36C24623Q1092_1.docx

36C24623Q1092

PAGE 1 OF

1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

UEI:

EFT:

PHONE:

FAX:

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

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA

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

ARE

ARE NOT ATTACHED.

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

ARE

ARE NOT ATTACHED

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

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DATED ________________________________. YOUR OFFER ON SOLICITATION

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

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

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

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

AUTHORIZED FOR LOCAL REPRODUCTION

(REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

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

36C24623Q1092 12-01-2023 harold mcquillia 757-315-3430 12-22-2023 12pm

EST

Harold McQuillia harold.mcquillia@va.gov Department of Veterans Affairs Network Contracting Office 6 100 Emancipation Drive Hampton

VA

23667 X X 621910 $22.5 Million

NET 30

N/A X Department of Veterans Affairs Charles George VA Medical Center 1100 Tunnel Road Asheville

NC

28805 Department of Veterans Affairs Network Contracting Office 6 100 Emancipation Drive Hampton

VA

23667

Department of Veterans Affairs Financial Services Center

PO BOX 149971

Austin

TX

78714-9971 512-460-5049 512-460-5221 X See CONTINUATION Page

BASIC LIFE SUPPORT AND ADVANCE LIFE SUPPORT SERVICES

Period of Performance: Base Year - 2/1/2023 - 1/31/2024 with two (2) option years.

See Section B2 for the Schedule of Services.

See Section B3 for the Performance Work Statement.

See Section E1 for the Instructions to Offerors.

See CONTINUATION Page X X Harold McQuillia Contracting Officer Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

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

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C246 Harold McQuillia harold.mcquillia@va.gov Department of Veterans Affairs Network Contracting Office 6 100 Emancipation Drive Hampton VA 23667

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

3. INVOICES: Invoices shall be submitted in arrears:

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

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

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

Basic Life Support Ambulance Svc (BLS) Base Rate (Non-Emergency) Contract Period: Base POP Begin: 02-01-2024 POP End: 01-31-2025 PRINCIPAL NAICS CODE: 621910 - Ambulance Services PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Basic Life Support Mileage

POP Begin: 02-01-2024 POP End: 01-31-2025

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Ambulance Life Support Svc (ALS) (Non-Emergency) Base Rate

POP Begin: 02-01-2024 POP End: 01-31-2025

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Ambulance Life Support Svc (ALS) (Emergency) Base Rate

POP Begin: 02-01-2024 POP End: 01-31-2025

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Additional Attendant (When Ordered)

POP Begin: 02-01-2024 POP End: 01-31-2025

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Waiting Time (per hour)

POP Begin: 02-01-2024 POP End: 01-31-2025

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Reimbursable Supplies/Service and/or Equipment Items

POP Begin: 02-01-2024 POP End: 01-31-2025

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Basic Life Support Ambulance Svc (BLS) Base Rate (Non-Emergency) Contract Period: Option 1 POP Begin: 02-01-2025 POP End: 01-31-2026

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Basic Life Support Mileage

POP Begin: 02-01-2025 POP End: 01-31-2026

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Ambulance Life Support Svc (ALS) (Non-Emergency) Base Rate

POP Begin: 02-01-2025 POP End: 01-31-2026

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Ambulance Life Support Svc (ALS) (Emergency) Base Rate

POP Begin: 02-01-2025 POP End: 01-31-2026

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Additional Attendant (When Ordered)

POP Begin: 02-01-2025 POP End: 01-31-2026

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Waiting Time (per hour)

POP Begin: 02-01-2025 POP End: 01-31-2026

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Reimbursable Supplies/Service and/or Equipment Items

POP Begin: 02-01-2025 POP End: 01-31-2026

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Basic Life Support Ambulance Svc (BLS) Base Rate (Non-Emergency) Contract Period: Option 2 POP Begin: 02-01-2026 POP End: 01-31-2027

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Basic Life Support Mileage

POP Begin: 02-01-2026 POP End: 01-31-2027

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Ambulance Life Support Svc (ALS) (Non-Emergency) Base Rate

POP Begin: 02-01-2026 POP End: 01-31-2027

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Ambulance Life Support Svc (ALS) (Emergency) Base Rate

POP Begin: 02-01-2026 POP End: 01-31-2027

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Additional Attendant (When Ordered)

