Attachment A - PWS VAPHS ALS-BLS Services .docx

Performance Work Statement VA Pittsburgh Healthcare System (VAPHS) Ambulance Transportation Services

Performance Work Statement ALS / BLS Ambulance Transportation Services VA Pittsburgh Healthcare System (VAPHS), Pittsburgh, PA

1.0 Scope:

The VA Pittsburgh Healthcare System (VAPHS) is seeking a five-year Indefinite Delivery Indefinite Quantity (IDIQ) contract for Ambulance Transportation Services to transport beneficiaries throughout the Pennsylvania, Ohio, and West Virginia tri-state area. The Contractor agrees to provide services, 24-hours per day, seven days per week, (to include all federal holidays) for all VAPHS beneficiaries for all of the following VAPHS locations:

University Drive (Main campus) University Dr. C Pittsburgh, PA 15240 H.J. Heinz Campus (Community Living Center) 1010 Delafield Road Aspinwall, PA 15215

Beaver County VA Clinic 300 Brighton Rd.

Rochester, PA 15074 Belmont County VA Clinic 67800 Mall Ring Road, Ohio Valley Mall, Suite 215 St. Clairsville, OH 43950

Fayette County VA Clinic 627 Pittsburgh Rd., Suite 2 Uniontown, PA 15401 Monroeville VA Clinic 421 Mall Circle Dr.

Monroeville, PA 15146

Washington County VA Clinic 95 West Beau St., Crossroads Center, Suite 200 Washington, PA 15301 Westmoreland County VA Clinic 5274 Route 30, Suite 10 Greensburg, PA 15601

2.0 Contract Definitions:

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

Advanced Cardiac Life Support (ACLS) – 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.

Advanced Life Support Transport (ALS) - Defined as services required for critical Beneficiary care in which beneficiaries require an ambulance, staffed in accordance with Pennsylvania State laws and Pennsylvania Department of Health (DOH) rules and regulations governing the certification and licensure of private ground ambulances. This ambulance, at a minimum, will be staffed with an Emergency Medical Technician (EMT) and a Paramedic who can provide cardiac monitoring, Advanced Cardiac Life Support (ACLS), advanced airway management, and medication administration and monitoring.

Authorized Ordering Personnel - Individuals employed at VAPHS System who are authorized to request services from the Contractor and receive copies of the Trip Sheets from the Contractor.

Base Rate - Base Rate is defined as the rate paid for one-way transportation from a designated pick-up point to a designated delivery point. The Base Rate shall constitute full compensation for one-way trips which do not exceed the “Mileage Threshold” (25 miles) as shown in the Schedule of Supplies or Services and Prices/Costs.

Basic Life Support (BLS) - Defined as services required for non-critical Beneficiary care in which Beneficiary requires an ambulance, staffed in accordance with current Pennsylvania State laws and Pennsylvania DOH rules and regulations governing the certification and licensure of private ground ambulances. This ambulance, at a minimum will be staffed with an EMS vehicle operator (EMSVO) and an Emergency Medical Technician (EMT) who can provide basic airway management and IV’s at KVO (Keep Venous Open) without the use of medications.

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

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 7:59 AM, Monday through Friday, all day Saturday and Sunday and Federal holidays.

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

Contracting Officer (CO) - VA official with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings, and is a member of the vehicle inspection team.

Program Point of Contact (POC)- VA 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 contacting authority remains with the CO.

Contractor - The term “Contractor” as used herein refers to both the prime Contractor and their employees, and any subcontractors and their employees. The 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.

Daily Request for Services Sheet – Requests for services shall be recorded on the daily travel manifest and furnished to the Contractor via e-mail or telephone, by the POC no later than 4:00 PM. prior to the day the transportation is needed.

Dry Run - A dry run is defined as a request for service by authorized Medical Center personnel, whereby the Contractor arrives at the designated pick-up point and no Beneficiary is transported due to a change in the Medical Center’s needs. The Contractor shall be entitled to the applicable base rate only when dry runs are encountered due to no fault or negligence of the Contractor.

Escort - Such as a relative of the Beneficiary or an VA Pittsburgh Healthcare System (VAPHS) employee accompanying the Beneficiary when the VAPHS has determined such an escort is in the best interest of the Beneficiary.

