36C24122Q0380.docx

SUBJECT*

Connecticut Veterans Administration Ambulance Service

GENERAL INFORMATION

VA Boston Healthcare System Contracting Officer (90C) 940 Belmont Street Brockton MA 02301

POINT OF CONTACT*

Contract Specialist Jeffrey Fleming jeffrey.fleming@va.gov 774-826-3525

PLACE OF PERFORMANCE

950 Campbell Avenue

West Haven CT

ADDITIONAL INFORMATION

AGENCY’S URL

URL DESCRIPTION

EMAIL DESCRIPTION

Sources Sought Notice Sources Sought Notice

DESCRIPTION

Sources Sought Notice

1. INTRODUCTION:

This Sources Sought notice is for information and planning purposes only and shall not be construed as a solicitation or as an obligation on the part of the Department of Veterans Affairs (VA). The VA is currently conducting market research to locate qualified, experienced, and interested potential sources. Responses will not be considered as proposals, nor will any award be incurred by interested parties in responding to this Sources Sought announcement.

NCO 1 Contracting is seeking interested sources for a future solicitation and procurement.

At this time, no solicitation exists. This is for information and planning purposes.

2. BACKGROUND:

VISN 1 Healthcare System (New England) has a requirement to provide Basic Life Support (BLS) and Advanced Life Support (ALS) Ambulance Services to its beneficiaries., including medical services and personnel, for patients of the Connecticut VA Medical Centers. The Connecticut VA Medical Center includes the two (2) major medical centers and nine (9) community-based outpatient clinics (CBOCs) listed below:

VA Medical Facilities

Locations:

Community Based Outpatient Clinics (CBOC):

3. OBJECTIVES:

VISN 1 Healthcare System is looking for small business concerns, especially Service Disabled Veteran Owned Small Business (SDVOSB) and Veteran Owned Small Business (VOSB) contractors that can perform ALS and BLS Ambulance Services, non-profit and large business concerns are also welcomed to respond to this notice. The current primary NAICS code of this requirement is 621910 (Ambulance Services), which has a size standard of 16.5 million.

4. SUBMITTAL INFORMATION:

Contractors having the skills and capabilities necessary to perform the stated requirements should submit a response as detailed below. Companies should provide clear and unambiguous evidence to substantiate their capability to fulfill the requirements above. If this information is not provided, your firm cannot be considered a viable source for this procurement. Interested parties shall furnish the following minimum information:

1. Company name and address – ensure your company is registered in the System for Award Management (SAM) at www.sam.gov.

· Dunn and Bradstreet (DUNS) number.

· Provide SAM unique entity identifier (UEI) (if available).

2. Company point of contact name, telephone number, and email address.

3. Evidence that you are a small business (if applicable):

· Small Business – ensure you are listed as small business in SAM, reps and certifications. Provide the NAICS codes you are listed as a small business under.

· CVE certified SDVOSB or VOSB (or in the process of certification) – ensure you are certified in the CVE veteran database at www.vetbiz.va.gov/. Provide evidence of certification.

4. If your company holds a Federal Supply Schedule (FSS) Contract, list the GSA Contract Number and SINs.

5. Capabilities/Qualifications:

· A written response providing clear and unambiguous evidence to substantiate the capacity to fulfill this requirement.

· Description of the capabilities/qualifications/skills/required licenses your company possesses to perform services in the geographic areas described above.

· Evidence of existing capability to perform the required transportation services with all necessary resources in place upon the execution of the awarded contract.

6. Past Experience:

· Brief summary of the company’s history relative to similar requirements in size and scope.

· Provide the information on projects of similar size and scope for which the responder was a prime or subcontractor including size of fleet and numbers of employees.

· Provide contract number the work was performed under, period of performance and one professional reference with contact information.

It is requested that the above information be provided no later than April 15, 2022, at 12:00PM EST. Responses should be emailed to Jeffrey Fleming, Contract Specialist at jeffrey.fleming@va.gov .

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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 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.

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Community Based Outpatient Clinics (CBOC):

A listing of VA personnel authorized to communicate the arrangement of these 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 average number of daily runs is approximately 12 (12). 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 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. Contractor shall furnish all necessary linen.

Federal HIPPA, state, and local laws shall govern the release of patient information to the contractor. Any state you Travel in rules/laws/guidance

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 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.

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 hospital linens, pillows, and any and all 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.

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.

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 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. All bills for this subcontractor service will be paid directly to the Contractor at the contract rate, and the Contractor shall reimburse the subcontractor at their agreed to rate. In the event the Contractor is unable to perform services or have services performed as required, the Contractor shall immediately notify the Connecticut VAMC Travel Section and provide a justification for non-performance. Connecticut VAMC reserves the right to re-procure services which cannot be performed by the Contractor or its subcontractor in accordance with the terms, conditions, and schedule of this contract. Connecticut VAMC shall be the sole judge in determining when services will be re-procured.

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. 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.

J. 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.

K. 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.

L. 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.

M. 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.)

N. 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.

O. 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.

P. 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.

Q. 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.

R. 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.

S. 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.

T. 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.

U. INFECTION CONTROL PROCEDURES

U.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.

U.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.

