36C24623Q0383 0001.docx
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- V225-- Basic Life Support (BLS) and Advance Life Support (ALS) AMBULANCE SERVICES Federal contract opportunity
- Solicitation number
- 36C24623Q0383
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| 36C24623Q0383 0002.docx | DOCX document | |
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AMENDMENT 0001 RFQ 36C24623Q0383
BLS AND ALS AMBULANCE SERVICES
FOR FAYETTEVILLE NC VA HEALTHCARE SYSTEM
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 spe cified 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 C
HANGES 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 SI
GNER
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, et c.)
(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) 03-26-2023 2023203 Department of Veterans Affairs Network Contracting Office 6 100 Emancipation Drive Hampton VA 23667 Department of Veterans Affairs Network Contracting Office 6 100 Emancipation Drive Hampton VA 23667 To all Offerors/Bidders
36C24623Q0383 03-16-2023
X X
See CONTINUATION Page X Request for Quote (RFQ) No. 36C24623Q0383 is hereby amended to address the Government's response to Contractor's questions, see Page 2.
2. The original Price/Cost Schedule, Section B.2, is replaced in its entirety by the Schedule in Amendment 0001.
Comp lete and submit this revised Schedule with your proposal.
3. The original Performance Work Statement (PWS), Section B.3, and Special Contract Requirements, Section B.4, have been replaced in their entirety by Amendment 0001. Please see highlighted areas.
4. The closing date for proposals remains the same and are due March 30, at 1:00PM EST.
5. All other terms and conditions remain the same.
Stephanie Thompson Contracting Officer
CONTINUATION PAGE
Q.1. Are the quantities confirmed on the Price/Cost Schedule? There is a significant increase in quantities and miles between year 1 and the following years.
A.1. Yes, the estimated quantities as stated are confirmed for this requirement.
Q.2. Page 11 states the contractor shall furnish twenty-four (24) hour ambulance service seven (7) days a week, however, Page 33 states Normal working hours are Monday through Friday, 8am – 4:30pm, excluding federal holidays. What is the actual coverage expectation?
A.2. The contractor shall provide scheduled and on-call Basic Life Support (BLS) and Advance Life Support (ALS) ambulance transport services for beneficiaries of the Fayetteville NC VA Medical Center (FNCVAMC) Emergency Department as needed by the FNCVAM twenty-four (24) hours a day, (seven) 7 days a week. The Performance Work Statement, Section B.3, has been revised by this amendment to reiterate this requirement and paragraph 1.0 of Special Contract Requirements, Section B.4, has been deleted.
Q.3. Please define Special Mode Transport Svc.?
A.3. Special Mode Transportation Service means an ambulance, ambulette, air ambulance, wheelchair van, or other mode of transportation specially designed to transport disabled persons (this would not include a mode of transportation not specifically designed to transport disabled persons, such as a bus, subway, taxi, train, or airplane). A modified, privately-owned vehicle, with special adaptive equipment and/or capable of transporting disabled persons is not a special mode of transportation for the purposes of this requirement.
Q.4. Can CLIN’s be added for waiting time, bariatrics patients, and no loads?
A.4. Contract line items (CLINs) for Waiting Times and No Loads have been added to the Price/Cost Schedule, Section B.2 by this amendment. Complete and submit this revised Price/Cost Schedule with your proposal.
Q.5. What percentage of trips are greater than 60 miles?
A.5. Approximately 25% of trips are greater than 60 miles.
B.2 PRICE/COST SCHEDULE
ITEM INFORMATION
| ITEM NUMBER |
| DESCRIPTION OF SUPPLIES/SERVICES |
| QUANTITY |
| UNIT |
| UNIT PRICE |
| AMOUNT |
| 667.00 |
| TRP |
| __________________ |
| __________________ |
Basic Life Support Ambulance Svc (BLS) /Advance Life Support Svc (ALS): STAT Base Rate, Load weight Only Contract Period: Base POP Begin: 05-01-2023 POP End: 09-30-2023 PRINCIPAL NAICS CODE: 621910 - Ambulance Services PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 6,667.00 |
| MI |
| __________________ |
| __________________ |
Basic Life Support Ambulance Svc (BLS)/ Advance Life Support Svc (ALS): Mileage (beyond the established mileage thresholds) This rate is in addition to the rate trip in LINE 0001 Contract Period: Base POP Begin: 05-01-2023 POP End: 09-30-2023
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 667.00 |
| TRP |
| __________________ |
| __________________ |
Advance Life Support Svc: Base Rate (Non-Emergent) Load Weight Only
POP Begin: 05-01-2023 POP End: 09-30-2023
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 667.00 |
| TRP |
| __________________ |
| __________________ |
Advance Life Support Svc: Base Rate (Emergent) Load Weight Only
POP Begin: 05-01-2023 POP End: 09-30-2023
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 6,667.00 |
| MI |
| __________________ |
| __________________ |
Advance Life Support Svc: Mileage (beyond the established mileage thresholds) This rate is in addition to the rate per trip of LINE ITEM 0003 Contract Period: Base POP Begin: 05-01-2023 POP End: 09-30-2023
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 667.00 |
| TRP |
| __________________ |
| __________________ |
Special Mode Transport Svc: Base Rate Load Weight Only
POP Begin: 05-01-2023 POP End: 09-30-2023
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 6,667.00 |
| MI |
| __________________ |
| __________________ |
Special Mode Transport Svc: Mileage (beyond the established mileage thresholds) this rate is in addition to the rate trip of Line 0001 Contract Period: Base POP Begin: 05-01-2023 POP End: 09-30-2023
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 42.00 |
| EA |
| __________________ |
| __________________ |
Oxygen (when ordered)
POP Begin: 05-01-2023 POP End: 09-30-2023
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 200.00 |
| HR |
| __________________ |
| __________________ |
Basic Life Support Svc (BLS) Waiting Time, when required (per hour) Contract Period: Base POP Begin: 05-01-2023 POP End: 09-30-2023 PRINCIPAL NAICS CODE: 621910 - Ambulance Services
PRODUCT/SERVICE CODE: V225
Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 25.00 |
| TRP |
| __________________ |
| __________________ |
Basic Life Support Ambulance Svc (BLS) No Load (occurs when service is requested, contractor responds, but patient is not transported.)