EMS vehicle operator (EMSVO) – An individual that operates a ground EMS vehicle for an EMS agency.

EMT – Emergency Medical Technician – An individual that has completed training in accordance with the Pennsylvania Department of Health Excess Cost - The difference between prices charged by another source used and the applicable Contract prices.

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).

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

KKK Specification - Each ground ambulance used in the performance of this Contract must meet the current specifications of Federal Specification KKK-A-1822F (Federal Vehicle Standards | GSA).

Mileage Rate - In addition to the base rate, The Contractor shall receive the mileage rate for each mile beyond the 25-mileage threshold. This rate applies to loaded, one-way transportation only. In no event shall the Contractor receive this rate for miles traveled within the 25-mile mileage threshold.

Mileage Threshold - 25-mile radius from the designated pick-up point to the designated delivery point.

Monthly Trip Summary Sheet – A summary of trips report that the Contractor submits to the POC monthly.

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

Ohio Public Utility Commission - Public Utilities Commission of Ohio | Ohio.gov

Ohio Department of Public Safety, Division of Emergency Medical Services.

Ohio Emergency Medical Services | Emergency Medical Services

PA Public Utility Commission - Pennsylvania Public Utility Commission | Regulating Utility Services | PA PUC. See 52 Pa. Code Chapter 29. Motor Carriers Of Passengers (pacodeandbulletin.gov)

Paramedics - An individual that has completed training in accordance with the Pennsylvania Department of Health 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).

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

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

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

Scheduled Trip(s) - The term “Scheduled Trip” as used in this 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.

Scheduling Trip Sheet – Document that specifies the date, Beneficiary name and last four digits of Social Security number, time of pickup, destination, time of drop off, mileage if outside the Contract Mileage Threshold, and any notes regarding issues particular to the specific transport or condition, including recording oxygen, cardiac monitoring, and any other items provided.

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

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

VetRide - VA-Approved Transportation Software Utilization for Veteran Transportation under this contract. The VA will provide training to utilize this system.

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

West Virginia Department of Health and Human Resources - Bureau for Public Health Office of Emergency Medical Services - West Virginia Office of Emergency Medical Services (wvoems.org)

3.0 Beneficiary Transportation:

3.1 Contractor shall provide ambulance 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, including Federal Holidays. The majority of 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 VAPHS with the communication method of contacting the Contractor on a twenty-four (24) hour per day basis. The VAPHS shall notify the Contractor if the proposed method of communication is not acceptable.

3.2 Contractor shall provide all vehicles, personnel, management, supplies, transportation, equipment, and reports necessary to cover ground ambulance services. Contractor care shall cover the full range of ambulance services provided in the local community. Paramedics responding to emergency conditions (codes) will bring equipment/supplies required by state regulations, and ACLS equipment and medications to include, but not limited to, cardiac monitoring, intubation equipment, transport ventilator, automated external defibrillator (AED), video laryngoscope, pulse oximetry, glucometer, portable oxygen, protective clothing and written procedures.

3.3 The Contractor shall have available the appropriate number of vehicles to provide services in a timely manner as outlined by the contract.

3.4 The Contractor shall be required to complete long distance trips, i.e., trips of 75 miles and over, on a regular basis.

3.5 Performance shall be in accordance with the requirements contained in this PWS and standards of the Pennsylvania DOH, Bureau of Emergency Medical Services, and The Joint Commission.

3.6 Morgue Transports: It may become necessary for the Contractor to be called upon to transport the remains of a deceased Beneficiary between the various VA 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 beneficiaries: The Contractor shall transport one Beneficiary per trip under ambulance services.

3.8 Direct Beneficiary Transfer: All Beneficiary transfers between VA facilities shall be direct transfers.

3.9 Escorts: VA Pittsburgh Healthcare System reserves the right to have an escort, such as a relative, care provider or staff member accompany the Beneficiary when VAMC determines that such an escort is in the best interest of the Beneficiary. VAMC will also be the sole judge in determining when an escort is required. There shall be no charge to VAMC when escorts are authorized to travel with Beneficiary. The Contractor shall only be required to transport the escort with the Beneficiary and shall not be required to return the escort back to point of origin.