POP Begin: 02-01-2026 POP End: 01-31-2027

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Waiting Time (per hour)

POP Begin: 02-01-2026 POP End: 01-31-2027

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Reimbursable Supplies/Service and/or Equipment Items

POP Begin: 02-01-2026 POP End: 01-31-2027

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

B.3 PERFORMANCE WORK STATEMENT

1. General: The Charles George VA Medical Center (CGVAMC) has a requirement for ambulance services to transport Veterans when 1) the CGVAMC cannot provide the medical service required, 2) to assist in getting non-ambulatory Veterans to and from medical appointments, and 3) any and all cases where non-ambulatory Veterans require transportation, and 4) any and all cases where patient care is needed at the Basic or Advanced Life Support Level for ambulance transport.

2. Description of Services: The contractor shall provide scheduled and on-call Basic Life Support (BLS), and Advance Life Support (ALS), services for beneficiaries of the Charles George VA Medical Center. This will involve trips to and from any location within the Primary Service Area (PSA) of the Charles George VA Medical Center and beyond, as appropriate. Trips are generally confined to within the Primary Service Area (PSA); however, they may encompass travel to points as far away as Richmond, VA or beyond, if necessary. All ALS transport units shall have at least one paramedic credentialed per North Carolina Office of EMS Guidelines. Credentialed paramedics shall be competent in managing and administration all medications as outlined in the North Carolina Board Approved Medications for Credentialed EMS Personnel. All ALS ambulances shall be equipped to the paramedic standards as stated by the North Carolina Office of Emergency Medical Services. The Contractor shall provide all vehicles, personnel, management, supplies, transportation, equipment and reports necessary to cover all scheduled and on-call ground ambulance transportation services as identified below in the Section II, Schedule and Section III, Pricing. The contract shall cover a base year period and three (3) one-year Option Years. Performance shall be in accordance with the requirements contained in this Performance Work Statement (PWS) and the standards of the Joint Commission on Accreditation of Healthcare Organizations. Offered prices shall include all medications necessary for the safe transport of all patients.

3. Number of Patients: It is understood and agreed that only ONE patient will be transported on a trip unless specifically authorized, or requested by the VA.

When more than one patient is transported on a trip, reimbursement will be made at the rate not exceeding the cost of transporting a single patient. When loaded, the longest distance over which a patient is transported may be claimed when more than one patient is transported in a single ambulance concurrently.

Contractor must ensure that pick-ups and drop-offs are scheduled so that the total distance traveled will result in the most economical charge to the Government.

3.1. Waiting Time: If pickup is other than VA Medical Center the contractor will contact the Travel Clerk first (828)298-7911 extension 5543, Mobility Manager (828)298-7911 extension 5658 during administrative hours of 7:30AM through 3:30pm, Monday through Friday. During non-administrative hours (nights, weekends, and Holidays), the contractor will contact the Administrative Officer of the Day (AOD) at (828)298-7911 extension. The contractor will call as soon as the contractor anticipates a delay. This call is only for verifying the contractor’s arrival time at the pick-up point (verification is made by confirming the time of pickup with the VA Staff, or the patient when the pickup is made off the VA Campus).

3.2 Rates: Rates will apply twenty-four hours a day seven days a week. Payment for mileage traveled beyond the county limits will be limited to “One Way Only” for the distance over which the patient is transported. Mileage cost will be paid in addition to the applicable rate per trip for any trip entirely within the city and county limits. Trip mileage shall be determined by the latest edition of the Google standard Mileage Guide. The Contractor shall receive the base rate quoted in the schedule for all one-way trips ordered. The base rate shall constitute full compensation for one-way trips which go not exceed the mileage threshold as defined herein. The Contractor shall also receive reimbursement of mileage charges for any mileage less than the mileage threshold. The odometer reading at the time of the county line is crossed shall be provided and the odometer reading at the arrival of destination.

3.3 Orders: Requests for services will be made in writing or by telephone and confirmed by telephone shortly thereafter from authorized VA personnel. The Government will not be held liable for those services performed by the Contractor(s) which are ordered by people who are unauthorized. The request will specify a range of dates and times for acceptable delivery of a transported patient. When contacted, the Contractor shall immediately notify the Charles George VA Medical Center if they can provide the service. If the Contractor cannot provide the service requested the VA reserves the right to obtain the service from another source and will charge the contractor any excess cost as a result thereof. The Charles George VA Medical Center will be the sole judge in determining when to order service from another source. Contractor will be informed of the condition of the patient at the time of request for service. The Contractor will be required to assign appropriate personnel for the transportation of patient. It is required that the contractor will furnish an EMT on all requests, however, the Charles George VA Medical Center reserves the right to request the services of a EMT Paramedic level if available in lieu of the EMT Basic and Intermediate.