Contract Period: Base POP Begin: 05-01-2023 POP End: 09-30-2023 PRINCIPAL NAICS CODE: 621910 - Ambulance Services
PRODUCT/SERVICE CODE: V225
| 200.00 |
| HR |
| __________________ |
| __________________ |
Advance Life Support Svc (ALS)
Contract Period: Base POP Begin: 05-01-2023 POP End: 09-30-2023 PRINCIPAL NAICS CODE: 621910 - Ambulance Services
PRODUCT/SERVICE CODE: V225
| 25.00 |
| TRP |
| __________________ |
| __________________ |
Advance Life Support Ambulance Svc (ALS)
Contract Period: Base POP Begin: 05-01-2023 POP End: 09-30-2023 PRINCIPAL NAICS CODE: 621910 - Ambulance Services
PRODUCT/SERVICE CODE: V225
| 1,600.00 |
| TRP |
| __________________ |
| __________________ |
Basic Life Support Ambulance Svc (BLS)/Advance Life Support Svc (ALS) STAT Base Rate, Load weight Only Contract Period: Option 1 POP Begin: 10-01-2023 POP End: 09-30-2024
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 16,000.00 |
| MI |
| __________________ |
| __________________ |
Basic Life Support Ambulance Svc / Advance Life Support Svc: Mileage (beyond the established mileage thresholds) This rate is in addition to the rate trip in LINE 1001 Contract Period: Option 1 POP Begin: 10-01-2023 POP End: 09-30-2024
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 1,600.00 |
| TRP |
| __________________ |
| __________________ |
Advance Life Support Svc: Base Rate (Non-Emergent) Load Weight Only
POP Begin: 10-01-2023 POP End: 09-30-2024
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 1,600.00 |
| TRP |
| __________________ |
| __________________ |
Advance Life Support Svc: Base Rate (Emergent) Load Weight Only
POP Begin: 10-01-2023 POP End: 09-30-2024
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 16,000.00 |
| MI |
| __________________ |
| __________________ |
Advance Life Support Svc: Mileage (beyond the established mileage thresholds) This rate is in addition to the rate per trip of LINE ITEM 1003 Contract Period: Option 1 POP Begin: 10-01-2023 POP End: 09-30-2024
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 1,600.00 |
| TRP |
| __________________ |
| __________________ |
Special Mode Transport Svc: Base Rate Load Weight Only
POP Begin: 10-01-2023 POP End: 09-30-2024
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 16,000.00 |
| MI |
| __________________ |
| __________________ |
Special Mode Transport Svc: Mileage (beyond the established mileage thresholds) this rate is in addition to the rate trip of Line 0001 Contract Period: Option 1 POP Begin: 10-01-2023 POP End: 09-30-2024
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 100.00 |
| EA |
| __________________ |
| __________________ |
Oxygen (when ordered)
POP Begin: 10-01-2023 POP End: 09-30-2024
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 200.00 |
| HR |
| __________________ |
| __________________ |
Basic Life Support Svc (BLS)
Contract Period: Option 1 POP Begin: 10-01-2023 POP End: 09-30-2024 PRINCIPAL NAICS CODE: 621910 - Ambulance Services
PRODUCT/SERVICE CODE: V225
| 25.00 |
| TRP |
| __________________ |
| __________________ |
Basic Life Support Ambulance Svc (BLS)
Contract Period: Option 1 POP Begin: 10-01-2023 POP End: 09-30-2024
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 200.00 |
| HR |
| __________________ |
| __________________ |
Advance Life Support Svc (ALS)
Contract Period: Option 1 POP Begin: 10-01-2023 POP End: 09-30-2024 PRINCIPAL NAICS CODE: 621910 - Ambulance Services
PRODUCT/SERVICE CODE: V225
| 25.00 |
| TRP |
| __________________ |
| __________________ |
Advance Life Support Ambulance Svc (ALS)
Contract Period: Option 1 POP Begin: 10-01-2023 POP End: 09-30-2024
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 1,600.00 |
| TRP |
| __________________ |
| __________________ |
Basic Life Support Ambulance Svc (BLS)/Advance Life Support (Svc): STAT Base Rate, Load weight Only Contract Period: Option 2 POP Begin: 10-01-2024 POP End: 09-30-2025
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 1,600.00 |
| MI |
| __________________ |
| __________________ |
Basic Life Support Ambulance Svc/Advance Life Support Svc: Mileage (beyond the established mileage thresholds) This rate is in addition to the rate trip in LINE 2001 Contract Period: Option 2 POP Begin: 10-01-2024 POP End: 09-30-2025
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 1,600.00 |
| TRP |
| __________________ |
| __________________ |
Advance Life Support Svc: Base Rate (Non-Emergent) Load Weight Only
POP Begin: 10-01-2024 POP End: 09-30-2025
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 1,600.00 |
| TRP |
| __________________ |
| __________________ |
Advance Life Support Svc: Base Rate (Emergent) Load Weight Only
POP Begin: 10-01-2024 POP End: 09-30-2025
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 16,000.00 |
| MI |
| __________________ |
| __________________ |
