36C24226Q0009 0001.docx

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) 08-29-2025

SBAR APPROVED

Department of Veterans Affairs 400 Fort Hill Ave.

Canandaigua

NY

14424 Department of Veterans Affairs Network Contracting Activity 400 Fort Hill Ave.

Canandaigua

NY

14424 To all Offerors/Bidders

36C24226Q0009 08-26-2025

X X X This Amendment corrects a typographical error in the Performance Work Statement, page 11, section Period of Performance.

The correct Period of Performance for this requirement is 12 months from the date of award with two 12-month option periods.

Lisa Harris Contract Officer Amendment to 36C24226Q0009 FY26 NYH Ambulette

B.3 STATEMENT OF WORK

INTRODUCTION

The Department of Veterans Affairs, New York Harbor Healthcare System (VA NYHHS) requires 24 hours, 7 days per week, 365 days per year assisted transportation (taxi, wheelchair, or litter/stretcher vehicle) services (“ambulette services”) at the following campuses:

Veterans Affairs New York Harbor Healthcare System (VA NYHHS)

(2) Outpatient Clinics

The government intends to award an Indefinite-Delivery Requirements-type Contract with Fixed Price line-item costs associated with varying levels of trip distances and service levels.

The intent of an awarded contract shall be to have a business entity provide ambulette transport services and wheelchair transport services for beneficiaries of the New York Harbor Healthcare Services (VA NYHHS) in New York, NY, and surrounding areas.

The Contractor gaining award shall provide all vehicles, personnel, management, supplies, transportation, equipment, reports, and anything else necessary to provide ambulette transport services and wheelchair transport services as identified in the Schedule of Supplies/Services and Prices/Costs and the Performance Work Statement (PWS) in accordance with all terms, conditions, and provisions stated herein.

PERIOD OF PERFORMANCE

The period of performance for this requirement is 12 months from the date of the award with two 12-month option periods.

DESCRIPTION/SPECIFICATIONS/WORK STATEMENT

DEFINITIONS:

Add-On Service / Add-On Trips – Service not pre-scheduled but submitted to the contractor daily requiring a 60-minute response time or better. These are services which are needed after the scheduling deadline submitted by hospital staff (Examples: emergency room runs, clinic add on appointments, transfers to or from other facilities)

Administrative Officer of the Day (AOD) – VA employee who acts as the administrator during all hours that are not normal working hours. Normal working hours are 7:30 a.m. to 4:30 p.m. Monday through Friday, including holidays.

No service or no-load charge –When a driver is dispatched to pick up a patient and for various possible reasons, the run is not completed, at no fault of the driver. A no service form will be completed by the driver and submitted to Contracting Officer Representative (COR) or designee (staff who approved the no-service) for signature/concurrence. When the VA NYHHS travel office provides reasonable notification, a no-load charge will not apply. Reasonable notification is defined as when the travel office notifies the contractor of cancellation 15 minutes prior to the pickup time.

QUALIFICATIONS:

1. Proposals will be considered only from offerors who are regularly established in the business called for and who are financially responsible and have the necessary equipment and personnel to furnish service in the volume required for all the items under this contract. Subcontracting of services shall not be authorized for the transportation of wheelchair patients and litter patients without prior approval of the Contracting Officer. Successful offeror shall meet all requirements of Federal, State, or City codes regarding operations of this type of service. Contractor vehicles and personnel must meet Federal Department of Transportation regulations to provide special needs transportation in New York State.

2. REQUIRED SUBMISSIONS. Offerors shall submit the following information with proposal and prior to exercise of any option to this contract:

a. Insurance certificate(s).

b. Business license(s).

c. List of all vehicles and vehicle identification number (VIN), as well as location of hub/main office.

d. Inspection report for all vehicles.

e. Copies of valid driver's/chauffeur license.

3. RATES AND MILEAGE

a. Base Rate: For all one-way trips and no-loads within the mileage threshold limits from a designated pick-up point to a designated delivery point, the contractor shall receive the flat base rate awarded for that trip. The Base Rate shall constitute full compensation for one-way trips which do not exceed the mileage threshold.

b. Mileage Rate: In addition to the base rate, the contractor shall receive the mileage rate awarded for each mile traveled beyond the specified mileage threshold. This rate applies to loaded, one-way transportation as well as no load trips. In the event fraction miles result, VA NYHHS shall pay the rounded off amount to the next higher whole mile. In no event shall the Contractors receive this rate for miles traveled within the specified mileage threshold.

