36C24625R0001.docx

36C24625R0001

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

659-25-1-123-0001 36C24625R0001 08-15-2024 Daniel Spaulding 757-722-9961 x17592 09-16-2024

05:30PM

EDT

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

VA

23667 X X 621910 $22.5 Million N/A X Department of Veterans Affairs Salisbury VA Health Care System (VAHCS) 1601 Brenner Ave.

Salisbury

NC

28144 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 ALS/BLS Ambulance Services Location: Salisbury VA Health Care System (North Carolina) Period of Performance:

Base Period: 10/20/2024 - 10/19/2025 Option One: 10/20/2025 - 10/19/2026 Option Two: 10/20/2026 - 10/19/2027 Option Three: 10/20/2027 - 10/19/2028 Option Four: 10/20/2028 - 10/19/2029 See Section E.1. "Instructions to Offerors and Evaluation Criteria".

This solicitation is 100% set-aside for small businesses.

See FAR Clause 52.216-19 ORDER LIMITATIONS for the minimum and maximum order values. The minimum guaranteed order is not less than $2,500.00 for this solicitation. Only one (1) award will be made.

See CONTINUATION Page 659-3650160-123-829800-2119 010041089 X X Daniel Spaulding Contracting Officer, NCO 6 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 Daniel Spaulding

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.

https://www.tungsten-network.com/customer-campaigns/veteransaffairs/

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

36C24625R0001

Page 1 of Page 1 of

B.2 PERFORMANCE WORK STATEMENT (REVISION DATE 20240325)

Performance Work Statement (PWS)

GROUND AMBULANCE

VISN 6/Station 659 NAICS 621910

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

2. Background: The Salisbury VAHCS main campus is located at 1601 Brenner Ave, Salisbury, NC 28144. The following are the facilities operating within the Salisbury VAHCS.

W.G. (Bill) Hefner VA Medical Center (Salisbury VAMC) 1601 Brenner Avenue Salisbury, North Carolina 28144 Rowan County

Kernersville Health Care Center (HCC) 1695 Kernersville Medical Parkway Kernersville, NC 27284 Forsyth County

South Charlotte Veterans Health Care Center (HCC) 3506 W Tyvola Road Charlotte, NC 28208 Mecklenburg County

Charlotte-VA Community Based Outpatient Clinic (CBOC) 8601 University East Drive Charlotte, NC 28213 Mecklenburg County

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

4. Scope/Requirements

4.1. Types of Ambulance Service

4.1.1. The contractor shall provide emergent, and non-emergent Basic Life Support (BLS) and Advanced Life Support (ALS) ambulance services on an as-needed basis in accordance with all federal, state, and local regulations.

4.1.2. Occasionally a veteran will need to be transported with VA staff and equipment; the contractor shall return VA Staff and equipment to the original place of pick-up.

4.2. Transport of Miscellaneous Items with the Patient

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

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

4.3.1. Emergency Medical Technicians (EMTs) & Other Personnel

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

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

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

4.3.1.4. EMTs and other contractor personnel as applicable must pass the Contractor’s background check and must not have been convicted of (or have any pending charges for) a felony for the past five years. Personnel (and Contractor) must report any new or additional charges or convictions if they arise during the course of performance under this contract so VA can review them and determine whether the employee in question needs to be discharged of his or her duties until the matter is adjudicated.

4.3.2. Tuberculosis Exposure Control Policy

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

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

4.4. Contractor Equipment, Vehicles, and Inspection

4.4.1. Ambulances shall meet all applicable federal, state, and local regulations and specifications, including but not limited to licensing, registration, and safety standards. In accordance with the North Carolina Office of Emergency Medical Services, each ambulance shall be equipped as outlined for vehicles designated to provide Advanced Life Support (ALS) and Basic Life Support (BLS) services.

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

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

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

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

4.4.6. The contractor must be capable of transporting the drugs and/or equipment as required by the patient as required for the transported patient.