3.10 Authorized Medical Center Personnel: Prior to performance, the POC 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.

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 Contractor’s request for services log submitted. When ordering services (whether it is by telephone, mail, encrypted e-mail and/or in-person), the VAPHS will provide the Contractor with the following type of information.

3.11.1 Mode of transportation required

3.11.2 Required date and time of arrival

3.11.3 Name of Beneficiary

3.11.4 Pick-up and delivery point

3.11.5 Any other special instructions

3.12 Place of Business: The contractor agrees to utilize the VetRide Vendor Portal or VA-Approved Transportation Software for this purpose and any ordering of services will be recorded in VA-Approved Transportation Software NLT 12 hours by Contractor. Requests for service may also be in writing or oral from an authorized representative of the VA and may be completed by telephone and/or encrypted e-mail.

3.13 Dispatcher: The Contractor shall provide a dispatcher 24 hours a day/ 7 days a week. The Contractor shall identify the contact information for transportation requests, including the following:

3.13.1 Company name and address.

3.13.2 Business hours contact name and number.

3.13.3 After hours contact name and number.

3.14 Beneficiary Eligibility: The Department of Veterans Affairs will pay transportation costs only for eligible Veteran beneficiaries. Contractors shall contact the appropriate POC if there are any questions concerning the eligibility of the VA beneficiaries.

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

3.16 Mileage Threshold for Ground Ambulance Services: The Mileage Threshold for the VAPHS is a 25-mile radius from the designated pick-up point for each trip (i.e., Contractor is required to pick-up Beneficiary at the VA, the Mileage Threshold would be a 25-mile radius from the VA). Charges for travel within this Mileage Threshold shall be inclusive with the base rate. One-way mileage for travel beyond the 25-mile Mileage Threshold shall be claimed under the applicable mileage rate.

3.17 Contractor Reimbursement:

3.17.1 Reimbursement for mileage outside the Contract Mileage Threshold of coverage (25 miles), 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 internet web site of Google Maps, MapQuest, Yahoo, or other internet mileage authority. Allowable charges for mileage outside the Contract Mileage Threshold areas of coverage shall not exceed +5% of the current Standard Mileage Rate.

3.17.2 Contractor is expected to complete trips originating from points and/or transporting beneficiaries to destinations greater than 75 miles from VA Pittsburgh Healthcare System (VAPHS). Contractor will be entitled to 50% of the Standard Mileage Rate for those “no-load” miles for trips that are greater than 75 miles without beneficiaries on-board, back to the 25-mile base trip radius for VAPHS.

3.17.3 Should the VAPHS decide 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.

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

3.17.5 If the Contractor fails to meet the response time requirements in this Contract, VAPHS will not be charged for these instances.

3.18 Auxiliary Service: The Contractor may be required at times to transport Beneficiary 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 VA Pittsburgh Healthcare System. No payment will be made for the second vehicle without pre-approval.

3.19 Other Charges: It is understood that the prices listed in the accepted 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.

4.0 Ambulance Transportation Services:

4.1 The Contractor shall be responsible for providing all vehicles and personnel, necessary to meet all ALS and BLS ground ambulance transportation requirements under this Contract. The Contractor shall be authorized to utilize another ambulance service company, as a subcontractor (certified to be within all requirements of this Contract) to complete these transportation requests only if prior approval for the subcontractor has been received from the POC. The Government has a business relationship with the Prime Contractor only. Only the Prime Contractor may bill the Government for services. All bills for this subcontractor service will be paid directly to the Prime Contractor at the Contract rate, and the Prime Contractor shall make payment to the subcontractor at their agreed rate. In the event the Contractor is unable to perform services or have services performed as required, the Contractor shall immediately notify the POC 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 is responsible for excess re-procurement costs which may 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 VA 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)).

4.2 Should the VA determine that immediate transportation is essential to prevent loss of life or serious bodily harm, alternate transportation services may be procured without referral to the ambulance Contractor. However, in these extremely rare cases, no charge shall be levied against the Contractor.

