Attachment A Performance Work Statement 7-9-2021 Revised 7-30-2021.pdf

Attachment A

PERFORMANCE WORK STATEMENT – AMBULANCE SERVICES

1.0 Description:

The Corporal Michael J. Crescenz VA Medical Center (CMCVAMC), 3900 Woodland Avenue, Philadelphia, PA 19104 is seeking to award a five-year Indefinite Delivery Indefinite Quantity (IDIQ) contract for ambulance services to transport patients including physically or mentally handicapped individuals, aged and infirm persons, their attendants and personal belongings throughout the tristate area to include but not limited to: Southern New Jersey, the Greater Philadelphia area, Delaware, and other VA and approved non-VA facilities. The Contractor agrees to provide all required labor, material, equipment and supervision of contractor personnel for both emergent and non-emergent ACLS/ALS, and Basic Life Support (BLS) ambulance services, 24-hours per day, 7 days per week (to include all federal holidays) for all eligible Veteran beneficiaries of the CMCVAMC as listed below:

Community Living Center (CLC) 3461 Civic Center Boulevard Philadelphia, PA 19104

Outpatient Dialysis Clinic 4219 Chestnut Philadelphia, PA 19104

Snyder House 1425 Snyder Avenue Philadelphia, PA 19145

Camden VA Clinic 300 South Broadway Suite 103 Camden, NJ 08103

Gloucester County VA Clinic 211 County House Road Sewell, NJ 08080 Victor J. Saracini Outpatient Clinic 433 Caredean Drive Horsham, PA 19044

Burlington County VA Clinic 300 Lincoln Drive Suite E Marlton, NJ 08053

West Philadelphia VA Clinic 6232 Market Street Philadelphia, PA 19139

2.0 Contract Definitions:

2.1 Administrative Officer of the Day (AOD) - VA official that works in the admissions area during evenings and nights, and monitor hospital activities during other than normal working hours. This person is located at the main site of the CMCVAMC and acts as hospital administrator during off-hours.

2.2 Advanced Cardiac Life Support Support/Advanced Life Support Transport (ACLS/ALS) - Defined as services required for critical patient care in which Patients require an ambulance, staffed in accordance with State laws and regulations governing the certification and licensure of ground ambulances. This ambulance, at a minimum, will be staffed with a Certified Emergency Vehicle operator/Emergency Medical Responder (EMR) and a Paramedic who can provide cardiac monitoring, Advanced Cardiac Life Support (ACLS), advanced airway management, and medication administration and monitoring.

2.3 Base Rate - For all one-way trips within the 25-mile threshold 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 that do not exceed the 25-mile threshold.

2.4 Basic Life Support (BLS) - Defined as services required for non-critical patient care in which Patient requires an ambulance, staffed in accordance with current State laws and regulations governing the certification and licensure of ground ambulances. This ambulance, at a minimum will be staffed with a Emergency Vehicle Operator/Emergency Medical Responder (EMR) and Emergency Medical Technician (EMT) who can provide basic airway management and IV’s at KVO (Keep Venous Open) without the use of medications. This may also include psychiatric emergencies that do not involve any ACLS/ALS care.

2.5 Beneficiary - Veterans and other members determined to be eligible for benefits by the

CMCVAMC.

2.6 Business Hours/Days - Business hours/days are defined as the time of 8:00AM to 4:30PM, Monday through Friday, except Federal holidays. Federal holidays, include New Year’s Day, Martin Luther King Day, President’s Day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans’ Day, Thanksgiving Day, Christmas Day and other specifically designated days by the President of the United States to be a Federal holiday. Off business hours/days are defined as the time of 4:31PM to 7:59AM, Monday through Friday, all day Saturday and Sunday and Federal holidays.

2.7 Contract – The Contract awarded as a result of this solicitation.

2.8 Contracting Officer (CO) - VA official with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings.

2.9 Contracting Officer’s Representative (COR) – CMCVAMC official responsible for providing Contract oversight and technical guidance to the CO. Responsibilities include certifying invoices, placing orders for service, providing technical guidance, and overseeing technical aspects of the Contract. Also acts as member of the vehicle inspection team. All contracting authority remains with the CO.

2.10 Contractor - The term “Contractor” as used herein refers to both the prime Contractor and his employees, and any subcontractors and their employees. The prime Contractor shall be responsible for assuring that his subcontractors comply with the provisions of this Contract. The Government has a contracting relationship with the Prime Contractor only.

2.11 Emergency ALS/ BLS – Set of clinical interventions for the urgent treatment of cardiac arrest, stroke and other life-threatening medical emergencies, as well as the knowledge and skills to deploy those interventions. These need a response from the contractor in a much lower amount of time than the regular ALS and BLS.

