P09 LOU SMT PWS FINAL 01.21.2022.docx

Performance Work Statement Robley Rex Veterans Affairs Medical Center (VAMC) Non-Emergent Wheelchair Van Transportation Services

1. DESCRIPTION OF SERVICES: The contractor agrees to furnish 24-hour, seven days per week, non-emergent transportation service for wheelchair bound inpatient and outpatient beneficiaries of the Robley Rex VAMC and its Community Based Outpatient Clinics (CBOC’s), and Robley Rex VAMC catchment area (see attachment 1), to include weekends and federal holidays. Services will include all vehicles, personnel, management, supplies, transportation, insurance, equipment and reports necessary to provide ground transportation services for beneficiaries of the Robley Rex VAMC and its CBOC’s. The contractor shall meet all requests for transports.

2. FEDERAL HOLIDAYS:

(And any other Federal Holiday as determined by the President).

3. COMMINITY BASED OUTPATIENT CLINICS (CBOC): Facility locations:

A. Service needs shall be for the following designated facilities:

· Robley Rex VAMC, 800 Zorn Avenue, Louisville, KY;

· New Albany CBOC, 811 Northgate Boulevard, New Albany, IN 47150;

· Stonybrook CBOC, 9208 Taylorsville Rd, Louisville, KY 40299;

· Shively CBOC, 3934 North Dixie Highway, Louisville, KY 40216;

· Newburg CBOC, 3430 Newburg Road, Louisville, KY 40218.

· Ireland Army (LACH) CBOC, 851 Ireland Avenue, Fort Knox, KY 40121;

· Grayson County CBOC, 619 West Main Street, Clarkson, KY 42726;

· Carroll County CBOC, 1901 Highway 227, Carrollton, KY, 41008;

· Scott County CBOC, 279 North Gardner Street, Scottsburg, IN, 47170.

B. Mileage shall be based on the latest edition of “Bing” available online for driving directions; deviations from the mapping system require prior written request, before trip transport, from the Contracting Officer’s Representative (COR). The VAMC reserves the right to deny deviations from the stated mapping system. The Bing online Driving Directions (fastest route) shall be used to calculate the mileage. If the online directions do not go all the way to the patient’s address, VAMC shall consider the actual mileage within a 5–7-mile difference. No other mapping system is authorized.

4. LOCAL MILEAGE LIMITS & RATE: Payment for mileage traveled beyond -30- mile local mileage limit (LML) of the point of pick-up (loaded run) is subject to the terms of this contract. The LML for the purpose of this contract is defined as mileage from 0-30 mile radius in any direction from the origin of the Robley Rex VA Medical Center, located at 800 Zorn Avenue, Louisville, KY; or when transportation involves one of the Robley Rex VAMC CBOC’s as the pick-up or destination point. The Contractor shall ensure that the pickups and drop-offs are scheduled so that the total distance traveled shall result in the most economical cost to the government.

5. NUMBER OF PATIENTS: The contractor agrees that only one patient and possibly one attendant shall be transported on a trip unless specifically authorized by the COR for each authorized transportation request.

6. COMPANIONS & LUGGAGE: The following items may accompany the patient at no extra expense:

A. One companion; age 18 or older, contractor may ask for identification if applicable.

B. At times an authorized official of the Department of Veterans Affairs Medical Center may, in the interest of the patient, allow a relative to accompany him/her at no extra charge to the VAMC.

C. Three pieces of luggage

D. One wheelchair (manual or electric) or scooter.

E. A (personal care) attendant is a person employed to assist, guide, or provide a service for our veterans to and from clinics. The attendant shall be responsible for ensuring the veteran is safely transported to and from the vehicle and as well as to and from the clinic. At no time shall patients be left unattended.

7. VEHICLES:

A. All vehicles used to transport patients in wheelchairs must be equipped with a wheelchair lift that is in compliance with Americans with Disabilities Act (ADA) compliance (49 CFR § 38) requirements and specifications. The vehicle(s) must also have a wheelchair lockdown system, an appropriate doorway clearance (for standard wheelchair, bariatric wheelchair (up to 30 inches in width), and electric wheelchair and scooters), a raised roof on all vans transporting wheelchair patients. All passenger locations in all vehicles transporting VAMC patients shall have both lap and shoulder restraint systems. If transporting veterans in electric mobility carts, the cart should be secured the same as a wheelchair and the patient should be seated in a seat and properly secured. Vehicles shall be a smoke-free environment.

B. The Contractor shall provide the VAMC with an initial inspection report of all vehicles to be utilized in the performance of this contract prior to contract award and at the beginning of the contract period for each option year. Any vehicle that does not meet the requirements of this contract cannot be utilized in the performance of this contract. Any vehicle that has not been inspected at the beginning of the contract period and is anticipated to be utilized, the contractor shall provide an individual inspection report prior to utilization.

C. All vehicles provided under this contract shall be licensed and meet those requirements mandated by the Kentucky/Indiana Departments of Health and Transportation, local requirements, and all federal standards in effect at the time the contract is awarded.

D. If any equipment is added after inspection, subsequent to award of contract, it shall be inspected and approved by the designated COR before being place into use under this contract.

E. Vehicle maintenance, equipment inspections and operational status reports shall be performed, recorded and as necessary after the initial inspection. Quarterly the contractor shall provide the provide Maintenance and Vehicle Operational Status report to the COR on all vehicles utilized on this contract.

F. The VAMC will be the sole judge of determining when to order service from another source. The Contractor is required to furnish a minimum of 5 vehicles at any given time to meet the terms and condition of transport. This requirement is not to be construed as a limitation upon the number of vehicles, which may be needed, nor as restriction on the number of additional vehicles may the Contractor wish to employ in the performance of this contract.

The VAMC reserves the right to refuse services from the contractor if any vehicle(s) does not meet this minimum specification. The VAMC will not incur any cost associated with the contractor providing inadequate or faulty equipment. All vehicles used in this contract shall:

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

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

iii. Be equipped with operational air conditioning/heating, systems. If the air conditioning system becomes inoperable or is unable to maintain temperatures between 68-79 degrees Fahrenheit in the patient compartment, the vehicle must be immediately pulled from service at the termination of the current trip and shall not be used again for service under this contract until the air conditioning/heating system has been repaired.

iv. Have exterior free of grime, oil, or other substances and free from cracks. Breaks, dents, and damaged paint that noticeably detracts from the overall appearance of the vehicle.

v. Be equipped with hubcaps or wheel covers and have all vehicle body molding in place, or if removed, holes must be filled and painted.

vi. Have passenger compartment that shall be clean of dirt and free from torn upholstery or floor coverings, damaged or broken seats, protruding sharp edges and vermin or insects.

vii. Have unobstructed vision on all sides.

viii. Be equipped with an operable two-way mobile radio and/or cellular telephone communication system, which affords contact with the vehicle during all hours of operation. Beepers are not an acceptable substitute.

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

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

xi. Not have leaks of any kind.

xii. Be equipped with a functioning horn.

xiii. Have operable seat belts on all seats and proper wheelchair restraints.

xiv. Have fully charged. Certified and non-expired fire extinguisher.

xv. The contractor shall provide the COR with a list of all vehicles to provide services under this contract, including vehicle identification numbers. An updated list shall be provided to the VAMC COR on a quarterly basis.

xvi. Violations to the above stipulations shall result in payment for services rendered to be withheld the VAMC until an updated list is provided. All vehicles shall be made available for inspection at any time when ordered by the COR at the VAMC's discretion. Any vehicle found not in conformity with the above standards or any vehicle receiving two or more complaints within a five-day period concerning cleanliness or other deficiencies shall be removed from service immediately until subsequent inspections verify correction of deficiencies. The VAMC reserves the right to order the immediate removal from service any vehicle not in compliance with any vehicle standards referenced herein. Failure to comply with this requirement may be cause for disallowance of compensation for services rendered in the violating vehicle.

xvii. Contractors may be required to present proof of repairs and preventative maintenance at the request of the VAMC for vehicles to be used in the performance of this contract.

xviii. Servicing of vehicles shall not be an excuse for not performing contracted services. Vehicles shall be maintained by regular maintenance. The vehicle shall be clean (interior and exterior), cooling and heating systems working properly, worn tires should be replaced, and noticeable noises should be checked, and repairs performed if necessary. Maintenance and quality control records should be available upon request Manufacturer's instructions are followed regarding use of vehicle and all installed adaptive equipment, wheelchair locks, etc.