5.0 Vehicle Response Times:

5.1 The Contractor shall respond to all calls for ground ambulance transport service by being on-site at the designated point of pick-up within 20 minutes of notification for an Emergency Advanced Life Support (ALS) vehicle and within 30 minutes of notification for an Emergency Basic Life Support (BLS) vehicle. Exceptions, to the 20- or 30-minute expectation will be investigated and analyzed, including the identification of corrective actions if applicable. As determined appropriate, the Contractor shall take corrective actions to ensure timely response. The Contractor shall respond to all calls immediately for emergency ground ambulance transportation service for the VAPHS. The Contractor shall provide and respond to all emergency calls in accordance with Federal, State, and Local regulations, governing dispatch of emergency medical (ambulance) vehicles and medical care of on-board beneficiaries, to include the use of sirens and other measures to ensure timely arrival at the designated VA Medical facility.

5.2 The Contractor shall respond to all calls for ground ambulance transport service by being on-site at the designated point of pick-up within 60 minutes of notification for a Non-Emergency Advanced Life Support (ALS) vehicle and/or Non-Emergency Basic Life Support Vehicle (BLS).

5.3 If the time period for pick-up, stated herein, is physically impossible due to location of Beneficiary, the Contractor shall contact the individual or department that placed the call and inform them of the anticipated time required for pick-up and delivery of said Beneficiary.

5.4 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. Failure of the Contractor to perform in accordance with this compliance rating may constitute sufficient cause for termination of the Contract for “cause,” (see FAR clause 52.212-4(m)) or other appropriate contractual action.

5.5 Immediate Notification: It is the responsibility of the Contractor to immediately notify the VAPHS authorized ordering personnel 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 VAPHSV ordering personnel 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 applicable ordering office shall be the sole entity for determining when to request the services from another source), and present the reason for the delay to the POC as an occurrence that may be subject to default. Based upon the reason for the delay, the Contractor may be charged with excess costs incurred by the VA Pittsburgh Healthcare System in ordering the service from another source or other appropriate contractual action may be taken by VA Pittsburgh Healthcare System.

6.0 Waiting Time:

6.1 For scheduled trips, waiting charges shall commence fifteen (15) minutes from the time the Contractor actually arrives at the designated pick-up and/or delivery points.

6.2 There are occurrences when a Beneficiary will be scheduled for appointments requiring transportation from different VAMC facilities, nursing home, or place of residence. At no time shall a Beneficiary be required to wait arrival of a pre-scheduled trip beyond fifteen (15) minutes. Failure of the vehicle to arrive at the Beneficiary’s residence or VA facility / nursing home within the allotted time frame (15 minutes), may result in automatic cancellation of the trip, and services may be secured from other sources with default action to be considered against the Contractor.

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

7.0 General Contract Requirements:

7.1 Contractor Employees:

7.2 VA Pittsburgh Healthcare System 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.

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

7.4 The Contractor shall comply with 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.

7.5 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, and employee photo identification cards for performance of services under this Contract. Employee photo identifications shall be worn in clear view above the waist. Contractor vehicles used for the transportation of beneficiaries must be clearly marked with company logos, vehicle identification number, and required state EMS registration decals. Contractor personnel shall not smoke in vehicles while transporting VA beneficiaries.

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

8.0 Contractor Qualifications:

8.1 All Contractor personnel performing Contract services shall meet the qualifications as specified in this Contract, as well as any qualifications required by Federal, State, County, and local government entities from the place in which they operate. Contractor personnel shall meet these qualifications at all times while performing Contract services.

8.2 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 POC within two weeks. 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.

8.3 Emergency Medical Technician (EMT) and Paramedic Qualifications: EMTs and paramedics providing services under this Contract shall have the following qualifications, in addition to those required by Federal, State, and Local Government:

8.3.1 EMTs shall have completed training in accordance with the standards published by the Pennsylvania DOH with a minimum curriculum of 152 hours of clinical and didactic training or equivalent. Paramedics shall have completed training in accordance with the standards published by the Pennsylvania DOH with a minimum of 1,250 hours of combined clinical and didactic training or equivalent. Such training programs must also be acceptable under the regulating requirements for local EMS Systems supported by the Pennsylvania DOH under PL 93-154.

