S02 36C24524R0030 0001.pdf

5. PROJECT NUMBER (if applicable)

CODE 7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER 3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO. 1. CONTRACT ID CODE

FACILITY CODE CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office. is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER 16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30 PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243

(Type or print) (Type or print)

(Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code)

(If other than Item 6)

(Specify type of modification and authority)

(such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer)

1 36

Department of Veterans Affairs VISN 5 Contracting 849 International Drive

Linthicum MD 21090

Department of Veterans Affairs VISN 5 Contracting 849 International Drive

Linthicum MD 21090

To all Offerors/Bidders

36C24524R0030

04-23-2024

X

X X

** HOUR & DATE for Receipt of Offers is EXTENDED to:

See CONTINUATION Page

X 1

The purpose of this amendment is to update the Performance Work Statement and Section B.4 Price/Cost Schedule, changes are stated in the Questions and Answers. Questions and Answer is also attached.

Proposal due date is extended to May 3, 2024 by 1:00PM EST

CS: Dan Feng Lu | danfeng.lu@va.gov

Evelyn E. Mount Contracting Officer

B.3 PERFORMANCE WORK STATEMENT

1. Purpose: The Baltimore VA Medical Center VA Medical Center (hereafter VAMC), its associated Community-Based Outpatient Clinics (CBOCs), and affiliated healthcare clinics require contracted non-emergency ambulance transportation services. The contractor shall provide all vehicles, personnel, management, supplies, equipment, and necessary reporting for the provision of Stretcher Transports, Basic Life Support (BLS), Advanced Life Support (ALS), Critical Care Transport (CCT) services. The contactor shall make these ambulance services available to the VA as needed, 24 hours a day, seven days a week (24/7), including weekends and holidays.

2. Background: The Baltimore VAMC main campus is located _10 N. Greene Street, Baltimore MD.21201., serving over 300,000 veterans, primarily from the Maryland area and its Community-Based Outpatient Clinics. Veterans served within this facility lives within the following counties and zip codes.

