36C24518R0003-002.docx

36C24518R0003

PAGE 1 OF

1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

DUNS:

DUNS+4:

PHONE:

FAX:

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

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA

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

ARE

ARE NOT ATTACHED.

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

ARE

ARE NOT ATTACHED

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

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DATED ________________________________. YOUR OFFER ON SOLICITATION

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

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

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

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

AUTHORIZED FOR LOCAL REPRODUCTION

(REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

36C24518R0003 12-22-2017 Gina Napier 304-429-6755, x3645 01-26-2018

11:00 AM

90C Department of Veterans Affairs Network Contracting Office 5 Satellite Office 1540 Spring Valley Drive Huntington

WV

25704 X X Y 621910 $15 Million X N/A X 90C Department of Veteran Affairs Huntingon VA Medical Center 1540 Spring Valley Drive Huntington

WV

25704 Department of Veterans Affairs Network Contracting Office 5 Satellite Office 1540 Spring Valley Drive Huntington

WV

25704

90C FSC e-Invoice Payment http://www.fsc.va.gov/fsc/einvoice.asp Invoice Setup Information 1-877-489-6135 Invoice must be submitted electronically

Setup 1-877-489-6135 See CONTINUATION Page $0.00 See CONTINUATION Page X X Linda Smith Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

(continuation from Standard Form 1449, block 18A.)

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

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C245 Linda Smith Department of Veterans Affairs Network Contracting Office 5 Satellite Office 1540 Spring Valley Drive Huntington WV 25704

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

3. INVOICES: Invoices shall be submitted in arrears:

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

FSC e-Invoice Payment http://www.fsc.va.gov/fsc/einvoice.asp Invoice Setup Information 1-877-489-6135 Invoice must be submitted electronically

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

B.2 CONTRACT DETAILS

DESCRIPTION

This is a Commercial Fixed Price, Multiple Award Indefinite Delivery / Indefinite Quantity (IDIQ) contract, for Ground Ambulance Services. This will be a one (1) Year Base performance period from April 1, 2018 to March 31, 2019, with four (4) Option Years. The Department of Veteran Affairs is seeking to award no more than five (5) IDIQ contract to capable vendors.

FIXED PRICE INDEFINITE-DELIVERY/INDEFINITE QUANTITY (IDIQ) CONTRACT

This is a Fixed Price, Multiple Award IDIQ contract for Ground Ambulance Services. The Contractor’s pricing will be based on estimated quantities at the time of award.

MINIMUM GUARANTEE & CONTRACT CEILING

Each contract awarded resulting from this solicitation will include a minimum guarantee amount of $1,000.00. The total contract ceiling of this Multiple Award IDIQ is $15,000,000.00 for a Base plus four (4) Option Years, beginning April 1, 2018.

ORDERING PROCEDURES

Successful awardees will receive an IDIQ contract, with individual contract ceilings determined at the time of award based upon geographic performance coverage. Task Orders will not be competed after initial contract award, but rather executed for each awardee as needed.

B.3 LIMITATIONS ON SUBCONTRACTING-- MONITORING AND COMPLIANCE (JUN 2011)

This solicitation includes FAR 52.219-14 Limitations on Subcontracting. Accordingly, any contract resulting from this solicitation will include this clause. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) retained by VA to assist in assessing the contractor's compliance with the limitations on subcontracting or percentage of work performance requirements specified in the clause. To that end, the support contractor(s) may require access to contractor's offices where the contractor's business records or other proprietary data are retained and to review such business records regarding the contractor's compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor's compliance with the limitations on subcontracting or percentage of work performance requirement.

36C24518R0003

Page 1 of Page 1 of

STATEMENT OF WORK (SOW)

Ambulance Services for the Huntington VA Medical Center (VAMC)

Version 1.0 dated December 4, 2017

PART 1 – GENERAL INFORMATION

1.0 General. This is a non-personal services contract to provide Basic Life Support (BLS) and Advanced Life Support (ALS) Ambulance services to Veteran patients and their beneficiaries receiving care and healthcare support from the Huntington Veteran Affairs (VA) Medical Center located in Huntington, WV. The Government shall not exercise any supervision or control over the Contractor or Contractor employees, performing the services herein.