2.12 Escort - Such as a relative of the Patient or a CMCVAMC employee accompanying the Patient when the CMCVAMC has determined such an escort is in the best interest of the Patient.

2.13 Excess Cost - The difference between prices charged by another source used and the applicable Contract prices.

2.14 Financial Services Center VA - (FSC) – Payment is made through electronic funds transfer - Department of Veterans Affairs, Financial Services Center, PO Box #149971, Austin, TX 78714- 9971; FAX: 512-460-5540 (services).

2.15 The Joint Commission (TJC) – A national organization dedicated to improving the care, safety and treatment of patients in a health care facility and environment.

2.16 KKK-A-1822F Specification - Each ground ambulance used in the performance of this Contract must meet the current specifications of Federal Specification KKK-A-1822F (http://apps.fss.gsa.gov/vehiclestandards/ or https://www.safeambulances.org/organizations/gsa/) for information.

2.17 Mileage Rate - In addition to the base rate, the contractor shall receive the mileage rate for each mile traveled beyond the 25-mile threshold. This rate applies to loaded, one-way transportation. In the event fraction miles result, VA shall pay the rounded off amount to the next http://apps.fss.gsa.gov/vehiclestandards/ https://www.safeambulances.org/organizations/gsa/ higher mile. In no event shall the Contractor receive this rate for miles traveled within the 25-mile threshold.

2.18 Mileage Threshold – 25-mile radius from a designated pick up point to a designated delivery point.

2.19 No-Patient Charge - Fee allowed to Contractor for scheduled pick-ups for which due to circumstances beyond the Contractor’s control (i.e. Patient refuses pick-up, Patient not home, Patient not medically/mentally suitable for transport, etc.) are not completed. This charge shall only be accessed on actual trips to the Patient pick-up point and shall not be assessed on scheduled pick-ups that are cancelled by the VA and/or the Patient.

2.20 Patient - A beneficiary receiving services from the ambulance Contractor under this Contract.

2.21 Protected Health Information (PHI)- individually identifiable health information, held or maintained by a covered entity or its business associates acting for the covered entity, that is transmitted or maintained in any form or medium (including the individually identifiable health information of non-U.S. citizens).

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

2.24 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.

2.25 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.

2.26 Scheduled Trip(s) - The term ”Scheduled Trip” as used in this Solicitation/Contract refers to those trips in which the Contractor has been given advance notice (advance notice is defined as notice given by 4:30PM the prior business day) of required services and a specific pick-up time.

2.27 Travel Assistant - Individual employed in VA Travel Section who is authorized to request services from the Contractor.

2.28 Unscheduled Trip(s) - The term “Unscheduled Trip” as used in this Solicitation/Contract refers to those trips required on an as needed basis and advance notice is not given.

2.29 Waiting Grace Period - The waiting grace period is defined as thirty (30) minutes. The base rate for all ambulance services shall include a thirty (30) minute waiting grace period at origin and destination before waiting charges commence.

2.30 Pre-Hospital Registered Nurse (PHRN) - A PHRN is a registered nurse that has additional education, knowledge and skills competency related to the management of emergency medical conditions. PHRNs are certified to practice as EMS providers in Pennsylvania by the Department of Health.

3.0 Performance Requirements:

3.1 All Contractor personnel, both prime and subcontractor shall be responsible for providing all vehicles and personnel, necessary to meet all critical care transport, ACLS/ALS and BLS transport requirements of this Contract. In the event the Contractor is unable to perform services or have services performed as required, the Contractor shall immediately notify the COR and the beneficiary travel department and provide a justification for non-performance. The VA reserves the right to re-procure services which cannot be performed by the Contractor, in accordance with the terms, conditions, and schedule of this Contract. The Contractor shall indemnify the VA for excess re-procurement costs that result from the Contractor’s inability to perform the required service. Payment of re-procurement costs shall not relieve the Contractor from any other provision in this Contract covering inspection, acceptance and deductions from payment. The CMCVAMC will be the sole judge in determining when services will be re-procured. The failure of the Contractor to perform services within the required time frames and in accordance with terms and conditions may also provide cause for termination of the Contract for “cause,” (see FAR clause 52.212-4(m)).

a. Vehicle Response Times:

The Contractor shall be at CMCVAMC within 20 minutes after notification for an Emergency Advanced Cardiac Life Support/Advanced Life Support Transport (ACLS/ALS) and/or Emergency Basic Life Support Life Support (BLS) vehicle.

The Contractor shall be at CMCVAMC within 45 minutes after notification for ground ambulance transport service for a Non-Emergency Advanced Cardiac Life Support/Advanced Life Support (ACLS/ALS) vehicle and/or Non-Emergency Basic Life Support Vehicle (BLS).