3.4 Life Threatening Emergency Calls: Contractor will dispatch ambulance no later than five (5) minutes after notification by Charles George VA Medical Centers authorized personnel of a life-threatening emergency call. If the Contractor is unable to provide an immediate pickup (within fifteen (15) minutes after notification) in a life-threatening emergency, the Contractor shall immediately contact the VA Requestor and advise of its inability to provide services within the requested timeframe. At that time, VA personnel will take whatever action is appropriate.

4. Authorizing Personnel: The following Charles George VA Medical Center personnel are authorized to request or authorize ambulance services for the Charles George VA Medical Center are:

• Chief, HAS

• Assistant Chief, HAS

• Patient Travel Assistant

• Administrative Officer of the Day (AOD)

5. Loading/Unloading Patients: Contractor(s) will be required to assist patient from point of pick-up to ambulance and from ambulance to point of destination.

6. Reimbursement: The Charles George VA Medical Center’s Travel Coordinator and Contracting Office Representative will review each invoice for transport. The VA will only reimburse those veteran patients eligible for transportation. Contractor will invoice each transportation call separately.

6.1 Time Data Collection System must be electronic and made available to the COR on a monthly basis.

7. Buncombe County and City Limits: Buncombe County limits, for this contract, are defined as follows: “That area that falls within Buncombe County as indicated on the official maps of the State of North Carolina.”

8. 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 bloodborne pathogens, which will be provided by the Contracting Officer’s Representative (COR).

9. Commission on Accreditation of Ambulance Standards: The contractor shall perform required services in accordance with the standards of the Commission on Accreditation of Ambulance Services, established principles and ethics of the medical profession established by the American Medical Association (AMA) and American College of Emergency Physicians (ACEP).The contractor, upon request, shall provide quality data and information related to services provided and participate in Charles George VA Medical Center Care System, VA Performance Improvement Programs when requested to do so. Upon request the contractor shall also provide documentation of the competency of staff that will be providing the contracted services. Current credentials (i.e. BLS, PHTLS, ACLS) are acceptable in that they should correspond to State of North Carolina regulatory requirements. The contractor shall be responsible for ensuring contractor employees providing work on this contract are fully trained and completely competent to perform the required work; they shall also be required to maintain records that document competence/performance level of employees working on this contract. Upon request the contractor shall provide a current copy of the competence assessment checklist (including current licensing) and annual performance evaluation, if performed, to the Contracting Officer’s Representative (COR) for each contractor employee working on this contract.

b Health Information Portability and Accountability Act (HIPPAA): 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 VHA regulations, which are obtainable at :http://www.hipaa.org/ and http://www1.va.gov/vhapublications/. The contractor shall not maintain and/or share sensitive or patient identifiable information in any form or for any purpose, other than what is needed to perform its obligation under the established business agreement.

11. Contractor Personnel: 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.

11.1 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. 11.2 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:

11.2.1 Name

11.2.2 EMT License Number

11.2.3 Driver’s License Number

11.2.4 Date of Initial Training

11.2.5 Date of Refresher Training

12. Training: Emergency Medical Technicians providing emergency services on this contract must meet the following training requirements:

a. Have completed training in accordance with the standard published by the US Department of Health and Human Services (PL 93-154) and follow State of North Carolina Statutes requiring a minimum of 110 hours, with at least 20 hours of supervised clinical supervision, including 10 hours in a hospital emergency department. EMTs must also meet ongoing re-certification requirement standards determined by the State of North Carolina.

b. Evidence of the "equivalent" training program successfully completed by the EMT must be submitted to the contracting officer before award. Failure to provide the requested evidence of training will result in an offer of being determined nonresponsive and that offer will not be considered for award.