1.1 Description of Services. The Contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, and other items and non-personal services necessary to perform Ambulance services as defined in this Statement of Work except for those items specified as Government furnished property and services.

1.2 Background. The U.S. Department of Veterans Affairs Medical Center in Huntington, West Virginia, is honored to serve nearly 30,000 Veterans in a primary service area that includes 10 counties in West Virginia, 2 counties in southern Ohio and 12 counties in eastern Kentucky. The medical center is a fully accredited 80-bed acute medical and surgical care facility offering primary and subspecialty outpatient care including rehabilitation and mental health services.

Since 1932, the Huntington VA Medical Center has been improving the health of the men and women who have so proudly served this nation. Located in the picturesque Spring Valley area of Huntington, and affiliated with the Joan C. Edwards School of Medicine at Marshall University, the Medical Center provides a broad scope of treatment modalities with the most advanced technology available in the region.

1.2.1. Primary Care is the foundation of our Ambulatory Care Program and is provided through the Medical Center based clinic and VA staffed outpatient clinics located in Prestonsburg, KY, Charleston, WV, Lenore, WV, and Gallipolis, OH. The Huntington VA Medical Center is part of the VA Capitol Health Care Network (VISN 5), serving Veterans from economically and demographically diverse areas within West Virginia, Maryland, the District of Columbia, and portions of Virginia, Kentucky, Ohio, and Pennsylvania.

1.3 Objectives. The Huntington VAMC provides diagnostic and therapeutic services in medicine and surgery; additionally, this 80-bed facility also provides ambulatory service to those veterans not requiring hospitalization.

1.4 Scope. The Contractor must provide all equipment, personnel, supervision, and support to provide these Ambulance services. All services will be provided in accordance with the terms and conditions of any resultant contract, applicable federal and state regulations, and industry standards.

1.4.1. Advanced Life Support (ALS) - ALS shall be provided by ambulance vehicles containing at a minimum an on-board Paramedic, cardiac monitoring, Advanced Cardiac Life Support (ACLS) drugs and procedures, advanced airway management and medication monitoring and administration. Ambulances for ALS services shall be staffed in accordance with current Ohio, West Virginia, and Kentucky state laws and regulations governing the certification and licensure of private ambulances. This ambulance at a minimum will be staffed with a vehicle operator and an Emergency Medical Technician (EMT).

1.4.2. Basic Life Support (BLS) - BLS is defined as services required for non-critical patient care in which patient requires an ambulance. Ambulances for BLS services shall be staffed in accordance with current Ohio, West Virginia, and Kentucky state laws and regulations governing the certification and licensure of private ambulances. This ambulance at a minimum will be staffed with a vehicle operator and an Emergency Medical Technician (EMT).

1.4.3. Geographic Coverage. The Contractor shall provide Scheduled, Unscheduled, and Urgent/Emergency Ambulance services twenty-four (24) hours per day, seven (7) days per week, for both BLS and ALS, to VA beneficiaries receiving care at the Huntington VAMC. Upon request by the VA, the Contractor shall transport VA beneficiaries FROM their place of origin TO the beneficiaries’ place of treatment and RETURN TO beneficiary’s place of origin. All vehicles, personnel, and services rendered by the Contractor shall conform to all federal, state, and local statutes, rules, and regulations; specifically, for the states of West Virginia, Kentucky and Ohio. The average mileage per transport is approximately 30 miles. Per any resultant contract, Ambulance transportation services should support the following counties in the states of West Virginia (WV), Ohio (OH) and Kentucky (KY):

Magoffin Pike

1.4.4. Transportation Limitations & Transfers. The Huntington VAMC provides Orthopedic services to hospitals in VISN 5 and VISN 9 and Bariatric procedures for most of the VA Medical Centers on the entire East coast. Those requiring such services normally visit the Huntington VAMC once and then all other medical visits are normally thru Closed Circuit Television (CCTV) or Tele-Medicine. Additionally, the Huntington VAMC does not provide Inpatient Psychiatric services therefore patients requiring such services must be transferred to a facility that does; the facility of choice is solely up to the discretion of the medical provider, however the closest facility providing Psychiatric services is as least two (2) hours away. On a case-by-case basis, transfers are also made to varying state-side locations for Electroshock Therapy (ECP), Cardiac treatment, Spinal Cord Injuries, Parkinson’s Disease, Liver and Lung Transplants, and other facilities that have Cardiac Intervention capabilities. Locations providing these services are identified in the Section B: Price/Cost Schedule of any resultant contract. At times, patients require transportation via commercial air transport, however most are transported via ground Ambulance services.