CMCVAMC will perform cardiac ablation procedures (and other complex procedures), where clinical staff will need an ALS ambulance parked on site in case immediate transportation for any unforeseen emergencies related to the procedures may arise. These requests will be prescheduled as needed; generally, one-week notice is provided. An ambulance would need to be onsite for approximately 5 hours, generally between 8AM – 4PM on the day of the pre-scheduled procedure. This would be in addition to any other ambulance services should the need arise on the same day.

The contractor shall have and provide a PHRN for complex transfers when necessary.

CMCVAMC will provide as much prior notice as possible; generally, one day notice is provided.

The PHRN will travel with the patient to the Hospital of the University of Pennsylvania.

Historically, this has occurred approximately four times/year.

3.2 Response Time Compliance Rate: The Contractor shall maintain, at a minimum, a 95% compliance rate on responses to pick-up or deliver during the Contract year.

3.3 Immediate Notification: It is the responsibility of the Contractor to immediately notify the CMCVAMC beneficiary travel team or AOD when unable to make a pick-up or delivery by the exact time specified for previously scheduled trips; or unable to dispatch an ambulance to a designated pick-up point within the required time frame for unscheduled requests for services.

The immediate notification shall include the reason for the delay and whether the pick-up or delivery can be made at a later time and if so, specification of that time. However, it shall be the sole discretion of the CMCVAMC beneficiary travel team or AOD to accept the later pick-up or delivery time, and based upon the reason for delay, present the delay for payment reduction or refuse the later pick-up or delivery time and order the services from another source (the CMCVAMC beneficiary travel team, AOD or COR shall be the entities for determining when to request the services from another source), and present the reason for the delay to the CO as an occurrence that may be subject to default. Based upon the reason for the delay, appropriate contractual action will be taken by the CMCVAMC.

3.4 Waiting Time: All scheduled trips, include the waiting grace period of thirty (30) minutes defined above. Any wait time after this period the vendor must separately invoice any wait time in accordance with the Price/Cost Schedule.

3.5 Substitution of Patient: The VA reserves the right to substitute the Patient requiring services at any time during the performance of this Contract, to prevent delays or cancellations. There shall be no additional charge to the VA when such changes occur.

3.6 Morgue Transports: It may become necessary for the Contractor to be called upon to transport the remains of a deceased Patient between the various CMCVAMC facilities or to the County morgue for purposes of post-mortem. The Contractor shall agree to accept such assignments when called upon under the provisions of the Contract and to supply personnel normally assigned non-emergency vehicles in performing this service.

3.7 Number of Patients: The Contractor shall transport one patient per trip under ambulance services.

3.8 Direct Patient Transfer: All Patient transfers between VA facilities shall be direct transfers from a designated pick-up point to a designated delivery point.

3.9 Escorts: Only one (1) patient shall be transported on a trip allowing for only one (1) family member escort or caregiver when authorized by CMCVAMC. An authorized Official of the

CMCVAMC may, in the interest of the patient, allow a relative, care provider or staff member accompany him/her at no extra charge to the Government.

3.10 Authorized Medical Center Personnel: Prior to performance, the CO shall 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. The Contractor shall immediately notify the beneficiary team, AOD or COR if they receive a request from unauthorized personnel.

3.11 Request for Services: All requests will be placed against pertinent schedule items, on a unit price basis, and will be verified against invoices and the Contractor’s online portal. When ordering services other than the online portal (telephone, facsimile, e-mail and/or person), the Contractor is obligated to include and update the portal with the request. The CMCVAMC will provide the Contractor with the following type of information:

Mode of transportation required, Required date and time of arrival, Name of Patient, Pick-up and delivery point, and Any other special instructions

3.12 Dispatcher: The Contractor shall identify the contact information for transportation requests, including the following:

Company Company Address Normal Hours Contact Person Normal Hours Telephone No.

After Hours Contact Person:

After Hours Services Telephone No.

3.13 Vehicles transporting VA beneficiaries must be dedicated exclusively to VA transports. The Contractor may not carry non-VA contract beneficiaries or private-pay patients with VA beneficiaries under this contract.

3.14 The Contractor shall be required to transport non-ambulatory Patients on gurneys, litters, and geriatric chairs who are not in need of emergency transportation or medical attention.

3.15 Contractor Reimbursement:

Reimbursement for mileage outside the Contract Mileage Threshold of coverage, shall be at the mileage rate stated in the price schedule and shall be based upon the miles from the pick-up point to the specified destination. Any mileage from the place of business and/or location of vehicle and the pick-up point, or from the delivery destination back to the place of business and/or location of next trip are not considered as a separate item of this reimbursement, but would be expected to be incorporated into the mileage rate that is the Contractor’s responsibility as part of the administrative costs (or costs of doing business). Trip mileage under the contract shall be determined by using the mileage tracker on the online portal.