c. Mileage Threshold: The mileage threshold is defined as within fifteen (15) driven road miles from the patient’s pickup point. Mileage shall be calculated utilizing the Payment for mileage to or from the point of care shall be limited to the VA’s calculation according to the VA’s Bing Maps API determination. Bing Maps API is optimized to determine mileage based on the shortest time of travel.

d. Toll Charges: It is agreed and understood that the prices quoted in the schedule do not include any ferry, bridge, tunnel, or road toll charges. Any such legitimate toll charges incurred shall be limited to loaded trips when the patient is traveling in the vehicle, or to a no-load trip, and shall be listed separately on the Contractor’s invoices.

i) Ferry use is prohibited for all trips unless approved by COR or Business Office Service Chief or Assistant Chief.

ii) All invoices must be accompanied by supporting documentation of tolls actually paid (Receipts or EZ Pass log)

e. Reasonable Mileage: To determine what is considered reasonable mileage, VA will utilize VA’s calculation according to the VA’s Bing Maps API determination that provides the shortest route in terms of mileage. Unless specifically approved by the Travel Office for extenuating circumstances, requests for payment of mileage determined not reasonable by the VA will not be paid. Contractor must ensure that pickups and drop-offs are scheduled so that the total distance traveled will result in the most economical charges to the Government. The Travel Office and Chief of the Business Office shall determine chargeable trip mileage from VA NYHHS Campuses to the Veteran’s home address.

f. Mileage Dispute: In the event of a dispute over the distance which the patient is transported to arrive at a specific destination, mileage will be defined/measured by VA’s calculation according to the VA’s Bing Maps API determination.

g. Wait Time: For time lost in waiting due to causes beyond the control of the driver, the contractor will be reimbursed in 15-minute increments, at the rate of one-fourth the hourly rate quoted. The base rate for medical transportation services shall include a 30-minute waiting grace period at origin and destination; the wait time charge only applies if the crew is delayed longer than 15 minutes at the time of pickup or delivery.

Wait time must be approved in advance by the COR or designee, if the COR or designee is not available, wait time must be approved in advance by another authorized ordering official (see E.1) or the AOD. No charges will be honored without prior approval. If the pickup is at a location other than the VA Medical Center, the contractor shall notify an authorized ordering official as soon as the driver expects wait charges will be incurred. The call is only for the purpose of verifying the driver’s arrival at the pickup point and is not necessary if the driver anticipates no delay for which the Contractor will claim reimbursement. The Contractor’s failure to notify an authorized ordering official shall result in non-payment for waiting time. Wait time shall not apply to the reasonable amount of time required for escorting the patient to the vehicle, loading and securing patient in vehicle, or unloading and delivering the patient to the authorized care giver or specified destination area. Fifteen minutes is routine.

h. Rate for Multiple Patient Transport: It is understood and agreed that more than one patient can be transported on one trip. If the COR (or designee), authorized ordering official, or AOD authorizes the Contractor to transport more than one patient on a trip, payment shall be made for each patient according to the price/cost schedule. The cost of each patient’s trip, to include the base rate and any miles that passenger was transported beyond the mileage threshold, shall be calculated and invoiced separately from the other passengers on the same trip.

PASSENGER TRANSPORTATION:

Contractor shall provide medical transportation services seven (7) days per week (including holidays), twenty-four (24) hours per day, three hundred sixty-five (365) days per year, for the term of this contract. Most of the requests for service will be between the hours of 6:00 a.m. and 6:00 p.m. Monday through Friday. The contractor shall provide the VA Medical Center with the communication method of contacting the Contractor on a 24 hour per day basis. Access to the VA NYHHS shall be obtained through the main entry at the front of the medical centers.

If a patient being transported declines to be properly belted, he/she will not be transported. The COR or designee will be notified promptly. If the patient removes the securing devices during the trip, the driver will notify the COR or designee of this upon arrival at destination. The Contractor is not required to transport any VA patient who refuses to be properly secured while being transported. Any transport that cannot be completed due to the patient’s refusal to be properly secured will be treated as a no-load.

Contractor drivers shall ensure proper loading/unloading techniques are always followed, in accordance with Department of Transportation guidelines. Contractor shall always comply with the most current guidelines, including any revisions that occur during the life of this contract. The contractor shall ensure that drivers receive appropriate safety training on loading/unloading techniques and such training shall be documented and made available to the COR or designee annually and/or prior to contract submission or renewal.

Contractor shall provide “through the door” assisted service for all patients to and from the designated appointments. Patients shall be picked up on the ward, in their homes, in the clinics, or at other areas designated by the VA and taken to the authorized destination or appointment. All patient appointments shall be always attended by an authorized responsible party. Assistance in maneuvering stairs and other barriers shall be provided by the driver and/or authorized attendant when necessary. These services may need to be provided within or outside the home (i.e., from the door to the vehicle). When the patient is delivered to a destination (i.e., a clinic or other appointment), an authorized care giver or medical staff at the destination must be informed of the patient’s arrival by the Contractor’s driver or authorized attendant.