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

4.4.7.1. The contractor personnel performing services for the VA, shall, at all times, conduct themselves in a professional manner, and be identified by having the company name, and employee name affixed to the uniform. The Contractor shall be responsible for furnishing all vehicles, uniforms, nametags and/or badges for performance of services under this contract. Employee identifications shall be worn in clear view above the waist. The contractor personnel shall not smoke/play loud music originating from any device in vehicles while transporting VA patients.

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

· Be at least 18 years of age and have not less than one year of experience as a licensed driver; and

· For the past three years:

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

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

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

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

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

4.4.7.4. Ambulance drivers shall have a valid driver’s license, in accordance with Federal, State, and local government requirements for their place of operation for the services they perform, be capable of administering oxygen and shall have successfully completed the standard and advanced first aid course of the American Red Cross of U.S. Bureaus of Mines of equivalent and be capable of providing necessary medical assistance to the attending emergency medical technician or paramedic.

4.4.7.5. Emergency Medical Technician (EMT) and Paramedic Qualifications: EMT’s and Paramedic’s providing services under this contract shall have the following qualifications, in additions to those required by Federal, State, and Local Government:

· Have completed training in accordance with the standards published by the Department of Health and Human Services with a minimum curriculum of 150 hours or equivalent including an in-hospital training period. Such training programs must also be acceptable under the regulating requirements for local EMS Systems supported by DHHS under PL 93-154, Federal Register 39:24304. (1974).

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

4.5. Transportation Request

4.5.1 Transportation Requests:

4.5.1.1. Personnel authorized by the Contracting Officer shall make requests for service by telephone. Confirmation of each telephone authorization shall be faxed as soon as possible following the call for service. Request for services will be made to the telephone number specified by the Contractor or to one back-up number in the event of no answer at the primary number specified. All contacts from the Contractor will be initiated during administrative hours with the Transportation Coordinator at (704) 638-9000, ext. 4439; pager number 704-637-8170 or the Administrative Officer of the Day (AOD) at (704) 638- 9000 ext. 2577 during non-administrative hours. If Contractor is unable to contact the Transportation Coordinator - the Contractor will contact the AOD.

4.5.1.2. A list of authorized ordering personnel shall be made available upon award of the contract. Employees may be added or deleted from the list during the term of the contract at the discretion of the Contracting Officer and the COR. The Contractor shall be notified of such changes as they occur.

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

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

The Contracting Officer will furnish the Contractor with the names of individuals above by separate memorandum upon issuance of the contract. The Contracting Officer will update this list throughout the life of the contract as personnel changes.

Personnel other than the Contracting Officer have no authority to modify any term of this contract. Any deviation from the terms of the contract must be approved in writing by the Contracting Officer responsible for this contract.

Non-authorized VA employees and private agencies (e.g., nursing homes) are not considered authorized to place transportation requests. Patients of the VA Medical Center are not authorized to place their own transportation requests. All transportation requests must originate from the Salisbury VAMC Travel Program Staff/or authorized VA employees.

4.5.1.3.1. When placing transport requests (“orders”), the authorized VA employees shall contact the designated Contractor point of contact(s) to provide the following information:

· Mode of transportation required,

· Required time of arrival

· Name of the beneficiary,

· Pick-up and delivery point,

· Type and number of additional medical care specialists required,

· Type of equipment required,

· Last four of the patient's Social Security Number, and

· Any other special instructions

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

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

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

4.5.1.7. In no instance shall the contractor be required to furnish more than four (4) ambulances for basic life support service and two (2) ambulances for advanced life support service at any one time. When the total number of contracted vehicles is in use and the SVAHCS requires additional vehicles, the SVAHCS Transportation Coordinator or AOD will contact the contractor first, before another ambulance carrier is called.

4.5.1.8. The number of transports under normal operating conditions are as implied by the CLIN quantities shown in the Section B.3 Price/Cost Schedule. The number of actual transports may vary throughout the life of the contract.