County Zip

Code County Zip

Code County Zip

Code

Washington, DC 20011 Fowbelsburg, MD 21155 Baltimore, MD 21228

Washington, DC 20032 Upperco, MD 21155 Catonsville 21228

Washington, DC 20422 Upper Falls, MD 21156 Carroll, MD 21229

Charlotte Hall, MD 20622 White Marsh, MD 21162 Morrell Park, MD 21230

Fort Meade, MD 20755 Baltimore, MD 21201 Baltimore, MD 21231

Greenbelt, MD 20770 Baltimore, MD 21202 Baltimore, MD 21234

Silverspring, MD 20910 Baltimore, MD 21204 Loch Raven Village, MD 21234

Aberdeen, MD 21001 Eudowood, MD 21204 Parkville, MD 21234

Baldwin, MD 21013 Ruxton, MD 21204 Parkville, MD 21234

Boring, MD 21020 Towson, MD 21204 Baltimore, MD 21236

Brooklandville, MD 21022 Baltimore, MD 21205 Nottingham, MD 21236

Butler, MD 21023 Raspeburg, MD 21206 Baltimore, MD 21237

Chase, MD 21027 Baltimore, MD 21207 Rosedale, MD 21237

Cockeysville Hunt Valley, MD 21030 Gwynn Oak, MD 21207 Northwood, MD 21239

Cockeysville Hunt Valley, MD 21031 Woodlawn, MD 21207 Baltimore, MD 21244

Fork, MD 21051 Baltimore, MD 21208 Windsor Mill, MD 21244

Fort Howard, MD 21052 Pikesville, MD 21208 Baltimore, MD 21251

Freeland, MD 21053 Mt Washington, MD 21209 Baltimore, MD 21282

Garrison, MD 21055 Roland Park, MD 21210 Pikesville, MD 21282

Glen Arm, MD 21057 Baltimore, MD 21211 Baltimore, MD 21284

Glen Burnie, MD 21061 Govans, MD 21212 Loch Raven, MD 21284

Glyndon, MD 21071 Clifton, MD 21213 Towson, MD 21284

Hydes, Md 21082 Baltimore, MD 21214 Baltimore, MD 21285

Bradshaw/Kingsville, MD 21087 Arlington, MD 21215 Towson, MD 21285

Long Green, MD 21092 Baltimore, MD 21216 Baltimore, MD 21286

Timonium/Lutherville, MD 21093 Druid Park, MD 21217 Loch Raven Village, MD 21286

Timonium/Lutherville, MD 21094 Baltimore, Md 21218 Towson, MD 21286

Maryland Line, MD 21105 Baltimore, MD 21218 Baltimore, MD 21287

Hereford/Monkton, MD 21111 Baltimore, MD 21219 Annapolis, MD 21401

Owings Mills, MD 21117 Sparrows Point, MD 21219 Cumberland, MD 21502

Bentley Springs, MD 21120 Baltimore, MD 21220 Cambridge, MD 21613

Parkton, MD 21120 Middle River, MD 21220 Hagerstown, MD 21742

Perry Hall, MD 21128 Baltimore, MD 21221 Pocomoke, MD 21851

Jacksonville, MD 21131 Essex, MD 21221 Perry Point, MD 21902

Phoenix, MD 21131 Baltimore, MD 21222 Elkton, MD 21921

McDonogh Run, MD 21133 Dundalk, MD 21222 Alexandria, VA 22310

Randallstown, MD 21133 Franklin, Md 21223 Winchester, VA 22602

Reisterstown, MD 21136 Highlandtown, MD 21224 Harrisonburg, VA 22801

Riderwood, MD 21139 Brooklyn, MD 21225 Martinsburg, WV 25401

Glencoe, MD 21152 Curtis Bay, MD 21226 Martinsburg, WV 25405

Sparks, MD 21152 Arbutus, MD 21227 Huntington, WV 25704

Stevenson, MD 21153 Baltimore, MD 21227 Beckley, WV 25801

Halethorpe, MD 21227 Lansdowne, MD 21227 Clarksburg, WV 26301

Franklin, WV 26807

3. Acronyms

ALS – Advanced Life Support AOD – Administrative Officers of the Day BLS – Basic Life Support CCT – Critical Care Transport CCTP – Critical Care Transport Paramedic CCEMTP – Critical Care Emergency Medical Transport CO – Contracting Officer COR – Contracting Officer’s Representative CPR – Cardiopulmonary Resuscitation DOL – Department of Labor EMT – Emergency Medical Technician IAW – In Accordance With OO – Ordering Officer PWS – Performance Work Statement QASP – Quality Assurance Surveillance Plan QC – Quality Control Plan TB – Tuberculosis TJC – The Joint Commission VTS – Veteran Transportation Service

4. Scope/Requirements

4.1. Types of Ambulance Service

4.1.1. The contractor shall provide Emergent, non-emergent Stretcher Transports, Basic Life Support (BLS), Advanced Life Support (ALS), and Critical Care Transport (CCT) Tier 1, 2, and 3 ambulance services on an as-needed basis in accordance with all federal, state, and local regulations.

4.1.2. Occasionally a veteran will need to be transported with VA staff and equipment;

the contractor shall return VA Staff and equipment to the original place of pick-up.

4.2. Transport of Miscellaneous Items with the Patient

The Contractor may also be required to transport patient luggage, medical records, medication, and comfort items from pickup points to destination at no additional cost to the Government. Luggage to be transported will be restricted to suitcase and valise types. When patients are transported to the Baltimore VAMC, destination is deemed to be the ER, Admissions, the clinic, or service within the hospital, or directly to the ward as instructed by VA Staff.

4.3. Contractor Personnel: Contractor personnel shall be courteous and always conduct themselves in a businesslike manner while providing services under this contract.

4.3.1. Emergency Medical Technicians (EMTs), Critical Care Transport Paramedics

(CCTPs) & Other Personnel

4.3.1.1. EMTs, CCTPs and other medical personnel (as applicable) shall at all times meet the qualifications specified in this contract as well as all applicable federal, state, and local government laws, regulations, and standards. EMTs, CCTPs and other medical personnel (as applicable) shall be certified, licensed, or otherwise officially recognized by the local, state, or regional government or public entity where the emergency service is operated or by which it is governed.

4.3.1.2. If the contractor wishes to add or replace personnel throughout the life of the contract, it shall provide evidence of required training, certifications, licensing, and any other qualifications to the Contracting Officer’s Representative (COR) for review.

4.3.1.3. All ambulance drivers shall have a valid driver’s license in accordance with state requirements for their place of operation and the services they perform. If the contractor wishes to add or replace drivers throughout the life of the contract, it shall provide a valid driver’s license to the

COR.

4.3.1.4. CCTPs shall have met all state requirements for the tier in which they are performing services in (I, II, III). Proof in the form of a current certificate for the successful completion of such must be provided to the COR upon request.

4.3.1.5. Investigative Requirements for Contract Personnel: Contract personnel will be subject to the same investigative requirements as those for regular VA appointees and employees. The level of investigation commensurate with the level of access to perform the performance work statement is: Special Agreement Checks (SAC). Fingerprinting for contract personnel will be conducted at the VAMC. Thereafter the contracted employees will be subject annually to the same requirement, with a 90-day window to complete such requirement as provided by the VAMC. The VA Security and Investigation Center (SIC) is responsible for adjudicating all background investigations for contract employees.

4.3.1.6. EMTs, CCTPs, and other contractor personnel as applicable must pass the Contractor’s background check and must not have been convicted of (or have any pending charges for) a felony for the past five years.

Personnel (and Contractor) must report any new or additional charges or convictions if they arise during the course of performance under this contract so VA can review them and determine whether the employee in question needs to be discharged of his or her duties until the matter is adjudicated.

4.3.2. Tuberculosis Exposure Control Policy

4.3.2.1. The contractor shall provide the VA with a policy on tuberculosis (TB) exposure and control, to include TB decontamination.

4.3.2.2. The contractor shall have its personnel tested for TB in accordance with state guidelines and provide written confirmation to the COR that all personnel (current employees and any new hires) performing services under this contract are current in their TB test by at the start of each Ordering Period.

4.4. Contractor Equipment, Vehicles, and Inspection

4.4.1. Ambulances shall meet all applicable federal, state, and local regulations and specifications, including but not limited to licensing, registration, and safety standards.