Advance Life Support Svc: Mileage (beyond the established mileage thresholds) This rate is in addition to the rate per trip of LINE ITEM 2003 Contract Period: Option 2 POP Begin: 10-01-2024 POP End: 09-30-2025
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 1,600.00 |
| TRP |
| __________________ |
| __________________ |
Special Mode Transport Svc: Base Rate Load Weight Only
POP Begin: 10-01-2024 POP End: 09-30-2025
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 16,000.00 |
| MI |
| __________________ |
| __________________ |
Special Mode Transport Svc: Mileage (beyond the established mileage thresholds) this rate is in addition to the rate trip of Line 2001 Contract Period: Option 2 POP Begin: 10-01-2024 POP End: 09-30-2025
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 100.00 |
| EA |
| __________________ |
| __________________ |
Oxygen (when ordered)
POP Begin: 10-01-2024 POP End: 09-30-2025
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 200.00 |
| HR |
| __________________ |
| __________________ |
Basic Life Support Svc (BLS)
Contract Period: Option 2 POP Begin: 10-01-2024 POP End: 09-30-2025 PRINCIPAL NAICS CODE: 621910 - Ambulance Services
PRODUCT/SERVICE CODE: V225
| 25.00 |
| TRP |
| __________________ |
| __________________ |
Basic Life Support Ambulance Svc (BLS)
Contract Period: Option 2 POP Begin: 10-01-2024 POP End: 09-30-2025
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 200.00 |
| HR |
| __________________ |
| __________________ |
Advance Life Support Svc (ALS)
Contract Period: Option 2 POP Begin: 10-01-2024 POP End: 09-30-2025 PRINCIPAL NAICS CODE: 621910 - Ambulance Services
PRODUCT/SERVICE CODE: V225
| 25.00 |
| TRP |
| __________________ |
| __________________ |
Advance Life Support Ambulance Svc (ALS)
Contract Period: Option 2 POP Begin: 10-01-2024 POP End: 09-30-2025
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| GRAND TOTAL |
| __________________ |
B.3 PERFORMANCE WORK STATEMENT (PWS)
1.0 PURPOSE:
The Fayetteville NC VA Coastal Healthcare System requires a qualified contractor to furnish all labor, materials, insurance, licenses and equipment to provide safe and comfortable services necessary for both Special Mode Transportation for Beneficiary Travel eligible Veterans to include the Wilmington Healthcare Center catchment area and emergent inter-facility advanced life support (ALS)/basic life support (BLS) ground ambulance transport services for the Fayetteville NC VA Medical Center (FNCVAMC) Emergency Department as needed by FNCVAMC. The contractor shall furnish these services twenty-four (24) hours a day, seven (7) days a week for the beneficiaries of the Fayetteville VAMC Emergency Department, Fayetteville, NC. Contractor shall assist the patient as needed to access the vehicle for transportation. This may include, but is not limited to, bed to stretcher or stretcher to bed transfer when necessary.
The Fayetteville NC VA Coastal Healthcare System is seeking a Firm Fixed-Price contract vehicle to procure these services in a Base plus two option periods.
2.0 BACKGROUND:
The Department of Veterans Affairs Medical Center, 2300 Ramsey Street, Fayetteville, North Carolina, provides diagnostic and therapeutic services in medicine, surgery, rehabilitation medicine, psychiatry, and skilled nursing home care for the beneficiaries of the Department of Veterans Affairs. This facility also provides ambulance services to those veterans not requiring hospitalization. The Contractor shall provide STAT Basic Life Support (BLS) and/or Advanced Life Support (ALS) Ambulance Services. Contractor will respond and be onsite ready to deliver services 15 minutes from the requested service time.
| 3.0 | ACRONYMS: |
| 3.1 | ALS – Advanced Life Support |
| 3.2 | AOD – Administrator on Duty |
| 3.3 | BLS – Basic Life Support |
| 3.4 | CC – Critical Care |
| 3.5 | CO – Contracting Officer |
| 3.6 | COR – Contracting Officer’s Representative |
| 3.7 | CPR – Cardiopulmonary Resuscitation |
| 3.8 | DOL – Department of Labor |
| 3.9 | EMT-B – Emergency Medical Technician-Basic |
| 3.10 | EMT-P – Emergency Medical Technician-Paramedic |
| 3.11 | VAMC – Veterans Affairs Medical Center |
| 3.12 | IAW – In Accordance With |
| 3.13 | PWS – Performance Work Statement |
| 3.14 | QASP – Quality Assurance Surveillance Plan |
| 3.15 | QCP – Quality Control Plan |
| 3.16 | TB – Tuberculosis |
| 3.17 | TJC – The Joint Commission |
4.0 REQUIREMENTS:
The Contractor shall provide the following Ambulance Services on an as-needed basis:
4.1 BASIC LIFE SUPPORT (BLS):
Basic Life Support (BLS) Services is defined as a basic level of pre-hospital and inter-hospital emergency care and non-emergency medical services that includes airway management, cardiopulmonary resuscitation (CPR), control of shock and bleeding and splinting of fractures, as outlined in the Basic Life Support national curriculum of the United States Dept. of Transportation and any modifications to that curriculum specified in rules adopted by the Department.
