36C24720R0008-002.pdf

Performance Work Statement

Dorn VA Medical Center

Columbia, SC

NON-EMERGENT AMBULANCE SERVICE

Purpose: The purpose of this requirement is for an IDIQ service type contract, to furnish 24-hour ambulance transportation service for the beneficiaries of the DORN VA Medical Center.

Columbia, SC and 7 (seven) Community Based Outpatient Centers (CBOCs); Anderson, Greenville, Spartanburg, Rock Hill, Florence, Sumter, and Orangeburg, all under the jurisdiction of the Dorn VAMC, Columbia, SC 29209.

WJB Dorn VA Medical Center Anderson CBOC

6439 Garners Ferry Road 3030 N. Highway 81

Columbia, SC 29209 Anderson, SC 29621

Sumter CBOC Florence CBOC

407 North Salem Avenue 1822 Sally Hill Farms Blvd

Sumter, SC 29150 Florence, SC 29501

Greenville CBOC Rock Hill CBOC

41 Park Creek Drive 2670 Mills Park Drive

Greenville, SC 29605 Rock Hill, SC 29732

Orangeburg CBOC Spartanburg CBOC

1767 Village Park Drive 279 North Grove Medical Park Drive

Orangeburg, SC 29118 Spartanburg, SC 29303

Services to be provided includes all labor, materials, insurances, licenses, and equipment to provide transport services to and from Dorn VAMC. Upon request of authorized medical center staff, the contractor will provide Basic Life Support (BLS) and/or Advanced Life Support (ALS) transports of patients to designated locations. The Contractor may be required to transport patients to another facility for treatment or tests, “wait”, and possibly transport same patient to a pre-determined location. The Contractor may be required to transport patients from their home to the primary service area encompassing the following: All counties in the State of South

Carolina. On occasions, services will be required for the Charlotte, NC CBOC, the Salisbury, NC VAMC, and the Fayetteville, NC VAMC. Additionally, services may be required for the

Augusta, GA VAMC, the Dwight David Eisenhower Medical Center located at Fort Gordon, Ga, the Dublin, GA VAMC, Atlanta, GA VAMC, Birmingham, AL VAMC, the Tuskegee, AL

VAMC, and Hospitals located in Charleston.

A Contracting Officer Representative (COR) shall be delegated through a letter of delegation that outlines the COR’s specific responsibilities and shall be provided to the Contractor at the time of contract award.

• Request for service shall be made either in writing or by telephone.

• Contractor shall be provided with patient’s pick-up/delivery points, appointment time, location, and vehicle requirements.

Contractor shall provide Ambulance Service, to the maximum extent possible, by honoring

Transportation requests made twenty-four (24) hours in advance.

• Contractor shall be able to accept request for same day service and to schedule them in a manner that meets the arrival time needs.

The Contractor shall pick up the patient as near to the scheduled pickup time as possible. If

Contractor arrives earlier than the scheduled pick-up the Driver shall wait at the pickup location until five (5) minutes past the scheduled pickup time before calling the Dispatcher for instructions.

FEDERAL HOLIDAYS

New Year’s Day Martin Luther King Holiday Presidents day

Memorial Day Independence Day Labor Day

Columbus Day Veterans Day Thanksgiving Day

Christmas Day

A. TASKING:

1. 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, pursuant to Department of Veterans Affairs authorization, more than one patient is transported concurrently on a trip, reimbursement shall be made only at the rates contained in the schedule of costs for transporting a single patient. Regardless of the number of patients transported concurrently on a single trip within Richland

County limits, the Contractor shall be reimbursed for only the Base Rate (Item 1) for one trip. Regardless of the number of patients transported concurrently on a single trip beyond Richland County limits, the Contractor shall be reimbursed for the

Mileage Rate (Item 2) for only one trip to the longest distance traveled with any one patient on that trip.

