36C24122Q0380 01-03-2023

X

The purpose of this amendment is to issue the RFQ formatted correctly, the pages moved in translation to Contract Opportunities.

There is no change in the submission date.

Jeffrey S. Fleming Contracting Officer

PAGE 1 OF

1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

UEI:

EFT:

PHONE:

FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Only) 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) 30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

(REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

689-23-2-7061-0019 36C24122Q0380 01-03-2023 Jeffrey Fleming 774-826-3525 02-03-2023 14:00

EST

Department of Veterans Affairs Network Contracting Office 1 (NCO 1) Contracting Officer (90C) 940 Belmont Street Brockton MA 02301 Jeffrey S. Fleming Jeffrey.Fleming@va.gov X 621910 $20 Million N/A X Department of Veterans Affairs VA Connecticut Healthcare System 950 Campbell Ave.

West Haven MA 02301 Department of Veterans Affairs VA Boston Healthcare System Contracting Officer (90C) 940 Belmont Street Brockton MA 02301

Department of Veterans Affairs Financial Services Center PO Box 149971 Austin TX 78714-9971 877-353-9791 See CONTINUATION Page This solicitation will result in an award of a Fixed-Price Indefinite Delivery, Indefinite Quantity (IDIQ) Contract for Ambulance Services for Beneficiaries of the Connecticut Healthcare System. This contract shall be for a period of one (1) base year and four (4) option years.

The Contractor shall provide all labor, materials, vehicles, supervision, training, and safety measures necessary to meet the requirements of the Performance Work Statement (PWS) herein. The Government intends to award a Fixed Price, option year contract.

All proposals must be submitted electronically to Jeffrey.fleming@va.gov.

Questions must be submitted in writing no later than 01/12/2023 14:00 hours. Via Email to Jeffrey.Fleming@va.gov All questions will be answered via Amendment to this Solicitation.

Minimum Award Guarantee: $250,000.00 Maximum Ceiling, including options: $7,000,000.00 See CONTINUATION Page X x Jeffrey S. Fleming Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C241 Jeffrey S. Fleming Department of Veterans Affairs Network Contracting Office 1 (NCO 1) Contracting Officer (90C) 940 Belmont Street Brockton MA 02301

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

3. INVOICES: Invoices shall be submitted in arrears:

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

B.2 PERFORMANCE WORK STATEMENT

GENERAL OVERVIEW

The Connecticut VA Medical Center requires a contractor to furnish Basic Life Support (BLS) and Advanced Life Support (ALS) Ambulance Services to its beneficiaries. The contractor must provide all equipment, personnel, supervision, and support to have these services in place on or before 09/01/2022. All services will be provided in accordance with the terms and conditions of this contract, applicable federal and state regulations, and industry accepted quality standards highlighted in this Statement of Work. The awarded contract will have a Period of Performance (POP) of One (1) Base Year with the option for Four (4) additional One (1) – Year Option Periods.

Pricing is established on a per trip basis (one way – loaded miles only) with an additional per mile charge for every mile over 25 miles. The estimated number for each type of transport is laid out in the Price/Cost Schedule.

A. SCOPE OF CONTRACT

The Connecticut VA system includes the VA West Haven Medical Center and nine (9) community- based outpatient clinics (CBOC) as laid out below. Services include patient transport twenty- four (24) hours per day, seven (7) days per week, including all holidays.

The contractor shall provide twenty- four (24) hour ambulance service (ALS and BLS) to VA beneficiaries receiving care at one or more of the facilities listed below. Upon request by the VA, the contractor shall transport VA beneficiaries from the beneficiaries’ place of origin to the beneficiaries’ place of treatment. The Contractor shall have the capacity to schedule, coordinate and execute the estimated volume of 260 BLS and 25 ALS trips per month plus additional mileage. Average mileage per transport is approximately 20 miles. The VA experiences seasonal shifts in transportation needs and the contractor shall adapt to these changes while maintaining all performance standards. All vehicles, personnel, and services rendered shall conform to all Federal, state, and local statutes, rules, and regulations.

VA Medical Facilities

The following facilities require transportation of VA beneficiaries. Any and all facilities may order transportation.