4.4.2. The VA reserves the right to inspect the contractor’s equipment and vehicles or require documentation of compliance with state laws, rules, regulations, and guidelines governing emergency medical transport vehicles (ambulances). VA inspections of contractor equipment do not constitute a warranty or guarantee 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 in the performance of this contract which are not in compliance with contract requirements. The restriction of such equipment and vehicles shall not relieve the contractor from performance in accordance with the contract nor necessitate additional cost to the VA.

4.4.3. Vehicles shall be clean and maintained in good repair in accordance with manufacturer’s instructions.

4.4.4. The contractor shall not borrow or exchange supplies, equipment, and/or medications with the VA. Equipment attached to or in use by the patient at time of pick-up may remain with the patient during transport to ensure continuity of care. Medical Control Authorities are responsible for maintaining and supplying medication during patient transport. All VA equipment and unused medications must be returned to VA during patient drop-off or as promptly as feasible within 24 hours.

4.4.5. The contractor shall furnish all linen required for patient transport at no additional cost. Linen shall not be exchanged with linen belonging to VAMC or its CBOCs.

4.4.6. The contractor must be capable of transporting the drugs and/or equipment as required by the patient as listed in Attachment A Critical Care Transport Capabilities Confirmation. The contractor shall have the appropriate medications, up to and including CCT Tier III if necessary, based on the EMS region the ambulance provider is functioning in.

4.4.7. The contractor shall furnish qualified personnel as required by contract specifications to accomplish all services under this contract.

4.4.7.1. The contractor personnel performing services for the VA, shall, at all times, conduct themselves in a professional manner, and be identified by having the company name, and employee name affixed to the uniform. The Contractor shall be responsible for furnishing all vehicles, uniforms, nametags and/or badges for performance of services under this contract. Employee identifications shall be worn in clear view above the waist.

The contractor personnel shall not smoke/play loud music originating from any device in vehicles while transporting VA patients.

4.4.7.2. Each driver shall possess a driver’s license that is valid for the class of vehicle driven. Evidence of a special transportation service vehicle permit, or endorsement issued by the commissioner of public safety.

• Be at least 18 years of age and have not less than one year of experience as a licensed driver; and o For the past three years:

Have not had a driver’s license canceled or suspended.

Have a driving record clear of convictions for operating a motor vehicle or motorcycle without insurance.

Have a driving record clear of convictions for driving a motor vehicle without a valid current license for the class of vehicle driven

Have a driving and criminal record clear of convictions for driving under the influence of alcohol or a controlled substance.

4.4.7.3. The contractor personnel will ensure that the patient is secured to the stretcher/cot and that the stretcher /cot is secure in the back of the ambulance before the vehicle moves.

4.4.7.4. Ambulance drivers shall have a valid driver’s license, 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 shall have successfully completed the standard and advanced first aid course of the American Red Cross of U.S. Bureaus of Mines of equivalent and be capable of providing necessary medical assistance to the attending emergency medical technician or paramedic.

4.4.7.5. Emergency Medical Technician (EMT) and Paramedic Qualifications:

EMT’s and Paramedic’s providing services under this contract shall have the following qualifications, in additions to those required by Federal, State, and Local Government:

• Have completed training in accordance with the standards published by the Department of Health and Human Services with a minimum curriculum of 150 hours or equivalent including an in-hospital training period. Such training programs must also be acceptable under the regulating requirements for local EMS Systems supported by DHHS under PL 93-154, Federal Register 39:24304.

(1974).

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

4.5. Transportation Request

4.5.1 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:

a) Receive and respond to electronic trip requests

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

c) Submit claims via the electronic HCFA 1500 in the VetRide Vendor Portal or VA-

Approved Transportation Software system.

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

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

ii. Contract Number

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

iv. Authorization number(s)

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

vi. Base Rate

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

viii. Date of Birth and Sex

ix. Diagnosis Codes or Nature of Illness or Injury

x. Documentation of circumstances when billing for waiting time

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

xii. VA authorizing official’s name

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

e) Unauthorized charges will be reviewed by the Contracting Officer Representative (COR) 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.

4.5.1.1. A transportation request is defined as one incidence of a request for one-way service (Stretcher Transports, BLS, ALS, CCT). 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. The VAMC 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, facsimile) will be used to place Transportation requests.

4.5.1.1.1. The VAMC 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.

4.5.1.1.2. 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. The VAMC Travel Program Staff/or authorized VA employees may place a “hold” on payment of this order until it has been reconciled.

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

Contracting Officer (CO) Ordering Officers (OO) Administrative Officer of the Day (AOD) Beneficiary Travel Office Staff Contracting Officer’s Representative (COR)

The Contracting Officer 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 Contracting Officer will update this list throughout the life of the contract as Ordering Officers change.

Ordering Officers are responsible for issuing and administering orders placed under this contract. Ordering Officers have no authority to modify any term of this basic contract. Any deviation from the terms of the basic contract must be approved in writing by the Contracting Officer responsible for this contract.

The Contractor shall accept orders against this contract only from the Contracting Officer and/or authorized ordering officers. Fulfilling orders from persons other than the Contracting Officer or ordering officer may result in loss or delay in payment for supplies/services provided under such orders.