2. WAITING TIME: For time lost in waiting at either or both ends of a trip due to causes beyond the Contractor’s control, the Contractor will be reimbursed per quarter hour as quoted in the schedule for each quarter hour or fraction thereof more than one-quarter hour for the time reported to the designated VA personnel. If the pick-up point is other than the VA Medical Center; the Contractor will call the Contracting

Office Representative (COR), Special Mode Transportation (SMT), at Dorn VAMC during administrative hours (8:00AM through 4:30PM, Monday through Friday) or the Administrative Officer of the Day (AOD) on duty during non-administrative hours (during evenings, nights, weekends, and holidays) as soon as it is anticipated that a delay may develop for which the Contractor expects to claim reimbursement.

This call is only for verifying the arrival time at the pick-up point and is not necessary if the contractor anticipates no delay for which reimbursement will be claimed. The contractor’s failure to notify the travel section when waiting beyond the grace period shall result in non-payment for waiting time. In the case of patients transported to an airport for being transported by aircraft, the contractor’s driver must remain at the airport until such time the aircraft has departed the airport. Any wait time more than

1 (one) hour must be approved by the COR, SMT coordinator, supervisor, Chief/Asst

Chief of the Business Office, either by phone call, email, or text.

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

4. NON-PICKUP OF PATIENT: When ambulance service involves a trip to or from the medical center, patient’s residence, patient refusal due to unforeseen circumstances the patient is not available for pick-up, the contractor will collect for the trip at the rates applicable under the schedule portion of this contract. The VA reserves the right to substitute patients in these instances to prevent the “no-load” situation.

5. RATES: Rates will apply twenty-four hours per 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. Such mileage costs will be paid in addition to the applicable rate per trip for any trip entirely within the county limits.

Trip mileage shall be determined by the latest edition of the Bing Maps. 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 do 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. Mileage will only be calculated when veteran is onboard ambulance.

6. TOLL CHARGES:

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

b. If Contractor’s place of business is located beyond the local telephone call zone of this medical center, Contractor agrees to provide a toll-free telephone number or will accept telephone orders for service on a collect basis.

7. ORDERS FOR SERVICES:

a. Personnel authorized to order service shall make request for service by telephone, fax, email, or any combination. 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. All contacts from the

Contractor will be with the SMT Clerk, SMT Supervisor, COR, or the

Administrative Officer of the Day (AOD) during non-administrative hours.

b. 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.

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

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

e. Mental Health patients who need restraints, the ambulance will use the wrist, body, and ankle restraints to ensure the safety of the veteran.

f. Obese/overweight veterans may require the assistance of additional ambulatory crew members. In this case, please notify Special Mode

Transportation Coordinator, Program Manager, or the COR.

g. All medication, to include narcotics, will be the responsibility of the patient, or in the patient’s personal belonging bag.

8. RESPONSE TIME: 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 obtaining service from an alternate source and charging the Contractor.

a. If the VA is unable to establish telephone contact with the Contractor for

Basic Life Support (BLS) service within one (1) hour, or if the Contractor fails to furnish BLS ambulance service within 45 minutes after receiving a request, or within 45 minutes of the scheduled pick-up 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 communicate with the contractor and decide when to order service from another source.

b. Advanced Life Support (ALS) will be furnished for life-threatening/urgent transport. If the VA is unable to establish telephone contact with the

Contractor for urgent Advanced Life Support (ALS) service within one (1) minute at the numbers specified, or Contractor fails to furnish an ALS ambulance within fifteen (15) minutes after receiving a request, the VA reserves the right to obtain service from another source and charge the

Contractor with any excess costs which may result. If, within five (5) minutes after receiving a request for ALS service, the Contractor makes the determination if they are unable to provide the service within fifteen (15) minutes. The VA will communicate with the contractor and decide when to order service from another source.

9. REPORTING REQUIREMENTS: For all scheduled appointments for patients’ entrance to the building will be in the Main ambulatory entrance. Direct admissions will enter through the emergency entrance. Ambulance personnel will stop at the Emergency Department desk to let the clerk and nurse know the patient has arrived and to get any additional instructions. Emergent patients will enter the emergency entrance and need to have a “warm hand-off” to VA clinicians or designees.

10. GOVERNMETN OWNED EQUIPMENT OR SUPPLIES: Any and all government equipment, linens, etc., taken with patients must be returned. The

Contractor shall furnish all linens, blankets, and supplies. The VA Medical Center will not participate in a linen exchange program or any supply exchange program.

