Questions Lenore QA.pdf

1. Please clarify whether the performance for this PWS is expected to occur at the Lenore

CBOC location. The PWS repeatedly references the Hershel “Woody” Williams VA

Medical Center (Huntington, WV) as the point of contact and place of performance;

however, the solicitation title and several supporting attachments appear to indicate that services are associated with the Lenore VA Clinic. The Performance Work Statement

(PWS) includes every location within the Huntington VAMC, as it was approved by a national panel for ambulance services. Contracting has specifically highlighted the

Lenore location to indicate that this particular requirement pertains to Lenore and its surrounding catchment areas.

2. Section 4.4.3.2 specifically references transportation requests originating out of the

Hershel “Woody” Williams VA Medical Center (HWW VAMC). Can the Government please confirm whether requests from HWW VAMC will routinely be placed under this

PWS? This contract specifically pertains to the Lenore region. While the accompanying

Performance Work Statement (PWS) encompasses the entirety of the Huntington area, the services delineated within are exclusively mandated for Lenore and its designated catchment areas.

The CLIN table lists Wait Time/30 minutes, but the text uses after first 15 minutes, is the first 30 minutes included or billable after 15 minutes? There is a 30-minute buffer period included. After this initial 30 minutes, billing will proceed in 15-minute increments.

3. If critical care readiness is expected to be maintained 24/7/365, this will significantly increase costs associated with maintaining and staffing a Critical Care Transport (CCT) team. However, the CLIN structure only lists one (1) Critical Care Transport per year.

Given the low projected utilization, will the government consider adjusting the required response time for CCT transports—originating only from a hospital setting—to two (2) hours to account for the readiness requirement? CCT will not be needed at the Lenore

Location, See updated CLIN

4. The solicitation requires maintaining three (3) ALS units available 24/7/365;

however, the CLIN data reflects only ten (10) ALS transports during the initial 20month base period—averaging approximately 0.03 transports per day, or one call every 36–37 days. Given this low utilization, will the government consider reducing the required number of ALS units to align with historical demand? Additionally, if ALS transports are not pre-scheduled, will the government consider extending the required response time for unscheduled ALS requests to two (2) hours to allow for a more efficient and cost-effective staffing model?

The CLIN will be updated to approximately 5 ALS calls a year. A 2-hour response time for unscheduled will be fine

**NOTE** In the last 12 months, there have been 287 total trips assigned to STAT, including ALS, BLS, and CCT, roughly averaging 23.92 (24) trips per month. Distinctly: ALS

– 2 (0.17 per month); BLS – 285 (23.75 per month) ; CCT – 0.

The plan for 24/7/365 would look like this for Lenore.

1 BLS

.41 ALS

0 CCT.

The quantities specified in the IDIQ contract are estimates only. The amounts provided above reflect the actual billable services rendered over the past 12 months. All proposals will be evaluated against the quantities outlined in the IDIQ solicitation.

5. Can the government please clarify which time standards are correct - 4.2.3 sets ALS/BLS add-ons at 2 hours and emergent at 20 minutes, but in section 4.4.2.12 add-ons are at

60 minutes and urgent at 30 minutes. 4.2.3 speaks to Scheduled times, 4.4.2.12.3 speaks to not scheduled in advanced.

6. Can the government clarify the expected ratio of scheduled transports (those scheduled the day prior) versus emergent or same-day add-on requests?

The government understands the importance of having clarity on this matter for effective planning and resource allocation. Based on the current operational data and historical trends, the expected ratio of scheduled transports (those scheduled the day prior) to emergent or same-day add-on requests is approximately as follows:

1. Scheduled Transports: 70-80% o These are transports that are scheduled at least a day in advance and typically include routine appointments, patient discharges, and other non-emergent needs.

2. Emergent/Same-Day Add-On Requests: 20-30%

These transports include urgent medical needs, hospital transfers, and other timesensitive requests that require immediate attention.

It is important to note that these ratios are estimates based on past performance and may vary depending on specific circumstances and operational demands at any given time.

We encourage ongoing communication and flexibility to adapt to fluctuations in demand and ensure that both scheduled and emergent transport needs are met efficiently. The government will continue to monitor and analyze transport patterns to provide the most accurate and up-to-date information possible.

7. Can you please confirm whether the inclusion of FAR 52.222-55 under EO 14026 is intentional and still applicable to this contract, given that EO 14026 has been revoked?

No, that clause needs to be removed.

8. 4.1.2.1 BLS Life Support (BLS) CPT Code is for emergency BLS transport. Can you clarify if it should be A0428? A0428 is for non-emergency transport requiring basic life support. A0429 is for emergency transport requiring basic life support.

According to the Performance Work Statement (PWS), this is classified as a Non-

Emergency Transport. Therefore, the appropriate code to use is A0428.

9. 4.1.2.2 Advanced Life Support (ALS) CPT code listed is for Oxygen. Can you clarify if this should be A0426? A0422 is used for billing the cost of oxygen and oxygen supplies provided during ambulance transport (BLS or ALS) in life-sustaining situations.A0426 is for non-emergency transport requiring Advanced Life Support (ALS), where more complex medical care is provided during the transport. 4.1.2.2 needs updated to the appropriate code A0426.

10. Can you clarify the flat mileage rate is per mile for " 4.1.3.3. One-way return trips outside of 100 miles will utilize flat mileage rate over 100 miles except for reoccurring transportation requests." For trips 100 miles or less, it seems the standard mileage rate applies. For the portion of the trip that exceeds 100 miles, a flat mileage rate per mile will be used for reimbursement.