1.4.4.1. The Contractor shall only transport one patient per trip UNLESS specifically authorized by the VAMC. When more than one patient is being transported during a single trip, reimbursement will be made at the furthest destination point, regardless of the number of patients. Regardless of the number of patients being transported, concurrently on a single trip beyond the Mileage Threshold, the Contractor will be reimbursed at the Mileage Rate for only one trip to the longest distance traveled with any one patient during that trip. The Contractor shall ensure that the pick-ups and drop-offs are scheduled so that the total distance traveled will result in the most economical charge to the Government.

1.4.4.2. On a case-by-case basis, the Contractor Officer Representative may, in the interest of the patient, allow a relative to accompany him/her at no extra charge to the Government.

1.4.5. Mileage Threshold. The Mileage Threshold is a distance of thirty (30) miles from the beneficiaries point of origin to their destination for treatment; the additional “Mileage Charge” will only apply to those miles traveled after the thirty (30) mile threshold per trip has been reached. In the event fraction miles occur, the VA will pay the round-off amount to the nearest mile. Trip mileage shall be determined by the latest edition of Bing Standard Mileage Guide at www.bing.com online driving directions from VA to patient’s home address. The Bing online Driving Directions (fastest route) will be used to calculate the mileage. If the online directions do not go all the way to patient’s address, VA will consider the actual mileage within a 5-10 mile difference.

1.4.5.1. One-way trips for Specialty Care will be billed at a “Flat Rate” per Section B: Price/Cost Schedule of any resultant contract. The “Flat Rate” shall constitute full compensation for one-way trips and do not receive additional mileage charges regardless of mileage threshold.

1.5 Period of Performance. At the Government’s discretion, the period of performance for this requirement shall be for one (1) Base Year and four (4) Option Years, as follows:

1.6 General Information

1.6.1 Quality Control. The Contractor shall develop and maintain an effective quality control program to ensure services are performed in accordance with this SOW. The Contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The Contractor’s quality control program is the means by which they assure that their work complies with the requirement of the contract. The Quality Control Plan is to be delivered at the time of proposal submission.

1.6.2 Quality Assurance. The Government shall evaluate the Contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan. This plan is primarily focused on what the Government must do to ensure that the Contractor has performed in accordance with the performance standards. It defines how the performance standards will be applied, the frequency of surveillance, and the minimum acceptable defect rate(s).

1.6.3 Hours of Operation. The Contractor is responsible for conducting business twenty-four (24) hours a day, every day of the week and on holidays, except when the Government facility is closed due to local or national emergencies, administrative closings, or similar Government directed facility closings; at which time the Contracting Officer will provide further direction. The Contractor must always maintain an adequate workforce for the uninterrupted performance of all tasks defined within this SOW when the Government facility is not closed for the above reasons. When hiring personnel, the Contractor must maintain the stability and continuity of the workforce at all times.

1.6.4 Type of Contract. The Government will award a Commercial Fixed Price Multiple Award Indefinite Delivery/Indefinite Quantity contract.

1.6.5 Special Qualifications of Contractor Personnel

1.6.5.1. Emergency Medical Technicians (EMT). Emergency Medical Technicians providing emergency services on ambulances under this contract shall have the following qualifications:

a. Have completed training in accordance with the standards published by the Department of Health and Human Services with a minimum curriculum of 81 hours or “equivalent” including an in-hospital training period. Such training programs shall also be acceptable under the regulating requirement for local EMS systems supported by DHHS under PL 93-254. 39 Federal Regulations 24,304 (1974).

b. Evidence of the “equivalent” training program successfully completed by the EMT shall be submitted with the offer to the Contracting Officer for inspection.

c. The EMT shall be certified, licensed 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. Copies of all licenses/certificates shall be submitted with offeror’s proposal and available upon request.

d. The EMT shall be enrolled periodically in “refresher” continuing education or advanced training programs as required by each State Government entity in which the service is being rendered to Veterans. Evidence of successful completion of refresher training must be submitted to the Contracting Officer for inspection.