The Contractor shall not be permitted to borrow medical equipment from the Medical facilities. The Contractor shall provide all medications required while in transport, sheets, and blankets and other equipment and supplies required for use while in transport, for direct patient care. Contractor shall at no time and under any circumstances exchange supplies, equipment, and/or medications with the VA.

11. RECORDS: At the option of the Government, the Contractor may be required to transport records with patients from station to station.

12. INCIDENT REPORT: Should an incident and/or accident occur involving the welfare of a beneficiary, the Contractor shall immediately notify the Travel Clerk, Supervisor, Patient Support Unit, or the Administrative Officer (AOD) during evenings, nights, weekends, and holidays. This notification will be made by telephone within one (1) hour. A written report of the incident shall be filed with the

Travel Clerk and the Contracting Officer’s Representative by the close of business the next business day.

Immediately after any event, the contract must notify the COR, SMT clerk, SMT supervisor, or AOD. These incidents, whether large or small, must be reported in full detail (date, time, patient, place, names of involved parties, and any other pertinent information) to the COR in writing within 24 hours, with implemented corrective actions. Contractor will also notify the COR, in writing, within 24 hours of any complaints made by the patients regarding service issues, and providing recommendations for improvement, when necessary.

13. PATIENT WELFARE AND ABUSE

a. The contractor shall be held responsible for patient welfare during transport.

The contractor shall be held responsible for patient and/or Government property during transport. Any damaged or lost wheelchairs, walkers, crutches or personal belongings will be replaced by the contractor at no additional cost to the Government or beneficiary.

b. The Government requires the contractor to exercise extreme caution and care in the handling of patients. Any abuse of patients will be grounds for default action or Termination of the contract.

c. In the event a patient's condition worsens during transport, the Contractor shall transport the patient to the closest facility appropriate for the required care. In the event a patient should expire during transport the Contractor shall return to the VA Medical Center.

14. VEHICLES: Ambulance used under this contract shall be licensed and shall meet the minimum vehicle requirements as mandated by the South Carolina Department of

Transportation and the State (Columbia, Richland county) Government.

15. AMBULANCE MEDICAL EQUIPMENT:

a. Each medical care vehicle will have patient compartment facilities, oxygen and suction systems and equipment, environmental climate equipment, communications equipment, and any additional systems, equipment, accessories, and supplies as required by the State of South Carolina.

b. Each advanced life support (ALS) vehicle will have certified paramedics, patient compartment facilities, oxygen, heart monitor, suction systems, and intravenous IV equipment, environmental climate equipment, communications equipment, and any additional systems, equipment, accessories, and supplies as required by the State of South Carolina.

16. PATIENT RIGHTS: The Contractor shall be courteous to VA beneficiaries and shall not smoke while transporting patients. Patients may bring a reasonable number of belongings such as a personal “carry on” suitcase.

17. MISCELLANEOUS:

a. At no time will the Contractor leave vehicles on VA premises unless a pick-up or delivery is in process. Once a patient has been removed from vehicle and properly secured with Emergency personnel, the running vehicle will be removed from the Emergency Department exit door to prevent environmental hazards due to exhaust fumes.

b. Contractor employees shall always conduct themselves in a business-like manner while on VA premises and while transporting patients.

c. When transporting patients to or from Medical facilities, the driver, acting for the contractor, will ensure that the patient’s luggage, medical records, medications, and prosthetic devices are properly accounted for and delivered with the patient as required.

d. Contractor shall provide a “Run Sheet” as part of the patient’s permanent record. This Run Sheet shall include a record of the patient’s vital signs, medications used, oxygen use, patient’s emotional attitude, and any changes in the patient’s condition. The list stated here shall not be construed to be as all-inclusive; the Contractor shall provide all pertinent information.

18. CONFIDENTIALITY: Protects printed and sensitive data in accordance with the provisions of the Privacy Act of 1974 and other applicable laws. Protects the data from unauthorized release or from loss and alterations.

19. TRAINING

1. To be eligible to perform under this contract, each contract employee must meet the minimum training required outline below and minimum contractor furnished training outlined in paragraph (2) (c), (1) Through (8).