4.1a Staffing:
For BLS services, each ambulance shall be staffed by Emergency Medical Technicians with a current North Carolina EMT-B license or as required by local, state, or regional Government, or public entity by which the ambulance services are governed.
4.2 ADVANCED LIFE SUPPORT (ALS):
Advanced Life Support (ALS) Services is defined as an advanced level of pre-hospital and inter-hospital emergency care and non-emergency medical services that includes BLS, electrocardiography, cardiac defibrillation, cardiac monitoring, IV therapy, administration of drugs and solutions, use of adjunctive medical devices, trauma care, and other authorized techniques and procedures.
4.2a Staffing:
For ALS service, each ambulance shall be staffed by Advanced Emergency Medical Technician-Paramedics with a current North Carolina EMT-P license or as required by local, state, or regional Government, or public entity by which the ambulance services are governed.
4.2b Typical situations when Fayetteville NC VA Coastal Healthcare System would require ALS Services:
· Patients with IVs
· Patients requiring cardiac monitoring with defibrillator and pacing capabilities
· Establishing or maintaining IV to include antiarrhythmic, narcotics, vasopressors and IV fluids
· Monitoring/maintaining respiratory status to include intubation and pulse oximetry
4.3 CONTRACTOR PERSONNEL:
Contractor employees shall be courteous and conduct themselves in a business-like manner at all times while providing services under this agreement. The contractor shall ensure that the following personnel (Emergency Medical Technicians (EMT- Basic, Intermediate and Paramedics), Non-Emergency Attendant/ Drivers) requirements are met:
a) Ensure and certify that personnel performing the services required under this contract are properly licensed and fully trained in the use of the vehicle and equipment that will be used in the carrying out contracted services.
b) The contractor shall ensure minimum staffing requirements as mandated by the State of North Carolina are met. Each vehicle shall be operated with sufficient personnel for adequate patient care, at least one of whom shall be an Emergency Medical Technician (EMT B, I or P Level). Contractor must maintain records of each employee as to character and physical capabilities of performing the services of a driver and/or attendant.
Qualifications: The contractor must be licensed as advanced and basic care transport by the ambulance service by the State of North Carolina to provide Emergency Medical Services. The contractor must maintain licensure/certification with the State of North Carolina, throughout the life of the contract. License/certification lapses or expiration is grounds for termination of the contract of discontinuance of further ordering from this contractor. The contractor must maintain documentation demonstrating they meet all requirements of Federal, State, County or City codes regarding operation of this type of service. Documentation shall be made available to the VA immediately upon request for the duration of this contract. The contractor shall comply with the provisions of the Privacy Act of 1974, the Health Insurance Portability and Accountability Act (HIPAA) of 1996, as well as all applicable regulations pertaining to fire safety and blood borne pathogens, which will be provided by the Contracting Officer’s Representative (COR).
A record of each employee as to character, physical capabilities, and qualifications performing the duties of an ambulance driver or attendant must be maintained at the contractor's establishment and made available for inspection upon request of the contracting officer or COR.
A roster of Emergency Medical Technicians (EMT-All Levels), and Non-Emergency Attendant Drivers (EMTs and LPNs if used to provide these services) shall be furnished to the contracting officer or COR upon request, and shall contain the following information:
· Name
· EMT License Number
· Driver’s License Number
· Date of Initial Training
· Date of Refresher Training 4.3a Paramedics and EMTs Paramedics, EMTs and other medical personnel (as applicable), shall at all times meet the qualifications specified, as well as all applicable federal, state and local Government laws, regulations, and standards. They shall be certified, licensed, or otherwise officially recognized by local, state, or regional Government or public entity by which the emergency service is governed.
4.3b Non-Emergency Attendants/Drivers
i. Attendants/drivers shall be capable of administering oxygen and have successfully completed the Standards and Advanced First Aid Courses of the American Red Cross or US Bureau of Mines or equivalent. Proof in the form of a current certificate for the successful completion of such training must be provided upon request.
ii. 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.
4.3c Driver Conduct The following acts are not permissible by drivers which provide services under this agreement or while on Fayetteville NC VA Healthcare System premises:
i. Use of intoxicating liquors, narcotics, or controlled substances of any kind (excluding Dr.’s prescriptions which do not impair driving ability), while on duty or reporting for duty.
ii. Gambling in any form.
iii. Smoking and other uses of tobacco while on duty.
iv. Carrying of pistols, firearms, or concealed weapons.
v. Resorting to physical violence to settle a dispute with a fellow employee(s), customer(s), or the general public while on duty.
vi. Spitting, or any other unsanitary, or offensive practice or behavior while on VAMC premises
vii. Use of loud, indecent, or profane language and/or making threatening or obscene gestures towards customers or other employees.
viii. Stopping for personal business, including use of a restroom, while a patient is in the vehicle.
ix. The driver shall not leave the vehicle with the key in the ignition at any time.
x. Engaging a customer in a verbal confrontation in an attempt to settle a disagreement. Should a disagreement arise, the driver is to contact his dispatcher/supervisor via the radio system.
xi. Soliciting or accepting tips from customers, companions, or others at any time.