1.6.5.2. Non-Emergency Attendant / Ambulance Drivers. Non-Emergency Attendant / Ambulance Drivers shall be capable to administer oxygen and have successfully completed the Standards and Advanced First Aid Courses of the American Red Cross or U.S. Bureau of Mines or equivalent. Proof in the form of a certificate that such first aid training has been successfully completed shall be submitted with offeror’s proposal and available upon request.

1.6.5.3. All Contractor personnel performing contract services shall meet the qualifications and be licensed as specified in the contract, as well as any qualifications required by Federal, State, County and local Government entities from the place in which they operate.

1.6.5.4. The Contractor shall be responsible for protecting the personnel furnishing services under this contract. To carry out this responsibility, the Contractor shall provide the following for these personnel:

a. Workers’ Compensation

b. Professional Liability Insurance

c. Income tax withholding

d. Social Security payments

1.6.5.5. The parties agree that such personnel are employees of the Contractor. Minimum contract submittals require an annual statement of certification of State driving records, license verification, and insurance. Contractors must provide an annual statement that drivers are screened, trained, and competent to safely transport patients. This annual statement of driver competency must include any applicable certifications, such as Advanced Cardiac Life Support or specialized training to assist and secure patients by stretcher or wheelchair.

1.6.6 Post Award Conference/Periodic Progress Meetings. The Contractor agrees to attend any post-award conference convened by the contracting activity or contract administration office in accordance with Federal Acquisition Regulation Subpart 42.5. The Contracting Officer, Contracting Officers Representative (COR), and other Government personnel, as appropriate, may meet periodically with the Contractor to review the Contractor's performance. At these meetings, the Contracting Officer will apprise the Contractor of how the government views the Contractor's performance and the Contractor will apprise the Government of problems, if any, being experienced. Appropriate action shall be taken to resolve outstanding issues. These meetings shall be at no additional cost to the government.

1.6.7 Contracting Officer (CO). The Contracting Officer is the only person authorized to approve changes or modify any of the requirements of this contract. The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration. Only the Contracting Officer is authorized to make commitments or issue changes that will affect price, quantity or quality of performance of this contract.

1.6.8 Contracting Officer Representative (COR). The (COR) will be identified by separate letter. The COR monitors all technical aspects of the contract and assists in contract administration. The COR is authorized to perform the following functions: assure that the Contractor performs the technical requirements of the contract: perform inspections necessary in connection with contract performance: maintain written and oral communications with the Contractor concerning technical aspects of the contract: issue written interpretations of technical requirements, including Government drawings, designs, specifications: monitor Contractor's performance and notifies both the Contracting Officer and Contractor of any deficiencies; coordinate availability of government furnished property, and provide site entry of Contractor personnel. A letter of designation issued to the COR, a copy of which is sent to the Contractor, states the responsibilities and limitations of the COR, especially regarding changes in cost or price, estimates or changes in delivery dates. The COR is not authorized to change any of the terms and conditions of the resulting order.

1.6.9 Contract Performance & Monitoring. The Government may evaluate the quality of professional and administrative services provided, but retain no control over the medical, professional aspects of services rendered (e.g. professional judgments, diagnosis for specific medical treatment), in accordance with FAR 37.401(b).

1.6.9.1. The Contractor will develop a quality assurance program and will provide such information to the COR on a quarterly basis. The quality assurance program will be mutually agreed upon at the beginning of the contract and may be modified by either party but the VAMC retains final approval of any modifications. The COR has responsibility for validating the data provided by the Contractor. The Contractor is advised that only the Contracting Officer has the authority to make changes to the contract. After contract award, any incidents of non-compliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer.

1.6.9.2. The COR shall furnish a statement in writing to the Contracting Officer at close of the contract to include a summary of Contractor actions and a statement that all requirements of the contract were fulfilled as agreed.

1.6.9.3. The Contractor shall permit on-site visits by VA personnel and accrediting agencies to assess contracted services, e.g., adequacy, compliance with contract requirements, and record keeping if applicable. The Contracting Officer Representative (COR) maintains vendor certificates and contract records. State driving records, license verification, training and insurance are to be reviewed by the COR on an annual basis prior to the exercise of an option year. The COR must conduct a review prior to the assignment of a new contract driver, upon an accident event, and at any other time at the discretion of the COR.

