36C25018Q0283-002.docx

36C25018Q0283

PAGE 1 OF

1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

DUNS:

DUNS+4:

PHONE:

FAX:

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

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA

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

ARE

ARE NOT ATTACHED.

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

ARE

ARE NOT ATTACHED

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

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DATED ________________________________. YOUR OFFER ON SOLICITATION

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

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

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

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

AUTHORIZED FOR LOCAL REPRODUCTION

(REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

655-18-3-921-0028 36C25018Q0283 02-12-2018 Kelly Poole 734-222-6177 03-23-2018 15:00 Department of Veterans Affairs Ann Arbor Healthcare System Network Contracting Office 10 2215 Fuller Road Ann Arbor

MI

48105 x 621910 $15 Million X N/A X Department of Veterans Affairs Aleda E. Lutz VA Medical Center 1500 Weiss Street Saginaw

MI

48602 Y Department of Veterans Affair Ann Arbor Healthcare System Network Contracting Office 10 2215 Fuller Road Ann Arbor

MI

48105

Department of Veterans Affairs Financial Management System PO Box 149971 Austin

TX

78714-9971 877-353-9791 512-460-5540 See CONTINUATION Page The contractor shall provide 24 hour ambulance services for beneficiaries of the Aleda E. Lutz VA Medical Center, in accordance with the Statement of Work, clauses, and provisions contained herein.

This procurement will be conducted under the governing policies of FAR 13.5 Simplified Procedures for Certain Commercial Items.

See CONTINUATION Page X Kelly Poole Contracting Officer Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

(Continuation from Standard Form 1449, block 18A.)

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

a. CONTRACTOR: Name: ________________________

Address: _______________________

City, State, Zip: _________________

Telephone Number: ______________

Fax Number: ___________________

DUNS: ________________________

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

[X] 52.232-33, Payment by Electronic Funds Transfer - System for Award Management, or

[NA] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly [NA]

b. Semi-Annually [NA]

c. Other [X] Monthly in Arrears

4. GOVERNMENT INVOICE ADDRESS: All invoices from the contractor shall be submitted via www.OB10.com to the following address:

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

AMENDMENT NO DATE

B.2 REVIEW REQUIRED REGISTRATION WITH CONTRACTOR PERFORMANCE ASSESSMENT SYSTEM (CPARS)

(a) As prescribed in Federal Acquisition Regulation (FAR) Part 42.15, the Department of Veterans Affairs (VA) evaluates contractor past performance on all contracts that exceed $150,000, and shares those evaluations with other Federal Government contract specialists and procurement officials. The FAR requires that the contractor be provided an opportunity to comment on past performance evaluations prior to each report closing. To fulfill this requirement VA uses an online database, CPARS, which is maintained by the Naval Seal Logistics Center in Portsmouth, Virginia. CPARS has connectivity with the Past Performance Information Retrieval System (PPIRS) database, which is available to all Federal agencies. PPIRS is the system used to collect and retrieve performance assessment reports used in source selection determinations and completed CPARS report cards transferred to PPIRS. CPARS also includes access to the federal awardee performance and integrity information system (FAPIIS). FAPIIS is a web-enabled application accessed via CPARS for contractor responsibility determination information.

(b) Each contractor whose contract award is estimated to exceed $150,000 is required to register with CPARS database at the following web address: www.cpars.csd.disa.mil. Help in registering can be obtained by contacting Customer Support Desk @ DSN: 684-1690 or COMM: 207-438-1690. Registration should occur no later than thirty days after contract award, and must be kept current should there be any change to the contractor's registered representative.

(c) For contracts with a period of one year or less, the contracting officer will perform a single evaluation when the contract is complete. For contracts exceeding one year, the contracting officer will evaluate the contractor's performance annually. Interim reports will be filed each year until the last year of the contract, when the final report will be completed. The report shall be assigned in CPARS to the contractor's designated representative for comment. The contractor representative will have sixty days to submit any comments and re-assign the report to the VA contracting officer.

(d) Failure to have a current registration in the CPARS database, or to re-assign the report to the VA contracting officer within those sixty days, will result in the Government's evaluation being placed on file in the database with a statement that the contractor failed to respond.