8.3.2 Shall submit evidence of re-certifications and equivalent training program successfully completed to the POC upon contract award and annually upon contract anniversary.

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

8.3.4 Shall attend all refresher continuing education, or advance training programs as required by the local or state government entity in which service is rendered. In no instance shall this be less frequent than annually. Such refresher training shall be equivalent to that developed by the Pennsylvania Department of Health Bureau of Emergency Medical Services.

Roles and responsibilities. An EMSVO operates ground EMS vehicles for an EMS agency, as authorized by an EMS agency.

Certification. The Department will certify as an EMSVO an individual who meets the following qualifications:

Completes an application for EMSVO certification on a form or through an electronic process, as prescribed by the Department.

8.4 Ambulance Drivers: Drivers shall have a valid EMS vehicle operator (EMSVO) certification in accordance with Federal, State, and local government requirements for their place of operation, for the services they perform, be capable of administering oxygen and have successfully completed an Emergency Vehicle Operator course approved by the Department of Health for the State of Pennsylvania and be capable of providing necessary medical assistance to the attending medical care specialist.

8.5 Drivers shall meet the following requirements:

8.5.1 Be a minimum of 18 years of age.

8.5.2 Have a valid EMSVO certification.

8.5.3 Be free from physical or mental defect or disease which may impair the ability to operate an EMS vehicle. Please see 28 Pa. Code § 1023.22. EMS vehicle operator. (pacodeandbulletin.gov) for additional information.

8.5.4 Has not been convicted of driving under the influence of alcohol or drugs in the last four years.

8.5.5 Has not been convicted of reckless driving or had a driver's license suspended due to use of drugs or alcohol or a moving traffic violation within the last two years.

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

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

8.8 All Contractor staff shall be assessed to determine competence and performance compliance with Pennsylvania DOH, Emergency Medical Services guidelines.

9.0 Contractor Equipment, Vehicles, and Inspection:

9.1 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.

9.2 Ambulances shall meet all current applicable Federal, State, and local specifications and regulations including, but not limited to, licensing, registration, and safety standards. Appropriate licensing by the State of Pennsylvania is required.

9.3 The vehicle(s) 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:

9.3.1 An emergency safety kit

9.3.2 Portable oxygen unit (s)

9.3.3 Fire suppression equipment

9.3.4 Appropriate road emergency warning equipment

9.3.5 Laptop w/ EMS Charts software or approved equal. The primary purpose is to complete Beneficiary run forms. These computers are tied into the statewide EMS charts system which standardizes medical run reporting.

9.4 BLS ambulance transports shall, in conjunction with the above, be equipped with stretchers to accommodate beneficiaries 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 VAPHS above the rates established in the Schedule of Supplies or Services and Prices/Costs.

9.5 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 beneficiary and provide appropriate respiratory care, which does not include tracheotomies, cricoidectomies or cricotracheotomies.

9.6 The Contractor shall provide oxygen when it is requested by authorized medical facility personnel or required by the Beneficiary’s medical condition. Oxygen required for ambulance services shall be at the rate and price shown in the Schedule of Supplies or Services and Prices/Costs.

9.7 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 Beneficiary 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 Beneficiary care (e.g., ALS, BLS), shall include, but not be limited to, monitors, defibrillator with external pacemaker, intubation equipment, transport ventilator, intravenous equipment, medications, Beneficiary compartment facilities, oxygen, and suction equipment and accessories.

10.0 Beneficiary Incidents and Complaints:

10.1 The Contractor shall immediately notify the POC of any incidents involving injury to VA beneficiaries during transport. The Contractor shall promptly complete and submit to the POC an incident report.

10.2 The VA may request incident reports for any customer service-related incident reported by beneficiaries, visitors, or staff requiring investigation. Fully documented reports are required within 24 hours of request and may result in additional requests for information.

10.3 The Contractor shall notify the POC in writing within 24 hours of any complaints made by the beneficiaries with regards to the ambulance service. The Contractor may provide recommendations for improved services along with the Beneficiary complaints for the VA’s review. No recommendation shall be construed as being in effect until it is provided as a written modification to the Contract from the CO.