Should the VA make a determination that a previously scheduled trip may be cancelled, and a vehicle has already been dispatched to the designated pick-up point, VA may notify the Contractor to cancel the order. For orders that are cancelled while the Contractor is already in route to the designated pick-up, the Contractor shall be entitled to receive 50% of the base rate for the trip, as provided in Schedule of Supplies or Services and Prices/Costs. This charge shall not include any mileage charge.

Should the Contractor arrive at the destination before VA cancels the order, of if the Contractor is unable to perform a scheduled pick-up for reasons beyond the Contractor’s control, e.g., incorrect address, or Patient absence, or Patient refusal, then the Contractor shall receive 100% of base rate for a one way trip as provided in the Schedule of Supplies or Services and Prices/Costs, and applicable mileage if outside Contract Mileage Threshold areas of coverage.

Other Charges: It is understood that the prices listed in the Schedule of Supplies or Services and Prices/Costs shall be inclusive of any and all ferry, bridge, tunnel or road toll charges.

Contractor shall not bill the VA for any such separate charges.

3.16 Auxiliary Service: The Contractor may be required at times to transport Patient luggage, medical records, medication and other items including, but not limited to, wheelchairs, Stryker frames, litters, and nutritional supplements from the pick-up point to destination. The Contractor shall not open, manipulate or otherwise seek information from these records or personal effects.

The records and personal effects shall be delivered intact to the prearranged destination.

Luggage to be transported shall be restricted to suitcase and valise type. These services shall be provided at no additional cost; however, should there not be room to transport these items and a second vehicle is needed, payment will be half (1/2) the charge from the first transport, only if the second vehicle is pre-approved by CMCVAMC. No payment will be made for the second vehicle without CMCVAMC pre-approval.

3.17 CMCVAMC reserves the right to restrict any Contractor employees from performing services under this Contract who do not meet the required qualifications for the services they are to perform, who violate Federal and/or any applicable regulations, or are identified as a potential threat to the security, safety, health and/or operational mission of the VA and its veteran population. The restriction of such Contractor personnel shall not relieve the Contractor from performing all the required services, in accordance with all terms, conditions, and schedules contained herein.

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

The Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S. Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services under this Contract.

Contractor personnel performing services to the VA shall at all times 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. The Contractor shall be responsible for furnishing all vehicles, personnel, equipment and supplies, vehicle fuel, uniforms, nametags and/or badges for performance of services under this Contract. Employee identifications shall be worn in clear view above the waist. Contractor personnel shall not smoke in vehicles while transporting VA Patients.

Contractor employees shall not represent themselves as VA employees while performing under this Contract.

3.18 Contractor/Subcontractor Personnel Qualifications:

All Contractor personnel, both prime and subcontractor, performing Contract services shall meet all qualifications and licensing as specified in this Contract, as well as any qualifications and licensing required by each State from the place in which they operate. Contractor personnel shall meet these qualifications at all times while performing Contract services.

During the Contract period of performance, if the Contractor proposes to add-on or replace personnel to perform Contract services, the Contractor shall submit required evidence of training, certifications, licensing, background and security clearances, and any other qualifications to the designated COR. At no time shall the Contractor utilize add-on or replacement personnel to perform Contract services who do not meet the qualifications under the terms and conditions of this Contract.

Emergency Vehicle Operator (EMSVO), Emergency Medical Responder (EMR), and Emergency Medical Technician (EMT) and Paramedic Qualifications: Ambulance staff providing services under this Contract:

Shall have completed training in accordance with the standards published by Federal and State Government.

Shall have evidence of re-certifications and equivalent training programs that are successfully completed.

Shall be certified, or otherwise officially recognized by the state or regional government or public entity where the emergency ambulance service is operated or by which it is governed.

Shall attend all refresher continuing education, or advance training programs as required by the State government entity in which service is rendered. In no instance shall this be less frequent than what is required by Federal and State Government.

The Contractor shall be responsible for the training and competency of its paramedics in the use of the video laryngoscope for difficult intubations.

Ambulance Drivers: Drivers shall have a valid operator’s or chauffeur’s license in accordance with Federal and State government requirements for their place of operation, for the services they perform, be capable of administering emergency patient care and have successfully completed an Emergency Vehicle Operator course approved by the State where certified and be capable of providing necessary medical assistance to the attending medical care specialist.

Should governmental requirements differ on this contract, then the strictest shall apply.

The ambulance Contractor’s Medical Director shall certify all ambulance staff and direct emergency medical response processes.

All staff of the ambulance Contractor is required to be assessed regarding competence and performance per State, Emergency Medical Services.

