PWS UPDATED PWS.docx

Performance Work Statement (PWS)

GROUND AMBULANCE

VISN 5 / Station 540 NAICS 621910

B.2 PERFORMANCE WORK STATEMENT

1. Purpose: The Louis A Johnson VA Medical Center (hereafter LAJVAMC), its associated Community-Based Outpatient Clinics (CBOCs), and affiliated healthcare clinics require contracted ambulance transportation services. The contractor shall provide all vehicles, personnel, management, supplies, equipment, and necessary reporting for the provision of Basic Life Support (BLS), Advanced Life Support (ALS), C3-Interfacilty or Critical Care Transport (CCT) services. The contactor shall make these ambulance services available to the VA as specified in the terms of this contract below.

2. Background: LAJVAMC campus is located 1 Med Center Drive, Clarksburg, WV 26301, serving over 25,342 Veterans, primarily from the North Central West Virginia area and it’s four Community-Based Outpatient Clinics. The hospital has 103 inpatient beds and sees approximately 1,960 inpatient admissions and 304,714 outpatient visits a year. Veterans served within this facility lives within the following counties and zip codes.

3. Acronyms ALS – Advanced Life Support AOD – Administrative Officers of the Day BLS – Basic Life Support C3-IFT – C3 Interfacility Transport 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 Service

4.1.1. The contractor shall provide scheduled, add-on, and emergent transport.

4.1.1.1. Scheduled –LAJVAMC will provide a schedule of all pick-ups by noon the day prior to pick-up. For Monday and Holidays, the schedule will be provided the last workday prior to the break.

4.1.1.2. Add-on – Appointments that are scheduled after the cut-off time of the day prior. These are for routine appointment, non-critical transport.

4.1.1.3. Emergent –Requests for transport after the cut-off time for patients who cannot wait.

4.1.2. Types of transportation Service

4.1.2.1. Basic Life Support (BLS) - (A0428) Non-Emergency Transport, Basic Life Support (BLS) ambulances provide transport to patients who do not require extra support or cardiac monitoring. A BLS ambulance is staffed by at least one Emergency Medical Vehicle Operator (EMVO) and at least emergency medical technicians (EMTs) or Paramedic and who have training in basic emergency medical care such as basic airway management, use of an automated external defibrillator and basic drug administration

4.1.2.2. Advanced Life Support (ALS) - (A0426/A0427) Advanced Life Support (ALS) ambulances transport patients who need a higher level of care during transport above those services provided by a BLS ambulance. The unit is staffed by at least one paramedic and are qualified to render advanced life support to patients such as advanced airway management, drug administration and cardiac monitoring under the direction of a hospital. Vehicle must be operated by a EMVO, EMT, or Paramedic.

4.1.2.3. Critical Care Transport (CCT) – Patient Transportation when medically necessary, for a critically ill or injured patient needing critical care paramedic (CCP) skills between medical care facilities and provided by an authorized ambulance service to provide critical care transport and staffed by one or more critical care paramedic or other health care professional in an appropriate specialty area. Vehicle must be operated by a EMVO, EMT, or Paramedic.

4.1.2.4. C3 Inter-Facility Transport – C3IFT – C3 Interfacility transportation of a critically injured or ill individual by a ground ambulance vehicle. This includes the provision of medically necessary supplies and services, at a level beyond the scope of a paramedic.

4.1.2.5. Basic Patient Transport / Minivan – Patient is ambulatory; does not need any medical care, special transportation, or equipment.

4.1.2.6. Stretcher/Wheelchair Transport – Patient requires use of a stretcher or wheelchair but does not require a higher level of medical care.

4.1.3. Costing for each type of trip based on each type of transport.

4.1.3.1. A one-way trip will be billed to include the base rate and 40 miles. Any trip over 40 miles will be billed per mile.

4.1.3.2. Trips requiring travel outside of the listed catchment area will be billed at the level of service plus over 40 miles for the loaded miles plus an additional flat rate as an incentive to take the trip. Offloaded trips over 75 miles will be billed per mile.

4.1.3.3. Trips to Pittsburgh are based on a for one-way flat rate based on type of service. There will not be additional mileage, offloaded return rate, or wait time.

4.1.3.4. Offloaded, one-way return trips outside of 75 miles will utilize mile rate on line 0010. Offloaded trips are do not include patients and typically occur when a patient is dropped off at a distant hospital.