11.0 Infection Control Procedures:

11.1 The Contractor shall follow the VA Pittsburgh Healthcare System Infection Prevention and Control policies and procedures to prevent and control the spread of infectious agents to all persons. Internet link to policy Medical Center Policy - Medical Center Memoranda Library - By MCM Category (sharepoint.com)

11.2 The Contractor shall identify and submit a list of all their Reusable Medical Equipment (RME) to the VA Pittsburgh Healthcare System (VAPHS) POC. RME will be determined to be Critical, Semi-Critical, or Non-critical. Critical and Semi-critical RME will have a Standard Operating Procedure (SOP), a document detailing all steps and activities of a process or procedure that follows manufacturers’ cleaning, disinfection and/or sterilization guidelines. These SOPs will be submitted to the POC for approval by the VAPHS Infection Control Nurse. All Non-critical RME will be classified into two (2) categories based on manufacturer’s instructions for cleaning and/or disinfection. If surface disinfection with the approved surface disinfectant will damage the equipment, a specific SOP shall be developed by the Contractor and submitted to the POC for approval by the VAPHS Infection Control Nurse. If surface disinfection with the approved surface disinfectant will not damage the equipment, it may be used.

11.3 The Contractor shall submit the RME list yearly to the POC.

11.4 The Contractor shall review and submit the RME SOPs on a yearly basis, or when a change in manufacturer’s recommendation occurs, to the POC.

11.5 The Contractor shall not re-use or re-sterilize Single Use (disposable) medical devices.

12. VetRide Information – Transportation Request

12.1 VetRide or VA-Approved Transportation Software Utilization:

The contractor agrees to utilize the VetRide Vendor Portal or VA-Approved Transportation Software with every patient transported under this contract.

Department of Veteran Affairs will provide the software and access to the VetRide Vendor Portal or VA-Approved Transportation Software for the vendor/contractor in this contract. The Contractor will utilize the VetRide Vendor Portal or VA-Approved Transportation Software fully as instructed:

1. Receive and respond to electronic trip requests.

1. Receive, use, and ensure the use of the Vendor pass by the driver.

1. Submit claims via the electronic HCFA 1500 in the VetRide Vendor Portal or VA-Approved Transportation Software system.

1. All invoices must be submitted within 30 calendar days of date of service in accordance with 38 CFR 70 to be considered timely submission.

0. The contractor’s invoice must be on the HCFA 1500 to include:

0. Contract Number

0. Date of Service (to include Box 24 A-J)

0. Authorization number(s)

0. Pick-up and drop-off location of the patient

0. Base Rate

0. Name (Last, First and Middle Initial (if any)) and Full Social Security number (Box 1a) of patient transported.

0. Date of Birth and Sex

0. Diagnosis Codes or Nature of Illness or Injury

0. Documentation of circumstances when billing for waiting time

0. Any miscellaneous charges for which the contractor is expecting reimbursement i.e., Tool charges, waiting time, etc.

0. VA authorizing official’s name

0. Healthcare Procedure Coding System/National Level II (HCPCS)

1. Unauthorized charges will be reviewed by the Project Point of Contact (POC) as to the validity of the charges and as to whether the payment will be made. A final determination will be made within 30 days after notifying the Contractor of the charges, which are being suspended.

A transportation request is defined as one incidence of a request for one-way service (BLS, ALS). No more than one patient will be transported per order unless approved by an authorized VA staff. Transportation requests will be made through VetRide or VA-Approved Transportation Software Utilization. Contractors must have the capability to receive orders, update ride status, and input trip costs and other required data through this portal. Contractors must have dedicated staff available to monitor this portal 24/7. (VAPHS) Travel Program Staff will be available to assist with account setup and training for the Contractor’s Staff. In the event VetRide or other VA-Approved Transportation Software Utilization is down, other methods of communication (i.e., telephone) will be used to place Transportation requests.

12.2 (VAPHS) Travel Program Staff/or authorized VA employees will work with the Contractor the following business day to reconcile any transportation requests that were placed outside of VetRide or VA-Approved Transportation Software Utilization.

12.3 The Contractor must update VetRide or VA-Approved Transportation Software Utilization with any data and/or notes in real time that deviate from the original order such as invoicing for additional mileage due to a road closure, wait time, reason for no load, etc. (VAPHS) Travel Program Staff/or authorized VA employees may place a “hold” on payment of this order until it has been reconciled.