See Paragraph 7.0 for the websites pertaining to the States’ requirements for personnel and ambulance.

3.19 Contractor/Subcontractor Equipment, Vehicles, and Inspection:

The VA reserves the right to inspect Contractor’s equipment and vehicles or require documentation of compliance with contract specifications, and State laws, rules, regulations and guidelines governing emergency medical transport vehicles (ambulances). VA inspections of Contractor facilities shall in no way constitute a warranty by the VA that the Contractor’s vehicles and equipment are properly maintained. The VA reserves the right to restrict the Contractor’s use of equipment and vehicles which are in need of repair, unclean, 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 VA.

Ambulances shall meet all current applicable Federal and State specifications and regulations including, but not limited to, licensing, registration, and safety standards. Appropriate licensing by the States of Pennsylvania, New Jersey and Delaware are required.

The ambulances shall be clean and maintained in good repair in accordance with manufacturer’s instructions and specifications at all times during the performance of this Contract, and shall contain:

An emergency safety kit, Portable oxygen unit (s), Fire suppression equipment, and Appropriate road emergency warning equipment.

BLS ambulance transports shall, in conjunction with the above, be equipped with stretchers to accommodate patients over 500 pounds, have an on-board EMT, and perform basic airway management. If bariatric ambulance services are required, there will be no additional charges to the CMCVAMC above the rates established in the Price/Cost Schedule.

ACLS/ALS ambulance transports shall, in conjunction with the above, be equipped with pulse oximetry and on-board Paramedic, perform cardiac monitoring, provide 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.

The Contractor shall provide oxygen when it is requested by authorized medical facility personnel or required by the Patient’s medical condition.

The Contractor shall provide all medications required while in transport, sheets and blankets and other equipment and supplies required for use while in transport, for direct patient care. The Contractor shall at no time and under any circumstances exchange supplies, equipment and/or medications with VA. The prices quoted in the Schedule of Supplies or Services and Prices/Costs shall be inclusive of consumables used in transport. All vehicles used for critical patient care (e.g., 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 equipment and accessories.

See Paragraph 7.0 for the websites pertaining to the States’ requirements for personnel and ambulance.

3.20 Patient Incidents and Complaints:

Incident Report -The Contractor shall immediately report all medical incidents and/or vehicle accidents including those where there is no apparent injury to the patient while transporting VA beneficiaries. Notify the Travel Department during normal business hours and the AOD after hours.

1. A written report from the driver documenting the facts of the incident/accident shall be provided to the Contracting Officers Representative (COR) within 24 hours of the occurrence.

The written report shall include the names, addresses, and telephone numbers of any witnesses as well as any applicable police reports.

**Any accidents involving major damage, serious personal injury or loss of life shall be reported to the COR and CO immediately.**

3.21 Infection Control Procedures:

1. The Contractor shall follow the Infection Prevention and Control policies and procedures according to city, state, federal, and any accrediting agency regulations for ambulance personnel to prevent and control the spread of infectious agents to all persons, including preventing the spread of COVID-19.

2. The Contractor shall also be in compliance with all Reusable Medical Equipment (RME) policies and procedures according to city, state, federal, and any accrediting agency regulations for ambulance personnel.

3.22 Driver's Conduct:

While on duty the following are not permissible by drivers that provide services under this contract or while on VA premises:

Do not participate in a dispute with a fellow employee, customer(s) or the public while on duty.

Use of loud, indecent or profane language and/or making threatening or obscene gestures towards customers or other employees.

Engaging customer in a verbal confrontation in an attempt to settle a disagreement. Should a disagreement arise, the driver shall contact his dispatcher/supervisor via the radio system or cellular phone.

Soliciting or accepting tips from customers, companions or others at any time.

3.23 Invoicing:

Payment to the Contractor shall be made monthly, in arrears, upon receipt of a properly prepared invoice. Payment for services will be at the rates specified in the Price/Cost Schedule. All monthly invoices from the contractor will be electronically submitted through the Tungsten Network within 10 days following the end of the month of services.

The information page for the Financial Service Center (FSC) of the Department of Veterans Affairs that includes information regarding electronic invoice submission can be referenced at:

http://www.fsc.va.gov/einvoice.asp

Department of Veterans Affairs Financial Services Center PO Box 149971 Austin TX 78714-8971 Customer Support Help Desk (877-353-9791)

Invoices must be approved by the benefit travel team/supervisor or COR prior to payment release. Invoices without the required information will be rejected.

Failure to comply with all terms and conditions of this contract shall result in invoices/claims submitted for reimbursement during that period to be considered incomplete. Interest penalties imposed under the Prompt Payment Act shall not apply to incomplete invoices or invoices received after the established invoice due date.