4.5.1.9. The patient may bring with her or him up to three (3) liters of oxygen. The contractor shall be responsible for providing adequate and safe storage of the oxygen tanks during transport.

4.5.1.10. Response Times*

4.5.1.10.1. The following guidelines will be used for Contractor Response to transportation requests and advanced notice to the Contractor:

4.5.1.10.1.1. The Contractor will be provided 72 hours advance notice for stay and wait appointments to the maximum extent practicable given patient needs. In the event of a stay and wait transport request with less than 72-hours’ notice to the Contractor, the impact to timeliness of the transport or its effect on completion of other transports will not affect Contractor performance assessment or full payment for service rendered. Where insufficient notice is given, the Contractor will still attempt completion of the transport (to the extent possible) with the late notice transport being given lower priority to other transports.

4.5.1.10.1.2. The Contractor will be provided twelve (12) hours advance notice for transports of a round-trip distance in excess of 90 miles, to the maximum extent practicable given patient needs. In the event of a 90-mile transport request with less than 12-hours’ notice to the Contractor, the impact to timeliness of the transport or its effect on completion of other transports will not affect Contractor performance assessment or full payment for service rendered. Where insufficient notice is given, the Contractor will still attempt completion of the transport (to the extent possible) with the late notice transport being given lower priority to other transports.

4.5.1.10.1.3. Bariatric patients are defined as a single patient with body weight equal to or more than 300 lbs. The Contractor will be provided eight (8) hours advance notice for bariatric patients weighing from 300 to 400 lbs. The Contractor will be provided twelve (12) hours advance notice for bariatric patients weighing more than 400 lbs. Where insufficient notice is given, the Contractor will still attempt completion of the transport (to the extent possible) with the late notice transport being given lower priority to other transports.

4.5.1.10.1.4. When conditions, neither foreseeable and/or controllable by the Contractor occur, such as but not limited to severe storms, flooding, hazardous road and travel conditions, time and distance requirements shall be considered secondary to safety precautions. Delays or exceptions to the required quality of services shall be reported to the Transportation Coordinator or Administrative Officer of the Day (AOD). The COR will make a determination as to whether such delays in service will be excused.

4.5.1.10.2. If the VA is unable to establish telephone contact with the Contractor for Basic Life Support (BLS) service within thirty (30) minutes or if the Contractor fails to furnish BLS ambulance service within a reasonable time, the VA reserves the right to obtain the service from another source and to charge the Contractor with any excess costs which may result there from. The VA will be the sole judge in determining when to order service from another source. In no instance will the Contractor be required to furnish more than six (6) ambulances at one time.

4.5.1.10.3. If the VA has a life-threatening transport, the VA will contact the Rowan County EMS to provide the 911 services.

4.5.1.10.4. If the VA has an Advanced Life Support (ALS) service, the VA will establish contact with the contractor. If the VA is unable to establish telephone contact with the Contractor for ALS service within thirty (30) minutes, the VA reserves the right to obtain service from another source and to charge the Contractor with any excess costs which may result.

4.5.1.10.5. The Contractor will furnish qualified Advanced Cardiac Life Support (ACLS) personnel who are competent to perform ACLS protocols.

4.5.1.10.6. All ALS ambulance transfers will be staffed by at least one (1) currently licensed paramedic (EMT-P).

4.5.1.10.7. Timeliness and Lateness Penalty

4.5.1.10.7.1. The Contractor shall maintain at a minimum, a 95% compliance rate on response to pick-up or deliver during the contract year. If the Contractor fails to provide service within the time frames specified herein, the Government reserves the option of either obtaining service from an alternate source and charging the Contractor with any excess costs there from (see 2c and 2d above) or assessing a fee for each late pick-up. Compensation will be obtained by deducting the applicable amount from Contractor’s invoice as specified below:

*Trip value is the total of the basic trip plus any additional mileage, if applicable, for the scheduled trip. Contractor shall provide a monthly report to the COR which identifies each request for service by patient name, time of receipt of call, whether BLS or ALS unit requested, time of arrival, and time elapsed from receipt of call and time of arrival. Other pertinent information as necessary may be included. This report, in conjunction with VA records, shall be used for calculation of late fees to be deducted from Contractor’s invoice, if applicable.