1.6.10 Identification of Contractor Employees. All contract personnel attending meetings, answering Government telephones, and working in other situations where their Contractor status is not obvious to third parties are required to identify themselves as such to avoid creating an impression in the minds of members of the public that they are Government officials. They must also ensure that all documents or reports produced by Contractors are clearly marked as Contractor products or that Contractor participation is appropriately disclosed.

1.6.11 Organizational Conflict of Interest. Contractor and personnel performing work under this contract may receive, have access to or participate in the development of proprietary or source selection information (e.g., cost or pricing information, budget information or analyses, specifications or work statements, etc.) or perform evaluation services which may create a current or subsequent Organizational Conflict of Interests (OCI) as defined in FAR Subpart 9.5. The Contractor shall notify the Contracting Officer immediately whenever it becomes aware that such access or participation may result in any actual or potential OCI and shall promptly submit a plan to the Contracting Officer to avoid or mitigate any such OCI. The Contractor’s mitigation plan will be determined to be acceptable solely at the discretion of the Contracting Officer and in the event the Contracting Officer unilaterally determines that any such OCI cannot be satisfactorily avoided or mitigated, the Contracting Officer may affect other remedies as he or she deems necessary, including prohibiting the Contractor from participation in subsequent contracted requirements which may be affected by the OCI.

1.6.12 Evidence of Insurance Coverage. The Contractor shall maintain the Insurance requirements per Contract FAR and VAAR Clauses 52.228-10, 52.247-21, and 852.228-72 respectively. Confirmation of such will be prepared to the Contracting Officer, along with proposals. Any change or cancellation of such Insurance shall require a 30-day written notice to the Contracting Officer.

PART 2 – DEFINITIONS & ACRONYMS

2. Definitions and Acronyms

2.1. DEFINITIONS:

2.1.2. BENEFICIARY.

2.1.3. CLASS 3 INTERFACILITY TRANSPORT (C3IFT). This level of care is intended for the transport of patients whose acuity or criticality does not require the level of expertise possessed by the CCT-level provider but exceeds the normal scope of practice for field EMS providers. The individuals allowed to perform this level of transport have completed training which prepares them to deal with medications and procedures not normally seen during their day-to-day provision of EMS.

2.1.4. CONTRACTOR. A supplier or vendor awarded a contract to provide specific supplies or service to the government. The term used in this contract refers to the prime.

2.1.5. CONTRACTING OFFICER. A person with the authority to enter into, administer, and or terminate contracts, and make related determinations and findings on behalf of the government. Note: The only individual who can legally bind the government.

2.1.6. CONTRACTING OFFICER'S REPRESENTATIVE (COR). An employee of the U.S. Government appointed by the Contracting Officer to administer the contract. Such appointment shall be in writing and shall state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract.

2.1.7. DEFECTIVE SERVICE. A service output that does not meet the standard of performance associated with the Statement of Work.

2.1.8. DELIVERABLE. Anything that can be physically delivered, but may include non-manufactured things such as meeting minutes or reports.

2.1.9. QUALITY ASSURANCE. The government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.

2.1.10. QUALITY ASSURANCE Surveillance Plan (QASP). An organized written document specifying the surveillance methodology to be used for surveillance of Contractor performance.

2.1.11. QUALITY CONTROL. All necessary measures taken by the Contractor to assure that the quality of an end product or service shall meet contract requirements.

2.1.12. SUBCONTRACTOR. One that enters into a contract with a prime Contractor. The Government does not have privity of contract with Sub-Contractors.

2.1.13. WORK DAY. The number of hours per day the Contractor provides services in accordance with the contract.

2.2. ACRONYMS:

PART 3 - GOVERNMENT FURNISHED PROPERTY, EQUIPMENT, AND SERVICES

3.0 GOVERNMENT FURNISHED ITEMS AND SERVICES:

3.1. Equipment. The Government will normally transport a beneficiary while still utilizing Government medical equipment during Ambulance transport. The Contractor is responsible for the safe and operational return to the VAMC of such medical equipment.