Locations:

Community Based Outpatient Clinics (CBOC):

A listing of VA personnel authorized ordering officials to communicate the arrangement of orders for transportation services will be forwarded to the Contractor after award of contract. Updated listings shall be provided to the contractor when required during the term of the contract.

The Contractor shall contact the Contracting Officer on all matters pertaining to administration. Only the Contracting Officer is authorized to make commitments to issue changes that shall affect the price, quantity, quality, or delivery terms of this contract.

B. AMBULANCE SERVICES

The contractor shall furnish ambulance service 24 hours per day, 7 days per week, including all holidays for all patients including trips originating at one of the VA facilities.

The contractor shall furnish all linen supplies during transport.

The contractor shall provide as many ambulances as necessary to furnish timely service or subcontract the job to another company that meets all the terms and conditions in this contract. Timely service is service that meets the response times indicated in Paragraph C- “Response Time.”

The Contractor’s subcontractor, if any, shall not bill the VA directly and the VA will not pay more than the rates in this contract for all trips performed by the Contractor or their subcontractor. It is the responsibility of the Contractor to pay their subcontractors directly.

The contractor’s business, vehicles and personnel shall be licensed in accordance with the State of Connecticut Rules and Regulations Relating to Emergency Medical Services; Provide the state rules and regulations regarding vehicle storage, equipment and supplies as well as required safety inspections and certifications. The VA reserves the right to confirm compliance by viewing the Contractor’s records and/or performing a physical inspection themselves. The ambulances used in the performance of this contract will be licensed and meet the minimum vehicle requirements as mandated by the State of Connecticut Department of Public Health (CT 19a-179) or the Federal Specification for Ambulance, KKK-A-1822F (Change 8), dated July 1, 2015, whichever is more stringent. Chassis or compartment modifications are permissible when they clearly exceed the minimal specification. The electrical system must, at a minimum, meet the standards of the federal Specification for Ambulance, KKK-A-1822F (Change 7), Section 3.7, Electrical System and Components, dated February 2, 2015.

Each emergency medical care vehicle will have patient compartment facilities, oxygen, suction systems and equipment, and additional systems equipment, accessories, and supplies (See Sec 3.15 of KKK-A-1822F), as well as environmental climatic equipment, and communications.

All vehicles utilized in the performance of services under this contract shall meet 49 CFR Part 38 – Americans with Disabilities Act (ADA) Accessibility Specifications for Transportation Vehicles. Vehicles shall be made available for inspection when it is requested by the VA.

The Contractor may be required to furnish more than one ambulance at a time. Vehicle must be able to accommodate all necessary life sustaining equipment during critical care transport and the addition of 1 VA staff member in addition to ambulance personnel.

In the event of a large number of vehicles requested contractor shall be contacted to determine if he/she can or cannot furnish the vehicles. The COR will record the time of the call, the time service is required, the name of the Contractor’s representative and whether or not the Contractor cannot provide the vehicle. If the Contractor cannot provide the added vehicle, the COR will record the name of the ambulance service called which did provide the added vehicle.

Federal HIPPA, state, and local laws shall govern the release of patient information to the contractor. For trips originating outside of Connecticut, laws of the state in which the trip originates or federal HIPPA law shall govern the release of patient information.

C. RESPONSE TIME

It is estimated that 85% of all requests for service will be placed by fax and 15% by telephone from an authorized representative of the VA Connecticut Healthcare System. A list of authorized employees will be provided at the time of contract award. Requests may also be completed by in person (by giving a written or verbal request).

PRESCHEDULED TRIPS: It is expected that the contractor will arrive at the prescheduled pickup time for any prescheduled trips.

UNSCHEDULED PICKUPS (Non-Emergency): The contractor shall respond to VA request for ambulance service by arriving at the patient’s place of origin within thirty (30) minutes from the time the order/call is placed by the VA for both unscheduled BLS requests and unscheduled ALS requests. Response time will be calculated from the time of receipt of the Fax/Telephone request for services.

EMERGENCIES: If at any time the contractor determines that the patient being transported requires emergency medical service, the contractor shall immediately call 911 for emergency services and/or proceed to the nearest emergency room.