B.1 LIMITATIONS ON SUBCONTRACTING-- MONITORING AND COMPLIANCE (JUN 2011)

This solicitation includes FAR 52.219-4 Notice of Price Evaluation Preference for HubZone Small Business Concerns. Accordingly, any contract resulting from this solicitation will include this clause. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) retained by VA to assist in assessing the contractor's compliance with the limitations on subcontracting or percentage of work performance requirements specified in the clause. To that end, the support contractor(s) may require access to contractor's offices where the contractor's business records or other proprietary data are retained and to review such business records regarding the contractor's compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor's compliance with the limitations on subcontracting or percentage of work performance requirement.

B.2 SUBCONTRACTING COMMITMENTS--MONITORING AND COMPLIANCE (JUN 2011)

This solicitation includes VAAR 852.215-70, Service-Disabled Veteran-Owned and Veteran-Owned Small Business Evaluation Factors, and VAAR 852.215-71, Evaluation Factor Commitments. Accordingly, any contract resulting from this solicitation will include these clauses. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) to assist in assessing contractor compliance with the subcontracting commitments incorporated into the contract. To that end, the support contractor(s) may require access to the contractor's business records or other proprietary data to review such business records regarding contract compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor compliance with the subcontracting commitments.

B.3 PRICE SCHEDULE

The Contractor shall provide Basic Life Support (BLS) Ambulance Service and Advanced Cardiovascular Life Support (ACLS) Ambulance Service, as specified herein, for eligible beneficiaries of the Department of Veterans Affairs, Aleda E. Lutz Medical Center (VA), 1500 Weiss Street, Saginaw, Michigan, 48602. Services shall be provided on a twenty-four hour per day, seven day per week basis for the period of June 1, 2018 – May 31, 2023.

Guaranteed Minimum: Overall contract guaranteed minimum is in the amount of $50,000.00 for the life of the contract.

Contract Maximum: Overall contract maximum is in the amount of $xxxxx for the life of the contract.

Ordering Period I: June 1, 2018 – May 31, 2019 Description of Service

Est.

Qty

Total: $___________

Ordering Period II: June 1, 2019 – May 31, 2020 Description of Service

Est.

Total: $___________

Ordering Period III: June 1, 2020 – May 31, 2021 Description of Service

Est.

Total: $___________ Ordering Period IV: June 1, 2021 – May 31, 2022 Description of Service

Est.

Total: $___________

Ordering Period V: June 1, 2022 – May 31, 2023 Description of Service

Est.

Total: $___________

Grand Total: Ordering Periods I, II, III, IV, and V: $_________

B.3 STATEMENT OF WORK

The Contractor shall provide Basic Life Support (BLS) Ambulance Service and Advanced Cardiovascular Life Support (ACLS) Ambulance Service, as specified herein, for eligible beneficiaries of the Department of Veterans Affairs, Aleda E. Lutz Medical Center (VA), 1500 Weiss Street, Saginaw, Michigan, 48602. Services shall be provided on a twenty-four hour per day, seven day per week basis for the ordering period of June 1, 2018 – May 31, 2023.

The Contractor shall perform required services in accordance with the standards of the Commission on Accreditation of Ambulance Services (CAAS) http://www.caas.org, and established principles and ethics of the medical profession.

The contractor shall transact all business, there under, with the Contracting Officer (CO) and/or the Contracting Officer’s Representative (COR) or his/her designee, and in no case shall deal directly with or solicit from beneficiaries of VA.

CONTRACT DEFINITIONS/ACRONYMS

1. Advanced Cardiovascular Life Support (ACLS) – ACLS shall be provided by ambulance vehicles containing, at a minimum, two on-board attendants and shall be staffed in accordance with current Michigan State laws and regulations governing the certification and licensure of private ambulances. This ambulance, at a minimum shall be staffed with a Paramedic, and either a Paramedic or Certified Emergency Medical Technician. Ambulance services shall also include cardiac monitoring, Advanced Cardiovascular Life Support (ACLS) drugs and procedures, advanced airway management and medication monitoring and administration.

2. Basic Life Support (BLS) – BLS is defined as services required for non-critical patient care in which a patient requires an ambulance, staffed in accordance with current Michigan State laws and regulations governing the certification and licensure of private ambulances. This ambulance, at a minimum, shall be staffed with two Emergency Medical Technicians (EMT), and be capable of providing basic airway management.

3. Beneficiary – Veterans and other members determined to be eligible for benefits by the VA.

4. Contracting Officer (CO) – VA official with the authority to enter into, administer, and/or terminate contracts, make related determinations and findings, and who is a member of the vehicle inspection team.