12.4 Only the following VA staff are authorized to place, cancel, or make changes to transportation requests:

Contracting Officer (CO), Point of Contact (POC), Ordering Officers (OO), Administrative Officer of the Day (AOD), Beneficiary Travel Office Staff The POC will furnish the Contractor with the names of individuals above, who are authorized as Ordering Officers, by separate memorandum upon issuance of the contract. The POC will update this list throughout the life of the contract as Ordering Officers change.

12.5 Alternate Invoicing Instructions:

To be utilized when required as a backup to VetRide at discretion of POC.

a) The Contractor shall provide the POC the invoice summary monthly by the fifth day after the end of the previous month. The invoice amount shall match the charges provided in the detailed monthly trip summary sheet. Once approved by the POC, the Contractor shall submit the invoice in accordance with the Invoicing section in this PWS and shall include the current contract Task Order # and VA Pittsburgh Healthcare System Purchase Order Number. The trip summary sheet shall include the beneficiary’s name, date and time of each trip, mileage, pick up time, drop off time and any authorized additional charges pickup point, destination, and departure/arrival times, and if waiting time is claimed. If detours are encountered due to road construction or other obstruction, invoice shall be so noted. This report shall be in Excel format and emailed to the POC. The POC shall be furnished at time of award. The Contractor shall contact the POC with any questions, requests for clarification, or the need for additional information during the hours of 7:30 a.m. to 4:00 p.m. During non-business hours (4:00 p.m. to 7:30 a.m.), the Contractor shall contact the AOD.

b) 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.

c) 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

d) Invoices must be approved by the VA Pittsburgh Healthcare System (VAPHS) Travel Team/supervisor or POC prior to payment release. Invoices without the required information will be rejected.

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

f) 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.

g) Contractor will identify and assign personnel to be the liaison for billing and invoicing processes.

h) Invoices submitted by the Contractor to the VAPHS for services furnished a VAPHS beneficiary under the terms of this contract shall be for services in full. Neither the beneficiary his insurer, nor any third party shall be invoiced.

12.6 Ordering: In accordance with FAR 16.505, The CO shall issue Task Orders against the IDIQ contract with a period of performance not to exceed one year. Authorized Government personnel shall place service calls against these Task Orders as stated below. Each Task Order will be funded with an estimated value for that period of performance. The contractor, along with the POC, must monitor the contract value as service calls are placed and invoices are paid. The contractor is not authorized to continue services if the contract value falls below a zero balance, therefore the CO must be notified when remaining contract value is low so that more funds can be added.

13.0 Special Contract Requirements:

13.1 Reports/Deliverables: The Contractor shall be responsible for complying with all reporting requirements established by the Contract. Contractor shall be responsible for 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.

13.2 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.

14.0 VHA Healthcare Directives:

The Contractor shall comply with the requirements of the following VA Healthcare Directives:

Tuberculosis Screening- VHA Directive 2011-036, Safety and Health During Construction. Contractor must certify annually to the COR(s) that all Contractor employees working at VAPHS facilities have a documented screening for latent Tuberculosis within the last 12 months. If screening for latent Tuberculosis is positive, clearance from a physician is required prior to working at VAPHS.

Seasonal Influenza Vaccination - VHA Directive 1192, Seasonal Influenza Prevention Program for VHA Health Care Personnel. Contractor shall certify annually to the COR(s) that all employees working at VAPHS facilities have received a seasonal influenza vaccination.

Contractor employees that fail to meet these requirements shall not be permitted to work at VAPHS facilities.

CDC COVID-19 Concerns: Compliance with all CDC guidelines as well as VA Pittsburgh Healthcare System, policies, and best practices.

15.0 HIPAA Compliance:

BUSINESS ASSOCIATE AGREEMENT:

A Business Associate Agreement (BAA) is required as defined in Health Insurance Portability and Accountability Act (HIPAA), Public Law 104-191. (See Section D of the RFQ solicitation for completion)

16.0 Contractor Personnel Security Requirements:

VA Information and Information System…