LATE PERFORMANCE: If prior to travel or during travel to the beneficiaries’ place of origin the contractor determines that they cannot comply with the response time, the contractor shall notify the appropriate VA travel office immediately. The contractor shall not withhold notification for any reason.

Upon request, the contractor shall cooperate and furnish to the VA information detailed in the contractor’s dispatch logs, electronic records or equivalent real time recording system, ambulance sheets, or other materials requested.

If available, the Contractor shall sign a “Transport Log” upon arrival at the VA facilities. Contractors may be asked to sign out for items listed but not limited to VA hospital linens, pillows, and any and all VA hospital equipment or property moved with a patient for transport.

D. PERFORMANCE STANDARD

The Contractor is expected to meet the following performance requirements:

E. CONTRACTOR EMPLOYEES

Contractor employees shall not be considered Government employees for any purpose. The Connecticut VAMC reserves the right to restrict any contractor employee from performing services under this contract who does not meet the required qualifications for the services he/she is required to perform and who violates Federal regulations or is identified as a potential threat to the security, safety, health and/or operational mission of the VA and its patient population. The restriction of such contractor personnel shall not relieve the Contractor from performing all the required services, in accordance with all terms, conditions, and schedules contained herein.

The Contractor shall furnish qualified personnel as required by contract specifications to accomplish all services under this contract.

Contractor personnel performing services to the Connecticut VAMC shall conduct themselves in a professional manner, maintain personal hygiene, wear clean, neat uniforms, and be identified by having the company name, and employee name affixed to the uniform. Employee identifications (that associate the employee with the Contractor) shall be worn in clear view above the waist. Contractor personnel shall not smoke in facilities or on the ambulance ramp to the Emergency Care Unit. There shall be no smoking within the vehicles by Contractor, patient, or any other passenger.

when transporting patients to or from medical facilities, the driver, acting for the Contractor shall ensure that the patient's luggage, medical records, medications, and prosthetic devices are properly accounted for and delivered with the patient as required.

Each patient shall be treated with the utmost of respect and concern, with a professional approach to his/her dignity as an individual and patient. All communication, both verbal and non-verbal, by Contractor's personnel with and in the presence of the patient, will be conducted in a professional manner. The Contractor's personnel shall practice the utmost discretion when discussing the patient's condition with hospital professionals in the presence of the patient, relatives, and/or caregivers.

F. CONTRACTOR PERSONNEL QUALIFICATIONS

All Contractor personnel performing contract services shall meet the qualifications as specified in this contract, as well as any qualifications required by Federal, State, County, and local government entities from the place in which they operate. Records of each employee as to name, level, and certification to perform the duties of an ambulance driver or attendant shall be maintained and made available for inspection upon request. The VA requires that all contractor personnel receive a physical verification of safe driving record and drivers check every 2 years, and safety training one time per year.

Evidence of successful training shall be provided to the Contracting Office upon request.

EMT-P and EMT-B providing services under this contract shall have the following qualifications, in addition to those required by Federal, State, and Local Government:

· Have completed training in accordance with the standards published by the Department of Health and Human Services (HHS). Such training programs must also be acceptable under the regulating requirements for local EMS Systems supported by DHHS under PL 93-154. Or shall submit evidence of equivalent training program successfully completed to the Contracting Officer.

· Shall attend (at the expense of the contractor) all refresher continuing education, or advance training programs as required by the local or state government entity in which service is rendered. In no instance shall this be less frequent than every two (2) years. Such refresher training shall be equivalent to that developed by the Department of Transportation, National Highway Safety Administration.

· The contractor shall provide its employees with certified training for ventilator operation as there may be a need to transport a patient who is on a ventilation system.

· Ambulance Driver: Drivers shall have a valid operator's or chauffeur's license in accordance with Federal, State, and local government requirements for their place of operation for the services they perform. Drivers shall have EMT-B certification as a minimum.

· All attendants/van drivers on duty must be qualified to administer oxygen and shall have successfully completed the Standard and Advance First Aid Courses of the American Red Cross, U.S. Bureau of Mines, or equivalent. Proof in the form of a current or unexpired certificate that such first aid training has been successfully completed must be available upon request.