4.5.2. Cancellations

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

4.5.2.1.1. A “no show” is defined as a transportation request which is cancelled after the contractor has dispatched a vehicle and the vehicle is enroute or has arrived at the pick-up location, and there is no longer a requirement for patient transportation. “No show” cancellations are to be billed in accordance with CLIN 0009, 1009, 2009, 3009 or 4009 for the applicable period of performance.

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

4.6.1. Ambulance personnel shall pick-up and deliver patients at specified locations (e.g., front door of facility Entrance). These locations will be specified by VA staff when an order is placed and communicated to the transporting personnel.

4.6.2. When applicable, ambulance personnel shall report to the Veteran Transportation Service (VTS) Dispatcher or Administrative Officer of the Day (AOD) to (1) announce his/her arrival to pick-up and transfer the patient and (2) obtain report of pertinent information regarding the patient’s condition from the primary nurse/physician.

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

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

4.7. Patient Welfare

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

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

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

4.8. Incident Reporting

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

4.8.2. The COR will monitor the service provided. The contractor shall cooperate with the COR in providing information and answering questions in a timely manner. The contractor shall promptly inform the COR of any complaints received directly from patients. If warranted, the VA may conduct incident investigations and require written response from the contractor within 48 hours of request.

4.8.3. Substantiated complaints regarding the behavior or courtesy may result in the Contractor being required to remove the offender(s) from providing service to the Salisbury VAHCS facilities. Offenders who accumulate five (5) unrelated, substantiated complaints in a 12-month period shall be prohibited from providing any further services under this contract. The COR shall monitor the service provided. Contractor shall cooperate with the COR in providing information and answering questions in a timely manner when requested. Contractor shall refer complaints received directly from the customer(s) to the COR. All complaints received by the COR and forwarded to the Contractor shall be investigated promptly. After investigation and disposition, Contractor shall respond to the COR within five (5) working days after receipt by the Contractor.

4.9. Invoicing

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

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

4.9.3. If unloaded mileage exceeds loaded mileage, the contractor may invoice for a flat fee only if the following also occur:

· Unloaded mileage exceeds 75 miles

· The contractor does not deviate from a route to intentionally make unloaded mileage exceed loaded mileage.

4.9.4. Except for no shows and trips when unloaded mileage exceeds loaded mileage in accordance with 4.9.3, the contractor shall invoice for loaded (patient onboard) services and mileage only.

4.9.5. Upon notification of the contracting officer, the vendor must receive training and begin implementation of invoices within the VA Tungsten Network e-Invoicing network. Invoices must be submitted via the Tungsten Network. These invoices shall not include patient information, but shall include the following:

· Contractor Name

· Contract Number

· Current Purchase Order Number

· Date of service

· Total amount invoiced including a summary of the total number of charges that align with the line items of this contract (i.e., total number of BLS Base Rate, total BLS Mileage incurred, etc.)

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

Payment by VA under this contract to a provider of ambulance transportation services authorized under this contract extinguishes any and all liability on the part of the VA BENEFICIARY for that transportation service. UNDER NO CIRCUMSTANCES ARE VA BENEFICIARIES, THIRD PARTY INSURANCES, MEDICARE, OR MEDICAID TO BE BILLED FOR THE SERVICES PERFORMED UNDER THIS CONTRACT.

5. Period & Place of Performance

5.1. See Section B.3 Price/Cost Schedule regarding the periods of performance.

5.2. The Place of Performance is variable and may occur within the state of North Carolina with rare transports to VA medical facilities in the State of Virginia. The following is the list of the medical facilities that comprise the Salisbury VAHCS.