U.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.

i. 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.

V. 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.

W. 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.

X. 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.

Y. 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.

Z. 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.

AA. 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.

CC. 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.

*If the date of the holiday falls on a Saturday, the Government holiday is the preceding Friday. If the date of the holiday falls on a Sunday, the Government holiday is the following Monday.

In addition to the days designated as holidays, the Government observes the following days:

· Any other day designated by Federal Statute

· Any other day designated by Executive Order

· Any other day designated by the President’s Proclamation

Off-Business hours/days are defined as the time of 4:31PM to 7:59AM, Monday through Friday, all day Saturday, all day Sunday, and Federal holidays.

Contracting Officer (CO) – Veterans Administration official with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings. Any changes to a resultant contract may only be made through a written modification as prepared and executed by the CO.

Contracting Officer’s Representative (COR) - VA official responsible for providing contract oversight and technical guidance to the Contracting Officer. COR responsibilities will include, but not be limited to: surveillance of services required under this contract, determining the adequacy of Contractor performance according to the specifications of this contract, acting as the Government's representative, ensuring compliance with contract requirements insofar as the work is concerned, certification of invoices, placing orders for service, providing technical guidance, overseeing technical aspects of the contract, and serves as a member on the vehicle inspection team. The COR cannot authorize deviations from the specifications and requirements of this contract. In the event the Contractor deviates without approval from the CO, such deviation shall be at the risk of the Contractor and any cost related thereto shall be borne by the Contractor. The POC will be designated in writing by the CO after contract award.

Contractor - The term "Contractor" as used herein refers to both the prime Contractor, their employees, and any subcontractors and their employees. The Contractor shall be responsible for assuring that their subcontractors comply with the provisions of this contract.

Joint Commission - A national organization dedicated to improving the care, safety, and treatment of patients in a health care facility and environment.

Prescheduled Trip(s) - The term "Prescheduled Trip" as used in this contract refers to those trips in which the Contractor has been given advance notice (advance notice is defined as a notice given by 4:00 p.m. the prior business day) of required services and a specific pick-up time and location.

Quality Assurance - Those actions taken by the Government to assure services meet the requirements of this contract.

Quality Assurance Surveillance Plan - An organized written document used for quality assurance surveillance. The document contains specific methods for performing surveillance of the Contractor's continuous performance.

Quality Control - Those actions taken by the Contractor to control the production of goods or services so they will meet the requirements of a contract.

Rate - Rate is defined as the rate paid for one-way transportation from a designated pickup point to a designated delivery point. This rate will be paid for all authorized one-way trips ordered under this contract action.

Unscheduled Trips(s) - The term "Unscheduled Trip" as used in this contract refers to those trips required on an as needed basis and advance notice is not given.

Waiting: Waiting, as used in this solicitation/contract, is defined as the time required and verified by authorized medical facility personnel for the contractor to wait at designated pick‐up and/or delivery points commencing after the required arrival check‐in with the individual(s) scheduling the travel.

Waiting Grace Period: The Waiting Grace Period is defined as fifteen (15) minutes prior to the time waiting charges commence. The base rate for ambulance services shall include a fifteen (15) minute waiting grace period at origin and destination. After the 15‐minute grace period charges are applied in 15‐minute increments.

Records Management Language for Statement of Work (SOW):

The following standard items relate to records generated in executing the contract and should be included in a typical procurement contract:

1. Citations to pertinent laws, codes and regulations such as 44 U.S.C chapters 21, 29, 31 and 33; Freedom of Information Act (5 U.S.C. 552); Privacy Act (5 U.S.C. 552a); 36 CFR Part 1222 and Part 1228.

2. Contractor shall treat all deliverables under the contract as the property of the U.S. Government for which the Government Agency shall have unlimited rights to use, dispose of, or disclose such data contained therein as it determines to be in the public interest.

3. Contractor shall not create or maintain any records that are not specifically tied to or authorized by the contract using Government IT equipment and/or Government records.

4. Contractor shall not retain, use, sell, or disseminate copies of any deliverable that contains information covered by the Privacy Act of 1974 or that which is generally protected by the Freedom of Information Act.

5. Contractor shall not create or maintain any records containing any Government Agency records that are not specifically tied to or authorized by the contract.

6. The Government Agency owns the rights to all data/records produced as part of this contract.

7. The Government Agency owns the rights to all electronic information (electronic data, electronic information systems, electronic databases, etc.) and all supporting documentation created as part of this contract. Contractor must deliver sufficient technical documentation with all data deliverables to permit the agency to use the data.

8. Contractor agrees to comply with Federal and Agency records management policies, including those policies associated with the safeguarding of records covered by the Privacy Act of 1974. These policies include the preservation of all records created or received regardless of format [paper, electronic, etc.] or mode of transmission [e-mail, fax, etc.] or state of completion [draft, final, etc.].

9. No disposition of documents will be allowed without the prior written consent of the Contracting Officer. The Agency and its contractors are responsible for preventing the alienation or unauthorized destruction of records, including all forms of mutilation. Willful and unlawful destruction, damage or alienation of Federal records is subject to the fines and penalties imposed by 18 U.S.C. 2701.