12.1 The EMT must be certified, licensed or otherwise officially recognized by the local, state, or regional government or public entity where the emergency ambulance service is operated or by which it is governed. Current and updated certifications of EMTs providing service under this contract must be submitted to the contracting officer. Emergency Medical Technicians (all Levels) providing emergency services on this contract must have the following qualifications:

a. Have completed the required all emergency medical technicians (all levels) re-certification training. State of North Carolina Office of EMS requires EMTs to have a minimum of 72 CME hours to be recertified every four years. The rules shall provide that all re-certification training provide didactic and skills practice components, including a field internship experience aboard an advanced life support permitted ambulance. The EMTs (all levels) must be certified, licensed or otherwise officially recognized by the local, state, or regional government or public entity where the emergency ambulance service is operated or by which it is governed.

b. Must possess:

1). EMT – B Card

2). EMT – I Card (Note: Does not apply to this acquisition if all personnel manning the ambulance meet all state requirements for performing the duties as assigned)

3). EMT – P Card

12.2 Drivers providing service under this contract shall have a valid ambulance personnel license with a driver designation as required by Federal, State and local law.

12.3 Contractor shall ensure each ALS and BLS driver who operates a permitted vehicle meets qualifications as required by the State of North Carolina and shall be responsible for assuring that its drivers are knowledgeable and competent in emergency vehicle operations and thoroughly familiar with the vehicles assigned.

12.4 Attendant/driver must have successfully completed standard and advanced first aid courses including use of cardiopulmonary resuscitation techniques (CPR) of the American Heart Association, or equivalent; can safely use all associated equipment, such as wheelchair lifts, and fire extinguishers; and been fully briefed and trained in passenger assistance techniques. Proof in the form of a current certificate that first aid training has been successfully completed must be available upon request. All contractor employees must be enrolled periodically in “refresher” continuing education or advanced training programs as approved and required by the State of North Carolina, Office of Emergency Medical Services. Such refresher training shall be submitted to the contracting officer upon request for verification of compliance. In no instance may this continuing education training be less frequent than every two years.

13. 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.

13.1 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.

13.2 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.

14. Ambulance 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.

14.1 The following equipment shall be supplied, but not limited to for proper patient care:

14.1.1 Medication administration device

14.1.2 Intravenous infusion pump that delivers a specific amount of fluids

14.1.3 Medications

14.1.4 Blood and blood products for adults, pediatric and neonatal patients

14.1.5 Infusion modules

14.1.6 Pump Infusion Sets

14.1.7 Cardiac Monitor

14.1.8 Defibrillator capable of delivering a minimum up to 200 joules biphasic, monitor 12-leads, synchronize cardioversion, and cardiac pacing

14.1.9 Equipment to monitor waveform capnography of a breathing and/or tracheal intubated patient.

14.2 Linen supplies are the responsibility of the contractor.

15. Insurance Coverage: Throughout the effective period of this contract, the contractor shall possess insurance coverage in the minimum amounts to satisfy contract clause 852.237-7, Indemnification and Insurance, or State of North Carolina requirements, whichever are higher. Any lapse in required coverage could result in discontinuance of further ordering. Prior to the start of contract performance, the contractor must submit to the contracting officer their certificate of insurance coverage evidencing required levels.

16. Response Times: Response time will be calculated from the receipt of the telephonic request for service. At the time of the request, the contractor shall acknowledge their ability to provide the service within the requested response time. If the contractor cannot provide the service for any reason, they must notify the VA staff person requesting the service of their inability to provide the service. Emergency Orders require response times quicker than standard orders. Response times are outlined below:

• Emergency Orders: Contractor shall arrive at the point of pickup no later than 15 minutes from the time of request.

• Routine Orders: Contractor shall arrive at the point of pickup no later than 30 minutes from the time of request.

• Long Hauls: Contractor shall arrive at the point of pickup no later than 30 minutes from the time of request.

16.2 If the contractor fails to furnish service within the required response times, the VA reserves the right to obtain this service from another source and may charge the contractor with any excess cost which may result and could be deducted from their monthly invoice. The VA will be the sole judge in determining when to order service from another source. Repeated failure to meet required response time may result in termination of the contract, or discontinuance of further orders. Response time will be calculated from the contractor’s receipt of the telephonic/fax request for service. The contractor shall not charge the VA a cancellation fee when cancellations are made prior to the ALS/BLS vehicle embarking upon the dispatch. The contractor shall have available for response two BLS staffed vehicles and one ALS staffed vehicle at a time for request for service.