4.1.3.3 One-way return trips

outside of 100 miles will utilize flat mileage rate over 100 miles except for reoccurring transportation requests

500 Per Mile

11. For Critical Care transports what are the historical originating facilities?

For Critical Care transports over the last 24 months, the historical originating facility has consistently been the Hershel “Woody” Williams VA Medical Center (VAMC). Patients requiring critical care have been transported from this facility to other hospitals that provide a higher level of care. This indicates that the Hershel “Woody” Williams VAMC serves as the primary point of origin for critical care transfers due to the necessity for advanced medical treatments and specialized care that cannot be provided in-house.

The pattern of transfers underscores the facility's role in stabilizing patients before transferring them to facilities that are better equipped to handle their advanced medical needs.

12. 4.3.3.1 and 4.3.3.2 are contradictory can the government clarify?

Section 4.3.3.1:

This section states that the contractor (vendor) is not allowed to borrow or exchange supplies and/or medications with the VA. It emphasizes that all supplies and medications needed for safe patient transport must be provided by the vendor. Equipment that is attached to or in use by the patient at the time of pick-up can remain with the patient during transport to ensure continuity of care. Medical Control Authorities are responsible for maintaining and supplying medications during the transport process.

Section 4.3.3.2:

This section requires that any VA equipment and unused medications, which may have been in the possession of the patient at the time of pick-up, must be returned to the VA.

The return is to be done at the time of patient drop-off or as promptly as feasible within

24 hours.

Key Differences:

Supply Provision vs. Return:

Section 4.3.3.1 deals with the provision and supply responsibility during transport, stating that the vendor must supply everything needed for safe transport without borrowing from the VA.

Section 4.3.3.2 deals with the return of VA-owned equipment and unused medications, highlighting that anything initially from the VA must be returned back after transport.

Responsibility Contrast:

Section 4.3.3.1 assigns all responsibility for providing supplies and medications to the vendor.

Section 4.3.3.2 focuses on ensuring that VA-owned items are returned after the transport is complete.

In essence, Section 4.3.3.1 outlines the vendor's responsibilities during transport, focusing on the prohibition of borrowing supplies from the VA, while Section 4.3.3.2 sets guidelines for the return of any VA-owned items used during transport.

13. The utilization data provided across the six performance periods appears inconsistent.

Given that Period 1 spans 20 months yet reflects the same or fewer transports than the subsequent one-year periods, can the Government please confirm whether the call volumes listed for each period are accurate?

o Period 1: 20 months – 511 transports o

Period 2: 12 months – 766 transports o

Period 3: 12 months – 766 transports o

Period 4: 12 months – 511 transports o

Period 5: 12 months – 511 transports o

Period 6: 3 Months - 256 transports

All option years should be the same except Period 6, it’s only for 4 months. Please see updated CLIN

14. Performance Work Statement requires the contractor to maintain capacity for up to eleven (11) simultaneous transports (eight BLS, three ALS, including one CCT Tier

1.1.1.1. III). When compared against the historical transport volumes—ranging from approximately 25 to 64 calls per month—this level of readiness appears disproportionate to demonstrated demand. Can the Government please clarify if consideration can be given to reducing the required number of staffed and available units to better align with the actual utilization levels?

PWS will now state The contractor shall maintain sufficient vehicles and personnel to meet the facility's demand for simultaneous transportation requests for Basic Life Support (BLS) and Advanced Life Support (ALS). The contractor must be prepared to provide simultaneous transports if the need arises, even if this occurs infrequently, such as up to twice a year. This requirement encompasses scenarios involving two ALS transports, two BLS transports, or a combination of one ALS and one BLS transport.

If Lenore requires ambulance services exceeding the usual simultaneous transportation requests for BLS or ALS, and these needs occur outside of the rare occasions, the contractor will be given adequate time to acquire the necessary vehicles and personnel to meet this increased demand. Any discussions regarding these increases and necessary adjustments will be managed through modifications to the contract as required.

How would the contractor develop a comprehensive plan to manage these simultaneous runs effectively, including contingency measures for rare occurrences when demand exceeds capacity? Additionally, how should the contractor address potential increases in demand and ensure preparedness to fulfill future requirements?

Below is the last 12 months of service calls,

– 2 (0.17 per month); BLS – 285 (23.75 per month) ; CCT – 0.

The quantities specified in the IDIQ contract are estimates only. The amounts provided above reflect the actual billable services rendered over the past 12 months. All proposals will be evaluated against the quantities outlined in the IDIQ solicitation.

historical transport volumes over the past 12 months and noted that the current requirement to maintain capacity for up to eleven simultaneous transports (eight BLS and three ALS, including one CCT Tier III) seems disproportionate to the demonstrated demand.

Specifically, our data indicates:

• Total trips: 287 (average 24 trips per month) o ALS trips: 2 (0.17 per month) o BLS trips: 285 (23.75 per month) o CCT trips: 0

The PWS amounts needs adjusted, the math doesn’t add up for this location.

15. The Performance Work Statement (Section 4.4.2.11) indicates that the facility will

“typically range from 10–20 transports each weekday,” which would equate to approximately 2,600–5,200 transports annually based on a standard 260-weekday year.

However, the CLIN structure reflects a maximum of 766 transports within a 12month period, which averages to roughly 64 transports per month or 3 per weekday—a significant variance from the PWS workload description. Can the government please clarify?

– 2 (0.17 per month); BLS – 285 (23.75 per month) ; CCT – 0.

This is the actual usage plan for 24/7/365 would look like this for Lenore which is slightly higher than the actual amounts. .

1 BLS

.5 ALS

0 CCT.

The quantities specified in the IDIQ contract are estimates only. The amounts provided above reflect the actual billable services rendered over the past 12 months. All proposals will be evaluated against the quantities outlined in the IDIQ solicitation.

16. Who is the incumbent contractor. STAT EMS LLC, contract # 36C24525D0017