Non-authorized VA employees and private agencies (e.g., nursing homes) are not considered authorized to place transportation requests.

4.5.1.2.1. All patient pick-up(s) and drop-off(s) shall be authorized via “orders” which shall only be issued by the designated Ordering Officers. When placing orders for services, the Ordering Officer shall contact the designated contractor point of contact(s) to provide the following information:

Mode of transportation required, Required time of arrival Name of the beneficiary, Pick-up and delivery point, Type and number of additional medical care specialists required, Type of equipment required, Last four of the patient's Social Security Number, and Any other special instructions

4.5.1.3. For ALL Transports – an Audit system will be put in place by the VA to include the COR or designee, Beneficiary Travel Department staff, and clinical staff to ensure appropriateness of the order and timeliness of the response.

4.5.1.4. The type of transportation service (Stretcher Transports, BLS, ALS, CCT) required will be discussed and determined by VA clinical personnel and the contractor. The contractor shall transport the patient per its policies and standard industry practice. If the type of transportation service differs from what was agreed upon by the VA and contractor, the contractor shall submit documentation to the VA explaining its rationale.

4.5.1.5. The VA may authorize an escort (e.g., spouse, relative, guardian, etc.) to accompany the patient during medical transport if it is practicable and, in the patient’s, best interest. The contractor shall allow the escort to accompany the patient at no additional cost.

4.5.1.6. The contractor shall have sufficient vehicles and personnel to provide services for up to four (4) simultaneous transportation requests. Transports required may be for any mix of Stretcher Transports, BLS, ALS transports.

One of these four simultaneous transports may require CCT capability up to Tier III. If the VAMC requires ambulance services exceeding four (4) simultaneous transportation requests, the vendor will be offered to provide the services if they have sufficient vehicles/personnel available; but may decline these additional orders if sufficient vehicles/personnel are unavailable.

4.5.1.7. The number of transports under normal operating conditions will typically range from 70-100 transports each weekday and significantly less on weekends and holidays. The number of actual transports may vary throughout the life of the contract.

4.5.1.8. The patient may bring with her or him up to three (3) liters of oxygen.

The contractor shall be responsible for providing adequate and safe storage of the oxygen tanks during transport.

4.5.1.9. Response Times*

4.5.1.9.1. Orders that are scheduled by 7pm local time the day before the required services are defined as scheduled in advance. With the exceptions found below, the contractor shall arrive on time for all orders scheduled in advance.

4.5.1.9.2. Emergent Transport (Originating from VA (Only): The contractor shall be required to provide Ground Ambulance arrangements within thirty (30) minutes of order/patient pick up call.

4.5.1.9.3. For all add-ons (not scheduled in advance) transportation requests, with pick up at the VAMC: The contractor will be allotted up to a sixty (60) minute response time from time of order placement for transportation requests that are not previously scheduled in advance.

a. For an urgent transport request for a critical patient (as deemed by the physician) with pick up at the VAMC, the contractor will be allotted up to a thirty (30) minute response time.

b. 911-Transports (Non-VA Initiated Orders)

a. When an invoice is received and noted as a non-VA initiated or 911 call, VA staff must determine the following:

b. Medical necessity

c. Eligibility

d. Services received

e. HCFA 1500

f. Ambulance Report Summary

4.5.1.9.4. For transportation requests which do not have a pick-up at the

VAMC:

a. The contractor may be required, if requested by the VA, to dispatch ambulances on short notice for transportation request not scheduled in advance; for these transportation requests the contractor shall dispatch ambulances within thirty (30) minutes of receiving the order.

b. Pick-up appointment times shall be agreed upon by the VA and contractor at time of order placement and be reasonable based upon travel distance, speed limits, and weather conditions.

c. The contractor’s patient pick-up time cannot be more than 15 minutes prior to the schedule pickup time nor 15 minutes later than the scheduled pickup time for transportation requests scheduled in advance.

* The contractor shall not be held liable for nonperformance caused by an occurrence beyond the reasonable control of the contractor and without its fault or negligence such as, acts of God or the public enemy, acts of the Government in its sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions, strikes, and unusually severe weather. The contractor MUST notify the VA with as much advance notice as possible should any of these occur.

4.5.2. Cancellations

4.5.2.1. For trips in which the contractor is notified of cancellation before the vehicle is dispatched, there shall be no charge to the Government.

4.5.2.1.1. A “no show” is defined as a transportation request which is cancelled after the contractor has dispatched a vehicle, the vehicle is enroute, or has arrived at the pick-up location, and there is no longer a requirement for patient transportation. The contractor may request one-way reimbursement for no-shows. No-show reimbursement shall be based upon the base rate for the type of service requested (Stretcher

Transports, BLS, ALS, CCT) and the one-way mileage (Stretcher Transports, BLS, ALS, CCT) accrued enroute to the pick-up location at time of cancellation. Mileage for no- show cancellations shall be confirmed by the contractor and reported to the VA as soon as possible from time of cancellation.