4.1.3.5. Waiting Time –For time lost in waiting at one or both ends of a trip due to causes beyond the Contractor's control, the Contractor will be reimbursed per half-hour as proposed in the cost schedule. For each half-hour or fraction thereof more than one-quarter hour for the time reported to the designated Veterans Affairs personnel. If the pick-up point is other than the Veterans Affairs Medical Center; the Contractor will call, email, or leave voicemail the Travel Clerk first or Transportation Assistant during administrative hours (7:30AM through 4:00PM, Monday through Friday) or the Administrative Officer of the Day (AOD) on duty during WHEN hours (Weekend, Holidays Evenings, nights) as soon as it is anticipated that a delay may develop for which the Contractor expects to claim reimbursement. This call is only for the purpose of verifying the arrival time at the pick-up point and is not necessary if the Contractor anticipates no delay for which reimbursement will be claimed. The Contractor's failure to notify the travel section when waiting beyond the grace period shall result in non-payment for waiting time.

4.2. Transportation Requirements

4.2.1. Luggage – 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.

4.2.2. Patient Pickup and Delivery from/to VAMC

4.2.2.1. Ambulance drivers will report and sign-in at the Travel Clerk's desk, Monday through Friday, from 8:00 AM through 4:30 PM and at the Admission Office from 4:30 PM to 8:00 AM Monday through Friday and weekends.

4.2.2.2. Ambulance drivers will deliver and pick-up patients at designated locations, i.e., Emergency Room, Special Treatment Room, Clinic Area, Ward (if known). These locations will be designated when designated Veteran Affairs personnel make contact.

4.2.2.3. Ambulance personnel will report to the Nursing Station 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.

4.2.2.4. When delivering a patient, the ambulance personnel will give report to appropriate nursing personnel. When requested, a run sheet of that run shall be faxed or sent electronically to the VA Medical Center.

4.2.2.5. In cases which the ambulance's dispatchers prioritize their requests for services as an emergency and a rescue squad is dispatched, the dispatcher will notify the calling party at the VAMC of the patient's location as soon as it becomes available.

4.2.2.6. Reporting – If response times cannot be met, a phone call will need to be placed immediately to the COR, Program Manager, or Beneficiary Travel Department.

4.2.3. Response Times

4.2.3.1. Scheduled - All scheduled requests will arrive on time for all orders.

4.2.3.2. Advance Life-Support

4.2.3.2.1. Add-on – 2 hours

4.2.3.2.2. Emergent – 30 minutes

4.2.3.3. Basic Life-Support

4.2.3.3.1. Add-on – 2 hours

4.2.3.3.2. Emergent – 30 minutes

4.2.3.4. Critical – 2 hours

4.2.3.5. Specialty Care – 30 minutes

4.2.3.6. Basic Patient Transport / Minivan – 2 hours

4.2.3.7. Stretcher/Wheelchair Transport – 2 hours

4.2.4. Number of Patients – Only one patient will be transported on a trip unless specifically authorized or requested by the Department of Veterans Affairs. When, pursuant to the Department of Veterans Affairs authorization, more than one patient is transported concurrently on a trip, reimbursement shall be made only at the rates contained in the schedule of costs for transporting a single patient. Regardless of the number of patients transported concurrently on a single trip, the Contractor shall be reimbursed for only the Base Rate for one trip. An Authorized official of the Department of Veterans Affairs may, when in the best interest of the Veteran, allow a relative or caregiver to accompany the Veteran, but caregiver/relative will have to provide their own transportation home.

4.2.5. Complete Trip –When ambulance service under the terms of this contract involves pick-up of a patient who is to be brought to this medical center or to another hospital and/or clinic for hospitalization or treatment, the trip will be considered complete when the patient is delivered by ambulance personnel to the admitting/evaluation unit, a specified ward or unit, or to the location specified at the time the trip is requested.

4.2.6. Non-Pickup of Patient - When ambulance service involves a trip to or from this medical center, patient's residence, or patient refusal, but due to unforeseen circumstances the patient is not available for pick-up, the Contractor will collect for the trip at the rates applicable under the schedule portion of this contract. The Department of Veterans Affairs reserves the right to substitute patients in these instances to prevent the "no-load” situation.

4.2.7. Non-Arrival of Patient - When ambulance service involves the pick-up of a patient scheduled to arrive by air and the ambulance driver finds such patient does not arrive as scheduled, the ambulance driver will contact the Travel Clerk, Supervisor, Patient Support Unit, or the AOD and inquire as to the status of the arrival. If appropriate, waiting time may be authorized for time lost in waiting in accordance with the rate applicable under the schedule of costs of this contract. If Contractor reported as scheduled and no patient is transported, Contractor will be reimbursed at the rates applicable under the schedule of costs of this contract.