PART 4 - CONTRACTOR FURNISHED ITEMS AND SERVICES

4.0 CONTRACTOR FURNISHED ITEMS AND RESPONSIBILITIES:

4.1 General. The Contractor shall furnish all supplies, equipment, facilities and services required to perform work under this contract that are not listed under Section 3 of this SOW.

4.2 Ambulance Fleet. The Ambulance fleet and its equipment and supplies must be of the quality, model and condition to assure the patient complete, high quality medical transportation and emergency first aid, if needed; shall meet the minimum standards for maintenance, equipment and staffing of all ambulance vehicles operated. Each ambulance vehicle shall be of model and make to ensure safe and comfortable transportation of the patient. It must have sufficient headroom to accommodate the patient in Fowler’s position and must be effectively heated and air-conditioned. It must be inspected and maintained daily to assure mechanical fitness and cleanliness.

4.2.1. The ambulance (emergency medical care vehicle) under the terms of this contract will be licensed and meet the minimal vehicle requirements as established by the West Virginia, Ohio, and Kentucky Departments of Health. The specifications are mandatory as minimal requirements for such vehicles, but chassis or compartment modifications are permissible when they clearly exceed the minimal specifications. The VA reserves the right to inspect the 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 needing repair, unclean, unsafe, damaged on the interior or exterior body, and/or 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.

4.3 Equipment. When transporting a patient in the performance of providing Ambulance transport services, at a minimum, each Ambulance shall be equipped as per each State law and regulations, as well as the optional medical equipment described in Federal Specifications KKK-A-1822D, which identifies the following:

a. At least one (1) Ambulance cot and collapsible stretcher or two stretchers, one of which is collapsible;

b. Adequate straps to secure the patients safely to stretcher or ambulance cot, and adequate means of securing the stretcher or ambulance cot within the vehicle;

c. Adequate supply of sanitary sheets, pillowcases and blankets;

d. Portable oxygen unit in good operating condition and with spare tank and with adequate supply of nasal cannulas or oxygen masks: oxygen masks must be of the disposable type or be thoroughly sterilized after each use and kept sterile;

e. Standard first aid kit;

f. Portable suction unit available for emergency use or transfer of severely ill patients, to be operated by professional staff only;

g. I.V. poles and stair chair; and

h. Access to IV pumps and cardiac monitors which are compatible to those used by the VAMC.

PART 5 - SPECIFIC CONTRACTOR TASKS & RESPONSIBILITIES

5.1 Basic Services. The Contractor shall be required to provide or perform the following services as part of this requirement.

5.2 Transportation Procedures. Transport of baggage, medical records and other personal effects with Veterans, will occasionally be required. Ambulance drivers will deliver and pick-up patients at designated locations, i.e., Emergency Room, Special Treatment Room, Clinic Area, Ward. These locations will be designated when contact is made by authorized VA personnel. The ambulance personnel will report to the Nursing Stations to (1) announce his/her arrival to pick-up and transfer the patient, and (2) obtain report of pertinent information regarding the patient’s condition from the primary nurse/physician. When delivering a patient, the ambulance personnel will give report to appropriate nursing personnel and provide a copy of the run sheet which will be retained by the facility for the patient’s medical record. In cases where the ambulance crew must divert to a local emergency room while performing a VAMC authorized transport, the Contractor’s dispatcher will notify the VAMC Travel Department or AOD of the patient’s location and status as soon as this information becomes available. In cases where the Contractor’s dispatchers prioritize their requests for services as an emergency and a rescue squad is dispatched, the dispatcher shall notify the on-call dispatcher at the VAMC, of the patient’s location as soon as it becomes available.

5.2.1. All equipment and machinery taken with the patients from the VA Medical Center shall be returned to the Medical Center. Universal precautions shall be used on all VA patients.

5.3 Patient Welfare and Abuse. The Contractor shall be held responsible for patient welfare during transport. The Contractor shall be held responsible for patient and/or Government property during transport. Any damaged or lost wheelchairs, walkers, crutches or personal belongings will be replaced by the Contractor.

5.3.1 The Contractor must take into consideration that he will be transporting ill patients. Drivers of vehicles shall comply with all applicable motor vehicle laws and regulations, cars should be swept clean and the exteriors washed periodically, and drivers shall refrain from smoking at all times. Drivers shall escort all patients to and from point of pick-up and destination. Contractor must be professional at all times when transporting Huntington patients.