4.3d Certification/Licensing Requirements Prior to performing any services under this agreement, the Contractor shall provide evidence of required training, certifications, licensing, and any other qualifications of any personnel performing services under this agreement. If the Contractor wishes to add or replace personnel, it shall provide the above requirements to the COR for approval.
4.3e Tuberculosis (TB) Exposure Control Policy
i. Prior to performance any services under this agreement, the Contractor shall provide Fayetteville NC VA Healthcare System their policy on TB exposure and control, to include TB decontamination.
ii. The Contractor shall have its personnel tested for TB and provide each of these test results to the COR.
| 4.4 | DESTINATIONS FOR VETERANS TRANSPORTED TO/FROM FAYETTEVILLE NC VA HEALTHCARE SYSTEM INCLUDE: |
| 4.4a | A clinic within Fayetteville NC VA Healthcare System to another clinic, or to the ER |
| 4.4b | From an out-building/out-lying area on the Fayetteville NC VA Healthcare System Campus to the ER, or other appropriate facility as determined by local protocol as part of the on-campus emergency response process |
| 4.4c | To and from the veteran’s house to Fayetteville NC VA Coastal Healthcare System (requiring an ambulance vs. a wheelchair van) |
| 4.4d | To and from the veteran’s house to Wilmington Healthcare Center, Fayetteville NC VA Coastal Healthcare System (requiring an ambulance vs. a wheelchair van) |
| 4.4e | To and from Fayetteville NC VA Coastal Healthcare System to other local area hospitals |
| 4.4f | To and from Fayetteville NC VA Coastal Healthcare System to other VISN-6 medical facilities (i.e., Durham VA Hospital, Salisbury VA Hospital, etc.) |
| 4.5 | ADDITIONAL SERVICES: |
Contractor shall 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 is restricted to a suitcase or travel case type bag when patients are transported to Fayetteville NC VA Healthcare System.
| 5.0 | CONTRACTOR VEHICLES, EQUIPMENT, AND INSPECTION: |
| 5.1 | VEHICLES |
The ambulances used under the terms of this contract shall be licensed and meet the minimum requirements governing emergency vehicles that is mandated by the State of North Carolina. Licensure must be maintained in a status throughout the term of the contract and a copy of updates provided accordingly. The contractor must have an adequate number of vehicles to meet the requirements of this contract, along with the evidence of satisfactory vehicle inspection prior to use under this contract. Every ambulance operated must have at least two personnel. At least one person shall be -certified in cardiopulmonary resuscitation or first aid and the person in the emergency compartment shall be certified at the least as an emergency medical technician-basic and/or critical care, EMT-Paramedic preferred.
5.1a The Contractor shall have the capabilities to sufficiently handle simultaneous calls and meet or exceed the minimum time requirements (see section 6.3 under ORDERS).
5.1b BLS vehicles are required to have at a minimum an emergency technician (EMT) attending the patient and a driver meeting minimum ambulance driver requirements of the State of North Carolina.
5.1c Ambulances shall meet all current applicable Federal, State and local regulations and specifications including, but not limited to, licensing, registration, and safety standards. Appropriate licensing by the State of North Carolina is required.
5.1d Specifically, ALS vehicles are required to have at a minimum a paramedic attending the patient and an EMT, meeting requirements as a driver. Vehicles and equipment used in the performance of this contract must be clean, orderly, and in excellent operating condition always, and records of maintenance/preventive maintenance must be made available for inspection upon request. All vehicles shall be smoke free and have “No Smoking” signage posted. Contractor must present standard operating procedure for vehicle and equipment cleaning between patients and provide evidence of compliance with such cleaning processes subject to verification by the COR. The contractor shall notify the contracting officer of any vehicle and equipment added/changed/deleted after award of contract. The Department of Veteran Affairs reserves the right to thoroughly inspect contractor vehicles prior to award and at any time during performance of any awarded contract. Mechanical defects noted at the time of inspection must be corrected and the ambulance (s) re-inspected prior to use under the contract.
| 5.1e | Vehicles shall be clean and maintained in good repair in accordance with manufacturer’s instructions. At no time will the Contractor leave vehicles on Fayetteville NC VA Healthcare System premises unless a pick-up or delivery is in process. |
| 5.1f | Fayetteville NC VA Healthcare System reserves the right to inspect Contractor's vehicles or require documentation of compliance with agreement specifications, and State laws, regulations, rules, and guidelines governing emergency medical transport vehicles (ambulances). Fayetteville NC VA Healthcare System inspections of Contractor vehicles will not constitute a warranty that the Contractor's vehicles are properly maintained. |
| 5.1g | Fayetteville NC VA Healthcare System reserves the right to restrict the Contractor’s use of vehicles which are not in compliance with agreement requirements. The restriction of such vehicles shall not relieve the Contractor from performing in accordance with the agreement, nor necessitate additional costs to VAMC. |
| 5.2 | VEHICLE MEDICAL EQUIPMENT AND SUPPLIES |
Every ambulance in service under this contract shall be equipped as required by the State of North Carolina and carry at least the minimal equipment necessary for the type of service to be provided, as determined by standards adopted by the State of North Carolina. Each emergency care vehicle shall have patient compartment facilities, oxygen and suction systems and equipment, environmental climatic equipment communications and additional systems equipment accessories and supplies as required by the applicable codes, rules and regulations established by Federal, State and Local regulating authorities. The contractor will be responsible for all medical and non-medical supplies needed to perform services. On Advanced Life Support vehicles, the contractor shall supply intravenous administration pump with the ability to maintain and administer at least two liquid medications in a precise volume-controlled manner.