4.2.8. Patient Custody: The Contractor shall not release the patient from his/her custody, unless custody is released to an appropriate facility staff on duty at the facility patient is being transported to, or to a designated point at the patient's residence. The Contractor shall take every reasonable measure to assure the well-being of the patient at their destination. The ambulance crew shall wait with the patient when transporting for scheduled appointments and provide assistance as needed, unless otherwise released by medical personnel at the location of the appointment.

4.2.9. Rates: Rates will apply twenty-four hours per day seven days a week.

4.2.9.1. Out of Catchment Area –Payment for mileage traveled beyond the catchment area will be limited to "One Way Only" for the distance over which the patient is transported. Unless such mileage costs will be paid in addition to the applicable rate per trip for any trip entirely within the catchment limits. The contractor shall receive the base rate proposed in the schedule for all one-way trips ordered. The base rate shall constitute full compensation for one-way trips which do not exceed the 75-mileage threshold as defined herein.

4.2.10. Mileage –Mileage is determined using Bing Maps.

4.2.11. Telephone System - The Contractor shall have telephone coverage to accept calls from the Clarksburg seven (7) days a week/24 hour a day, Sunday through Saturday. The contractor shall have sufficient telephone capacity to ensure immediate communication access between the Clarksburg and the Contractor's facility for the purposes of scheduling and/or canceling trip requests as well as handling other emergencies. If the Contractor's place of business is located beyond the local telephone call zone, the Contractor shall accept telephone orders for service on a collect basis or provide a toll-free number.

4.2.12. Tolls - It is agreed and understood that the prices proposed in the schedule do not include any ferry, bridge, tunnel, or road toll charges. Any such legitimate toll charges incurred shall be limited to one way only and shall be listed separately on the Contractor's invoice.

4.3. Contractor Personnel Requirements - Contractor personnel shall be courteous and always conduct themselves in a business-like manner while providing services under this contract.

4.3.1. Certification and Background Check Requirements –Critical Care Providers are required to meet the qualification or have been issue a license/certificate for the care they are providing that is officially recognized by the local, state, or regional government or public entity where the emergency service is operated and governed. This includes, not limited to, Pennsylvania, Ohio, Maryland, Washington DC, and West Virginia.

4.3.1.1. Any level of certification recognized by the WV Office of EMS including BLS, ALS & CCT providers must meet the qualifications of training, certification and re-certification set forth by said office.

4.3.1.2. Proof of certification must be provided upon request from the CO or COR for each contracted employee.

4.3.1.3. Any and all background checks will be completed by the WV Office of EMS during certification, recertification or if there is just cause. Vendor must complete a background check prior to allowing employees to provide support on this contract. Background checks will include criminal records. Vendor must use their own discretion, erroring on the side of caution, allow contracted employees with felony charges in the past 5 years to work on the contract. Vendors will use their discretion for employees who are pending felony criminal charges.

4.3.1.4. Proof of background check must be provided upon request from the CO or COR for each contracted employee.

4.3.1.5. All drivers shall have a valid driver’s license/certificate in accordance with state requirements for their place of operation, the services they perform, and the type of vehicle they are operating.

4.3.1.6. Proof of operator license/certificate must be provided upon request from the CO or COR for each contracted vehicle operator.

4.3.2. Training - In addition to formal training for license/certificate, the contractor shall provide 16 hours of orientation training for each employee up to 14 days after his or her initial assignment of duty. Vendor must provide proof of training upon request from the CO or COR

4.3.2.1. All contracted employees who have access to protected health information (PHI) in the performance of their official duties are required to take vendor Privacy and HIPAA focused training and Information Security Awareness Training and Rules of Behavior.

4.4. Contractor Provided Vehicles, Supplies, and Equipment

4.4.1. Infectious Prevention Transmission Based Precautions – Vendor is expected to follow the Center for Disease Control (CDC) for standard and transmission-based precautions for all patients, care givers, and staff.

4.4.2. Vehicles

4.4.2.1. Vehicles shall meet all applicable federal, state, and local regulations and specifications, including but not limited to licensing, registration, and safety standards for the services they are providing.

4.4.2.2. 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. 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 state laws, rules, regulations, and guidelines governing emergency medical transport vehicles. 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.