5.4 Incident Reporting. If an incident and/or accident should occur, involving the welfare of a VAMC patient or beneficiary, the Contractor shall file a report immediately to the Contracting Officer Representative (COR) with a copy to the Contracting Officer.

5.4.1. Requests for services will be made in writing or by telephone, and subsequently confirmed in writing by individual(s) designated by the Contracting Officer. Private agencies, i.e. nursing homes, are not considered authorized personnel. The Contractor will not alter determination of mode of travel.

5.4.2. If the Contractor fails to furnish ambulance service within thirty (30) minutes after receiving VAMC request for service or twenty (20) minutes for emergent calls, the VAMC reserves the right to obtain the services from another vendor. The requested crew and ambulance must arrive at the same time; prepared to provide service. The VAMC will be the sole judge in determining when to order service from another source; however, in no instance will the Contractor be required to furnish more than four (4) ambulances for Basic Life Support service, two (2) ambulances for Advanced Life Support service and one (1) must have the capability to transport Class 3 Interfacility Transports at any one time. When the total numbers of contracted vehicles are in use with VAMC patients, and the VAMC requires additional vehicles, the Contractor will be responsible for providing additional vehicles at the rates contained herein.

5.4.3. When the Contractor has been notified in advance of a scheduled run and service is not provided within thirty (30) minutes after the scheduled time, the VAMC reserves the right to obtain the service from another source and charge the Contractor with any excess cost which may result.

5.4.4. No delay is acceptable for emergent calls. The Contractor is to notify the VAMC when it becomes apparent that the emergent timeframe cannot be met. The VAMC reserves the right to obtain the service from another source and charge the Contractor with any excess cost which may result.

5.4.5. The VAMC will designate the Contracting Officer Representative (COR). All work coordination shall be made through the COR. The Contractor shall be provided a copy of the letter of delegation authorizing the COR at the commencement of the term of this agreement. No other person shall be authorized to act in such capacity unless appointed in writing by the Contracting Officer.

5.4.6. The Contractor shall immediately notify the VAMC of any delays in transporting patients.

5.5 Toll Charges. It is agreed and understood that the price quoted in the Price Schedule of any resultant contract includes any ferry, bridge, tunnel, or road toll. If the Contractor’s place of business is located beyond the local telephone call zone of the VAMC, the Contractor agrees to accept telephone orders for service at their expense.

5.6 Waiting Time. For time lost in waiting at either end, or both ends of a trip due to causes beyond the Contractor’s control, the Contractor shall be reimbursed at the rate of one-fourth the hourly rate per Schedule B: Price/Cost Schedule of any resultant contract, for each quarter hour or fraction thereof, in excess of one-half hour from the time he reports to the designated location.

5.6.1. If the pickup is other than at the VAMC, the Contractor will call the Huntington VA Medical Center Travel Clerk as soon as a delay is anticipated and for which he expects to claim reimbursement. This call is only for the purpose of verifying his arrival time at the pickup point and is not necessary if the Contractor anticipates no delay for which he will claim reimbursement.

5.7 Cancellations. On trips within the Mileage Threshold there will be no charge to the Government for canceled trips if the Contractor is notified before the vehicle is dispatched. Outside the Mileage Threshold there will be no charge to the Government prior to the vehicle being dispatched. A “no show” is defined as a trip which is canceled upon the Contractor’s arrival at the pick-up point and the Contractor may request reimbursement for a one-way trip.

5.8 Meals. When patients travel in an Ambulance during mealtimes (i.e. breakfast, lunch, dinner) the Contractor shall provide meals for each patient. The cost of the patient’s meal shall be listed as a separate item on the Contractor’s invoice and be supported by a receipt for the patient’s meal from the restaurant. Payments for meals will not be reimbursements unless a copy of the receipt is furnished to the COR. The maximum amount authorized for any one meal is $15.00, unless dietary restrictions apply per Physician written guidance. The Contractor will be notified at the time the call for service is made, if patients are authorized to receive meals. No meals will be furnished unless authorized by the VAMC. There may also be stipulations for providing patients and beneficiaries with special nutritional needs during long trips to receive specialty care.