The Contractor’s driver (or authorized attendant) shall observe the patient during transport. At the onset of any significant change in the patient’s condition (i.e., sudden onset of rapid or labored respiration, complaints, or chest pains), the driver shall call 911 and proceed according to the operator’s instructions.

After contacting 911, the driver shall communicate the scenario immediately to the Program Manager at 212-686-7500x3784 x3647 (NY) / 718-836-6600 x1972 (BK) (SA) or by contacting the VA Medical Center Emergency Room staff, at (212)-686-7500 for Manhattan, (718) 836-6600 for Brooklyn or 718-526-1000 for St. Albans – contact operator by dialing 0 and ask for Emergency Room Staff.

All diversions from destination shall be reported to the COR or designee.

Should the Contractor’s driver encounter any problems with transporting of patients, the driver shall contact the COR, or designee, at the VA NYHHS, from 7:30 a.m. to 4:00 p.m. During irregular tour of duty (4:00 p.m. to 7:30 a.m.), weekends or holidays, the driver shall contact the Administrative Officer of the Day (AOD) at the admissions desk.

Contractor’s driver shall notify the COR, or designee, of any problems transporting patients, including but not limited to accidents, safety problems, and patients unbolting themselves. The COR or designee shall be notified within one hour of the occurrence of the incident(s) by telephone and, if requested by the COR and/or Contracting Officer (CO), a written report of the incident(s) will be delivered to the COR or his/her designee by close of business the next working day. Failure to comply with provisions may be grounds for Termination for Cause.

When there is a need to transport medical records with the patient, the Contractor’s driver shall assure that the locked carrying pouch containing the records is secure and delivered with the patient to the destination.

RESTRICTIONS: The Contractor may not transport non-VA contract beneficiaries or private pay patients with VA beneficiaries under this contract. No VA beneficiary in-route in any transport shall be transferred from the original vehicle to another vehicle at a location other than the destination address supplied by the Travel Office, unless extraordinary, urgent need situations arise. All such events must be reported to the Travel Office. Drivers shall not make non-emergent stops for any reason, during any patient transport under this contract.

While transporting VA patients under this contract, only authorized drivers, or attendants, or patient’s family member or representative shall be allowed in the vehicle. The number of riders in any vehicle shall not exceed the number of approved safety restraints available in the vehicle.

The contractor shall have a contingency/backup plan in the event the contractor is unable to perform services or have services performed as required. The contractor shall immediately notify the COR or designee and provide justification for non-performance and initiate the contingency/backup plan. Failure to comply with this provision is grounds for Termination for Cause.

DRIVERS AND AUTHORIZED ATTENDANTS:

1. Identification:

All Contractor’s drivers and attendants shall wear, in a readily observable area on the employee, a Contractor supplied photo identification badge (including employee’s name and business name) and company uniform, which identify the drivers and attendants while performing any aspect of service prescribed in this contract.

2. Screening and Records:

Records of each Contractor driver and attendant as to character (criminal background check performed) and physical capabilities (Health Certificate or statement of health from a private physician) shall be maintained and made available to the CO upon request. Contractor shall be responsible for appropriate driver screening and selection criteria when employing drivers. Such screening shall include, but is not limited to, testing drivers for prohibited drug use and alcohol misuse, and a criminal background check to the maximum extent permitted by law. Failure to comply with this provision may be grounds for termination for cause. Successful offeror shall provide a list of all personnel that will be performing contract tasks and requirements, including the name, title and job description of each employee, at a post-award meeting prior to starting performance.

3. First Aid Certification:

All Contractor’s drivers and attendants shall have passed the American Red Cross First Aid Course and have on file a current certificate (renewable every three years), made available to the CO upon request. Successful offeror shall provide copies of required personnel certifications at a post-award meeting prior to starting performance.

4. CPR Certification:

All Contractor’s drivers and attendants shall have passed the American Red Cross Adult CPR course and have on file a current certificate (renewed annually), made available to the CO upon request. Successful offeror shall provide copies of required personnel certifications at a post-award meeting prior to starting performance.

5. Background Criminal Checks and Investigations:

Contractor shall provide a copy of the State of New York background criminal check for each driver and attendant. All required background investigations are at the expense of the contractor. Copies of all background criminal checks and investigations shall be provided to the Contracting Officer at a post-award meeting prior to starting performance. Performance of the contract cannot begin until these documents have been received by the Contracting Officer.