4.5.2.2. For transportation requests OUT of the VAMC ONLY – The contractor will immediately dispatch a vehicle upon receipt of the order (including transportation requests in which the final destination may change prior to pick up due to the critical condition of the patient). When the contractor is notified of a cancellation prior to arrival at the VAMC campus, there shall be no charge to the Government.

4.6. Pick-Up/Drop-Off/Reporting Procedures

4.6.1. Ambulance personnel shall pick-up and deliver patients at specified locations

(e.g., front door of Baltimore VAMC Entrance). These locations will be specified by VA staff when an order is placed and communicated to the transporting personnel.

4.6.2. When applicable, ambulance personnel shall report to the Veteran Transportation Service (VTS) Dispatcher or Administrative Officer of the Day (AOD) 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.

4.6.3. When delivering a patient, ambulance personnel shall give report to the appropriate VA healthcare staff and provide a copy of the run sheet which will be retained by the facility for inclusion to the patient’s medical record.

4.6.4. In cases where ambulance personnel must divert to a local emergency department while performing a VA authorized transport, the contractor’s dispatcher shall notify the VA Beneficiary Travel Department or Administrative Officer of the Day of the patient’s location and status as soon as this information becomes available.

4.7. Patient Welfare

4.7.1. The contractor shall be responsible for the patient’s welfare during transport. The contractor shall be held responsible for patient and/or VA property during transport. Any damaged or lost wheelchairs, walkers, crutches, or personal belongings shall be replaced at the contractor’s expense.

4.7.2. The VA requires the contractor to exercise extreme caution and care in the handling of patients.

4.7.3. If a VA beneficiary being transported declines to be properly secured or removed the securement devices himself/herself, the driver will notify the Contracting Officer’s Representative (COR) of this fact prior to departure. The contractor is not required to transport any VA beneficiary who refuses to be properly secured while being transported. In the event that the beneficiary refuses to be properly secured, they shall be returned back into the building which they came from.

4.8. Incident Reporting

4.8.1. The contractor shall notify the COR, Requestor, Program Manager, Beneficiary

Travel Department, of any accidents and/or safety problems that occur while the patient is being transported. This notification shall occur within one (1) hour by telephone. A written report of the incident shall be delivered to the COR, Program Manager, or Beneficiary Travel Department, by the close of business of the next working day.

4.8.2. The COR will monitor the service provided. The contractor shall cooperate with the COR in providing information and answering questions in a timely manner.

The contractor shall promptly inform the COR of any complaints received directly from patients. If warranted, the VA may conduct incident investigations and require written response from the contractor within 48 hours of request.

4.9. Invoicing

4.9.1. Each transport shall include thirty (30) minutes of wait time; the contractor may invoice for wait times in excess of this initial thirty (30) minutes. Wait time shall begin only once the contractor has both reached the pick-up address location and the appointment time has elapsed. All wait times shall be itemized and invoiced in fifteen (15) minute intervals. For partial fifteen (15) minute intervals, zero (0) to seven (7) minutes shall be rounded down to zero (0) minutes and eight (8) to fifteen (15) minutes rounded up to fifteen (15) minutes.

4.9.2. When invoicing for mileage, the contractor shall round to the nearest mile.

Mileage ending in .5 or higher shall be rounded up to the nearest mile. Mileage ending in .4 or lower shall be rounded down to the nearest mile. Payment for mileage to or from the point of care shall be limited to the VA’s calculation according to the VA’s Bing Maps API determination. Bing Maps API is optimized to determine mileage based on the shortest time of travel.

4.9.3. Except for no shows, the contractor shall invoice for loaded (patient onboard) services and mileage only.

4.9.4. Upon notification of the contracting officer, the vendor must receive training and begin implementation of invoices via Vet Ride within 30 days versus VA

Tungsten Network e-Invoicing network. Invoices must be submitted via the electronic HCFA 1500 in the VetRide Vendor Portal or other VA approved software. These invoices shall not include patient information, but shall include the following:

Contractor Name Contract Number Current Purchase Order Number Date of service Total amount invoiced including a summary of the total number of charges that align with the line items of this contract (i.e., total number of BLS Base Rate, total BLS Mileage incurred, etc.)

An itemized list of charges or services rendered that align with the line items of this contract (i.e., BLS Base Rate, BLS Mileage incurred, etc.)

Payment by VA under this contract to a provider of air ambulance transportation services authorized under this contract extinguishes any and all liability on the part of the VA BENEFICIARY for that transportation service. UNDER NO CIRCUMSTANCES ARE VA

BENEFICIARIES, THIRD PARTY INSURANCES, MEDICARE, OR MEDICAID TO BE

BILLED FOR THE SERVICES PERFORMED UNDER THIS CONTRACT.

5. Period & Place of Performance

5.1. This contract’s ordering period shall be effective from July 1, 2024 through June

30, 2029.

5.2. The Place of Performance is variable and may occur within the states of Maryland, West Virginia, District of Columbia, Ohio, Kentucky, and Pennsylvania, ambulance services may be required to or from locations including, but not limited to the following:

5.2.1. Baltimore VA Medical Center to include specific Atrium Clinics, Emergency

Department, pavilions, or out-buildings on the Baltimore VAMC campus. The Baltimore VAMC address is: 1 0 N . G r e e n e S t r e e t B a l t i m o r e , M D .