17. Origin and Destination: Contractor shall provide services to beneficiaries of the Charles George VA Medical Center to any designated location within the defined service areas. The VA staff will specify the points of origin and the destination of every trip.

18. Patient Condition Upon Arrival: Upon arrival at the patient pick-up point, if the contractor determines the condition of the patient scheduled for pick-up is different than what was stated on the travel request, the contractor shall notify the Travel Office or Administrative Officer of the Day (AOD) for further instruction.

19. Trip Documentation: The contractor shall document each VA authorized transport with an appropriate document that specifies the date, patient name and identification #, time of pick up, destination, time of drop off, mileage, and any notes regarding issues piacular to the specific transport, including recording oxygen, cardiac monitoring, and other services provided (i.e. material items, supplies). The contractor shall transmit a copy of the trip ticket within 24 hours of providing the service. These forms will serve as documentation of the transport and will be a source document for reconciliation of the contractor’s requests for payment.

20. Non-Pick Up of Patient: 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 for the trip at the 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 “Unloaded Trips”, delays, and cancellations.

There shall be no additional charge to the VA when such changes occur.

21. Escort: Subject to limitations of current regulations, the VA reserves the right to have an escort, such as a relative, or care provider of beneficiary or VA staff accompany beneficiary when the VA determines that such an escort is in the best interest of the beneficiary. The VA will also be the final judge in determining when an escort is required. There shall be no additional charge to the VA when escorts are authorized to travel with beneficiary. Contractor shall only be required to transport escort with patient and shall not be required to return the escort back to point of origin.

22. Invoice Procedures: The contractor shall use an itemized billing format, with the resources furnished when submitting ambulance service invoices. Invoices shall be submitted in a timely manner to include options for weekly billing. If weekly billing is not applicable, all invoicing shall be no later than fifteen (15) calendar days, following the end of the month of services and are to include all contract services furnished for the preceding month. Invoices shall specify the contract number, patient name, date of service, pick-up and delivery point, and an itemized list of charges allowed under the contract, such as; pickup charge, mileage charge, and any additional materials, items, and services necessary (oxygen, etc.). The date of payment will be computed from the date a proper invoice is received by the VA payment center in Austin, TX. This will assist the contractor in expediting the invoices. Invoices are to be submitted to the following address: The VA will review and reconcile invoices with travel forms and VA logs. Unauthorized charges will be suspended pending investigation. Unauthorized charges are those that are being disputed or have not been preapproved by authorized VA personnel, and that are not allowable under the contract. A final determination will be made, within 30-days, after notifying the contractor of charges being suspended. However, if an item or service is required on a trip that is not specifically listed in the pricing section of this contract, it must be approved by the contracting officer and paid under a separate contract or purchase order.

23. Inspections: Before award or during the effective period of the contract, the VA reserves the right to thoroughly inspect and investigate the establishment, facilities, business reputation, and other licensure and qualifications of the contractor.

24. Incident/Accident Report: Any adverse events involving the welfare of a VA beneficiary while in the care of the contractor during transport shall be recorded and reported to the COR or to the AOD after normal business hours (4:00pm-7:30am and weekends) within 24 hours of the event. The contractor shall make initial contact immediately after the event via telephone, fax, or email notifying the VA of any incident, accidents, or medication or transfusion errors involving injury to VA patients during transport. The VA will provide POC’s and phone numbers after contract award and prior to service start. The contractor must prepare and submit a detailed incident report with all information necessary to conduct a full review (date, time, patient, place of pick, place of incident, names of parties involved, a detailed summary of events etc.) with recommended/implemented corrective action within 24 hours of such incident to the contracting officer with a copy to the Chief, Member Services Mid Atlantic Health Care System.

25. Patient Rights: The contractor shall be courteous to VA beneficiaries under their care. Any substantiated mistreatment of patients in the performance of this contract may be cause for termination of the contract, or discontinuance of further placement of orders. The VA reserves the right to request driver removal from transporting VA patients if mistreatment is substantiated. Drivers must be courteous and considerate of all patients they are transporting. The contractor shall notify the COR, in writing within 24 hours of any complaints made by the patients regarding service issues, providing recommendations for improved services.