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

4.4.3. Supplies and Medication

4.4.3.1. The vendor shall not borrow or exchange supplies and/or medications with the VA, except when equipment and/or medication are already attached and/or in use for continuity of care. This ensures the patient's treatment is not interrupted during transport. All required supplies and medications necessary for safe patient transport are the sole responsibility of the vendor, who must come prepared without relying on the VA's resources. This policy emphasizes the importance of vendors maintaining a well-stocked inventory and having clear communication with VA staff to ensure compliance and seamless patient care. Medical Control Authorities are responsible for maintaining and supplying medication during patient transport.

4.4.3.2. All VA equipment and unused medications must be returned to VA during patient drop-off or as promptly as feasible within 24 hours.

4.4.3.3. The contractor must be capable of transporting the drugs, supplies, and/or equipment required by the patient. The contract shall have the appropriate medications, including Critical Care Transport, if necessary, based on county and state requirements for the region.

4.4.4. Equipment

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

4.4.5. Linen - The contractor shall furnish all linen required for patient transport at no additional cost. Linen shall not be exchanged with linen belonging to LAJVAMC.

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.

4.5.2. 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 for the month prior will be billed by a date established by the vendor and the government once a month in batch form.

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

b. Contract Number

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

d. Authorization number(s)

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

f. Base Rate

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

h. Date of Birth and Sex

i. Diagnosis Codes or Nature of Illness or Injury

j. Documentation of circumstances when billing for waiting time

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

l. VA authorizing official’s name

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

e. Unspecified charges, charges not associated with the contract, 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.

4.5.2.1. A transportation request is defined as one incidence of a request for one-way service (BLS, ALS, CCT). 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. LAJVAMC 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.

4.5.2.1.1. LAJVAMC 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.

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

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

Contracting Officer’s Representative (COR)

4.5.2.3. 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.

4.5.2.4. 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.

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

4.5.2.5.1. 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

4.5.2.6. 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.

4.5.2.7. The type of transportation service (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.

4.5.2.8. 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.

4.5.2.9. 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.

4.5.2.10. The contractor shall have sufficient vehicles and personnel to provide services for up to four (4) simultaneous transportation requests. This will include 1 ALS, 3 BLS requirements. C3IFT and CCT will not be counted towards the four simultaneous transports.

4.5.2.11. If LAJVAMC 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.

4.5.2.12. Response Times

4.5.2.12.1. Orders that are scheduled by 12pm (noon) local time the day before the required service are defined as scheduled. With the exceptions found below, the contractor shall arrive on time for all orders scheduled.

4.5.2.12.2. Orders requested after 12:00pm (noon) the previous day, up to the time of pick-up will be considered add-ons. For all add-ons (not scheduled in advance) transportation requests, with pick up at LAJVAMC, the contractor will be allotted up to 2 hour response time from time of order placement for transportation requests.

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

4.5.2.12.4. Critical Care Transport, for a critical patient (as deemed by the physician) with pick up at LAJVAMC, the contractor will be allotted up to a 120-minute response time.

4.5.2.12.5. For transportation requests which do not have a pick-up at LAJVAMC

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.

d. 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.

4.5.3. Cancellations

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

4.5.3.2. 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 (BLS, ALS, CCT) and the one-way mileage (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.

4.5.3.3. For transportation requests out of LAJVAMC 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 LAJVAMC 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 LAJVAMC 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, if requested, 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.

If a VA beneficiary being transported declines to be properly secured or removed the securement devices himself/herself, the driver will notify the Ordering Officers (OO), Administrative Officer of the Day (AOD) Beneficiary Travel Office Staff, or COR 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 a beneficiary refuses to be properly secured, they shall be returned back to the location 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 and Program Manager 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 sixty (60) minutes of wait time; the contractor may invoice for wait times in excess of this initial sixty (60) 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 thirty (30) minute intervals. For partial thirty (30) minute intervals, zero (0) to fifteen (15) minutes shall be rounded down to zero (0) minutes and sixteen (16) to thirty (30) minutes rounded up to thirty (30) 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 and 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 ground 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. The Place of Performance is variable and may occur within the states of West Virginia, Pennsylvania, Ohio, Maryland, Washington DC.; ambulance services may be required to or from locations including, but not limited to the following:

5.1.1. Louis A. Johnson VA Medical Center to include front entrance and emergency department. The LAJVAMC address is: 1 Med Center Drive, Clarksburg, WV 26301.

5.1.2. LAJVAMC Community-Based Outpatient Clinics (CBOC)

5.1.3. Other VA Medical Centers and Hospitals, but not limited to:

5.1.4. Veteran’s Residence - TBD

5.1.5. North Central West Virginia Airport - 2000 Aviation Way, Bridgeport, WV 26330

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 4.5.2.10)

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. Contingency Plan for VetRide Vendor Portal is down. A description of the method/system used to log all requests for service. The contractor shall confirm 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, Program Manager, or Beneficiary Travel Department monthly.