Contractor will identify and assign personnel to be the liaison for billing purposes.

Billings rendered by the Contractor to the VAMC for services furnished a VAMC beneficiary under the terms of this contract shall be billings in full. Neither the beneficiary his insurer, nor any third party shall be billed. Billed services will be verified by VA staff and COR.

A password protected copy of the billing items below will be submitted via email to the COR prior to invoices being sent to FSC:

Patient’s name Trip date Pick up point name and address Pick-up point arrival time Pick-up point departure time Drop off point name and address Drop off point arrival time Number of miles if outside Contract Mileage Threshold http://www.fsc.va.gov/einvoice.asp

Contract Number and CURRENT Purchase Order (obligation number) Base charge plus an itemization of additional charges, if applicable, and name of VA Official who authorized trip.

Contractor Remittance Address: All payments by the Government to the Contractor will be made by Electronic Funds Transfer (EFT).

3.24 Contractor Communication System:

Contractor's Communication System shall consist of:

Telephone System

Contractor shall have sufficient telephone capacity to ensure immediate communication access between CMCVAMC and the Contractor for the purposes of scheduling and canceling trip requests as well as handling other emergencies. If the Contractor's place of business is located beyond the local telephone call zone, the Contractor shall accept telephone orders for service on a collect basis or provide a toll-free number.

The Contractor shall have telephone coverage to accept calls from CMCVAMC seven (7) days a week/24 hours a day Sunday through Saturday.

Online Portal

Contractor shall have an online portal available 24/7 for CMCVAMC to request ambulance services and monitor trips. The Contractor will continuously monitor the portal to provide requested services in a timely fashion.

The online portal will allow the Beneficiary Travel department, AOD, or COR to audit and track trips, including mileage, pick up/drop off locations and times, wait times, name of VA requestor, route information, etc. If the online portal is not working at any moment, the Contractor will be responsible to electronically track and report trips via telephone as requested. The Contractor shall provide a written summary of all trips conducted at the end of each day a system outage occurs.

Contractor must provide orientation and training for the online portal to the current VA staff or any new VA staff that may come onboard during the period of performance. The Contractor will be solely responsible for any needed upgrades to the online portal, including costs of the upgrade. Contractor shall provide training for the online portal consisting of two separate days during the first week after contract award. The Contractor will additionally provide one (1) additional day of training for a make-up session to be scheduled by the VA at a later date. The VA will attempt to schedule the make-up session within the second week of award, however the

VA reserves the right to schedule the make-up session later if in the best interests of the government.

Vehicle Communication

Contractor shall ensure the availability of mobile radio or cellular telephone communication with all vehicles providing transportation service at all times.

4.0 Contractor Quality Control Program (QCP):

The Contractor shall provide assurance that the transportation services meet health and safety standards for vehicle maintenance, operation, and inspection; driver qualifications and training;

client problem resolution, complaint resolution and the delivery of courteous, safe and timely service. The Contractor shall establish and maintain a QCP to ensure the requirements of this contract are provided as specified.

1. The Contractor's QCP shall include the following at a minimum, 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, how often inspections will be accomplished and documented, or the title of the individual(s) who will perform the inspections.

2. 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 acceptable performance.

3. On-site records of all vehicle maintenance and repairs performed for vehicles used in the performance of this contract.

4. The methods for identifying and preventing vehicle breakdowns and detailed procedure for alternative transportation of patients in the event of mechanical breakdown of vehicle.

5. On-site records identifying the character (background checks) and certifications of ongoing training of each employee performing service under this contract. Driver licensure, driving record, experience and appropriate driver training are required to be maintained by the Contractor.

6. The methods of identifying and preventing radio communication breakdowns.

7. The online portal will allow the Beneficiary Travel department, AOD, or COR to audit and track trips, including mileage, pick up/drop off locations and times, wait times, name of VA requestor, route information, etc. If the online portal is not working at any moment, the Contractor will be responsible to electronically track and report trips via telephone as requested.

The Contractor shall provide a written summary of all trips conducted at the end of each day a system outage occurs.

8. Procedure for Accident/Incident reporting.

9. Analysis of complaints, including the tracking and investigating of complaints and disposition of the cases.

10. Random audit of existing rides performed (minimum 10% of trips).

11. Client safety

12. Monitoring of on-time performance

** The Government reserves the right to request copies of any parts of the Contractor

QCP**

5.0 Other Requirements:

At no time will the Contractor leave vehicles on VA premises unless a pick-up or delivery is in progress or it is authorized beforehand by the CMCVAMC.

When a patient is transported with any VA owned equipment/property, the equipment shall be returned to the CMCVAMC within 24 hours in the same condition as it was released at no additional cost to the Government.