26. Safety Requirements: To protect the lives and health of patients, the contractor shall take such safety precautions as the contracting officer, or COR may determine to be reasonably necessary. The contracting officer or COR will notify the contractor of any safety non-compliance and the action to be taken. The contractor shall, after receipt of such notice, immediately correct the conditions to which attention has been directed. If the contractor fails or refuses to comply promptly, the contracting officer may issue an order stopping all or any part of the work and discontinuance of further order placement.

27. Infection Control: Contractor employees shall receive ongoing training on universal precautions and infection control as appropriate to their duties. Contractor drivers and attendants shall use universal precautionary measures always for the prevention and control of the spread of infectious agents to all persons. The contractor shall delay using drivers and/or attendants who have the cold, flu, COVID-19, chickenpox, measles, or have been around someone who is sick on trips until well or no longer symptomatic.

28. Disposal of Hazardous Waste: Contractor employees shall be trained on how to handle bio-hazardous waste during transport and how to properly dispose of biohazardous waste in designated containers, including how to dispose in designated containers when onsite at Charles George VA Medical Center. The contractor shall not dispose of any bio-hazardous materials at any location on the premises except as specified by the contracting officer.

29. Contractor’s Quality Control Program (QCP): The contractor shall establish and maintain a complete QCP to assure the requirements of this contract are provided as specified, during the life of the contract. The contractor’s QCP shall include the following:

a. An inspection plan covering all services required by this contract: The inspection plan must specify the type of inspections (i.e. scheduled, unscheduled), areas for inspection, frequency of inspections and documentation of inspections, and who will conduct the inspections, with his or her title specified.

b. On-site records of all inspections conducted by the Contractor: The inspection records must note findings and necessary corrective action taken, the timeframe, and follow-up responsibility/issues. The VA reserves the right to request copies of any and/or each inspection.

c. Internal procedures for updating medical service protocols: The contractor must have established internal procedures for updating medical service protocols, which have been revised, requires changes and/or incorporation of new protocols since licensing. The changes to processes, equipment, and/or protocol that may affect performance of contract must be communicated in writing to the Contracting Office.

d. Methods for identifying and preventing deficiencies: The contractor must have improvement mechanisms in place that allows the business to evaluate the quality of services performed by using established methods for identifying and preventing deficiencies before the level of performance becomes unacceptable.

Specific organizational monitoring functions and areas must be identified with levels of responsibility associated, noting intermediate supervisory responsibility and overall management responsibility for ensuring total acceptable performance.

e. On-site competency records of each employee: The contractor must have employee records available onsite that identifies the character, physical capabilities, certifications, and ongoing training records of each employee performing services under this contract.

f. On-site records for tracking of customer complaints and actions taken the contractor shall keep onsite records for tracking customer complaints or problems with the procedures or initiatives implemented for correction and/or elimination of the problem before negative effects caused interruption of performance on contract

g. Drug Testing Policy: The contractor shall have internal policies and procedures for addressing drug and alcohol abuse

h. Patient Satisfaction Survey: Contractor shall develop a patient satisfaction survey for the VA’s approval. Once approved contractor shall report results of the survey semi-annually.

30. Confidentiality of Patient Records: The Parties agree to hold all individually identifiable health information as that term is defined in the Health Insurance Portability and Accountability Act and regulations promulgated there under (collectively, “HIPAA”) that is after April 14, 2003 shared with, transferred or transmitted to, or otherwise obtained by OHSU on or from or on behalf of the CGVAMC providing the services under this Agreement (“Protected Health Information”) strictly confidential, and provide protections to prevent the unauthorized disclosure of such information, including, but not limited to the protection required by applicable federal, state and local laws and/or regulations regarding the security and the confidentiality of patient health care information including, but not limited to, HIPAA. Specifically, CGVAMC agrees as follows: (1) to maintain safeguards as necessary to ensure that the Protected Health Information is not used or disclosed except as required to perform its obligations under the Agreement, as expressly permitted herein or as required or permitted by law; (2) to ensure that any subcontracts or agents to whom it provides Protected Health Information agree to the same restrictions and conditions that apply with respect to such information; (3) to make available its internal practices, books and records relating to the use and disclosure of Protected Health Information to the Department of Health and Human Services or its agents as required by HIPAA; (4) to incorporate any amendments or corrections to Protected Health Information when notified by the VA that the information is inaccurate or incomplete; (5) at termination of this Agreement, if feasible, to return or destroy all Protected Health Information that it still maintains in any form and not to retain any such Protected Health Information in any form; (6) to ensure that, as to any Protected Health Information Tuesday, May 23, 2017 held by CGVAMC, CGVAMC policies are in place to allow access to that Protected Health Information by the subject of that information as required by HIPAA; and (7) to report to the VA any use or disclosure of Protected Health Information which is not allowed under the terms of the Agreement. If at any time after the effective date of this Agreement it is determined that either party is in breach of this Section, the other party, in its sole discretion, may immediately terminate this Agreement.