2 1 2 0 1

5.2.2. VAMC Community-Based Outpatient Clinics (CBOCs):

CBOC Name Address Loch Raven VA Outpatient Clinic

3900 Loch Raven Blvd, Baltimore MD 21218

Cambridge VA Outpatient Clinic

830 Chesapeake Drive, Cambridge MD. 21613

Pocomoke City VA Outpatient Clinic

1701 Market Street, Unit 211, Pocomoke, MD 21851

Glen Burnie VA Outpatient Clinic

808 Landmark Drive, Suite 128, Glen Burnie, MD. 21061

Eastern Baltimore County VA Outpatient Clinic

5235 King Avenue, Suite 200, Rosedale, MD 21237

Fort Meade VA Outpatient Clinic

2479 5th Street, Suite 5138, Fort Meade , MD. 20755

Alexandria Community Based Outpatient Clinic

6940 S kings HWY STE 208 Alexandria, VA 22310

Greenbelt Community Based Outpatient Clinic

7525 Greenway Center DR.

Greenbelt, MD. 20770

Southeast Community Based Outpatient Clinic

820 Chesapeake Street SE Washington , DC 20032

Cumberland Outpatient Clinic 200 Glenn Street Cumberland, MD 21502-2573

Franklin Contract Outpatient Clinic

91 Pine Street Franklin, WV 26807

Hagerstown Outpatient Clinic 1101 Opal Court Hagerstown, MD. 21742

Harrisonburg Contract Outpatient Clinic

1755 S. High Street Harrisonburg

Southern Maryland VA Outpatient Clinic

29640 Three Notch Road Charlotte Hall, MD 20622

Stephens City Outpatient Clinic 170 Prosperity Dr

Winchester, VA 22602 Aberdeen Vet Center Outstation

223 West Bel Air Avenue on Law Street Aberdeen, MD. 21001

Alexandria Vet Center 6940 S Kings HWY Suite 204 Alexandria, VA 22310

Annapolis Vet Center 100 Annapolis St Annapolis, MD 21401

Baltimore Vet Center 1777 Reisterstown Rd #199, Pikesville, MD 21208

Elkton Vet Center 103 Chesapeake Blvd #A Elkton, MD 21921

Martinsburg Vet Center 300 Foxcroft Ave, Martinsburg, WV 25401

Silver Spring Vet Center 2900 Linden Lane Suite 100

Silver Spring, MD. 20910 Washington D.C. Vet Center 1296 Upshur Street, Northwest

Washington, DC 20011

5.2.3. Other VA Medical Centers, Hospitals, or CBOCs within Veterans Integrated Service Network (VISN) 5 including, but not limited to:

Medical Center Name: Address:

Perry Point VA Medical Center 361 Boiler House Road, Perry Point, MD. 21902 Martinsburg VA Medical Center 510 Butler Ave, Martinsburg, WV 25405