5.2a The following equipment shall be supplied, but not limited to for proper patient care:
· Medication administration device
· Intravenous infusion pump that delivers a specific amount of fluids
· Medications
· Infusion modules
· Pump Infusion Sets
· Cardiac Monitor
· Defibrillator capable of delivering a minimum up to 200 joules biphasic, monitor 12-leads, synchronize cardioversion, and cardiac pacing
· Equipment to monitor waveform capnography of a breathing and/or tracheal intubated patient
| 5.2b Linen supplies are the responsibility of the contractor. | |
| 5.2c | Fayetteville NC VA Healthcare System reserves the right to inspect Contractor's equipment, or require documentation of compliance with agreement specifications, and State laws, rules, regulations, and guidelines governing emergency medical equipment. Fayetteville NC VA Healthcare System inspections of Contractor’s equipment will not constitute a warranty that the Contractor's equipment is properly maintained. |
| 5.2d | Fayetteville NC VA Healthcare System reserves the right to restrict the Contractor’s use of equipment which is not in compliance with agreement requirements. The restriction of such equipment shall not relieve the Contractor from performing in accordance with the agreement, nor impose additional costs to VA. |
| 5.2e | The Contractor shall have sufficient equipment within inventory to appropriately respond to any type of call within the PWS at all times while providing services under this agreement (see section 6.3 under ORDERS). Fayetteville NC VA Healthcare System reserves the right to inspect and verify that the equipment proposed is on hand. |
| 5.2f | The Contractor shall not be permitted to borrow medical equipment, nor at any time, or under any circumstances, exchange supplies, equipment, or medications with Fayetteville NC VA Healthcare System. |
| 5.2g | 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 Authorities are responsible for maintaining and supplying medication during patient transport. All Fayetteville NC VA Healthcare System equipment and unused medications must be returned to the VAMC during patient drop-off or as promptly as feasible. |
6.0 ORDERS:
An order is defined as one incidence of a request for service (BLS or ALS service). But for exceptions approved by authorized VA ordering employees, no more than one (1) patient will be transported per order.
| 6.1 | The type of transportation service required (BLS or ALS) will be discussed and determined by Fayetteville NC VA Healthcare System clinical staff and the Contractor. Contractor shall transport the patient per its policies and standard industry practice. If the type of transport differs from what was agreed upon by Fayetteville NC VA Healthcare System and the Contractor, the Contractor shall submit documentation to Fayetteville NC VA Healthcare System explaining its rationale. |
| 6.2 | Fayetteville NC VA Healthcare System may authorize an escort (i.e., 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 to the Government. |
| 6.3 | The Contractor shall have sufficient vehicles and personnel to provide services for up to three (3) simultaneous calls within a calendar day, for any mix of BLS or ALS services. If Fayetteville NC VA Healthcare System requires ambulance services exceeding three (3) simultaneous calls in a calendar day, 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. |
| 6.4 | If Fayetteville NC VA Healthcare System schedules an ALS level transport, and Fayetteville NC VA Healthcare System wishes to send a nurse or other specialized personnel with the ambulance, AND the equipment required from the Contractor does not exceed the scope of ALS level service, the Government shall be charged for an ALS level of service. |
| 6.5 | The Contractor shall not be held liable for non-performance caused by an occurrence beyond the reasonable control of the Contractor and without its fault or negligence, such as… |
| 6.5a | acts of God or the public enemy |
| 6.5b | acts of the Government in its sovereign or contractual capacity |
| 6.5c | fires |
| 6.5d | floods |
| 6.5e | epidemics |
| 6.5f | strikes |
| 6.5g | delays of common carriers |
| 6.5h | quarantine restrictions |
| 6.5i | unusually severe weather |
| 6.6 | RESPONSE TIMES: |
| 6.6a | For this agreement, Ambulances Services are split into two (2) levels (BLS and ALS), with time response requirements as noted below in the chart. The response times represent minimally acceptable response time standards. The Contractor is expected to exceed the minimum. The Contractor shall arrive no later than the pre-scheduled time. |
| 6.6b | The Fayetteville NC VA Healthcare System representative authorized to schedule services shall specify the level of service, the required response time, and origin and destination locations. If the Contractor feels the scheduled delivery does not accurately match the minimum service needed, the Contractor shall contact the authorized Fayetteville NC VA Healthcare System representative and request to change the scheduled service level. If the representative agrees and the Contractor must make a second trip, they are entitled to charge the Government for both trips. No additional cost will be paid unless authorized prior to the second trip. |
Response Options
Service Level
| Scheduled |
| Non-Schedule |
| BLS |
| 10 Minutes |
| 30 Minutes |
| ALS Non-emergent |
| 10 Minutes |
| 30 Minutes |
| ALS Emergent |
| 10 Minutes |
| 10 Minutes |
| Special Mode (SMT) |
| 60 Minutes |
| 60 Minutes |
6.6c Contractor is expected to meet the above response times, not meeting the above response times will result in a deduction from the trip value.