31. Disposition of Records: The Contractor shall dispose of archived records in accordance with HIPAA and the ambulance company’s accreditation standards. The Joint Commission & VA regulations and directives (See VA Directive 6371):

a. Records Control Schedule (RCS) 10-1, Section XXVI.

b. M (manual) 1, Part I, Chapter 5, Patient Records.

c. Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), Standard IM.2 and IM3

32. The C&A requirements do not apply, and that a Security Accreditation Package is not required

33. Definitions:

• Contracting Officer (CO):

The responsible party for administering contractual terms, and has warranted capabilities:

• Contracting Officer’s Representative (COR):

Is the designee to represent the Contracting Officer in furnishing technical guidance and advice or generally administer the work being performed under this contract. The foregoing is not to be construed as authorization to interpret or furnish advice and information to the Contractor(s) relative to financial or legal aspects of the contract. Enforcement of these segments is vested in and is the responsibility of the Contracting Officer.

• Basic Life Support (BLS):

o Staffed by two North Carolina State Certified Emergency Medical Technicians (EMT all levels).

o Transport the sick and injured non-life-threatened patient.

o Transport patients requiring oxygen therapy and extrication.

o BLS units can transport patient with I.V. saline lock.

o BLS units cannot start I.V. lines or transport medicated lines unless on a locked-out pump.

• Advanced Life Support (ALS):

o Staffed by a North Carolina o State Certified Emergency Medical Technician -Paramedic.

o Heart monitor with defibrillator and pacing capabilities.

o Establishing or maintaining I.V. accesses to include antiarrhythmic, narcotics, vasopressors and I.V. fluids.

o Monitoring/maintaining respiratory status to include intubation and pulse oximetry as needed.

• Primary Service Area (PSA):

The service area that is covered in the Western North Carolina Health Care System. This would cover McDowell County and west. It includes the Charles George VA Medical Center (VAMC), Hickory Community Based Outpatient Clinic (CBOC), Rutherfordton CBOC and Franklin CBOC.

• Outside PSA:

Trips that are not described in the PSA. Trips may be taken to other VA Medical Centers within VISN 6. The VA Medical Centers in VISN 6 are as follows:

i. Hampton VA Medical Center – Hampton, Virginia

ii. Durham VA Medical Center – Durham, North Carolina

iii. W.G. Hefner VA Medical Center – Salisbury, North Carolina

iv. Salem VA Medical Center – Salem, Virginia

v. Fayetteville VA Medical Center – Fayetteville, NC 36C24623Q1092

vi. Hunter Holmes McGuire VA Medical Center – Richmond, VA Page 1 of Page 1 of

B.4 SPECIAL CONTRACT REQUIREMENTS

1.0 WORK HOURS or HOURS OF OPERATION

The services covered by this contract shall be furnished by the contractor as defined herein. The contractor shall not be required, except in case of emergency, to furnish such services on Federal Holidays or during off duty hours as described below.

Normal working hours are Monday through Friday, 8:00am – 4:30pm, excluding federal holidays which are as follows:

New Year’s Day Birthday of Martin Luther King, Jr.

Washington’s Birthday Memorial Day Juneteenth National Independence Day Independence Day Labor Day Columbus Day Veterans Day Thanksgiving Day Christmas Day

Any other day specifically declared by the President of the United States to be a federal holiday.

When one of the holidays falls on Sunday, the following Monday shall be observed as a Federal Holiday. When a holiday falls on a Saturday, the preceding Friday shall be observed as a Federal Holiday.

2.0 BACKGROUND INVESTIGATIONS

A full background check is not required for this position, however all contract employees must bring photo identification and advance notice from the requiring service to obtain a VA Badge in order to work on a VA Facility. Upon award, the CO shall provide the contractor with detailed instructions on fulfilling security requirements.

All contractor employees are subject to the same level of investigation as VA employees who have access to VA Sensitive Information.