5. Contracting Officer’s Representative (COR) – VA official responsible for providing contract oversight and technical guidance to the Contracting Officer. Responsibilities include certification of invoices, placing orders for service, providing technical guidance, overseeing technical aspects of the contract, and serving as a member of the vehicle inspection team. All administrative functions remain with the Contracting Officer.

6. Contractor – The term “Contractor” used herein refers to both the prime Contractor and his employees, and any subcontractors and their employees. The Contractor shall be responsible for assuring that all subcontractors comply with the provisions of this contract.

7. Emergency Medical Care Vehicle-Vehicle outfitted out with all personnel, supplies and equipment necessary to furnish BLS or ACLS emergency care to the patient during transport

8. Gender - For the purpose of equal rights wherever the masculine gender is used in this solicitation, and the resulting contract, it shall be considered to include both masculine and feminine gender.

9. Joint Commission (formerly known as JCAHO) – A national organization dedicated to improving the care, safety and treatment of patients in a health care facility and environment.

10. Lie-Down Transportation-Transportation of a veteran when it is not anticipated that the patient will require any emergency treatment, but rather safe and secure non-emergent, non-ambulatory transportation.

11. Mileage Rate – Mileage rate for ambulance services is the rate paid for each mile traveled beyond the city limits of Saginaw. This rate applies to one-way transportation only.

12. Rates – Rates are defined as the rate paid for one-way transportation from a designated pick-up point to a designated delivery point. For every trip traveled outside the city limits, Contractor shall be reimbursed at a fixed rate plus an amount for any mileage traveled outside of the city limits. This rate shall be paid for all authorized one-way trips ordered under this contract action, with employees receiving, at a minimum, the Department of Labor Service Contract Act wage rates (included herein), during all phases of the trip made on behalf of the Government. Attached Service Contract Act wage rate determinations shall be updated each option year when/if new revisions are issued.

13. Service Hours/Days – Service shall be provided on a twenty-four hour per day, seven day per week basis

14. Sensitive Information- VA sensitive information is all Department data, on any storage media or in any form or format, which requires protection due to the risk of harm that could result from inadvertent or deliberate disclosure, alteration, or destruction of the information. The term includes information whose improper use or disclosure could adversely affect the ability of an agency to accomplish its mission, proprietary information, records about individuals requiring protection under various confidentiality provisions such as the Privacy Act and the HIPAA Privacy rule, and information that can be withheld under the Freedom of Information Act. Examples of VA sensitive information include the following: individually-identifiable medical, benefits, and personnel information; financial, budgetary, research, quality assurance; confidential commercial, critical infrastructure, investigatory, and law enforcement information; information that is confidential and privileged in litigation such as information protected by the deliberative process privilege, attorney work-product privilege, and the attorney client privilege; and other information which, if released, could result in violation of law or harm or unfairness to any individual or group, or could adversely affect the national interest or the conduct of federal programs.

15. Trip – One way transportation from a designated pick-up point to a designated delivery point.

16. Universal Precautions- Universal Precautions is an approach to infection control. According to the concept of Universal Precautions, all human blood and certain human body fluids are treated as if known to be infectious for HIV, HBV, and other blood-borne pathogens.

17. Unscheduled Trip(s) – The term “Unscheduled Trip” as used in this contract refers to those trips required on an as-needed basis and advance notice is not given.

18. Vehicle(s) – The term “Vehicle(s)” as used in this contract refers to ambulance transportation provided under the requirements of this contract.

19. Waiting – Waiting as used in this contract is defined as the time required and verified by authorized medical facility personnel, for the Contractor to wait at designated pick-up and/or delivery points when performing contract services.

SCOPE: Provide Basic and Advanced Cardiovascular Life Support Ambulance Transportation Services for the Department of Veterans Affairs Aleda E. Lutz Medical Center (VA), Saginaw, Michigan for the period of January 16, 2018 – May 31, 2018.

BASIC LIFE SUPPORT (BLS) ambulances shall be staffed, at a minimum, with two EMTs. Ambulance shall be on-site within one (1) hour after Contractor receives a request for BLS ambulance. The contractor shall be required to provide a minimum of three BLS ambulances at any given time; however, additional ambulances requested shall be furnished, if available, and at the contract price.