W.G. (Bill) Hefner VA Medical Center (Salisbury VAMC) 1601 Brenner Avenue Salisbury, North Carolina 28144 Rowan County

Kernersville Health Care Center (HCC) 1695 Kernersville Medical Parkway Kernersville, NC 27284 Forsyth County

South Charlotte Veterans Health Care Center (HCC) 3506 W Tyvola Road Charlotte, NC 28208 Mecklenburg County

Charlotte-VA Community Based Outpatient Clinic (CBOC) 8601 University East Drive Charlotte, NC 28213 Mecklenburg County

6. Quality Control Plan

6.1. Quality Control

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

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

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

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

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

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

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

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

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

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

6.2. Minimum Performance Standards

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

6.2.2. The Government will utilize a quality assurance surveillance plan (QASP) to monitor performance throughout contract performance. The QASP is provided as a separate attachment to the SF1449.

7. COVID-19 Or Other Similar Infectious Diseases

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

7.2. Contractor shall abide by all additional procedures and precautions that may be implemented by the VA based on VA-issued guidance and/or CDC recommendations. These procedures are subject to change throughout the life of the contract and will be incorporated via attachment (See S03 VTS Patient Transport PPE and Vehicle Cleaning/Disinfection SOP).

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

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

8. Conformity To Regulations

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

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

9. Wage Rates

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

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

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

10. Evidence of Coverage

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

11. Worker’s Compensation

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

12. Contractor Personnel Security Requirements

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

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

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

Contractor Responsibilities:

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

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

• All documents completed and submitted at the following website: http://www.va.gov/SECURITYINVESTIGATIONSCENTER/

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

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

12.1.1 HIPAA COMPLIANCE. HIPAA compliance is required. The contractor must adhere to the provisions of Public Law 104-191, Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the National Standards to Protect the Privacy and Security of Protected Health Information (PHI). As required by HIPAA, the Department of Health, and Human Services (HHS) has promulgated rules governing the security and use and disclosure of protected health information by covered entities, including the Department of Veterans Affairs (VA). In accordance with HIPAA, the contractor may be required to enter into a Business Associate Agreement (BAA) with VA.

12.1.2 BLOOD BORNE PATHOGENS: The contractor and the employees provided, pursuant to this contract, shall comply with the effective VAMC Policy (and Occupational Health requirements in accordance with OSHA Blood Borne Pathogens (BBP) Law and the OSHA Tuberculosis Compliance Directive, enforceable under OSHA’s General Duty Clause) governing health care workers infected with a blood borne pathogen. If the contractor obtains information that a health care worker providing care pursuant to this agreement may be infected with a blood borne pathogen, the contractor will advise the Contracting Officer immediately.

13. Medical Liabilities Insurance

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

14. Annual VHA Training

14.1 In accordance with VHA Directive 2003-028 "Compliance and Business Integrity Program", its updates or replacement directives, IG Guidance at 8994, Section II(C); Guidance at 4875, Section III (B)(4) Sentencing Guidelines, Section 8B2.1 (b) (4) (B) annual compliance training is to be provided to all contractors within the scope of their work. The medical center COTR’s are to coordinate the annual training with their respective Contracting Officer and Compliance and Business Integrity Officers. A copy of the documentation of the completed annual training is to be provided to the Compliance and Business Integrity Officers for their files.

In accordance with VHA Directive 1605.1 “Privacy and Release of Information”, updates or replacement directives annual VHA Privacy Policy Training is to be provide to all contractors within the scope of their work. A copy of the documentation of the completed annual training is to be provided to the Contracting Officer and the facility Privacy Officer for their files.

In accordance with VA Directive 6500, “Information Security Program”, updates or replacement directives annual VHA Cyber and Security Information Training is to be provided to all contractors within the scope of their work. A copy of the documentation of the completed annual training is to be provided to the Contracting Officer and the facility Information Security Officer for their files.

15. Conformance with Environmental Management Systems

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

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

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

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

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

16.3 For contracts with a period of one year or less, the contracting officer will perform a single evaluation when the contract is complete.