When transporting Veteran patients to or from medical facilities, the driver acting for the Contractor shall ensure that the patient's belongings (i.e. medical records, luggage) are properly accounted for and delivered with the patient as required (see Paragraph 3.16).

VA will provide the contractor with access to pertinent patient medical information, with the existing privacy rules and regulations, for the purpose of providing coordinated comprehensive care. Contractor shall ensure the confidentiality of all patient information and shall be held liable in the event of the breach of confidentiality. Any contract resulting from this solicitation will be subject to the Privacy Act of 1974, Federal Acquisition Regulations 52.224-1 Privacy Act Notification and 52.224-2 Privacy Act apply to this contract. The contractor is not authorized to release any medical record information. The VA is the sole entity authorized to release this information upon written request from the patient.

The contractor shall participate in regularly scheduled and/or unscheduled conference calls with CMCVAMC representatives to provide a report of on-going operational issues.

6.0 Depart of Labor (DOL) Wage Determination: Service Contract Act DOL Wage Determination No. 2015-4233, REV 18 dated 4/13/2021 applies to the resultant Contract from this solicitation.

7.0 Websites:

https://regulations.delaware.gov/AdminCode/title16/Department%20of%20Health%20and%20Social%2 0Services/Division%20of%20Public%20Health/Emergency%20Medical%20Services%20(EMS)/4301.shtml https://regulations.delaware.gov/AdminCode/title1/700/710.shtml EMSAct_37_Chapter 81.pdf (pa.gov) ACT 37 of 2009 as Amended (PDF) 28 Pa. Code Part VII. Emergency Medical Services (pacodeandbulletin.gov) Pennsylvania Bulletin (pacodeandbulletin.gov) https://nj.gov/health/ems/reg-enforcement/ https://www.njconsumeraffairs.gov/nur/pages/applications.aspx

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

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

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

8. Special Contract Requirements:

8.1. Reports/Deliverables: The Contractor shall be responsible for complying with all reporting requirements established by the Contract. Contractor shall be responsible for https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fregulations.delaware.gov%2FAdminCode%2Ftitle16%2FDepartment%2520of%2520Health%2520and%2520Social%2520Services%2FDivision%2520of%2520Public%2520Health%2FEmergency%2520Medical%2520Services%2520(EMS)%2F4301.shtml&data=04%7C01%7C%7C87317111b71b48b2354808d92f658357%7Ce95f1b23abaf45ee821db7ab251ab3bf%7C0%7C0%7C637592936223975594%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=foJ88B7xXq7VjpLLNfF5P%2FffhCz0qWdSx2ScxWCMswM%3D&reserved=0 https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fregulations.delaware.gov%2FAdminCode%2Ftitle16%2FDepartment%2520of%2520Health%2520and%2520Social%2520Services%2FDivision%2520of%2520Public%2520Health%2FEmergency%2520Medical%2520Services%2520(EMS)%2F4301.shtml&data=04%7C01%7C%7C87317111b71b48b2354808d92f658357%7Ce95f1b23abaf45ee821db7ab251ab3bf%7C0%7C0%7C637592936223975594%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=foJ88B7xXq7VjpLLNfF5P%2FffhCz0qWdSx2ScxWCMswM%3D&reserved=0 https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fregulations.delaware.gov%2FAdminCode%2Ftitle1%2F700%2F710.shtml&data=04%7C01%7C%7C87317111b71b48b2354808d92f658357%7Ce95f1b23abaf45ee821db7ab251ab3bf%7C0%7C0%7C637592936223975594%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=R3EGQjJhDRO4JBYcBeulGLldTKv0%2FZY5RT7%2FQASEGno%3D&reserved=0 https://www.health.pa.gov/topics/Documents/EMS/EMSAct_37_Chapter%2081.pdf https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.health.pa.gov%2Ftopics%2FDocuments%2FEMS%2FEMSAct_37_Chapter%252081.pdf&data=04%7C01%7C%7Cd417181278824f6f2a9908d92c4dd07e%7Ce95f1b23abaf45ee821db7ab251ab3bf%7C0%7C0%7C637589536326572740%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=9ZEr4QIqfn6pSuwBKuzmnhtcSdFJ4fHugKdchNplWaE%3D&reserved=0 http://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/028/partVIItoc.html&d= http://www.pacodeandbulletin.gov/Display/pabull?file=/secure/pabulletin/data/vol50/50-9/302.html https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fnj.gov%2Fhealth%2Fems%2Freg-enforcement%2F&data=04%7C01%7C%7Cd0c0894f5bdb412fa2f108d92b8410c3%7Ce95f1b23abaf45ee821db7ab251ab3bf%7C0%7C0%7C637588669818501805%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0&sdata=ozpo6nmXGqeIcTjUMhrEbi1yzpvC7qCyHBYWOqjhUCA%3D&reserved=0 https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.njconsumeraffairs.gov%2Fnur%2Fpages%2Fapplications.aspx&data=04%7C01%7C%7Cd0c0894f5bdb412fa2f108d92b8410c3%7Ce95f1b23abaf45ee821db7ab251ab3bf%7C0%7C0%7C637588669818481894%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0&sdata=LVXII6UhQ3Cpa1AvvVHutHBjArAjHBY4gkbyNJcojhQ%3D&reserved=0 assuring the accuracy and completeness of all reports and other documents as well as the timely submission of each. Contractor shall comply with contract requirements regarding the appropriate reporting formats, instructions, submission timetables, and technical assistance as required.