ADVANCED CARDIOVASCULAR LIFE SUPPORT (ACLS) ambulance shall be staffed with two attendants. One shall be a Paramedic and the other shall be a Paramedic or Certified Emergency Medical Technicians (EMT) with controlling capabilities for Endotracheal Intubation, IV Therapy, Cardiac Monitoring, Defibrillation, and Drug Therapy. Ambulance shall be on-site within thirty (30) minutes after Contractor receives a request for ACLS ambulance. The contractor shall be required to provide a minimum of one ACLS ambulance at any given time; however, additional ambulances requested shall be furnished, if available, and at the contract price.

WAITING TIME: For time lost in waiting at either or both ends of a trip, due to causes beyond their control, the Contractor shall be reimbursed at the rate set forth in the Pricing Schedule, for each quarter hour in excess of the first quarter hour from the time the Contractor reports to the designated person. If the pick-up is other than at the VA, the contractor shall call the Travel Clerk, or Supervisor of Patient Administration Service (contact numbers to be provided at time of award). This call is only for the purpose of verifying arrival time at the pick-up point and is not necessary if the contractor anticipates no delay for which a claim for reimbursement shall be made. Waiting time includes an attendant remaining with the patient at all times.

RATES: Rates shall refer to transportation of only one patient per ambulance. Payment for mileage traveled beyond the city limits shall be limited to "one way only" (Mileage shall be reimbursed for one way only, regardless if patient(s) is transported round trip). Such mileage costs shall be paid in addition to the applicable rate per trip. Mileage shall not be paid for trips entirely within the city limits. Trip mileage shall be determined by the latest edition of the Rand McNally Standard Mileage Guide. For purposes of verifying mileage claimed on invoices, www.mapquest.com shall be utilized.

ORDERS: Requests for services shall be made by telephone and subsequently confirmed by Patient Administration Service. If the contractor fails to furnish the required services within the time frames established in paragraphs above, the VA reserves the right to obtain the service from another source and to charge the contractor with any excess cost which may result (applies to the required ambulances only, 3 BLS and 1 ACLS). The VA shall be the sole judge in determining when to order service from another source. Services shall be primarily to the Aleda E. Lutz VA Medical Center, 1500 Weiss Street, Saginaw, Michigan.

CITY LIMITS: The city limits, for the purpose of this contract, are defined as follows. A “city trip” shall be defined as one made within the boundaries of Buena Vista Town line on the east, Spaulding Township line on the south, Saginaw Township on the west, and Carrollton Zilwaukee lines on the north.

TOLL CHARGES: 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 Contractor invoices.

If the Contractor’s place of business is located beyond the local telephone call zone of the VA, the Contractor agrees to accept telephone orders for service on a collect basis. It is estimated that approximately sixty (60) orders will be placed by telephone per month.

VEHICLES: The ambulances under the terms of this contract shall be licensed and meet the minimum ambulance requirements, as mandated by the State of Michigan, and Federal Specifications KKK-A-1822F, found at http://www.ok.gov/health/documents/KKK-A-1822F%20%2007.01.2007.pdf.

The Contractor must have an adequate number of ambulances to meet the requirements of this contract, along with evidence of satisfactory ambulance inspection prior to use under this contract. Ambulances and equipment must be clean, orderly, and in excellent operating condition at all times. Records of maintenance/preventative maintenance must be made available for inspection upon request.

Subject specification applies to Emergency Medical Care Vehicles Only. Subject specifications are mandatory as minimal requirements for such vehicles, but chassis or compartment modifications are permissible when they clearly exceed the minimal specifications.

The basic emergency care vehicle contracted for shall be of the Type I, Type II, or Type III ambulance (See KKK-A-1822F).

If the contractor’s facility operates two Type I, Type II, or Type III model vehicles, and one is used for emergency services and the other for lie-down transportation, the equipment meeting the specifications for the emergency medical care vehicle can be transferred, when necessary, (i.e., when down for maintenance), to the lie-down transport vehicle, which then may operate as an ambulance, provided it otherwise meets the specifications of emergency.

All ambulances shall have restraints for securing wheelchairs. All ambulances shall be smoke free and have “No Smoking” signage posted.

AMBULANCE MEDICAL EQUIPMENT/SUPPLIES: Each emergency medical care ambulance shall have patient compartment facilities, oxygen, suction systems and equipment, and additional systems equipment, accessories and supplies (See KKK-A-1822F), as well as environmental climatic equipment, and communications equipment.