6.1.2. The Government will evaluate the contractor’s performance under this contract to ensure the contractor’s QCP is adequate, and 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. All changes to the QASP will be coordinated with the vendor prior to any audit using the new standards is completed.

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 contractor’s quality control plan.

Reference

Provide on- time ambulance services

orders

of monthly invoices/reports

7. Conformity To Regulations

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

7.2. 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.

8. Wage Rates

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

8.2. 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).

8.3. 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

9. Evidence of Coverage 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.

10. Worker’s Compensation 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.

11. Contractor Personnel Security Requirements

11.1. Contracted employee will not have access to VA computer systems. If it is determined a contractor will have access to a VA computer system, the contractor employee who requires 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 vendor prior to contract performance. This requirement is applicable to all subcontractor personnel requiring the same access.

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

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

11.4. The contractor, when notified of an unfavorable determination for an employee, shall 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.

12. Property of the United States Government and HIPAA Rights

12.1. 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.

12.2. 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 retained per West Virginia law or returned to the VA.

12.3. 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. 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.

12.4. 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.

12.4.1. 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 Health Information (PHI). As required by HIPAA, the Department of Health, and Human Services (HHS) has promulgated rules governing the security and use and disclosure of protected health information by covered entities, including the Department of Veterans Affairs (VA). In accordance with HIPAA, the contractor may be required to enter into a Business Associate Agreement (BAA) with VA.

13. Medical Liabilities Insurance

13.1. The contractor shall carry required insurance (See VAAR Clause 852.237-7 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE) and vehicle insurance in accordance with the West Virginia Department of State Health Services.

14. Conformance with Environmental Management Systems

14.1. The contractor shall perform work under this contract consistent with the relevant policy and objectives identified in the agency, organizational, or facility environmental management system (EMS) applicable for your contract. The contractor shall perform work in a manner that conforms to all appropriate Environmental Management Programs and Operational Controls identified by the agency, organizational, or facility EMS, and provide monitoring and measurement information as necessary for the organization to address environmental performance relative to the environmental, energy, and transportation management goals. In the event an environmental nonconformance or noncompliance associated with the contracted services is identified, the contractor shall take corrective and/or preventative actions. In the case of a noncompliance, the contractor shall respond and take corrective action immediately. In the case of a nonconformance, the contractor shall respond and take corrective action based on the time schedule established by the EMS Site Coordinator. In addition, the Contractor shall ensure that their employees are aware of the roles and responsibilities identified by the environmental management system and how these requirements affect their work performed under this contract.

14.2. If an onsite contract is required, all on-site contractor personnel shall complete yearly EPA sponsored environmental training specified for the type of work conducted on-site. Upon contract award, the Contracting Officer's Representative will notify the facility-level Environmental Management Systems Coordinator to arrange EMS training for appropriate staff.

15. Contractor Performance Assessment Rating System (CPARS)

15.1. Required Registration with Contractor Performance Assessment Rating System (CPARS)

15.2. As prescribed in Federal Acquisition Regulation (FAR) Part 42.15, the Department of Veterans Affairs (VA) evaluates contractor past performance on all contracts that exceed $1,000,000 and shares those evaluations with other Federal Government contract specialists and procurement officials. The FAR requires that the contractor be provided an opportunity to comment on past performance evaluations prior to each report closing. To fulfill this requirement VA uses an online database. The CPARS database information is shared with the Past Performance Information Retrieval System (PPIRS) database, which is available to all Federal Agencies.

15.3. Each contractor whose contract award is estimated to exceed $1,000,000 is required to register with the Contractor Performance Assessment Rating System (CPARS) database at the following https://www.cpars.gov/ or by calling (207) 438-1690. Registration should occur no later than thirty days after contract award and must be kept current should there be any change to the contractor’s registered representative.

15.4. For contracts with a period of one year or less, the contracting officer will perform a single evaluation when the contract is complete. For contracts exceeding one year, the contracting officer will evaluate the contractor’s performance annually. Interim reports will be filed each year until the last year of the contract when the final report will be completed. The report shall be assigned in CPARS to the contractor’s designated representative for comment. The contractor representative will have thirty days to submit any comments and re-assign the report to the VA contracting officer.

15.5. Failure to have a current registration in the CPARS database, or to re-assign the report to the VA contracting officer within those thirty days, will result in the Government’s evaluation being placed on file in the database with a statement that the contractor failed to respond.