5.9 Invoicing & Payments. The Contractor shall invoice weekly in arrears for all services performed during that performance period. Invoices must be submitted in the Government-provided format (Attachment 3). All invoices will include the contract number, date of services, name of patient, pick-up and delivery points and an itemized listing of charges (to include meals) or services rendered in accordance with this contract. This will assist the Contractor in expediting the invoices. Under no circumstances are VA beneficiaries, third party insurances, Medicare or Medicaid to be billed for the services performed under this contract which are authorized by the VAMC Huntington Travel Office.

5.9.1. Invoices must be submitted on the Health Insurance Claim Form, HCFA-1500. Invoices shall be submitted to: Attn: Travel (136), Department of Veterans Affairs, 1540 Spring Valley Drive, Huntington, WV 25704 for processing and payment. Invoices shall be submitted within thirty (30) calendar days from the date(s) of service. 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. The beneficiary, his/her insurer, nor any other third party, shall be billed.

5.10 Fingerprinting. In accordance with VHA Directive 0710, Personnel Suitability and Security Program, all Contractor employees providing Ambulance services shall comply with Federal Fingerprinting regulations.

5.10 Infection Control Requirements

5.10.1. Health Tests. The Contractor shall submit proof of the following tests, current within the last year:

a. Tuberculosis Testing – All Contractor personnel shall provide documentation of a Purified Protein Derivative (PPD) test performed within the past year. In case of a past positive PPD test, a negative chest radiographic report to rule out active tuberculosis shall be provided. The PPD test shall be repeated annually.

b. OSHA Regulation Concerning Occupational Exposure to Bloodborne Pathogens – The Contractor shall provide training or a self-study training module to its personnel; provide Hepatitis B vaccination series at no cost to its personnel who elect to receive it; maintain and distribute an exposure determination and control plan to its personnel; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident. Contractor shall provide documentation that the employee(s) have received the Hepatitis B vaccination series or that the employee(s) declined to receive the series.

5.10.2. The VA shall notify the Contractor of any significant communicable disease exposures to its employees as appropriate. The Contractor’s occupational health provider shall adhere to current CDC/HICPAC Guideline for Infection Control in health care personnel (AJIC 1998; 26:289-354) for disease control. If the employees of the contracting agency suffer a communicable disease, the Contractor shall provide follow up documentation of employee’s clearance to return to the workplace prior to their return.

5.11 Confidentiality of Patient Records. The Contractor is a VA Contractor and shall assist in the provision of health care to patients seeking such care from or through VA. As such, the Contractor is considered as being part of the Department of Veterans Affairs health care activity. The Contractor is considered a VA Contractor for purposes of the Privacy Act, Title 5 U.S.C. 552a. For purposes of VA records access and patient confidentiality, the Contractor is considered a VA Contractor for the following provisions: Title 38 U.S.C.5701, 5705, and 7332. The Contractor may have access, as would other appropriate components of VA, to patient medical records including patient treatment records pertaining to drug and alcohol abuse, HIV and sickle cell anemia, to the extent necessary to perform its contractual responsibilities. However, like other components of the Department of Veterans Affairs, and notwithstanding any other provisions of the contract, the Contractor is restricted from making disclosures of VA records, or information contained in such records, to which it may have access, except to the extent that explicit disclosure authority from VA has been received. The Contractor is subject to the same penalties and liabilities for unauthorized disclosures of such records as VA.

5.11.1. The records referred to above shall be and remain the property of VA and shall not be removed or transferred from VA except in accordance with U.S.C.551a (Privacy Act), 38 U.S.C. 5701 (Confidentiality of claimant’s records), 5 U.S.C. 552 (FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332 (Confidentiality of certain medical records) and federal laws, rules and regulations. Subject to applicable federal confidentiality or privacy laws, the Contractor, or their designated representatives, and designated representatives of federal regulatory agencies having jurisdiction over Contractor, may have access to VA’s records, at VA’s place of business on request during normal business hours, to inspect and review and make copies of such records.

5.12 Contracting with Parties Listed on the OIG List of Excluded Individuals/Entities. In accordance with The Health Insurance Portability and Accountability Act (HIPAA) and the Balanced Budget Act (BBA) of 1977, The Office of Inspector General has established a list of parties and entities excluded from Federal health care programs. Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs.