36C24721R0064 0012.docx

5. PROJECT NUMBER (if applicable)

CODE

7.

ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF

PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE

OF YOUR

ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office.

is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERE

D CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES

SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR

OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendmen t, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED

STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER

16A. NAME AND TITLE OF

CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30

PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF

SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer) 521-22-1-829-0003 n/a Department of Veterans Affairs Central Alabama Veterans Health Care 215 Perry Hill Road Montgomery AL 36109-3798 Department of Veterans Affairs Ralph H. Johnson VAMC 325 Folly Rd.

Charleston SC 29412 To all Offerors/Bidders

36C24721R0064 07-23-2021

X x x ** HOUR & DATE for Receipt of Offers is EXTENDED to: extended till 12/13/2021 @1:00 CST See CONTINUATION Page 521-3610160-829-820100-2580 0100C0088 x The purpose of this amendment is to provide the following;

This amendment includes an updated 52.212-1 and 52.212-2 and new clauses,52.223-99, 852.219-77, 852.219-78.

This amendment includes an updated PWS.

This amendment includes Questions and answers from Vendors.

This amendment includes an updated Price/ Cost schedule.

This amendment inc ludes a Past Performance Questionnaire.

This amendment includes an Ambulance Request Form.

This amendment includes the clauses associated with an IDIQcontract.

NO

ADDITIONAL QUESTIONS WILL BE ACCEPTED AFTER 30 NOV 2021@3:00 CST.

Latoyer Furbush Contracting Officer

A.1 52.212-2 EVALUATION—COMMERCIAL ITEMS (OCT 2014)

ADDENDUM to FAR 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS

a. Period of Acceptance of Offers. The Offeror agrees to hold prices in its offer firm for a period of Ninety (90) calendar days from the date specified for the receipt of offers. The offeror shall date and sign the SF1449 in blocks 30 a, b and c agreeing to all terms and conditions of this solicitation and the resulting contract.

b. Offerors’ proposals are to be submitted electronically to Marcus.watts@va.gov. Offerors shall include in the subject line of the email the following: Solicitation 36C24721R0064, ADVANCED LIFE SUPPORT (ALS) STRETCHER TRANSPORTATION AND NON-EMERGENT MEDICAL SERVICES- Birmingham

· Electronic proposals shall be prepared in four separate attachments. The contractor must submit pricing for the base period and all option years. Option year pricing will be evaluated.

· Attachment I – Past Performance (Submit awarded contracts that are similar in scope and complexity to the PWS). This factor will be used to assess the Offeror’s past performance history providing advanced life support stretcher transportation and non-emergent medical services. Offerors shall provide a narrative describing their past performance history providing advanced life support stretcher transportation and non-emergent medical services. For each reference contract the Offeror submits as evidence of its past performance history providing advanced life support stretcher transportation and non-emergent medical services, the Offeror’s narrative must clearly state the following information:

(1) the legal name of entity with whom the Offeror held the contract;

(2) the contract number;

(3) whether the contract was for advanced life support stretcher transportation and non-emergent medical;

(4) a description providing details of the specific tasks the Offeror performed under that contract;

(5) in what geographic location the Offeror performed these services;

(6) the dates during which the Offeror performed the contract;

(7) the number of patients to whom the Offeror provided advanced life support stretcher transportation and non-emergent medical services.

(8) whether the provided reference contract is for services provided by the Offeror or provided by a proposed subcontractor of the Offeror’s;

(9) whether the Offeror or its proposed subcontractor was the prime contractor or a subcontractor for that provided reference contract;

(10) the name, phone number, and email address of a person at the entity with whom the Offeror (or Offeror’s proposed subcontractor) held the contract who can verify the information the Offeror provides in the narrative description for this factor.

NOTE: The information requested above is required for the Government to evaluate proposals for the Past Performance evaluation factor. General statements claiming relevant past performance history providing services that do not include specific references to prior contract work, or that do not include the information required above, may result in a government determination that the offeror has failed to submit relevant past performance history.

In addition, offerors should ensure that their submissions include a point of contact who can speak on behalf of the company, the company name, address, telephone number(s), email address and contract dates.

· Attachment II – Pricing (Requirements for Price Proposals. Offerors shall complete and submit the Price Schedule in section B. Offerors must propose to provide services for each of the contract line items identified in Section B of this Solicitation. No other format shall be accepted).

· Attachment III – ORCA Report if electronic copy has not been completed in the sam.gov database or submit a completed copy of 52.212-3 – Offeror Representations and Certifications

· Attachment IV- A completed VAAR 852.219-77- Limitations on Subcontracting certification shall be completed AND submitted at time proposals are due.

c. Proposals shall be emailed to Marcus Watts; marcus.watts@va.gov, and be received by 1:00pm C.S.T. on December 13, 2021.

d. To the extent the offeror has any relevant performance references, the offeror should ensure the attached past performance evaluation form is properly completed and separately submitted by the offeror’s references to the government by the time proposals are due).

e. Questions pertaining to this solicitation shall be emailed to marcus.watts@va.gov by November 30, 2021; 3:00pm C.S.T. Questions will be answered via an amendment to this solicitation on or about December 6, 2021. No telephone inquiries will be considered.

A responsibility determination required under FAR 9.1 will be made prior to award.

Per VA Acquisition Regulation 852.219-10(b)(1) incorporated by reference in this solicitation and the resulting contract, Offers are solicited only from eligible service-disabled Veteran-owned small business concerns. Only service-disabled Veteran-owned small business concerns (SDVOSBs) listed as “verified” at VA’s Vendor Information pages (VIP), available at www.vip.vetbiz.va.gov, may submit offers in response to this solicitation. Offers received from concerns that are not VIP-listed service-disabled Veteran-owned small business concerns shall not be considered. Please note that Offeror’s proposing as a Joint Venture or Mentor-Protégé arrangement will not be considered to meet eligibility as a SDVOSB for this procurement unless that Joint Venture is listed as “verified” at VA’s VIP.

Per FAR 52.204-7, included in this solicitation by reference, an Offeror is required to be registered in SAM when submitting its offer, and shall continue to be registered until time of award, during performance, and through final payment of any contract, basic agreement, basic ordering agreement, or blanket purchasing agreement resulting from this solicitation

ADDENDUM to FAR 52.212-2 EVALUATION—COMMERCIAL ITEMS

(a) The Government will award ONE (1) Base + 4 Option Years Firm Fixed Price Indefinite Delivery Indefinite Quantity (IDIQ) contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate offers:

Past Performance-This factor shall be used to assess the Offeror’s relevant past performance history providing contracted Advanced Life Support (ALS) Stretcher transportation, Basic Life Support (BLS) Stretcher transportation, Nonemergency Ambulance Stretcher transportation and Nonemergent Medical -Ambulette transportation services Price- This factor shall be used to assess the reasonableness of the Offeror’s proposed price

Past Performance is significantly more important than price.

(b) Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the Government to exercise the option(s).

(c) A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer's specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

EVALUATION CRITERIA for Advanced Life Support (ALS) Stretcher transportation, Basic Life Support (BLS) Stretcher transportation, Nonemergency Ambulance Stretcher transportation and Nonemergent Medical -Ambulette transportation Services: Basis for award will be made by evaluating proposals using the following criteria listed.

Factor 1. Past Performance Past performance evaluation results in an assessment of the offeror’s probability of meeting the solicitation requirements. It considers each offeror demonstrated recent and relevant record of performance in supplying products and services that met the contract requirements:

There are two aspects to the past performance evaluation:

(a)Relevancy of contractual work performed and;

b) How well the contractual work was performed Relevant is defined as contracts recently performed that include services that are similar is complexity, dollar value and contract type. The more recent the offeror’s performance in providing similar services – as defined above, the more consideration that will be given by the government in evaluating the ‘relevance’ of the offeror’s past performance history. The second aspect of the past performance evaluation is to determine how well the contractor performed on the contracts.

The government will review past performance information and determine the quality and usefulness as it applies to performance confidence assessment. Ensure your submissions include a point of contact who can speak on behalf of the company, the company name, address, telephone number(s), email address and contract dates. We have attached a past performance evaluation form for you to send to your references.

The Government may contact references, other than those identified by the offeror, and use the information received to evaluate the offeror’s past performance. The information evaluated may include data on efforts performed by other divisions, critical subcontractors, or teaming partners, if such resources will be brought to bear or significantly influence the performance of the proposed effort. Special emphasis will be placed on performance related to areas covered in the PWS for this solicitation. The government will also use information obtained from government data bases such as CPARS, PPIRS, and any other data base as necessary.

In the case of an offeror without a record of relevant performance history or for whom information on past performance is not available, the offeror may not be evaluated favorably or unfavorably on performance history.

Factor 2. Price The price will be evaluated based on the overall price to determine if the proposed price is fair and reasonable. This factor shall be used to assess the reasonableness of the offeror’s proposed price.

Performance Work Statement

DESCRIPTION OF WORK:

The sole Contractor must provide all supplies, materials, equipment, labor, supervision, management and transportation to furnish Advanced Life Support (ALS) and Basic Life Support (BLS) Stretcher transportation, and Nonemergency Ambulance Stretcher transportation and Nonemergent Medical-Ambulette transportation to eligible Veteran Administration (VA) beneficiaries of the Birmingham Veterans Affairs Medical Care System which includes the state of Alabama, Florida, Georgia, Mississippi, South Carolina, Tennessee, and Virginia in accordance with all terms of the contract. Service will be made available twenty-four (24) hours a day, seven (7) days a week, yearly, including Federal and State holidays. The sole contractor will be able to provide all modes of transportation services described for acute medical, mental health, and nonemergency/ambulette transports. The Contractor must furnish at a minimum: six ALS/BLS ambulances of which two must be stretcher-bariatric capable ambulances; and a minimum of two wheelchair capable Ambulettes, which are bariatric (large capacity) capable transportation services. The contractor shall be required to have a satellite office in both Birmingham Alabama and Huntsville, Alabama (or the closest county available) within 60 days after contract award. Further, one bariatric capable vehicle shall be housed at each satellite office. The contractor offering or proposing to offer Advanced Life Support (ALS) service must be licensed as emergency medical provider service operators Health Emergency Medical Services and will be EMS license https://www.alabamapublichealth.gov/ems/index.html, and authorized to operate by Alabama’s Public Service Commission, http://psc.alabama.gov/Transportation/transportation.htm in the state of Alabama.

The Contractor will provide Advanced Life Support (ALS) Ambulance Services, Basic Life Support (BLS) Services, Nonemergency Ambulance Stretcher Transport services, as well as ambulette transportation service in accordance with (IAW) https://www.alabamapublichealth.gov/ems/rules-and-protocols.html to the following VA facilities:

Satellite 700 South 19th St. S Birmingham, AL 35233

Bessemer CBOC 975 9th Ave. SW Ste. 400 Bessemer, AL 32055

Birmingham VA Clinic 2415 7th Ave.

Birmingham, AL 35233

Childersburg CBOC 151 9th Ave. NW Childersburg, AL 35044

Gadsden CBOC 206 Rescia Ave.

Gadsden, AL 35906

Guntersville CBOC 101 Judy Smith Dr.

Guntersville, AL 35976

Huntsville VA Clinic 500 Markview Dr. NW Huntsville, AL 35805

Jasper CBOC 1454 Jones Dairy Rd.

Jasper, AL 35501

Anniston/Oxford CBOC 96 Ali Way Creekside South Oxford, AL 36203

Shoals Area CBOC 422 DD Cox Blvd.

Sheffield, AL 35660

Memphis VAMC 1030 Jefferson Avenue Memphis, TN 38104

Charlie Norwood VAMC 1 Freedom Way Augusta, GA 30904

Atlanta VAMC 1670 Clairmont Road Decatur, GA 30033

Tennessee Valley 3400 Lebanon Road Murfreesboro, TN 37129

Period of Performance: Date of award through one year for a base year, with four (4) option years.

This will be a Firm-Fixed Price contract.

DEFINITIONS:

Administrative Hours: Monday through Friday from 8:00 a.m. through 4:30 p.m. excluding holidays.

Administrative Officer on Duty (AOD): Administrative specialist in charge after the normal business hours and holidays

Advanced Life Support, Level 1 (ALS1): The transportation by ground ambulance vehicle and the provision of medically necessary supplies, an assessment by an ALS provider trained to the level of the emergency medical technician-intermediate or paramedic as defined in the national EMS education and practice blueprint or in accordance with state and local laws or the provision of one or more ALS interventions, that is, a procedure beyond the scope of an EMT-basic.

Advanced Life Support, Level 1 (ALS1)-Emergency: An emergency response is one that, at the time the ambulance provider or supplier is called, it responds immediately. An immediate response is one in which the ambulance provider/supplier begins as quickly as possible to take the steps necessary to respond to the call.

Advanced Life Support, Level 2 (ALS2): Transportation by ground ambulance vehicle and the provision of medically necessary supplies and services including the administration of at least three separate administrations one or more different medications or the provision of at least one of the following ALS procedures:

Manual defibrillation/cardioversion Endotracheal intubation Central venous line Cardiac pacing Chest decompression Surgical airway Intraosseous line

Advanced Life support Assessment: Performed by an ALS crew as part of an emergency response that was necessary because the patient’s reported condition at the time of dispatch was such that only an ALS crew was qualified to perform the assessment.

Advanced Life Support (ALS) Transports: Ground transports requiring higher level of care on an ambulance equipped with Advance Life Support System and qualified staff as required by the State of Alabama, Department of Public Health, Office of Emergency Medical Services to provide Emergency Medical Services.

Basic Life Support Transports: Ground transports requiring non-invasive life support measures on an ambulance equipped and staffed as required by the State of Alabama, Department of Public Health, Office of Emergency Medical Services to provide Emergency Medical Services Ambulance and Ambulette Service Area: To encompass the states of Alabama, Florida, Georgia, Mississippi, South Carolina, Tennessee, Virginia, and other areas defined.

Ambulance: A vehicle that:

(a) is specifically designed for transporting the sick or injured;

(b) contains a stretcher, lines, first aid supplies, oxygen equipment, and other lifesaving equipment required by state or local laws; and

(c) is staffed with personnel trained to provide first aid treatment. The ambulance is designed and constructed to afford relative safety and comfort, and to avoid aggravation of the patient’s condition. It must meet the standards required by Federal, State, and local laws. See https://www.alabamapublichealth.gov/ems/rules-and-protocols.html and http://www.alabamaadministrativecode.state.al.us/docs/hlth/420-2-1.pdf

Ambulance Services: Services provided by a licensed ambulance provider in the ground or air transportation of a sick or injured person in a specially designed and equipped vehicle as defined above (Ambulance), which includes a trained ambulance attendant who is licensed or certified as required by state law.

Ambulatory Patient -A non-emergency VA beneficiary who does not require the use of an ambulance, wheelchair, or stretcher van, whose handicap prevents use of normal modes of transportation, such as a car, van or taxi, or prevents the person from entering/exiting a normal vehicle without special assistance. A VA facility clinician determines if the patient requires special mode transportation based on a medical impairment or special need.

Ambulatory Through The-Door: From pick-up point, patients will be taken to the authorized destination or appointment. All patients must always be attended by an authorized responsible party. When the destination is other than a VA facility, patient will be taken directly to their destination and presented to their caregiver. When transporting to another Health Care facility (either VA or Private) the patient must be presented to a staff member. Patient must not be left at the entrance or in the hallway of the facility or outside their place of origin.

Ambulette: A specially equipped van or similar vehicle for transporting disable, convalescent, or people with limited mobility in nonemergency circumstances.

Bariatric Transport – Treating and transporting with specialized lifting and monitoring equipment for a bariatric patient, who can be severely obese weighing between 350 and 550 pounds.

Base Rate – ALS Ambulance Transport: The base rate will consist of the all-inclusive rate for ALS ambulance transport with no additional charges for miles until miles are greater than 150 miles from the patient pickup point.

Base Rate – BLS Ambulance Transport: The base rate will consist of the all-inclusive rate for BLS ambulance transport with no additional charges for miles until miles are greater than 150 miles from the patient pickup point.

Base Rate – Ambulette Transport: The base rate will consist of the all-inclusive rate for Ambulette transport with no additional charges for miles until miles are greater than 150 miles from the patient pickup point.

Base Rate- Nonemergency Ambulance Stretcher Transport: These transports are low level and for transporting disable, convalescent, or people with limited mobility in nonemergency circumstances. Rate should be lower than ALS and BLS Base Rates. There will be no additional charges for miles until miles are greater than 150 miles from the patient pickup point.

Bed Confinement: A patient is considered bed-confined if he/she is:

Unable to get up from bed without assistance Unable to ambulate, and Unable to sit in a chair or wheelchair

Birmingham Veteran Affairs Health Care System: Birmingham Veterans Affairs Health Care System includes the state of Alabama, Florida, Georgia, Mississippi, South Carolina, Tennessee, and Virginia Community Based Outpatient Clinics: Clinics operated by or under the auspices of the Veteran Affairs Medical Center.

Contracting Officer Representative (COR): Main point of contact for normal day-to-day service matters. Works closely with the contracting officer in monitoring contract compliance. Furnishes technical guidance and advice, and monitors the services provided by the contractor. Advises the contracting officer regarding contractor performance and recommends required contract modifications.

Durable Medical Equipment (DME): Medical equipment that is ordered by a provider for use in the home, such as walkers, wheelchairs, etc.

Emergency Services: Services provided after the sudden onset of a medical condition manifesting itself by acute symptoms of such severity (including severe pain) that the absence of immediate medical attention could reasonably be expected to result in placing the patient’s health in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part.

Escort/Caregivers - An escort/caregiver is defined as an individual, not employed by the Contractor, who provides direct care to the patient being transported via special mode.

Ground Ambulance Services: Ambulance services provided by a vehicle designed to operate on the ground, including water and land.

Mental Health Patient – Standard patients require one attendant and one driver for a total of two personnel.

Mileage Rate – ALS Ambulance Transport: The mileage rate will be added to the ALS Ambulance Transport base rate after 150 miles have been reached. The mileage rate will be applied to all miles exceeding 150 miles for the trip.

Mileage Rate – BLS Ambulance Transport: The mileage rate will be added to the BLS Ambulance Transport base rate after 150 miles have been reached. The mileage rate will be applied to all miles exceeding 150 miles for the trip. For example: a trip total mileage is 200 miles. For the first 150 miles the base rate will be paid. For the additional 50 miles, the mileage rate per mile will be calculated and paid.

Mileage Rate – Ambulette Transport: The mileage rate will be added to the Ambulette Transport base rate after 150 miles have been reached. The mileage rate will be applied to all miles exceeding 150 miles for the trip.

Mileage Rate – Nonemergency Ambulance Stretcher Transport: The mileage rate will be added to the Base Rate - Nonemergency Ambulance Stretcher Transport after 150 miles have been reached. The mileage rate will be applied to all miles exceeding 150 miles for the trip. For example: a trips total mileage is 200 miles. For the first 150 miles the base rate will be paid. For the additional 50 miles, the mileage rate per mile will be calculated and paid. This rate should be less than the Mileage rates for ALS and BLS Multiple Riders - Multiple riders is defined as, more than one patient is transported simultaneously in one vehicle at any given point during a trip.

Non-Administrative Hours: Monday through Friday from 4:30 p.m. to 8:00 a.m., all Saturdays, Sundays and Federal/State holidays.

Nonemergency Medical Transport: All scheduled transportation, regardless of origin and destination, that does not meet the defined criteria of an emergency. By definition, hospital discharge trips, trips to and from end stage renal disease (ESRD) facilities for maintenance dialysis, trips to and from other outpatient facilities for chemotherapy or radiation therapy, and other diagnostic and therapeutic services are scheduled runs and, therefore, are considered to be “nonemergency” services.

Reportable Incidents: The “provider” must notify the BVAMC whenever a trip interruption of greater than 15 minutes occur or any accident, incident, safety problems, moving violations, and patient(s) unbolting their selves.

Dry Run: Sometimes called a “Rescue Assist” is when any ambulance response is requested and made by the supplier; however, the patient declines to be transported; or it is found the ambulance is not needed, the agreed upon discounted fee applies.

Specials: Are defined as patients who require two attendants not including the driver. As additional services such as monitors, medication, etc. required for transport.

Special Mental Health Patient: Mental Health patient transport where two attendants and one driver for a total of three personnel are required.

Specialty Care Transport (SCT): Medically necessary for a recipient, whose condition requires ongoing care that must be provided by one or more health professionals in an appropriate area such as nursing, medicine, respiratory care, cardiovascular care or paramedic with additional training.

STAT: Abbreviation of the Latin word statim, which means in medical jargon “instantly” or “immediately” in an emergency. Usually used for patients of an active heart attack, stroke, gunshot wound, etc.

Stretcher Patient - A non-emergency patient whose severe mobility impairment requires him or her to remain in a lying (supine) position, unable to sit in an upright position for prolonged periods of time. A VA facility clinician determines the patient's need for stretcher transport.

Travel Unit Personnel: VA Travel Unit Employees authorized to coordinate authorized transportation at VA expense. Travel Unit Personnel include: Administrative Officer on Duty (AOD), Beneficiary Travel Staff (Program Support Assistant), and Contracting Officer Representative (COR).

Urgent Trip Interruptions: A delay in the transporting of a patient due to a weather emergency, natural disaster, vehicle disablement; illness or incapacitation of attendees, etc.

Wait Time: Paid to the transportation provider. After an initial 30-minute arrival interval, calculated per 15-minute intervals. Must obtain authorization.

Wheelchair Patient - A non-emergency VA beneficiary confined to a wheelchair or scooter, using a wheelchair or scooter for mobility or with mobility impairments, whose handicap prevents use of normal modes of transportation such as car, van, or taxi. A VA facility clinician determines the patient needs wheelchair transport.

DELIVERY:

Ambulance and Ambulette Transportation services must be furnished on an as needed" basis twenty-four (24) hours every day of the year, to include federal and state holidays. The contractor must provide all labor, equipment, vehicles, fuel, materials and supplies and supervision necessary to perform all tasks, including administrative support and supervision.

***NOTE: THE CONTRACTOR WILL NOTIFY THE PATIENT AND THE TRAVEL UNIT BY TELEPHONE OF ANY DELAYS IN THE TRANSPORTING OF PATIENTS. THE VA WILL ESTABLISH PRIORITIES WHEN NECESSARY. ***

QUALIFICATIONS:

The contractor must be licensed to provide ambulance service by the State of Alabama, Department of Public Health, Office of Emergency Medical Services to provide Emergency Medical Services in accordance with Alabama Public Health, Alabama Emergency Medical Services: Rules, Protocols, and Guidelines https://www.alabamapublichealth.gov/ems/rules-and-protocols.html

Title 34, Chapter 35, Transient Merchants Code of Alabama | FindLaw

State of Alabama, Alabama Department of Public Health, Administrative Code, Chapter 420-2- 1, Emergency Medical Services, http://www.alabamaadministrativecode.state.al.us/docs/hlth/420-2-1.pdf

The contractor must maintain Licensure, Certification, Certificate of Public Convenience Necessity (COPCN) with the State of Alabama, as applicable, throughout the life of the contract in accordance with Alabama Code Title 37, Chapter 3.

Code of Alabama | FindLaw

In the event the license/certification/COPCN lapses or expires, this could be cause for termination of the contract or discontinuance of further ordering from the contractor.

The contractor must maintain documentation demonstrating they meet all requirements of Federal, State, and County or City codes regarding operation of this type of service. Documentation must be made available to the VA immediately upon request for the duration of this contract.

The contractor must 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 pertaining to fire safety, and blood borne pathogens, which will be provided by the COR.

JOINT COMMISSION STANDARDS:

The contractor must perform required services in accordance with the standards of The Joint Commission (JC); “or an equivalent body,” established principles and ethics of the medical profession established by the American Medical Association (AMA) and American College of Emergency Physicians (ACEP) The contractor must adhere to Veterans Health Administration (VHA) regulations and the policies, procedures, and regulations of the Medical Staff bylaws of the Birmingham Veterans Affairs Medical Care System.

The contractor, upon request, must provide quality data and information related to services provided and participate in Birmingham VAMC Performance Improvement Programs when requested to do so. Upon request the contractor must also provide documentation of the competency of staff that will be providing the contracted services.

The contractor must be responsible for ensuring contractor employees providing work on this contract are fully trained and completely competent to perform the required work; they must also be required to maintain records that document competence/performance level of employees working on this contract. Upon request the contractor must provide a current copy of the competence assessment checklist and annual performance evaluation to the Contracting Officer’s Technical Representative (COR) for each contractor employee working on this contract.

HEALTH INFORMATION PORTABILITY AND ACCOUNTABILITY ACT (HIPPAA):

The contractor must 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.

The contractor must 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.

CONTRACTOR PERSONNEL:

The contractor must ensure that the following personnel (Emergency Medical Technicians (EMT), Paramedic, Non-Emergency Attendant/ Drivers) requirements are met:

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.

The contractor must ensure minimum staffing requirements as mandated by the State of Alabama are met. Each vehicle must be operated with enough personnel for adequate patient care, at least one of whom must be an Emergency Medical Technician (EMT).

Contractor employees must conduct themselves in a businesslike manner, meet qualifications specified in this PWS, and meet qualifications required by Federal, State, County and local government entities identified in this PWS. Contractor must submit certification of training, as required and in compliance with local, state, and federal regulations.

Contractor must maintain records of each employee as to character and physical capabilities of performing the services of a driver and/or attendant.

A record of each employee as to character, physical capabilities, and qualifications performing the duties of an ambulance driver or attendant must be maintained at the contractor's establishment and made available for inspection upon request of the contracting officer or COR.

A roster of Paramedics, Registered Nurses (RN), Emergency Medical Technicians (EMT), and Non-Emergency Attendant Drivers (EMTs and LPNs if used to provide these services) must be furnished to the contracting officer or COR initially at the post-award conference and upon request during contract performance. It will contain the following information:

Name, date of birth, and social security number Copy of national criminal background check Copy of 10-panel drug screen, repeated annually (or a 5-panel screen and annual random pool if Transportation Provider is subject to DOT drug testing requirements).

Basic first aid (CPR may also be required) Certification, to included date of initial training, expiration date, and refresher training date.

Assisting passengers with disabilities certificate, such as Passenger Assistance Safety and Sensitivity (PASS) Documentation of any grievances received For each driver, Prior driving record for previous five years, to be updated annually, or upon request by BVAMC A copy of driver’s license for each driver, to be updated as the license expires and is renewed For each driver, any accidents or moving violations

If the Contractor proposes to add or replace personnel to perform contract services, the Contractor must submit the required evidence of training, certifications, licensing and all other qualifications, designated in this PWS, to the designated COR for approval. At no time must the Contractor utilize add-on or replacement personnel to perform contract services without prior approval of the COR or Contracting Officer.

Personnel must be able to communicate with persons from a variety of social economic, ethnic, and religious backgrounds.

Contractor Employees shall not be considered government employees for ANY purpose under the contract.

TRAINING:

Employees will have all necessary training required and certified to perform the requirements contained in this PWS. Personnel must have documented training as required. Records of training and certifications must be maintained and available for VA inspection upon request. Emergency Medical Technicians- Intermediate and Paramedics providing emergency services on this contract must meet the following training requirements:

Have completed training in accordance with the standard published by the and follow Alabama Statutes (Code of Alabama, Title 34, Chapter 18 Medical Technicians, Article 1, Article 2, and Article 3 Code of Alabama | FindLaw

EMTs must also meet ongoing recertification requirement standards determined by the State of Alabama, Alabama Public Health, Alabama Emergency Medical Services: Rules, Protocols, and Guidelines https://www.alabamapublichealth.gov/ems/rules-and-protocols.html

Evidence of the "equivalent" training program successfully completed by the EMT must be submitted to the contracting officer, immediately upon request.

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 or designated representative.

Paramedics providing emergency services on this contract must have the following qualifications:

Must possess EMT – P Card.

Evidence of the "equivalent" training program successfully completed by the Paramedic with a copy States of Alabama and Alabama Certification Certificate must be submitted to the contracting officer or COR.

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

Contractor must ensure each ALS driver who operates a permitted vehicle meets qualifications and will be responsible for assuring that its drivers are knowledgeable and competent in emergency vehicle operations and thoroughly familiar with the vehicles assigned.

Ambulance drivers must complete at least a 16-hour course of instruction on driving an authorized emergency vehicle, as defined by State of Alabama, Department of Public Health, Office of Emergency Medical Services to provide Emergency Medical Services (Reference Title 31, Chapter 11, Rule 511-9-2, Emergency Medical Services) and the State of Alabama, Alabama Department of Public Health, (Reference Administrative Code, Chapter 420-2-1, Emergency Medical Services, and Patient Care Protocols, Eighth Edition, January 2016).

Attendant/driver must have successfully completed standard and advanced first aid courses including use of cardiopulmonary resuscitation techniques (CPR) and Advanced Cardiac Life Support (ACLS) of the American Red Cross, U.S. Bureau of Mines, or equivalent; be able to 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.

Drivers must wear appropriate uniform and identification that clearly identifies them by name, title, job performed, and company name. All drivers must have a valid “Class D” Operator's License issued by the State of Alabama Department of Transportation.

Drivers providing services must have less than five (5) current points on their driver’s license, none of which for “Reckless Driving.

All contractor employees must be enrolled periodically in “refresher” continuing education or advanced training programs as approved and required by the State of Alabama, Department of Public Health, Department of Emergency Medical Services. Such refresher training must 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.

VEHICLES:

The Nonemergency Ambulance Stretcher Transport, ALS and BLS ambulances used under the terms of this contract must be licensed and meet the minimum requirements governing emergency vehicles that is mandated by State of Alabama, Department of Public Health and Department of Emergency Medical Services, and local authorities. Licensure must be maintained and current throughout the term of the contract. An initial copy of ALL vehicle licenses shall be provided at the post-award conference. A copy of ALL updates shall be provided within three-days of the update to the COR. The vehicles must be clearly marked and visibly aesthetic.

All ambulette transportation vehicles will:

have functioning mechanisms which ensure that all access doors are capable of being opened from the inside and remain closed and secure during travel.

have a functioning speedometer indicating speed in miles per hour and a functioning odometer correctly indicating distance in tenths of a mile.

be equipped with operational air conditioning heating systems. If the air conditioning system becomes inoperable during a day when the elevated temperature is forecast to reach 79 degrees or more, the vehicle shall be immediately pulled from service at the termination of the current trip and will not again be used for service under this contract until the air conditioning system has been repaired.

have unobstructed vision on all sides.

be equipped with a communication system where contact with the vehicle can be made during all hours of operation. Beepers are not an acceptable substitute.

not have leaks of any kind.

have operable seat belts on all seats.

have a fully charged, certified and non-expired fire extinguisher.

Maintain securement devices to secure Ambulance stretcher gurney beneficiaries.

have a backup for all lift capacity. The lift shall incorporate an emergency method of deploying, lowering to ground level with a lift occupant, and raising and stowing the empty lift if the power to the lift fails.

have a fixed seat position or a fixed secured floor or sidewall stretcher gurney lock must be approved for each ambulatory or stretcher gurney restricted passenger being transported, according to the passenger’s needs.

Be equipped to contain biohazard bodily fluids, secretions, and disposable containments, and provide decontamination to vehicles as needed.

The contractor must identify vehicles to be used exclusively for VA contract work. Identified vehicles must be available for inspection and approval by the VA. The VA and the Contractor will work together to schedule the inspection at the post-award conference. must have vehicles ready for work at the time of award. Additional vehicles may be used for work only after the vehicle(s) has been inspected and approved by the VA.