8. SERVICE ORDERS /PENALTIES:

A. Requests for service shall be made in writing or by telephone from a designated VAMC travel staff or the Administrative Officer of the Day (AOD). Private agencies, i.e., nursing homes, and CBOC’s are not considered authorized personnel. The Contractor shall not alter determination of the mode of travel. A list of all authorized personnel shall be forwarded to the contractor upon award of the contract.

B. Trip logs shall be faxed daily between 8:00 am but not later than 3:00 pm eastern standard time, for scheduled travel the next day. Requests for add on services after 2:00 pm will be forwarded to the contractor by 8:00 am the next day. Add on services are defined as requests for pick-up and drop off of patients with one (1) hour or less notification to the contractor to take a patient to a designated clinic such as VAMC discharges (Emergency Room and Inpatient), Radiation Therapy, CBOC’s, contract nursing homes or the main VAMC. The VAMC will make efforts to minimize add-ons as much as possible however, the contractor is required to specify when the add on pick up’s and drop off at destination shall occur. Add on requests are paid at the contracted rate.

C. Patients are not authorized to call the contractor and arrange their own non- emergent wheelchair transportation and bill to VAMC.

D. Drivers shall report to the travel desk, AOD, or appropriate personnel to identify the area where patients are to be delivered and picked-up.

E. Penalties for late pick-ups beyond fifteen minutes of scheduled pick-up time shall be reduced by 50% of the trip charge.

F. The Contractor shall ensure a wheelchair is available for use, however, if a VAMC wheelchair is furnished, the Contractor shall ensure the return of the VAMC wheelchair to the Travel Clerk or AOD no later than the next business day.

G. Patients shall not be left unattended at any time. Drivers are expected to remain with the patient during any paid waiting times. Patients are not allowed to remove themselves from their wheelchair at any time prior to and during transportation.

H. The VAMC reserves the right to cancel, change or substitute any patient pick-up.

I. The VAMC reserves the right to cancel any patient pick-up due to late response time after the specified or latest pick-up time ordered. VAMC may either reschedule the pick-up for another time or employ the services of another source, contracted or non-contracted, for same day service. Contractor shall be responsible for all additional costs incurred by the VAMC if another source is utilized.

9. CANCELED CALLS & NON PICK-UP: Any call dispatched which has arrived at destination and is canceled by the patient upon arrival shall be billed to the VAMC as a one-way trip. Both, the VAMC and the Contractor shall document canceled calls. When a non-pick-up occurs, the VAMC must be notified so that proper authorization for billing can be given. If the beneficiary travel office receives a clinic cancelation notice for a scheduled pick-up the contractor shall be notified within 30 minutes of the (cancelled) appointment time.

10. WAITING TIME: Waiting time shall not begin until 15 minutes after the designated pick-up time. However, if the contractor’s driver arrives earlier than the specified time, it is not considered waiting time for the purposes of payment. For the time lost in waiting at either or both ends of a trip due to causes beyond his/her control, the Contractor shall be reimbursed at the schedule line item price for wait time increments.

If the pick-up is at other than the VAMC the Contractor must call the Travel Office or AOD on duty as soon as he/she anticipates that a delay may develop for whom he/she expects to claim reimbursement. Prior authorization for waiting time charges must be obtained. The contractor shall furnish written documentation to substantiate the delay. This call is only for the purpose of verifying his/her arrival time at the pick-up point and is not necessary if the Contractor anticipates no delay for which he/she shall be reimbursed.

11. RECORD KEEPING:

A. Robley Rex VAMC Beneficiary Office will provide a list of designated dispatchers on a quarterly basis who shall transmit the logs and receive confirmation by the contractor.

B. Trip logs are to be maintained listing the following: Contractor name, mode of transport, wait time if authorized, patient name, last four of patient’s SSN, date of transport, time of pick-up, pick-up point, destination point, time patient dropped off, number of miles traveled, and cost of transportation.

C. The contractor and beneficiary travel staff shall reconcile daily logs at the end of each business day and/or no later than noon of the following business day.

D. Trip logs are to be submitted bi-weekly with each invoice. A log shall be maintained in the Travel Office and/or designated area.

E. Robley Rex VAMC shall submit a finalized trip log bi-weekly to the contractor to affirm the bi-weekly number of trips from the previous two weeks.

F. Discrepancies in trip logs submitted by the Contractor to the VAMC Travel Office shall possibly delay payment of invoices and no interest shall be paid due to contractor discrepancies.