2. Contractor Furnished Training.

(a) The contractor shall submit to the Contracting Officer written certification that each contract employee has been trained in the subject areas outlined in paragraph C prior to assignment under this contract. For replacement or new employees’ documentation of prior training must be submitted or the individual contract employee must complete the required training before being employed in support of this contract.

(b) All formal training required shall be administered (i.e., taught, presented) by persons who are certified as being qualified to instruct or teach, the specific subjects or topics required. Certification to instruct the specific subject shall be in the form of a certificate issued by an accredited institution of learning (school, college, university), a governmental (Federal, State, County, etc.) educational certification body (agency, board, commission), or by documentation that the person instructing has sufficient experience in/with the subject to be able to instruct the subject in an authoritative, practical and current manner.

(c) In addition to the formal training, the contractor shall provide 16 hours of orientation training for each employee fourteen (14) days after his or her initial assignment to duty. This orientation may be accomplished while the employees are on duty. The contractor shall certify to the COR as to the completion of the orientation for each employee within 45 days following assignment to duty. The follow-up orientation should include the following subjects and instructional time periods as well as other subjects as may be required:

(1) Accident and incident reporting (2 hours)

(2) Safe operation of emergency vehicles (2 hours)

(3) Quality Assurance (2 hours)

(4) Fire and emergency preparedness planning (2 hours)

(5) Handling patient complaints (1 hour)

(6) Infection control (2 hours)

(7) Universal precautions (policy and procedure) (2 hours)

(8) Safety and occupational health procedures (3 hours)

3. Contractor Furnished Training - The Contractor shall submit to the Contracting

Officer written certification of the follow-up orientation.

4. The EMT/Paramedics must be enrolled in 'refresher" continuing education, or advanced training programs as required by the local or state government entity in which the service is rendered to veterans or, a yearly basis. Such "refresher" training must be equivalent to that developed by the Department of Transportation or National

Highway Safety Administration. Evidence of successful completion for "refresher" training must be provided to the Contracting Officer for inspection.

20. PERSONNEL REQUIREMENTS:

a. Minimum of two (2) years’ experience

b. Minimum Qualifications Standards

(1) Contractor Education/Experience: Possess a high school education or equivalency, and have two (2) years of experience demonstrating the ability to meet and deal with the general public, to read, understand and apply printed rules, detailed orders, instructions, and training materials; to maintain pose and self- control under stress; and to construct and write clear, concise, accurate and detailed reports as determined by successful, high level of performance with other customers. Any type of military service may be credited toward meeting the requirements. In lieu of the above, each employee shall have two years of relevant education at a residency school above the high school level, or any combination of relevant education above the high school level and relevant experience totaling two (2) years.

(2) Drivers:

(a) Education/Experience: Possess a high school education or equivalency, and have two (2) years of experience demonstrating the ability: to meet and deal with the general public; to read, understand and apply printed rules, detailed orders, instructions, and training materials: to maintain pose and self-control under stress; and to construct and write clear, concise, accurate and detailed reports as determined by successful, high level of performance with other clientele.

(b) Possesses a valid South Carolina operator's license issued by the State of South Carolina, has not, within the last three years, been convicted of reckless driving or driving under the influence of alcohol or controlled substances and has not had a driver’s license suspended under the point system issued by the state. Possess a valid American Red Cross standard first aid and personal safety course card or its equivalent. Drivers must provide full name, date of birth, and social security number to VA prior to operating vehicles with VA beneficiaries. Proof in the form of a current certificate that such first aid training has been successfully completed must be available upon request.

(c) Possess a working knowledge of route specific to the area and knowledge of the nearest hospital available.

(d) Contractor must provide an annual statement that drivers are screened, trained and competent to safely transport patients. This annual statement of driver competency must include any advanced certifications, such as

Advanced Cardiac Life Support or specialized training to assist and secure patients by stretcher or wheelchair.