6. License:

All Contractor’s drivers shall maintain a valid operator or chauffeur’s license, required to operate the type of vehicle necessary to perform the service, as required by the State of New York. Contractor shall provide, upon request of the CO, a copy of the valid license of all drivers performing under this contract.

7. Physical Requirements:

All Contractor’s drivers and attendants shall perform duties that require the use of the above training and shall have the physical capabilities to aid when transporting patients. The CO/COR reserves the right to prohibit specific drivers from participating in the loading, transporting, and unloading of patients should it be determined the driver has engaged in unsafe practices. The Contractor shall promptly replace any personnel removed from the performance of services. This determination will be at the sole discretion of the CO/COR and will be based upon documented evidence.

All drivers and attendants, prior to commencing work and thereafter on an annual basis, shall demonstrate to the COR or designee at the VA NYHHS, the individual ability to safely load and unload patients, and the proper techniques and procedures to be followed during transportation of patients, in accordance with Department of Transportation Regulations. Contractor shall comply with the most updated guidelines always during performance.

8. Text Messaging:

Contractor drivers shall not text message while driving or violate any other distracted driver state or federal laws.

9. Attendants / St. Albans:

This subsection only pertains to transports of patients of St. Albans Community Living Center. An attendant is necessary for the safe handling of mentally unstable, dementia and adult day care patients who are high risk to themselves and surroundings when transported from St Albans Community Living Center to their respective appointments at the Brooklyn Medical Center. The attendants will act as an overseer of the happenings while in transport, allowing the driver to focus on safe transport of patients. There are approximately 350 rides per month from St. Albans. St Albans requires transportation of the following number of standing order patients:

a. Tuesday, Thursday, Friday – approximately thirteen (13) Dementia/mentally unstable patients per day

b. Monday, Wednesday, Friday – approximately twenty-five (25) physically impaired (wheelchair or motorized wheelchair) patients per day Prices bid in the schedule shall include the service of a trained professional (as required for the type of services ordered) on such trips.

CONTRACTOR CONDUCT:

The VA places the highest priority on the treatment of its beneficiaries. The Contractor, Contractor’s employees, and Contractor’s representatives shall treat each patient with respect, concern, and a professional approach to Patient’s dignity as an individual and as a patient. All communication both verbal and non-verbal by the Contractor’s personnel, with and in the presence of the patient, shall be conducted in a professional manner. Failure to comply with this provision may be grounds for Termination for Cause.

The Contractor’s personnel shall conduct themselves in a professional manner while performing any aspect of service related to this contract. All VA Medical Center rules and regulations shall be adhered to by the Contractor or Contractor’s personnel while said persons are at or on the grounds of the medical center. Failure to comply with this provision may be grounds for Termination for Cause.

ORDERS

Ordering Officials:

Only authorized points of contact shall have authority to place orders. Those names shall be provided once the contract is awarded. Once a full schedule of authorized names is provided, no other person has authority to place orders or contact the Contractor unless express written authority is granted by the Program Manager or COR. The contractor’s system which input the VA’s travel requests must been deemed secure by the VA New York Harbor’s Information System Security Officer (ISSO).

Requests for services will be recorded on the daily travel manifest and furnished to the Contractor via facsimile, encrypted e-mail and/or verbal telephone call (not text message), by the Travel Section VA NYHHS, no later than 4:00 p.m. prior to the day the transportation is required. The following information shall be provided by the VA to the contractor:

• Patient name (first and last name)

• Last 4 of Social Security Number on travel log for billing purposes

• Pick up point (include address, telephone #, city, state, bldg. and/or room number if applicable)

• Destination

• Time of pick up

• Additional information as needed (whether there are papers, medications, or other items to be transported with the patient and location of those items)

• Any specific physician instructions

IMPORTANT*** - All logs and documents with protected VA Sensitive Information must always remain with the driver and be covered so that they cannot be seen by anyone else (example in a briefcase or folder).

In the event a patient misses his/her scheduled appointment due to pick up delay, the VA shall reschedule the trip. Any such events will reflect negatively in the Contractor’s past performance review.

Any transportation service performed by the contractor, without a request from the VA, will be the responsibility of the contractor. Also see Paragraph- Restrictions

The Contractor shall maintain a record of all trips (scheduled on the travel log or add-on) and provide an encrypted email report that includes the patients name and last four of social security number, date and time of each trip, mileage, and/or any authorized additional charges. The encrypted email report shall accompany the invoice for each billing cycle. The Contractor shall contact Travel Section with any questions, requests for clarification, or the need for additional information at VA NYHHS travel section between the hours of 7:30 a.m. to 4:00 p.m. From 4:00 p.m. to 7:30 a.m., the Contractor shall contact the AOD.