G. Contractor shall utilize Vetride. Trips, rides and completed rides shall be recorded in Vetride, https://www.vetride.va.gov/app/home the Veteran's Transportation Service (VTS) scheduling portal.

12. INVOICING/PAYMENTS:

A. The Contractor will be paid bi-monthly in arrears upon submission of invoice for all services performed during the previous month. Per Prompt Payment Act, the VAMC has 30 days to process and pay charges invoiced from the date of receipt.

B. All invoices shall include the contract number, purchase order number, date of services, patient, pickup and delivery points, and an itemized listing of charges or services rendered in accordance with this contract.

C. Payment shall not be made for unauthorized pickups and missed pickups by the Contractor.

D. Missed Pickups shall be documented in performance reports.

E. When the VAMC has confirmation from the contractor on a pickup but fails to pick up the patient, he/she shall be charged for the VAMC locating alternate transportation.

F. Invoices shall be submitted to the Austin Finance Center no later than fourteen (14) calendar days following services furnished for the preceding month. The VAMC will review and reconcile invoices with trip logs. Unauthorized charges shall be suspended pending investigation.

G. Unauthorized charges are those that are being disputed or have not been pre-approved by authorized VAMC personnel, and that are not allowable under the contract. The Contracting Officer (CO) will make the final determination within 30-days, after notifying the contractor of charges being suspended.

H. Add on requests are paid at the contracted rate.

13. TOLL CHARGE:

A. It is agreed and understood that the trip price in the schedule includes any ferry, bridge, tunnel, or road toll charges.

B. If the Contractor’s place of business is located beyond the local telephone call zone of the VAMC, the Contractor agrees to accept telephone orders for service and shall provide a toll-free telephone number.

14. EVIDENCE OF INSURANCE COVERAGE: Before award of contract the Contractor shall furnish to the CO a certificate of insurance which shall contain an endorsement to the effect that cancellation of or any material change in the policies which adversely affect the interest of the VAMC in such insurance shall not be effective unless 30 days written notice of cancellation or change is furnished to the CO.

A. ACCIDENTS/EMERGENCIES:

i. In the event of an obvious or suspected injury to the patient or his/her companion, the driver shall call 911, if available, or contact emergency medical services. Care and transport shall be in accordance with area Emergency Response policy.

ii. In any event of accident, the VAMC should be contacted as soon as possible giving the name of patient/s and/or companions, patients SSN, and an account of what happened and to what hospital, if any, VAMC beneficiaries are being transported. A copy of the accident report shall be forwarded to Department of Veterans Affairs, 800 Zorn Avenue, Louisville Kentucky, 40206 within 24 hours of the accident. The Contractor shall be responsible for any traffic and parking violation and fines.

B. SAFETY REQUIREMENT: In the performance of this contract, the Contractor shall take necessary safety precautions as the Contracting Officer, or his/her designees may determine to be reasonably necessary to protect the lives and health of the occupants of the vehicles.

15. PROBLEM RESOLUTION: Contractor shall specify the key personnel that will be contacted for problem resolution in regard to this contract. Please provide name and telephone number of this person to the Contracting Office and the COR. Patient complaints will be investigated by the VAMC and the Contractor. Contractor shall provide written documentation to the VA resolving the complaint within 24 hours. Any substantiated complaint of patient abuse or neglect shall be grounds for corrective action.

16. PATIENT WELFARE & ABUSE:

A. The Contractor shall be held responsible for the patient welfare during transport. The Contractor shall be held responsible for patient and/or VAMC property during transport. Any damaged or lost wheelchair, walkers, crutches, or personal belongings shall be replaced at the Contractor’s expense.

B. The VAMC requires the Contractor to exercise extreme caution and care in the handling of patients. Any abuse of patients shall result in corrective action.

17. DRIVERS & ATTENDANTS:

A. A record of each employee as to character and physical capabilities of performing the duties of driver and attendant must be maintained and made available for inspection upon request. The CO will be notified, in writing, of any new personnel added after the award of and during the performance of this contract. Failure to furnish such notification may result in corrective action.

B. VA Security procedures require background checks of all contracted personnel who may have access to patient information. All background checks must have a satisfactory adjudication. Any unsatisfactory adjudications will require the immediate removal of the designated personnel. Failure to comply with the results of the security background results may be cause for corrective action.