G. CONTRACTOR EQUIPMENT, VEHICLES, AND INSPECTION

Ambulances shall meet all current applicable Federal, State, and local specifications and regulations including, but not limited to, licensing, registration, and safety standards by the respective states of service. Connecticut VAMC reserves the right to inspect contractor's equipment and vehicles or require documentation of compliance with contract specifications, State laws, rules, regulations, and guidelines governing emergency medical transport vehicles (ambulances). Inspections of contractor facilities shall in no way constitute a warranty by Connecticut VAMC that the contractor's vehicles and equipment are properly maintained. Connecticut VAMC reserves the right to restrict the Contractor's use of equipment and vehicles which are in need of repair, unclean, unsafe, damaged on the interior or exterior body, and are not in compliance with contract requirements. The restriction of such equipment and vehicles shall not relieve the Contractor from performing in accordance with the strict intent and meaning of the contract without additional cost to the government.

Vehicles shall contain:

· An emergency safety kit,

· Portable oxygen unit(s),

· Fire suppression equipment

· Appropriate road emergency warning equipment.

· Written emergency procedures.

· Protective clothing required for the protection of contractor employees where patient care is expected, such as - i) gowns, ii) gloves, iii) masks, etc.

BLS vehicle shall, in conjunction with the above, also provide on-board EMT-B, perform basic airway management, and provide IV at KVO without additives.

ALS vehicle shall, in conjunction with the above, also provide an on-board EMT-P, perform cardiac monitoring, provide Advanced Cardiac Life Support (ACLS) drugs and procedures, and perform advanced airway management and medication monitoring and administration. Advanced airway management means the ability to intubate a patient and provide appropriate respiratory care, including emergency cricothyroidotomy.

All vehicles are to be equipped in accordance with the laws and regulations promulgated by the respective states of service.

Radios shall be adequately powered to provide communication within the regional area as a minimum.

All vehicles must remain locked when not attended by Contractor employees to avoid unauthorized entrance. Vehicles (when not attended) shall NOT remain running due to exhaust fumes.

The Contractor shall provide oxygen when it is requested by authorized Connecticut VAMC facility personnel or required by the patient's medical condition.

With the exception of intravenous administration pumps, the Contractor shall not be permitted to borrow medical equipment from the Connecticut VAMC facilities. The Contractor shall provide all medications required while in transport, linens and blankets, and other equipment and supplies required for use while in transport for direct patient care. An exception will be made for medications which are outside the realm of what is carried in the vehicle and are case-specific to the patient needs.

Contractor shall at no time and under any circumstances exchange supplies, equipment and/or medications with Connecticut VAMC (with the exception of intravenous administration pumps, as determined by the transporting facility). The prices quoted in the Price/Cost Schedule (Section B.1. of the contract) shall be inclusive of consumables used in transport. All vehicles used for critical patient care (i.e., ALS, BLS), shall include, but not be limited to, monitors, defibrillator with external pacemaker, intubation equipment, intravenous equipment, medications, patient compartment facilities, oxygen and suction system equipment including portable oxygen suction and accessories. Upon approval by the transporting facility, the Contractor will be allowed to transport the intravenous administration pumps that are delivering a fluid or medication to a patient during transfer. The Contractor shall return the pumps to the lending facility within 72 hours of patient delivery.

The Contractor shall provide a formal written summary of the ambulance vehicle fleet (Make, Model and Year, equipment) to be utilized for services provided by the Contractor. The report shall identify the various ambulance levels and numbers, their staffing criteria, stock equipment and medications carried, and procedures. This report shall also include the location and telephone numbers of their establishment where calls are received, and vehicles are dispatched from.

H. BILLING

The Contractor shall provide all vehicles and manpower necessary to meet the ALS and BLS transport requirements of this contract. The Contractor will be authorized to utilize other ambulance service companies, as subcontractors (certified to be within all requirements of this contract) to complete these transportation requests.

Should Connecticut VAMC determine that immediate transportation is essential to prevent loss of life or serious bodily harm, transportation services may be procured via local 911 services without referral or charges to the contractor.