Add-On Trips: Requests for add-on trips not initially recorded on the travel log shall be made by facsimile and/or by telephone from the Travel Clerk or AOD. If the Contractor fails to furnish services within 60 minutes after receiving an add-on request for an order, the VA Medical Center reserves the right to obtain the services from another source. This will reflect negatively in the Contractor’s past performance review. For add-on trips that are over 100 miles, the COR or designee may allow some flexibility in the 60-minute response time. The COR and/or Contracting Officer will determine when to order service from another source.

Contractor shall give priority to transporting VA Patients that have scheduled trips, over add-on trips. Contractor shall ensure add-on trips will not conflict with scheduled transports arriving at their Destination in a timely manner.

INCLEMENT WEATHER:

In case of inclement weather, the decision as to whether a VA Patient will be transported will be made mutually by the COR (or designee) and the Contractor. Upon request of the Travel Clerk or AOD, the Contractor shall provide the estimated time of arrival for any vehicle in-route to pick-up a VA Patient or any VA loaded vehicle in-route to a specific destination.

The Contractor shall notify Travel, by telephone, at least one-hour in advance in the event the Contractor is unable to provide trips within the time frame necessary for the VA Patient to maintain their scheduled appointment or return trip from the medical facility. For trips outside the Mileage Threshold, the contractor must notify the VA in time for another company to travel to the destination and return in time for the patient to maintain their scheduled appointment. Contractor shall use the VA provided list of authorized individuals to contact in the event Travel is not available to receive the Contractor’s call.

PATIENT PRIVACY AND CONFIDENTIALITY:

Contractor shall maintain the confidentiality of all patient information and records associated with the performance of this contract. Awarded contractor shall be required to sign Business Associate Agreement (BAA) as mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). In accordance to RCS 10-1,4000.1.b.1 the NYHHS will retain the travel logs for six (6) years after final payment or cancellation secured at the VA facility, the vendor shall only keep the logs as long as it takes for purposes of the transaction and destroy all records in accordance to NARA.

NUMBER OF PATIENTS:

It is understood and agreed that more than one patient can be transported on one trip. No vehicle will transport more individuals than the number of approved safety restraint devices installed in that vehicle. When more than one patient is transported on a trip, whether it is to the same destination or to separate destinations, payment will be made in accordance with the terms listed in - Rates.

VEHICLES:

Failure to maintain compliance with any provision prescribed in this section for vehicles used in performance may be considered grounds for Termination for Default.

Each vehicle shall be always equipped when transporting a patient in the performance of this contract with equipment as required by Federal 49 CFR Parts 27, 37 and 38, Transportation for individuals with Disabilities (most current volume), State and Local Laws, ordinances, codes, rules and regulations. Vehicles shall comply with all Department of Transportation guidelines and shall comply with the most updated guidelines always during performance.

All vehicles shall be equipped to allow for direct communication always, between the drivers, base location and staff of the VA Medical Center. This equipment may be mobile telephone, cellular telephone, or radio dispatch which would allow linking to the VA Medical Center by telephone.

Contractor shall provide any telephone numbers or special access codes or devices to Travel Section to comply with the provision for direct communication.

All vehicles shall be equipped with properly functioning heater and/or air conditioning, with adequate capacity to maintain the comfort level of the patient during transport. Contractor shall not place a vehicle into service under this contract that does not protect the patient from outside temperatures that are not suitable for the patient’s well-being.

All vehicles shall be equipped with secured fire extinguishers, first aid kits, and two (2) flashlights that are readily available and operable for use in event of an emergency. Each vehicle shall contain a minimum of two (2) sanitary blankets.

All vehicles shall be well maintained in a clean and orderly condition. Vehicles must be free from physical damage: odor, debris, and accumulation (which may constitute an accident or fire hazard). Each vehicle shall have a daily maintenance/safety checklist. Checklists shall be maintained at the contractor’s establishment and made available for inspection upon request.

All vehicles shall be smoke free and provide the proper ventilation for the patient.

All vehicles shall be maintained with a professional appearance that is representative of the services being performed on behalf of the Department of Veterans Affairs. The CO reserves the right to prohibit specific vehicles from being used to perform transportation services under this contract. This determination will be at the sole discretion of the CO and will be based on documented evidence.

Each vehicle shall be equipped with flashing warning lights activated by the opening and loading doors and a properly functioning audible back-up signal.

The contractor shall transport patients authorized for transport by the VA, which shall include bariatric patients that may require more than one person to lift.