Washington DC VA Medical Center

50 Irving St. NW, Washington

Louis A Johnson Veterans’ Administration Medical Center

1 Medical Center Drive Clarksburg, WV 26301-4155

Beckley VA Medical Center 200 Veterans Ave Beckley, WV 25801

Martinsburg VA Medical Center 510 Butler Ave Martinsburg, WV 25405

Hershel Williams VA Medical Center

1540 Spring Valley Dr Huntington, WV 25704

5.2.4. Other Non-VA Medical facilities and Community Care facilities as authorized by the VA.

5.2.5. Veteran’s residence as authorized by the VA.

5.2.6. Local airports including:

Baltimore/Washington International Airport

7050 Friendship Rd Baltimore, MD 21240

Hagerstown Regional Airport 18434 Showalter Rd Hagerstown, MD 21742

Salisbury – Ocean City- Wicomico Regional Airport

5485 Airport Terminal Rd Unit A Salisbury, MD 21804

Martin State Airport 701 Wilson Point Rd, Middle River, MD 21220

Frederick Municipal Airport 310 Aviation Way, Frederick, MD 21701

Montgomery County Airpark 7940 Airpark Rd, Gaithersburg, MD 20879

Maryland Airport 3900 Livingston Rd, Indian Head, MD 20640

Tipton Airport 7515 General Aviation Dr #1, Fort Meade, MD 20755

Carroll County Regional Airport 200 Airport Dr, Westminster, MD 21157

Cambridge/Dorchester Reginal Airport

5263 Bucktown Rd, Cambridge, MD 21613

College Park Airport

1909 Corporal Frank Scott Dr, College Park, MD 20740

Crisfield-Somerset Airport 4784 Jacksonville Rd, Crisfield, MD 21817

Greater Cumberland Regional Airport

165 Terminal Loop, Wiley Ford, WV 26767

Easton Airport (Newman Field) 29137 Newman Rd, Easton, MD 21601

St Mary’s County Regional Airport 44200 Airport Rd, California, MD 20619

Garrett County Airport 771 Airport Rd, Accident, MD 21520

Ocean City Municipal Airport 12724 Airport Rd, Berlin, MD 21811

Bay Bridge Airport 202 Airport Rd, Stevensville, MD 21666

Lee Airport 3090 Solomons Island Rd, Edgewater, MD 21037

Essex Skypark 1401 Diffendall Road Essex, MD 21221

Washington Executive Airport 10399 Piscataway Rd, Clinton, MD 20735

Pier 7 Heliport 1800 S Clinton St, Baltimore, MD 21224

Harford County airport 3538 Aldino Rd, Churchville, MD 21028

Mexico Farms Airport 14112 Airport Ln SE, Cumberland, MD 21502

Claremont airport 166 Raintree Ln, Elkton, MD 21921

Fallston Airport 711 Reckord Rd, Fallston, MD 21047

Potomac Airfield 10300 Glen Way, Fort Washington, MD 20744

Havre de Grace Seaplane Base 309 St John St, Havre De Grace, MD 21078

Davis Airport 7200 Hawkins Creamery Rd, Gaithersburg, MD 20882

Massey Aerodome 33541 Maryland Line Rd, Massey, MD 21650

Freeway Airport 3900 Church Rd, Bowie, MD 20721

Gooden Airport 24030 Race Track Rd, Ridgely, MD 21660

Bennett Airport 28886 Naylor Mill Rd, Salisbury, MD 21801

Kentmorr airpark 114 Kentmorr Rd, Stevensville, MD 21666

Clearview Airpark 526 Oak Tree Rd, Westminster, MD 21157

Phillips army Airfield 6283 Demby Drive Aberdeen Proving Ground, MD 21005

Weide Army Airfield 9325 Gunston Road Ft Belvoir, VA 22060

Andrews Air Force Base 1050 W Perimeter Rd Joint Base Andrews, MD 20762

NAS Patuxent River 22268 Cedar Point Road NAS Patuxent River, MD 20670-1132

NOLF Webster Nawcad Pax River-Unit 11 St. Inigoes, Md 20684-0010

6. Quality Control Plan

6.1. Quality Control

6.1.1. The contractor shall maintain a Quality Control Plan (QCP) that contains, at a minimum, the following:

6.1.1.1. A description of the company’s organizational structure including a description of the roles and responsibilities of management and supervisors.

6.1.1.2. A description of the methods to be used by the contractor for identifying and preventing deficiencies or problems in the quality of service.

6.1.1.3. A description of the specific steps the contractor will take for corrective action if needed if a deficiency or problem in the quality of service occurs.

6.1.1.4. A description of the company’s records and tracking system used to identify up-to- date background checks, applicable certifications and tests, and training of each employee performing services under this contract.

6.1.1.5. A description of the method used to provide on-time ambulance services to meet the requirements of this contract (24/7 availability and up to 4 simultaneous transports in accordance with PWS 4.5.1.7).

6.1.1.6. A description of the methods used to identify and prevent radio communication breakdowns and a detailed procedure for alternative communications in the event of electronic and mechanical breakdown of vehicle two-way radios.

6.1.1.7. CONTENGENCY PLAN: (In case VetRide Vendor Portal is down) A description of the method/system used to log all requests for service. The contractor shall confirm that the log indicates the date and time of service call, actual time of pick-up versus the scheduled time, name of patient requiring services, designated pick-up and delivery points, mileage, and actual waiting time at pick-up and delivery points if waiting charges are claimed. The contractor shall confirm the log will be sent to the COR monthly.

6.1.2. The Government will evaluate the contractor’s performance under this contract to ensure that the contractor’s QCP is adequate, and that quality is achieved through a Quality Assurance Surveillance Plan (QASP).

6.1.3. The Government shall prepare a QASP after contract award derived from the

PWS and contractor’s submitted quality control plan. The QASP is a “living document” and the Government may review and revise it at any time. However, the Government shall coordinate changes to the QASP with the contractor.

6.1.4. The QASP will specify the work requiring surveillance and the Government’s method of surveillance.

6.2. Minimum Performance Standards

6.2.1. The contractor shall maintain performance standards in accordance with the standards outlined in the table below. Failure to meet the Acceptable Quality Levels (AQL) may result in termination of the contract.

6.2.2. The QASP will include the standards below as well as others derived from the successful offeror’s quality control plan.

Task PWS

Reference

Standard Acceptable Quality Level

Method of Surveillance

Provide on-time ambulance services

Section 4.5.1.9

Scheduled patient pick-ups shall not deviate more than 15 minutes past scheduled pick-up time for scheduled orders

97% Customer Feedback

Incident Reporting

Section 4.8 The contractor shall notify the Program Manager, Beneficiary Travel Department, of any accidents and/or safety problems that occur while the patient is being transported. This notification shall occur within one (1) hour by telephone. A written report of the incident shall be delivered to the Program Manager, Benefits Management, by the close of business of the next working day.

97% Customer Feedback

Invoice Reports

Section 4.9 Provide a monthly invoice including secondary documentation in accordance with Section 4.10 of the

PWS

95% 100% inspection of monthly invoices/reports

7. COVID-19 Or Other Similar Infectious Diseases

7.1. Contractor shall not refuse transports of COVID-19 positive or other similarly infected patients.

7.2. Contractor shall abide by all additional procedures and precautions that may be implemented by the VA based on VA-issued guidance and/or CDC recommendations.