I. Reporting

The solicitation and subsequent contact include FAR 52.222-41, Service Contract Labor Standards (SCLS). The Offeror and resultant contract awardee, by signing the offer and contract, is acknowledging they have reviewed the clause and will fully comply throughout the contract period. It is the responsibility of the Contractor to determine and pay the appropriate prevailing wage rate and fringe benefits for the location. The Government will not be held responsible for any mistakes in applying the SCLS.

VA reminds contractors of the Department of Labor Regulations which implement the SCLS and which read at 29 CFR § 4.115:

Employee coverage does not depend on form of employment contract. The Act, in section 8(b), makes it plain that the coverage of service employees depends on whether their work for the contractor or subcontractor on a covered contract is that of a service employee as defined in section 8(b) and not on any contractual relationship that may be alleged to exist between the contractor or subcontractor and such persons. In other words, any person, except those discussed in §4.156 below, who performs work called for by a contract or that portion of a contract subject to the Act is, per se, a service employee. Thus, for example, a person's status as an “owner-operator” or an “independent contractor” is immaterial in determining coverage under the Act and all such persons performing the work of service employees must be compensated in accordance with the Act's requirements.

J. PATIENT ESCORT

The Connecticut VAMC reserves the right to have an escort, such as a relative, or care provider of a beneficiary when it is determined that an escort is in the best interest of the beneficiary. There shall be no additional charge when escorts are authorized to travel with the beneficiary. At no time shall escorts or other personnel, except a physician, nurse or respiratory therapist treating the patient be allowed in the patient compartment of the ambulance while the vehicle is in route. In the event that an escort/clinician must accompany a patient, trip mileage for escort’s return, if applicable, will be paid in accordance with the schedule.

K. SUBSTITUTION OF BENEFICIARY

The Connecticut VAMC reserves the right to substitute the beneficiary requiring services at any time during the performance of this contract to prevent delays, cancellations, or dry runs. There shall be no additional charge to Connecticut VAMC when such changes occur.

L. NUMBER OF PATIENTS

The Contractor shall transport only one beneficiary per trip, under ambulance services, unless specifically authorized by Connecticut VAMC Healthcare personnel (authorized employees will be identified at contract award) to transport more than one, and at no time shall the Contractor transport more than two beneficiaries.

M. STANDARDS OF CARE

The Contractor shall adhere to the highest quality standards of both patient and medical care. Contractor shall adhere to the city, county, and state protocols established for emergency medical care and transportation. However, Connecticut VAMC may order specific levels of ambulance service to their campuses or to pick-up patients at other hospitals, nursing homes or patient homes when transporting to Connecticut VAMC.

N. ELECTRONIC TRANSMISSIONS

The Contractor shall, at all times during the contract period, have on his/her premises a functioning email to communicate requirements with Connecticut VAMC (i.e., patient incidents, requests for service, special correspondence, etc.). The Contractor shall indicate if there is e-mail availability for their company to complete communications with Connecticut VAMC (use of this communication system shall be mutually agreed upon after award of contract before any communications are completed in this manner.)

O. WAITING TIME

In order to be reimbursed for any fifteen-minute Waiting Time periods, the Contractor must submit proof of arrival time (date, location, and time from Trip report/GPS.)

Unscheduled trips: Waiting charges shall commence 15 minutes from the time the Contractor arrives at the designated pick-up and/or delivery points.

Prescheduled trips: Waiting charges shall commence 15 minutes from the prescheduled pick-up time or from the time the Contractor actually arrives at the designated pick-up point, whichever is later.

Trips shall be performed by Contractor so that patients are not held at any point to meet another vehicle for the purposes of carpooling unless authorized by the Connecticut VAMC Travel Clerk.

P. AUTHORIZED Connecticut VAMC HEALTHCARE PERSONNEL

Authorized personnel will be full time staff employed by Connecticut VAMC. Authorized personnel shall be communicating directly from Government telephones/fax machines/computers from within the facility.

Prior to performance, the Contracting Officer will provide the Contractor with a list of names or position titles and phone numbers of authorized Government personnel who may request services and receive calls from Contractor regarding contract performance. This list will be updated and submitted to the Contractor as changes occur. The Contractor shall ensure that requests for services are received from authorized medical center personnel. Services rendered in response to requests from other than authorized personnel shall be at the risk of the Contractor and any cost related thereto shall be borne by the Contractor.