Each vehicle and all accessories and systems must be clean and shall meet all maintenance standards of the manufacturer. All preventive maintenance shall be documented and records provided upon request by the CO.

CONTRACTOR’S QUALITY CONTROL PROGRAM (QCP):

The contractor shall establish and maintain quality control program to ensure all contract requirements are met. The Contractor’s QCP shall include the following or have incorporated into during performance of the contract, at a minimum:

1. An inspection plan covering all services required by this contract. The inspection plan must specify the areas to be inspected on either a scheduled or unscheduled basis and how often inspections will be accomplished and documented, and the title of the individual(s) who will perform the inspections.

2. On-site records of all inspections conducted by the Contractor noting necessary corrective action taken. The Contracting Officer reserves the right to request copies of any and/or each inspection.

3. The methods for identifying and preventing deficiencies in the quality of service performed before the level of performance becomes unacceptable and organizational functions noting intermediate supervisory responsibilities and overall management responsibilities for ensuring total acceptable performance.

4. The contractor shall maintain on-site records of all vehicle maintenance and repairs performed on vehicles used in the performance of this contract. The contractor shall institute methods to identify and prevent vehicle breakdowns, with detailed procedure for alternative transportation of patients in the event of mechanical breakdown of vehicle.

5. The contractor shall maintain on-site records identifying the character, physical capabilities, certifications, and ongoing training of each employee performing services under this contract.

6. The contractor shall have methods of identifying and preventing radio communication breakdowns and provide a detailed procedure for alternative communications in the event of electronic and mechanical breakdown.

7. The contractor shall maintain on-site records of any complaints or problems with procedures taken to allow for corrections and/or elimination before effects caused interruption of contract performance.

8. The contractor shall participate in quarterly scheduled and/or unscheduled conference calls with the Contracting Officer and COR to provide a report of on-going operational issues.

9. The contractor shall have a system that verifies the licenses and driving records of individuals operating the vehicles. The contractor shall make this information available for review by the Contracting Officer upon request.

PERFORMANCE STANDARD:

Contractor must maintain a 99% satisfaction rate per 100 trips to be considered as providing acceptable performance. Acceptable performance is considered as having no more than one (1) valid complaint per 100 trips. Validity of complaint is to be determined by the COR or Health Administration Service Chief or Assistant Chief. Valid complaints more than 1% per quarter may be grounds for termination.

Performance tracking will be monitored by the COR on a quarterly basis.

PERFORMANCE SURVEILLANCE PLAN / MONITORING PROCEDURES:

The Quality Assurance Surveillance Plan (QASP) is designed to monitor contract compliance. The COR will implement the plan to provide effective and systematic surveillance of all aspects of this contract.

The surveillance plan will employ various monitoring methods.

The COR or designee will implement a quarterly review of contract compliance and report to the CO findings and assessments:

· Performance Requirement Summary

· Performance

· Objectives

· Performance Standard Acceptable

· Quality

· Level

· (AQL)

· Method of

· Monitoring

· Incentive

1. Timeliness Scheduled- patients need to be at their appointments no more than 30 minutes prior to the appointment and no later than the appointment time. Pick up for these patients need to be no more than 30 minutes after the Contractor has been notified of completion of the patient appointment. Response times for unscheduled trips need to be within sixty (60) minutes. 99% Review of Ordering Log

2. Positive Past, Performance & Exercise of Option Period

3. Licensing of Employees and Vehicles- Contractor maintains current licenses for drivers, vehicle inspections and insurance. 100% COR or designee will periodically perform site visits/request copies of current licenses Positive Past Performance & Exercise of Option Period

4. Invoice Errors- Invoices comply with Invoice Procedures of the Contract and agreed upon Mileage Guide. 99% COR or designee will perform random sampling Positive Past Performance & Exercise of Option

5. Scheduled Trips are trips requested in advance by a schedule, telephone, encrypted email, or fax; and are requested before 4:30 pm on the prior day. Scheduled patients are required to be brought to the location of their appointment no more than 30 minutes prior to their scheduled appointment time and no later than their scheduled appointment time. Scheduled patients need to be transported within 30 minutes for their return trips once they have notified the Contractor, they have completed all their appointments. In the case of inclement weather and/or traffic, the COR or designee needs to be informed of each situation in which the patient will be brought in past her or his appointment time.

6. Unscheduled Trips are those trips required on an as-needed basis where advance notice is not given. An unscheduled trip is any trip in which the service is requested for the same day. Response time is within two hours of notification of need. For example, if a patient is being discharged, the Contractor may be alerted that the patient needs to be picked up immediately. The Contractor would be responsible for providing a vehicle to transport the patient home within two hours of the trip notification.