8.2. The following are brief descriptions of required documents that must be submitted by Contractor: weekly; monthly; quarterly; annually, etc. identified throughout the PWS and is provided here as a guide for Contractor convenience. If an item is within the PWS and not listed here, the Contractor remains responsible for the delivery of the item.

What Submit as noted Submit To

Task 3.12 Dispatcher Information Within 5 days of award and any time this information changes.

COR/CO

Task 3.18 Contractor Personnel/Competency Records

Upon request and when new personnel are added to contract.

COR/designee

Task 3.19 Inspection report for all vehicles used in this contract.

Yearly and Upon request of

CMCVAMC

COR/designee

Task 3.20 Patient Incidents and Complaints - Incident Report

In writing within 24 hours COR/designee

Task 4.0 Contractor’s Quality Control Program

Upon Request COR/designee

9.0 Service Delivery Summary: The Services Delivery Summary (SDS) represents the most important contract objectives that, when met, will likely indicate contract performance is satisfactory. Although not all PWS requirements are listed in the SDS, the contractor is expected to fully comply with all requirements in the PWS.

Task ID Indicator Standard Acceptable Quality Level

Method of Surveillance Incentive/Penalty

Initial Pick Up Delivery/ Wait Time

3.0 Patient must

be picked up and/or delivered by the Contractor’s employees in accordance with the

PWS

timelines

Contractor shall be responsible for pick-up and delivery points, actual time of arrival at pick-up and delivery points and actual waiting time at pick-up and delivery points.

95%

Daily observation/review of trips in online portal

Negative Past Performance Rating for Failure to Comply

Environment of Care

3.18

Contractor Personnel

Contractor shall maintain on-site records that document competence/performance level of contractor employees working on this contract in accordance with Joint Commission and other regulatory requirements.

100%

Periodic Inspection of contractor on-site Competency Records for employees

Negative past performance rating and may not continue services.

Environment of Care

3.19

Vehicles and medical equipment

Contractor shall ensure all vehicles operated and medical equipment utilized under the terms of this agreement meet all established requirements defined by this contract.

100%

Periodic review of contractor on-site Vehicle and Equipment Maintenance/Inspection Records validating compliance with all State requirements.

Contractor shall be required to provide annual compliance logs for all vehicles/equipment utilized to provide service to the VA.

Contractor vehicles shall also be subject to physical inspection by the VA at any time during the contract.

Negative Past Performance Rating for failure to comply.

Patient Safety 3.20 Veteran patient complaints

The Contractor shall notify the COR, in writing within 24 hours, of any complaints made by the patients or incidents with regards to transportation services.

100% Customer Feedback Negative past performance rating and may not continue services.

10. Transition Period

Transition-In Plan

For the first 45 calendar days, the incoming contractor will be provided transitional training i.e., will work side by side with the incumbent contractor on the local processes and procedures for performance of day to day duties, specifically deliverables. This effort is not functional training but is to familiarize the incoming contractor with the Corporal Michael J. Crescenz VA Medical Center (CMCVAMC) work environment as it relates to the requirements of the PWS. The overall goal of the transition period is to ensure uninterrupted support to the CMCVAMC and seamless transfer of responsibilities to the incoming contractor team. Management of the overlap between contracts is a Government function and guidance will be issued providing direction and clarification of each contractor’s responsibilities within the scope of their respective contracts.

This is the minimum essential task for the incoming contractor; nothing within this task limits the responsibility of the contractor to fully execute the contract from the date scheduled for full performance beginning 45 days after contract start date.

Transition-Out Plan The incumbent contractor shall develop a transition plan to be executed if the follow-on contract is awarded to another prime contractor.

The incumbent contractor will develop a transition out plan that includes: 1) in-brief for Government and incoming contractor team management; and 2) administrative and logistic requirements unique to the CMCVAMC.

The CLIN in the Price/Cost Schedule does not apply to the incumbent contractor.