Q. REQUESTS FOR SERVICES

All requests shall be placed against pertinent schedule items, on a unit price basis, and will be verified against invoices and contractor’s request for service log submitted per Section 20. When ordering services (whether it be by telephone, facsimile, mail, e-mail and/or in person), the Connecticut VAMC representative will provide the Contractor with the following type of information:

· Mode of transportation required

· Required date and time of arrival

· Beneficiary name (first and last name)

· Last 4 digits of Social Security Number

· Pick up point (include address, telephone #, city, state, building and/or room number if Applicable

· Destination (include address, telephone #, city, state, building name)

· Time of pick up

· Support required or items to accompany, (escort, other items)

· Additional information as needed (whether there are papers, medications, or other items to be

· transported with the beneficiary and location of those items)

· Including any specific physician instructions

· Type and number of additional medical care specialists required

· Type of equipment required; and

Dispatcher

Requests for Transportation services shall be made to the contractor personnel identified as seen below:

· Company

· Address

· City/State/Zip

· Contact Person

· Normal Hours Telephone No

· After Hours Contact Person

· After Hours Telephone No.

R. INVOICES

Billing documents shall include a report that (e.g., spreadsheet) shall contain the contract number, date, departure and arrival times, patient’s name, origin and destination addresses, total mileage per trip leg.

Payments for services will be monthly, in arrears, on certified invoices.

The prices listed in the accepted Schedule shall be inclusive of any and all ferry, bridge, tunnel, or road toll charges. Contractor shall not invoice Connecticut VAMC for any such separate charges.

S. REIMBURSEMENT FOR CANCELLED TRIPS

Should Connecticut VAMC make a determination that a previously scheduled trip must be cancelled, and a vehicle has already been dispatched to the designated pick-up point, Connecticut VAMC will notify the Contractor to cancel the order.

· Order cancelled when Contractor is already enroute to the designated pick-up: The Contractor will be paid the one-way rate for the trip and applicable mileage, as provided in the Price/Cost Schedule.

· Order cancelled after Contractor arrives at the destination: The Contractor will be paid the one-way rate for the trip and applicable mileage, as provided in the Price/Cost Schedule.

T. PATIENT RIGHTS

Contractor personnel shall not smoke in facilities or on the ambulance ramp to the Emergency Care Unit. There shall be no smoking within the vehicles by Contractor, beneficiary, or any other passenger.

Patients may bring a reasonable amount of equipment, such as folding wheelchair, consumable medical supplies, and personal suitcase.

Each patient shall be provided with safe and comfortable transportation to and/or from the Connecticut VAMC Healthcare System. The Contractor shall assume the total responsibility for the patient's safety and comfort during the entire transfer process, from the time the Contractor's staff reaches the patient, through the loading and unloading of the patient into the vehicle, and until the time the patient is properly delivered to the professional staff of the medical Center or other final destination.

U. INCIDENT/ ACCIDENT REPORTS

IMMEDIATELY upon any incident/accident involving a Connecticut VAMC patient being transported or escorted, verbal notification shall be made to the Connecticut VAMC COR and/or CO with all the facts as they relate to the incident/accident. A written report with a list of the Contractor staff names (drivers/escorts), patient's name, and pertinent information and witnesses shall be filed within forty-eight (48) hours of the incident/accident with the COR or CO. The report shall be filed no matter how minor the incident/accident appears to be.

The Contractor shall notify the COR in writing within 24 hours of any complaints made by the beneficiaries regarding the ambulance service. The Contractor may provide recommendations for improved services along with the patient complaints for Connecticut VAMC review. No recommendation shall be construed as being effective until and unless it is provided as a written modification to the contract from the CO.

V. INFECTION CONTROL PROCEDURES

V.1 TUBERCULOSIS TESTING:

- Contractor must provide evidence of negative PPD test within fourteen (14) calendar days prior to an employee with direct patient contact beginning service and annually thereafter.

- Contractor must provide medical evidence that employee is disease free for those employees having a positive PPD.