These procedures are subject to change throughout the life of the contract and will be incorporated via attachment (See S03 VTS Patient Transport PPE and Vehicle Cleaning/Disinfection SOP).

7.3. Contractor shall have written policy of steps they will take to prevent the spread of COVID-19 or other similarly infectious diseases by their employees and/or vehicles. This policy shall, at a minimum, include procedures of screening drivers before each shift, deliberate decontamination of their vehicles and all other preventative precautions taken by Contractor employees.

7.4. Contractor shall furnish all required PPE throughout the life of the contract.

8. Conformity To Regulations

8.1 The contractor and his/her operators shall conform to all Federal, State, and local regulations governing the performance of contracted services.

8.2 VAMC facilities have been designated NO SMOKING areas in their entirety. Individuals found in violation of this no smoking policy may be subject to a $50.00 federal citation for disregarding posted safety rules and regulations. Furthermore, the contractor may be directed to stop work. The contractor is to notify all of his/her employees and/or sub-contractors of this strict enforcement policy.

9. Wage Rates

9.1. Wage Determination(s) as listed in Section D in this solicitation are applicable to any resulting contract.

9.2. The contractor certifies by signature on this offer that the salaries to be paid workers involved in the performance of the contract are equal to or greater than those specified in the attached Wage Determination(s).

9.3 The Department of Labor has held that contractors must pay their employees the Service Contract Act waged while they are driving both to and from destinations for the VA.

The Wage Determination is attached in Section D.

10. Evidence of Coverage

10.1 Before commencing work under the contract, the contractor shall furnish the Contracting Officer with a certification from his/her insurance company indication that the coverage outlined in this contract has been obtained and that it may not be changed of canceled during the term of the contract.

11. Worker’s Compensation

11.1 The Act of June 25, 1936, 42 Stat. 1938 (40 USC 290), authorized the constituted authority of the several states to apply their workmen’s compensation laws to all lands and premises owned or held by the United States. The contractor agrees to procure and maintain while the contract is in effect, Worker’s Compensation and Employers Public Liability insurance. The policy shall provide coverage for Public Liability Limits of not less than the statutory limitations for any one accident, and at least meet the statutory limitations if more than one person is involved. Upon award of the contract, the contractor shall furnish to the Contracting Officer a certificate from its insurance company indicating that this coverage has been obtained and that such coverage may not be changed or canceled unless 30 day advance written notice is provided to the Contracting Officer.

12. Contractor Personnel Security Requirements

12.1 All contractor employees who require access to the Department of Veterans Affair's computer systems or who come into contact with veteran/beneficiaries shall be the subject of a background investigation and must receive a favorable adjudication from the VA Office of Security and Law Enforcement prior to contract performance. This requirement is applicable to all subcontractor personnel requiring the same access. If the investigation is not completed prior to the start date of the contract, the contractor will be responsible for the actions of those individuals they provide to perform work for the VA.

Position Sensitivity - The position sensitivity for this contract has been designated as LOW

RISK.

Background Investigation - The level of background investigation commensurate with the required level of access for this contract is National Agency Check with Written Inquiries.

Contractor Responsibilities:

• The contractor shall pre-screen all personnel requiring VA access to ensure they maintain a U.S. citizenship and are able to read, write, speak, and understand the English language.

• The contractor shall submit or have their employees submit the following required forms requested by Department of Veterans Affairs, Office of Security and Law Enforcement, Security and Investigations Center, 2200 Fort Roots Drive Bldg. 104, North Little Rock, AR 72114 within 30 days of receipt:

• All documents completed and submitted at the following website:

http://www.va.gov/SECURITYINVESTIGATIONSCENTER/

• The contractor, when notified of an unfavorable determination by the Government, shall http://www.va.gov/SECURITYINVESTIGATIONSCENTER/ withdraw the employee from consideration from working under the contract. Failure to comply with the contractor personnel security requirements may result in termination of the contract or cause.

The contractor shall agree that all deliverables, associated working papers, and other material deemed relevant by the contractor in the performance of this task order are the property of the United States Government. The contractor shall agree that all individually identifiable health information shall be treated with the strictest confidentiality. Access to records shall be limited to essential personnel only. Records shall be secured when not in use. At the conclusion of the contract, all copies of individually identifiable health records shall be destroyed or returned to the VA. Any individually identifiable health records shall be deleted from computers not belonging to the VA. The contractor shall comply with the Privacy Act, 38 U.S.C. 5701, 38 U.S.C. 7332, and 5 U.S.C. 552(a) et. Seq. Contractor staff shall sign confidentiality statements before the start date of the contract. The contractor shall comply with all provisions of the Health Information Portability and Accountability Act (HIPAA), including but not limited to privacy, security of electronic health data, and adherence to standards and code sets as required by HIPAA. The contractor shall ensure the confidentiality of all patient and employee information and shall be held liable in the event of breach of confidentiality. Any person, who knowingly or willingly discloses confidential information obtained from the VA with non-essential persons, may be subject to fines.

12.1.1 HIPAA COMPLIANCE. HIPAA compliance is required. The contractor must adhere to the provisions of Public Law 104-191, Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the National Standards to Protect the Privacy and Security of Protected…