All 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. The Contracting officer or the COR may authorize substitution of vehicles during work in emergency situations without prior inspection as authorized. The Transportation Provider must establish, maintain, and provide to the CO or COR within three days of request, or as otherwise required by the contract, the following records and related information:

Manufacture and model Model year Vehicle Identification Number Odometer reading at the time the vehicle enters service under this contract Type of vehicle (minibus, wheelchair van, stretcher van etc.)

Capacity (number of passengers) License Tag number Certificate of Insurance (see FAR Clause 52.228-10) Copy of Vehicle Registration Special Equipment Compliance with all applicable Federal, State and local laws and Department of Highway Safety & Motor Vehicles for Non-Emergent Transport.

All Vehicles must be equipped with GPS systems which have the following capabilities: Line Mapping – step by step directions.

Have functioning mechanisms which ensure all access doors are capable of being opened from the inside; and during travel, remain closed and secure.

Have a functioning speedometer indicating speed in miles per hour and a functioning odometer correctly indicating distance in tenths of a mile.

Be equipped with operational air conditioning and heating systems.

Have exterior free of grime, oil or other substances, free from rust, cracks, breaks, dents and damaged paint that noticeably detract from the overall appearance of the vehicle.

Be equipped with hubcaps or wheel covers.

Have all body molding in place, or if removed, holes must be filled and painted.

Have a passenger compartment free of dirt, torn upholstery or floor coverings, damaged or broken seats, protruding sharp edges, and vermin or insects.

Have an unobstructed vision on all sides.

Be equipped with an operable two-way radio and/or cellular telephone communication system, which affords contact with the vehicle(s) during all hours of operation. Beepers are not considered an acceptable substitute. If using a two- way radio, a base station for a scheduler must be provided at the VA.

Meet all safety and mechanical standards established by Local, State and Federal statutes and regulations.

Have windows and doors, which can be opened and closed in accordance with manufacturer standards.

Not have leaks of any kind.

Be equipped with a functioning horn.

Have operable seat belts on all seats.

Have fully charged, certified and non-expired fire extinguisher.

Wheelchair vehicles must have wheelchair tie down straps and effective securement devices to secure both wheelchair and wheelchair customers.

In addition to wheelchairs, vehicles must have the ability to transport VA patients with three-wheeled electric carts, medic chairs, bariatric stretchers and other approved transport devices.

Transport vehicles must have approved restraining devices that allow the patient to ride on three-wheeled carts, wheelchairs, medic chairs, stretchers, and other approved transport devices while in transport or describe alternate means to transport and accommodate the patient and their transport device.

Transportation Provider’s Fleet will demonstrate an ability to restrain patients and all associated equipment traveling with the patients.

Have a backup lift for all capacity to include Bariatric Patients. The lift must incorporate an emergency method of deploying, lowering to ground level with a lift occupant, and raising and stowing the empty lift, if the power to the lift fails.

A fixed seat position or a fixed secured floor or sidewall wheelchair lock must be approved for each ambulatory or wheelchair restricted passenger being transported, according to the passenger’s needs.

Contractor must have an adequate number of vehicles to meet the requirements of this contract. Contractor must have a minimum of eight (8) Ambulances.

Every ambulance operated is required to be staffed with the required number of trained personnel in accordance with the requirements listed in section 420-2-1-.19 Provider Service Staffing at the link below:

http://www.alabamaadministrativecode.state.al.us/docs/hlth/420-2-1.pdf Nonemergency/Ambulette transport vehicle must be staffed by at least one person, who meet the requirements of state and local laws where the services are being furnished Must have successfully completed and be certified in standard and advanced first aid courses including use of cardiopulmonary resuscitation techniques (CPR) at a minimum and Be legally authorized to operate all equipment on board the vehicles.

Advanced Life Support (ALS) vehicles must be staffed by at least two people, who meet the requirements of state and local laws where the services are being furnished and where at least one of whom must:

Be legally authorized to operate all lifesaving and life-sustaining equipment on board the vehicles Be certified as an EMT-Intermediate or an EMT-Paramedic by the state or local authority where the services are being furnished to perform one or more ALS services.

All vehicles must be smoke free and have “No Smoking” signage posted.

The contractor must notify the contracting officer of any vehicle and equipment added/changed/deleted after award of contract.

The VA reserves the right to inspect the Transportation Provider’s equipment and vehicles or require documentation of compliance with stated specifications, State laws, policies, regulations, and guidelines governing medical transport vehicles, during performance of any awarded contract. VA inspections of contractor equipment will not constitute a warranty that the contractor's vehicles and equipment are properly maintained. The VA reserves the right to restrict the use of equipment and vehicles, which are not in compliance with stated requirements.