- In no circumstance will an employee or driver be allowed to begin duty without prior submission of the required testing certification.

V.2. HEPATITIS B VACCINATION

- The employer shall make available the Hepatitis B vaccine and vaccination series within ten

(10) days of employment to all contract employees who have direct patient contact and follow-up to all contract employees who have an exposure incident.

- Contractor shall bear all costs associated with vaccinations.

- VA Form 10-5549c, Information about Hepatitis B Vaccine (Recombinant), Consent Form, or

- VA Form 10-5549d. Hepatitis B Vaccine Declination (Mandatory) (Attachment B) shall be submitted to the Contracting Officer within thirty (30) days of waiver, or completion of the first in the series of the Hepatitis B Vaccine, and at completion of the vaccination series. These forms shall be provided to the contractor upon award of the contract.

V.3 COVID-19 INFORMATION AND REQUIREMENTS

VHA Supplemental Contract Requirements for Ensuring Adequate COVID-19 Safety Protocols for Federal Contractors

1. Contractor employees who work in or travel to VHA locations must comply with the following:

a. Documentation requirements:

1) If fully vaccinated, shall show proof of vaccination.

NOTE: Acceptable proof of vaccination includes a signed record of immunization from a health care provider or pharmacy, a copy of the COVID-19 Vaccination Record Card (CDC Form MLS- 319813_r, published on September 3, 2020), or a copy of medical records documenting the vaccination.

2) If unvaccinated and granted a medical or religious exception, shall show negative COVID-19 test results dated within three calendar days prior to desired entry date. Test must be approved by the Food and Drug Administration (FDA) for emergency use or full approval. This includes tests available by a doctor’s order or an FDA approved over-the-counter test.

3) Documentation cited in this section shall be digitally or physically maintained on each contractor employee while in a VA facility and is subject to inspection prior to entry to VA facilities and after entry for spot inspections by Contracting Officer Representatives (CORs) or other hospital personnel.

4) Documentation will not be collected by the VA; contractors shall, always, adhere to and ensure compliance with federal laws designed to protect contractor employee health information and personally identifiable information.

2. Contractor employees are subject to daily screening for COVID-19 and may be denied entry to VA facilities if they fail to pass screening protocols. As part of the screening process contractors may be asked screening questions found on the COVID-19 Screening Tool. Check regularly for updates.

a. Contractor employees who work away from VA locations, but who will have direct contact with VA patients shall self-screen utilizing the COVID-19 Screening Tool, in advance, each day that they will have direct patient contact and in accordance with their person or persons who coordinate COVID-19 workplace safety efforts at covered contractor workplaces. Contractors shall, always, adhere to and ensure compliance with federal laws designed to protect contractor employee health information and personally identifiable information.

3. Contractor must immediately notify their COR or Contracting Officer if contract performance is jeopardized due to contractor employees being denied entry into VA Facilities.

X. REQUIRED REPORTS AND DOCUMENTS

1. PATIENT DATA “RUN SHEET”: Contractor shall provide a "Run Sheet" as part of the beneficiary’s permanent record. This Run Sheet shall include a record of the beneficiary’s vital signs, medications used, oxygen use, beneficiary’s attitudes, and any changes in the beneficiary's condition. The list stated herein shall not be construed to be as all inclusive; the Contractor shall provide all pertinent information.

2. CONTRACTOR AUTHORIZED REPRESENTATIVES: The contractor shall provide a list with the names, addresses, telephone numbers, and emails of authorized Contractor representative(s) who have the binding authority to act on behalf of the Contractor on administrative and/or performance matters pertaining to this contract.

Y. CONTRACTOR’S QUALITY CONTROL PLAN (QCP)

The Contractor shall develop and maintain an effective Quality Control Plan (QCP) to ensure services are provided in accordance with Performance Work Statement. The Contractor shall develop and implement procedures to identify, prevent and ensure non-recurrence of defective services. The Contractor’s QCP is the means by which he assures himself that his work complies with the requirements of the contract. The QCP shall be submitted as part of the Contractor’s Quotation. Any changes made to the QCP after contract award shall be submitted to the Contracting Officer for acceptance in writing prior to implementation.