7. When unforeseeable or uncontrollable conditions occur, such as, but not limited to severe storms, flooding, or other hazardous road and travel situations, time and distance qualifications shall be considered secondary to safety precautions. Any delays or exceptions to the required quality of services, due to such substantial difficulties, shall be reported to the Travel Office during normal business hours. Outside normal business hours, the Nurse Administrative Coordinator (HAC) of the Day (AOD) for the medical center is to be contacted. The CO will decide as to whether any such delays in service will be excused. VA will not be charged for trips canceled due to conditions listed within this paragraph.

8. The COR or designee shall be responsible for verifying contract compliance. Any incidents of Contractor noncompliance, as evidenced by the monitoring procedures in the Performance Requirement Summary, shall be forwarded immediately to the CO. of monthly trip tickets against monthly invoice Period.

9. Customer Satisfaction- No more than one (1) customer complaints for every one hundred (100) trips. 99% Customer complaints Positive Past Performance & Exercise of Option Period.

10. Uniforms/ Name tags- All staff to wear Awarded Contractor’s uniform and name tag and VA PIV/Security Badge 100% Check in with Travel and/or Administrative Officer of the Day Positive Past Performance & Exercise of Option Period

11. Documentation of services performed shall be reviewed prior to certifying payment. The COR and/or Alternate COR shall perform routine audits in conjunction with the contracting service to ensure proper documentation of services. VA shall pay only for services performed and in strict accordance with the schedule of prices/costs shown in the Schedule of Items. Contract monitoring and recordkeeping procedures shall be sufficient to ensure proper payment and to allow auditors to verify that services were provided.

12. Periodic Inspection: The contractor's facility, methodologies, and quality control procedures may be examined by the COR at any time during the life of the contract. Examinations may be either scheduled or random findings documented by the COR, or authorized designee, on the Surveillance Activity Checklist.

13. Random Basic Inspection: Contract requirements are to be monitored on a random basis. The COR, or authorized designee will randomly visit areas to check for compliance with contract requirements. Findings will be recorded on the Surveillance Activity Checklist.

14. The objective of the QASP is to evaluate how the contractor is performing in key areas. Of primary interest is the quality of the services provided in accordance with contract requirements. Specific areas as outlined in Exhibit A will be closely scrutinized. Revisions to the QASP are the joint responsibility of the CO and COR.

COVID-19 VACCINATION/ HEPATITIS B VACCINATION:

1. The employer shall make available the Hepatitis B vaccine and vaccination series within ten (10) days of employment to all contract employees who have occupational risk and follow-up to all contract employees who have an exposure incident

2. The employer shall make available proof of the COVID-19 vaccination or testing as per VHA Directive 1193 and VHA Directive 2021-18. These directives are new as of the Fall of 2021 and are updated frequently with the emerging trends and requirements of the COVID-19 pandemic, therefore, please reference the following website for the most up to date versions of these policies:

https://www.va.gov/vhapublications/publications.cfm?Pub=6

3. The 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 CO 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.

INFECTION CONTROL COMPLIANCE:

1. Contractor shall provide written certification of training to employees used in performance of this contract and Contractor compliance with the Blood borne Pathogens Standards. 29 CFR Part 1910.1030 (copy available on request). Certification must be received by the CO prior to employee being assigned for duty.

2. The infection control compliance requirements apply to Contractor employees providing services during any absence from duty of scheduled employees for any reason.

3. In no circumstance will an employee be allowed to begin duty without prior submission of the required training certification.

4. 29 CFR part 1910.1030 is OSHA’s standard for bloodborne pathogens shall be implemented and can be found at:

https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1030

The following is only intended to provide an highlighted overview of 29 CFR 1910.1030 and is not to be used in replacement of any guidance within the policy:

a. Develop written exposure-control plans;

b. Train all employees on occupational risks;

c. Maintain records on employee training;

d. Use warning labels;

e. Implement proper work methods including “Universal Precautions”, (i.e. proper care and disposal of personal protective equipment such as the use and disposal of latex gloves);

f. Offer Hepatitis B Vaccine (HBV) to employees;

g. Provide medical evaluations following employee’s exposure incident to HBV or HIV

h. Supply personal protective clothing and equipment (i.e., gloves and goggles)

CONTRACT ADMINISTRATION AND INVOICING:

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

The Contractor shall coordinate billing arrangements with the COR monthly, in arrears. Log documents shall include an encrypted email report that shall contain the contract number, date, time, patient’s name and address, and mileage. The COR will then approve the log and an invoice can then be submitted to http://www.tungsten-network.com/US/en/veterans-affairs/. Invoices shall not contain any patient information. Invoices shall be submitted monthly. The Contractor shall maintain a log, which will show pickup point and destination, and departure/arrival times if waiting time is claimed. If detours are encountered due to road construction or other obstruction, invoice shall so be noted. Actual toll logs shall also be submitted at this time.