C. The Contractor shall escort patients to and from pick up and drop off locations.

18. TRAINING:

A. Contractor shall be responsible for supervising the daily services provided under this contract; and shall provide orientation and training programs for all employees regarding safety, equipment management, and patient confidentiality appropriate to the service. Contractor shall provide documentation of training on a quarterly basis to the COR.

B. The contracted agency shall have written policies and procedures regarding personnel credentials.

C. The Contractor and all of the Contractor’s employees shall be required to sign a Department of Veteran Affairs’ confidentiality statement and it is the responsibility of the Contractor to assure these statements are completed on an annual basis.

D. The Contractor is required to take population specific training provided by the VAMC on an annual basis.

E. The Contractor shall provide orientation to designated personnel regarding VAMC policy and procedures, and any VAMC processes necessary for cooperative functioning between the contractor and VAMC. Up-dates and refreshers shall be provided upon request and when policy, procedures, or processes change.

F. DRIVER REQUIREMENTS: Drivers shall be trained in the following areas:

i. Defensive driving/proper vehicle operation ensuring safety.

ii. Drivers of vehicles are required to observe speed limits.

iii. Driver must be First aid and CPR certified.

iv. Universal Precautions training (location and availability of protective gear, availability of hepatitis injections, etc.)

v. Driver responsibilities (i.e., keeping logs of patient’s transported)

vi. Customer Service training

vii. Use of seat belts and all adaptive equipment in vehicles in accordance with manufacturer’s instructions

viii. Non-use of drugs and alcohol; maintaining a non-smoking environment in the vehicle

ix. Proper lifting techniques

x. Confidentiality of patient, in accordance with the Privacy Act of 1974.

xi. Licensure review annually.

xii. Drivers must report any/all moving violations immediately.

xiii. At no time shall patients be subjected to loud music of any kind.

19. SUBCONTRACTORS: Any subcontractors being utilized in the performance of this contract shall meet all the requirements stated herein.

20. CHANGES: The services specified in this contract may be changed only by written modification to the contract by the CO.

21. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 (HIPAA): In accordance with 45 CFR § 164.502 - Uses and disclosures of protected health information: General rules; this regulation policy requires a Business Associate Agreement in order for a Covered Entity to disclose Protected Health Information to a health care provider. A covered entity may disclose protected health information to a business associate and may allow a business associate to create, receive, maintain, or transmit protected health information on its behalf, if the covered entity obtains satisfactory assurance that the business associate will appropriately safeguard the information. A covered entity is not required to obtain such satisfactory assurances from a business associate that is a subcontractor. Based on this regulation a Business Associate Agreement is a requirement of this contract and included as an attachment to this document.

22. REQUIRED LANGUAGE: The solicitation and subsequent contact include FAR 52.222-41, Service Contract Labor Standards (SCLS). The Offeror and resultant contract awardee, by signing the offer and contract, is acknowledging they have reviewed the clause and will fully comply throughout the contract period. It is the responsibility of the Contractor to determine and pay the appropriate prevailing wage rate and fringe benefits for the location. The Government will not be held responsible for any mistakes in applying the SCLS.

VA reminds contractors of the Department of Labor Regulations which implement the SCLS and which read at 29 CFR § 4.115:

Employee coverage does not depend on form of employment contract. The Act, in section 8(b), makes it plain that the coverage of service employees depends on whether their work for the contractor or subcontractor on a covered contract is that of a service employee as defined in section 8(b) and not on any contractual relationship that may be alleged to exist between the contractor or subcontractor and such persons. In other words, any person, except those discussed in §4.156 below, who performs work called for by a contract or that portion of a contract subject to the Act is, per se, a service employee. Thus, for example, a person's status as an “owner-operator” or an “independent contractor” is immaterial in determining coverage under the Act and all such persons performing the work of service employees must be compensated in accordance with the Act's requirements.

References:

7.A. 49 CFR § 38 https://www.ecfr.gov/current/title-49/subtitle-A/part-38

21. 45 CFR § 164.502

https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164/subpart-E/section-164.502

29 CFR § 4.115

https://www.ecfr.gov/current/title-29/subtitle-A/part-4/subpart-C/subject-group-ECFR5ddb10756d41b73/section-4.115

Attachment: P10 VHA Local BAA LOU WC TRANS SVC April 2021.doc