Minutes Late Deduction
| 15 to 30 | 25% of the trip value* |
| 31 to 45 | 50% of the trip value* |
| 46 to 60 | 75% of the trip value* |
61 or more Trip shall be at no cost to the VA *Trip value is the total of the basic trip plus any additional mileage, if applicable, for the scheduled trip.
| 6.7 | RE: AMBULANCE TRANSPORTATION SERVICES |
| 6.7a | Orders for transport services will be made by telephone. |
| 6.7b | Only properly appointed ordering officers or warranted contracting officers are authorized to place orders against this agreement. |
| 6.7c | Private agencies (e.g., nursing homes) are not considered authorized to place orders. A list containing the names and phone numbers of Fayetteville NC VA Healthcare System staff who are authorized to place orders will be submitted to the Contractor at time of award. |
| 6.7d | If the Contractor fails to furnish ambulance services within the required response time, after receiving a request for a scheduled trip, Fayetteville NC VA Healthcare System may obtain the service from another source. |
| 6.8 | RE: AN INTER-HOSPITAL NON-EMERGENCY MEDICAL TRANSPORT |
| 6.8a | If a physician from the sending hospital provides EMS personnel with written medical orders, such written orders cannot exceed the scope of care for which the EMS personnel are authorized. |
| 6.8b | For an inter-hospital medical transport of a patient who requires medical care beyond the scope of care that the EMS personnel are authorized to render, a qualified physician, respiratory therapist, clinical perfusionist, or nurse familiar with the scope of care needed must accompany the patient and the transferring hospital and physician shall assume medical responsibility for that portion of the medical care. |
| 7.0 | PICK UP AND DROP OFF REPORTING PROCEDURES: |
| 7.1 | Ambulance personnel shall pick up and deliver patients at specified locations (i.e., Fayetteville VA main campus, Emergency Room, Fayetteville Health Care Center, Wilmington Health Care Center, other out-lying areas on the Fayetteville campus, Fayetteville, etc.). These locations will be designated when contact is made by authorized Fayetteville NC VA Healthcare System personnel. |
| 7.2 | When responding to a transportation order, ambulance personnel shall report to the Nursing Station to |
| 7.2a | announce his/her arrival to pick-up and transfer the patient and |
| 7.2b | obtain report of pertinent information regarding the patient’s condition from the primary provider. |
| 7.3 | When delivering a patient, ambulance personnel will give report to appropriate medical personnel and provide a copy of the run sheet which will be retained by the facility for the patient’s medical record. |
| 7.4 | In cases where the ambulance personnel must divert to a local emergency room while performing a Fayetteville NC VA Healthcare System -authorized transport, the Contractor’s dispatcher shall notify the VAMC Beneficiary Travel or AOD, of the patient’s location and status as soon as this information becomes available. |
| 8.0 | PATIENT WELFARE AND ABUSE: |
| 8.1 | The Contractor shall be held responsible for the patient’s welfare during transport. Contractor shall be held responsible for patient and/or Government property during transport. Any damaged or lost walkers, wheelchairs, crutches, or personal belongings will be replaced at the Contractor’s expense. |
| 8.2 | Fayetteville NC VA Healthcare System requires the Contractor to exercise extreme caution and care in the handling of patients. Any abuse of patients will be grounds for default action or immediate termination of the agreement. |
| 8.3 | The Contractor shall take into consideration that they will be transporting ill patients. Drivers are required to observe speed limits, sweep vehicles clean, and wash the exteriors periodically. Drivers are to escort patients to and from point of pick-up and destination. |
| 9.0 | CANCELLATIONS/NO SHOWS/NO LOADS: |
| 9.1 | CANCELLATIONS |
For trips in which the Contractor is notified of a cancellation before the vehicle is dispatched, there will be no charge to the Government.
9.2 NO-SHOWS
A “no-show” is defined as an order that is cancelled after the Contractor has dispatched a vehicle and the vehicle is enroute or has arrived at the pick-up location, and there is no longer a need for this patient transport. The Contractor may request one-way reimbursement for no-shows, which are based on the base rate for the service (BLS, ALS), and one-way mileage (BLS, ALS) 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 COR or designee as soon as possible from the time of cancellation.
9.3 NO LOAD
When ambulance service under the terms of this contract involves a trip to or from a VA facility, but due to unforeseen circumstances the patient is not available for pick-up, the contractor shall collect No Load rates applicable under the pricing portion of this contract. The contractor shall notify the AOD or Transfer Coordinator at the time it becomes known that the patient is not available for pick-up. The VA reserves the right to substitute beneficiary requiring service at any time during the performance of the contract to prevent “No Loads”, delays, and cancellations. There shall be no additional charge to the VA when such changes occur. The contractor will not be eligible to collect the No Load rate when contractor refuses the transport at time of arrival.