(3) Attendants-Emergency Medical Technician (EMT) and Paramedics prices quoted in the schedule shall include the services of a minimum of two (2)

Emergency- Medical Technicians (EMTs) for BCLS and a minimum of one

EMT and one Paramedic for every ACLS Service. In the event the VA

Medical Center determines it necessary for the patient to have more than one

ACLS attendant at bed side during transport, the contractor must provide the additional attendant. If the patient being transported requires mechanical ventilation, the contractor is responsible for his or her own mechanical ventilator, and the care of the patient during transport. If the patient being transported requires accompaniment by an RN, and the contractor does not supply the RN, an RN will accompany the patient during transport. The RN's responsibilities during transport will be clearly outlined in written physician orders. In the event of emergency, the care of the patient in transport will be the responsibility of the EMT/Paramedic. EMT's and Paramedics must provide full name, date of birth and Social Security Number to VA prior to assignments on vehicles with VA Beneficiaries. Paramedics in addition to b

(2) (a) above will be licensed in advanced and basic life support and having completed an appropriate training course in the last two years. Attendant should have a minimum of four hours of training in crisis intervention

(documented), since some of the patients requiring an attendant will be a psychiatric patient. An attendant will always be required for stretcher patients strictly for their safety during the trip and help during transfer to and from van. EMT's in addition to b (2) (a) above licensed in basic life support and having completed an appropriate training course in the last two years.

Attendant should have a minimum of four hours of training in crisis intervention (documented), since some of the patients requiring an attendant will be psychiatric patients. An Attendant will always be required for stretcher patients strictly for their safety during the trip and help during transfer to and from van.

(4) Age: Contractor and employees performing work under this contract shall be a minimum of eighteen (18) years of age or as required by local laws.

(5) 5 years of experience providing ALS ambulance service is required.

(6) Health and Physical Fitness Requirements:

(a) All employees assigned by the Contractor to work under this contract shall be physically able to perform all general duties, functions and activities; shall be free from any communicable disease, shall be in good general health without physical defects or abnormalities which would interfere with the performance of these duties, shall possess binocular vision correctable to 20/30 (smellen), shall be free of color blindness, and be capable of hearing ordinary conversation at 15 feet with either ear without benefit of a hearing aid. Certify under oath that he is not addicted to alcohol or any controlled substances. Physical examination report to describe above requirements for each driver shall be provided upon request.

(b) All employees shall be literate and able to communicate (speak) with clients in English to the extent of reading and understanding printed regulations, detailed written orders, training instructions and material, and shall be able to compose reports which convey complete information. The

Contractor is to certify the ability of all employees designated to provide service for this contract. When a patient is transported with any VA owned equipment the equipment shall be returned to the respective VA Medical

Center within 24 hours in the same condition as it was released at no addition cost to the Government.

21. PERIOD OF PERFORMANCE:

22. Period of performance: TBD

23. TERMINATION FOR CONVENIENCE:

In accordance with FAR 52.212-4 (l) The Government reserves the right to terminate

This contract, or any part hereof, for its sole convenience.

25. INVOICES:

a. Payment will be made upon receipt of a properly prepared detailed invoice, prepared by the Contractor and submitted through Tungsten Network (formerly known as OB10) http://www.tungsten-network.com/us/en/. A properly prepared invoice shall contain:

✓ Invoice Number and Date

✓ Contractor’s Name and Address

✓ Accurate Purchase Order Number

✓ Supply or Service provided

✓ Period Supply or Service Provided

✓ Total Amount Due

b. Please begin submitting your electronic invoices through the Tungsten Network for payment processing, free of charge.

c. If you have questions about the e-invoicing program or Tungsten Network, contact information is as follows:

• Tungsten e-Invoice Setup Information: 1-877-489-6135

• Tungsten e-Invoice email: VA.Registration@Tungsten-Network.com

• FSC e-Invoice Contact Information: 1-877-353-9791

FSC e-invoice email: vafsccshd@va.gov

NOTE: Contractor shall provide a monthly report to the Travel Clerk 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. 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.

http://www.tungsten-network.com/us/en/ http://www.tungsten-network.com/us/en/ mailto:VA.Registration@Tungsten-Network.com mailto:VA.Registration@Tungsten-Network.com http://vafsccshd@va.gov http://vafsccshd@va.gov