Z. CONTRACTOR'S RESPONSIBILITIES AND INSURANCE REQUIREMENTS

The Contractor shall obtain all necessary licenses and/or permits required to perform this work. The Contractor shall take all precautions necessary to protect persons and property from injury or damage during the performance of this contract. The Contractor shall be responsible for any injury to themselves, their employees, or others, as well as for any damage to personal or public property that occurs during the performance of this contract that is caused by his or his employees' actions and/or negligence. The Contractor shall maintain personal liability, automobile liability, and property damage insurance, as prescribed by the laws of the states, and in accordance with Federal and VA Acquisition Regulations herein. Evidence of coverage shall be submitted to the Contracting Officer before commencing work under this contract (copy of Certificate of Insurance), and it shall not be changed or cancelled without thirty (30) calendar days prior written notice to the Contracting Officer.

AA. DISPOSAL OF HAZARDOUS WASTE

The Contractor shall not dispose of any hazardous materials at any location on the Connecticut VAMC premises except as specified by the Contracting Officer.

BB. SALES OF COMPANIES OR NAME CHANGES

The Contractor gaining award of the contract shall notify the Contracting Officer, Department of Veterans Affairs, Contracting Officer (90C) in writing immediately upon entering an agreement (either oral or written) to sale or transfer all or part of its stock or other ownership interest to any other party. Contractor shall also contact the Contracting Officer immediately in writing in the event a company name change will happen, with information as to the reasons and/or determinations causing this action.

CC. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA), PRIVACY RULE, AND SECURITY RULE

1. Because the Contractor will have access to Protected Health Information (PHI) and Electronic Protected Health Information (EPHI) and is considered a covered entity, the Contractor is subject to regulations and guidelines issued by the Department of Health and Human Services, as mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), 45 CFR Parts 160 and 164, Subparts A and E, the Standards for Privacy of Individually Identifiable Health Information (“Privacy Rule”), and 45 CFR Parts 160 and 164, Subparts A and C, the Security Standard (“Security Rule”); and whereas, Department of Veterans Affairs Veterans Health Administration is a “Covered Entity” as that term is defined in the HIPAA implementing regulations, 45 CFR 160.103.

2. Patient Privacy and Confidentiality: All "patient papers" transported with the patient are confidential in accordance with HIPPA. Contractor's personnel may review these records for assessment and treatment purposes only. Appropriate administrative and medical information will be provided to the Contractor for patient transport. If the medical record is transported with the patient, it may be used as a source of information if the situation warrants (i.e., emergent care while in-route). In all other instances, all documents will remain intact and sealed.

DD. CONTRACT DEFINITIONS AND ACRONYMS

Advanced Life Support (ALS) - ALS shall be provided by ambulance vehicles containing at a minimum, an on-board EMT-P, cardiac monitoring, Advanced Cardiac Life Support (ACLS) drugs and procedures, advanced airway management and medication monitoring and administration. Ambulances for ALS services shall be staffed, certified, and licensed in accordance with current laws and regulations governing the certification and licensure of private ambulances by the respective states of service, and all ALS services shall be in accordance with current laws and regulations by the respective states of service.

Basic Life Support (BLS) - BLS is defined as services required for non-critical patient care in which patient requires an ambulance, which has been staffed, certified, and licensed in accordance with current laws and regulations governing the certification and licensure of private ambulances by the respective states of service. All BLS services shall be in accordance with current laws and regulations by the respective states of service. The ambulance at a minimum shall be staffed with a vehicle operator and an Emergency Medical Technician (EMT) - Basic Ambulance, basic airway management, and IV's at Keep Vein Open (KVO) without additives.

Base Rate: Base Rate is defined as the rate paid for one‐way transportation and handling of a patient, from a designated pick‐up point to a designated delivery point. This rate will be paid for all authorized one‐way trips ordered under this contract action up to 20 miles.

Beneficiary - Veterans and other members determined to be eligible for benefits by the Veterans Administration (VA).

Business Hours/Days - Business hours/days are defined as the time of 8:00AM to 4:30PM, Monday through Friday, except Federal holidays. The Federal Government observes the following days as holidays.