9.4 ADDITIONAL CHARGES
There will be no additional charge for time spent at the site (during, or after the normal hours of coverage) awaiting the arrival of additional Contractor staff and/or delivery of parts.
| 10.0 | INCIDENT REPORTING: |
| 10.1 | The Contractor shall be required to notify the Beneficiary Travel Department or AOD 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, and if requested by Fayetteville NC VA Healthcare System, a written report of the event shall be delivered to the Fayetteville NC VA Healthcare System Official by the close of business the next working day. |
| 10.2 | The COR/designee 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, Fayetteville NC VA Healthcare System may conduct incident investigations and require a written response from the Contractor within 48 hours. |
| 11.0 | INVOICING PROCEDURES: |
With the exception of “no shows” defined in 9.2, the Contractor shall invoice for loaded (patient onboard) services and mileage only. Time data collection system must be electronic. Contractor shall submit an electronic invoice by the tenth day of each month for services that occurred the preceding month. Electronic invoices shall be submitted to the COR; invoices shall not include patient information. Also, a copy of the invoice along with secondary documentation shall be sent to Beneficiary Travel and must include the following information:
| 11.1 | Blanket Purchase Agreement Number |
| 11.2 | Date(s) of Service |
| 11.3 | Patient’s Name |
| 11.4 | Pick-up/drop-off points |
| 11.5 | Total amount invoiced |
| 11.6 | An itemized list of charges or services rendered |
UNDER NO CIRCUMSTANCES ARE VA BENEFICIARIES, THIRD PARTY INSURANCES, MEDICARE OR MEDICAID TO BE BILLED FOR SERVICES PERFORMED UNDER THIS AGREEMENT WHICH ARE AUTHORIZED BY FAYETTEVILLE NC VA HEALTHCARE SYSTEM.
12.0 CONTRACTOR’S QUALITY CONTROL PROGRAM:
Contractor shall establish and maintain a complete Quality Control Program (QCP) to ensure the requirements of this agreement are provided as specified. The QCP shall address processes and procedures to ensure services are performed in accordance with all state and local standards and codes. Contractor’s QCP shall include the following at a minimum:
| 12.1 | Incorporation of either active or established internal policy or procedures for updating service protocols that may affect the performance of the agreement. |
| 12.2 | The methods for identifying and preventing deficiencies in the quality of service before the level of performance becomes unacceptable; and organizational functions, noting intermediate supervisory responsibilities, and overall management responsibilities for ensuring total acceptable performance. |
| 12.3 | On-site records identifying the character (background checks), certifications, applicable tests (e.g., TB Test), and documentation of ongoing training of all staff performing services under this agreement. |
| 12.4 | The methods of identifying and preventing radio communication breakdowns. A detailed procedure for alternative communication in the event of mechanical breakdown of vehicle two-way radios. |
| 12.5 | A log to account for all requests for service. The log shall indicate date and time of service calls, actual time of pick-up vs. scheduled time, patient's name, designated pick-up, and delivery points, mileage, and actual waiting time at pick-up/delivery points, if waiting charges are claimed. Contractor shall send log sheets to the COR monthly. |
| 12.6 | On-site records of complaints or problems, with procedures taken to allow for corrections and/or elimination before the effects cause interruption of performance of the agreement. Contractor shall report any complaints to the COR within 48 hours along with any planned corrective action. |
| 13.0 | SECURITY AND PRIVACY CONTROL: |
The Authorization and Accreditation (A&A) requirements of VHA Handbook 6500.6 do not apply to this requirement, therefore, a Security Accreditation Package is not required. No A&A or MOU/ISA is required. Sensitive information exposure as part of this agreement involves applicable security controls within the facility as part of the Fayetteville NC VA Healthcare System /VA Information Security.
If there are any questions related to privacy, please have a member of your staff, or yourself, contact the VA Privacy Service at (202)461-6309. If there are any questions related to the Information Security, contact the Office of Cyber Security at (304)262-7733.
| 13.1 | CONFIDENTIALITY OF PATIENT INFORMATION |
| 13.1a | Contractor will not have physical access to any VA computers and/or databases. The Contractor, in providing service, will assist in the provision of health care to patients seeking care through the VAMC. As such, the Contractor may have access to patient medical information to the extent necessary to perform its responsibilities per the agreement; and therefore, shall ensure the confidentiality/ security of all patient information and shall be held liable in the event of breach of confidentiality. |
| 13.1b | The Contractor shall comply with the provisions of the Privacy Act of 1974 (5 U.S.C. 552a), Confidentiality of Certain Medical Records (38 U.S.C. 7332), Confidential Nature of Claims (38 U.S.C.5701), and Confidentiality of Medical Quality-Assurance Records (38 U.S.C.5705). |
| 13.1c | The Contractor shall comply with all laws and regulations pertaining to confidentiality and security statutes. The Contractor shall comply with: Public Law 104-191, C.F.R. Parts 45, 160, 162 and 164 (Health Insurance Portability and Accountability Act). Failure to comply with statutes regarding confidentiality and security of patient health information/Individually identifiable information may result in financial sanctions. |
| 13.1d | VA protected health information (PHI) may be disclosed and used for treatment of patients. In accordance with 45 CFR 164.502(e), the Privacy Rule includes exceptions to the Business Associate standard. This agreement and its requirements meet the following exception and do not require a Business Associate agreement in order for Covered Entity to disclose Protected Health Information to: a health care provider for treatment. Based on the exception a Business Associate agreement is not required for this agreement. Except for medical emergencies (C.F.R. 42), the Contractor is authorized to release patient medical information to Fayetteville NC VA Healthcare System only. |
| 14.0 | THE JOINT COMMISSION (TJC) AND OTHER SPECIAL REQUIREMENTS: |
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