EVIDENCE OF INSURANCE COVERAGE:

Before award of the contract, the Contractor shall furnish to the CO a certificate of Insurance which shall contain an endorsement to the effect that cancellation of, or any material change in, the policies which adversely affect the interest of the Government in such insurance, shall not be effective unless a 30-day written notice of cancellation or change is furnished the CO.

SUBCONTRACTORS:

1. The Contractor shall incorporate the substance of this clause, its terms and requirements including this paragraph, in all subcontracts under this [contract vehicle], and require written subcontractor acknowledgment of same.

2. Violation by a subcontractor of any provision set forth in this clause will be attributed to the Contractor.

SPECIAL CONTRACT REQUIREMENTS

Please note that, although Sections Q through U reference subcontractors, nothing in this section should be interpreted to permit subcontracting without prior approval. See Section A.1.

POSITION SENSITIVITY:

The position sensitivity has been designated as LOW RISK. The level of background investigation commensurate with the required level of access is National Agency Check with Written Inquiries. All required background investigations are at the expense of the Contractor.

THE JOINT COMMISSION COMPETENCY REQUIREMENTS:

The Contractor shall be responsible to ensure that contractor employees (and/or subcontractor employees) coming to the work site shall receive the information required to perform their duties.

a. Contractor shall attend a pre-work orientation meeting prior to the commencement of work on site. This training will be documented and updated yearly. The VA shall schedule this meeting and it shall include discussion of the following topics: (VA shall provide information to the contractor regarding these topics and shall document the meeting.)

· Fire and Safety

· Infection Control

· Patient Privacy and Confidentiality

· Disaster Procedures

· Other

b. Contractor shall be responsible to ensure that Contractor’s employees (and/or subcontractor employees) coming to work site shall receive the information above.

c. Contractor shall be responsible to ensure Contractor employees (and/or subcontractor employees) providing work on this contract is fully trained and completely competent to perform the required work.

HIPAA COMPLIANCE:

a. As a covered entity, the Department of Veterans Affairs (VA) is required by law to obtain satisfactory assurance of a Business Associate and that the Business Associate appropriately safeguards protected health information it receives or creates on behalf of the covered entity.

Contractors and any subcontractors must adhere to the provisions of Public Law 104-191, Health Insurance Portability and Accountability Act (HIPAA) of 1996 to include the Administrative Simplification Provisions of the law and associated rules and regulations published by the Department of Health and Human Services (HHS). The Contractor shall comply with all HIPAA related rules and regulations to include Electronic Transactions, the Standards for Privacy of Individually Identifiable Health Information, and the Security Standards. This includes both the Privacy and Security Rules published by the Department of Health and Human Services (HHS). As required by HIPAA, HHS has promulgated rules governing the use and disclosure of protected health information by covered entities. The covered entity component of the Department Veterans Affairs is the Veterans Health Administration (VHA). In accordance with HIPAA, the Contractor will be required to enter into a Business Associate Agreement (BAA) with VHA.

b. Business associates must follow VHA privacy policies and practices. All contractors and business associates must receive privacy training annually. This requirement is met by completing VHA Privacy and Information Security Training (TMS 10176) and HIPAA Training (TMS 10203) or other VHA approved privacy training. This shall be coordinated with the COR. Proof of training is required to be on file with the COR, and available to the CO if requested.

c. Any violation of HIPAA will be reported to the CO in writing within twenty-four (24) hours of the Contractor’s discovery of an occurrence. Included in the report will be a description of the occurrence, patient names (if known), location, date, and time. A copy of any filed police report will be provided by the Contractor to the CO within twenty-four (24) hours of completion.

**NOTE: Please see page 28 for additional training requirements.

CONTRACTING WITH PARTIES LISTED ON THE OIG LIST OF EXCLUDED INDIVIDUALS/ENTITIES:

a. In accordance with The Health Insurance Portability and Accountability Act (HIPAA), Sections 1128 and 1128A of the Social Security Act and the Balanced Budget Act (BBA) of 1977, the Office of Inspector General has established a list of parties and entities excluded from Federal health care programs. Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs.

b. Therefore, all offerors shall review the OIG List of Excluded Individuals/Entities on the OIG web site at www.hhs.gov/oig to ensure that the proposed candidate(s) and/or firm(s) are not listed.