The Contractor shall provide Ambu-bag and/or respirator for respirator dependent patients who may or may not be prior intubated by tracheostomy or end tracheal tubes and/or respirator for respirator dependent patients which may or may not be prior intubated by tracheostomy or end tracheal tubes. Contractor shall choose respirator or Ambu-bag, as appropriate. However, for trips outside the Saginaw city limits, contractor is required to "bag" the patient.

The contractor shall provide blood transfusion monitoring if prior established and shall maintain in-place IV line with appropriate pressure of either a Swan Ganz catheter, Arterial line, or both.

The acuity of the patient with any of the above may require a VA provided RN or Physician to accompany the patient in transport from the Medical Center.

Contractor shall provide an ACLS certified Paramedic when requested. Paramedics or advanced Emergency Medical Technicians do not meet this requirement unless they have received an ACLS certification.

AUTHORIZED ATTENDANCE BY RELATIVE: An authorized official of the VA may, in the best interest of the beneficiary, allow a relative to accompany a patient at no cost to the VA.

GOVERNMENT OWNED EQUIPMENT/SUPPLIES: Any and all equipment and linens taken with patients from VA Medical Center must be returned to the Medical Center. The Contractor must provide its own linens and contractor linens shall not be exchanged with VA linens.

UNIVERSAL PRECAUTIONS: Universal Precautions shall be observed at all times during transport of, or waiting with, all VA patients.

INSPECTIONS: The contractor’s facility and all vehicles intended for use under this contract shall be inspected and approved by a VA Inspection Team prior to start of work under this contract. The contractor shall make every effort to coordinate availability of vehicles on the date mutually agreed upon for the inspection of the facility and vehicles. The contractor shall be notified in writing of deficiencies found during inspections. Failure to correct deficiencies within the time frame allowed by the Contracting Officer, or to comply with all Federal, State, and local Safety requirements as specified herein, may result in action to terminate the contract for cause.

THE JOINT COMMISSION COMPLIANCE STANDARDS: The Contractor shall continuously meet or exceed all standards of The Joint Commission (formerly known as JCAHO). All applicable VA policies and procedures shall be followed by the Contractor.

General: The patient population treated at the VA consists of veterans with varying physical, psychiatric, and psychological needs. Their conditions are, in many cases, directly related to the individual’s service to this country. Contract personnel shall provide compassionate care with respect for the special needs of the veteran population served, and show professional courtesy toward the VA support staff as an integrated part of the medical center’s mission, vision and values as stated below.

VHA Mission Statement: Honor America’s Veterans by providing exceptional health care that improves their health and well-being.

VHA Vision Statement: VHA will continue to be the benchmark of excellence and value in health care and benefits by providing exemplary services that are both patient-centered and evidence-based. This care will be delivered by engaged, collaborative teams in an integrated environment that supports learning, discovery and continuous improvement. It will emphasize prevention and population health and contribute to the Nation’s well-being through education, research and service in national emergencies.

Core Values:

· Integrity: Act with high moral principle. Adhere to the highest professional standards. Maintain the trust and confidence of all with whom I engage

· Commitment: Work diligently to serve Veterans and other beneficiaries. Be driven by an earnest belief in VA’s mission. Fulfill my individual responsibilities and organizational responsibilities

· Advocacy: Be truly Veteran-centric by identifying, fully considering, and appropriately advancing the interests of Veterans and other beneficiaries.

· Respect: Treat all those I serve and with whom I work with dignity and respect. Show respect to earn it.

· Excellence: Strive for the highest quality and continuous improvement. Be thoughtful and decisive in leadership, accountable for my actions, willing to admit mistakes, and rigorous in correcting them.

Patient Rights: The Contractor shall respect the patient’s beliefs, values and cultural influences. Protection of all patient rights is of highest priority. Patient privacy and confidentiality shall be maintained at all times. The medical record contains information about current Advance Directives, which shall be reviewed and honored by the Contractor. All required documentation shall be fully completed within VA-required timeframes. The Contractor patient care services provided shall be included in VA data collection activities related to patient compliments, complaints and satisfaction. All patient complaints which are unable to be resolved by the Contractor shall be referred to the Patient Representative. The contractor and patient care services provided shall be included in VA data collection activities related to patient compliments, complaints and satisfaction. The contractor shall fully complete all signed and informed consent documentation within VA-required timeframes for all invasive procedures, and any non-invasive procedure requiring patient consent. The Contractor shall abide by the VA Code of Ethics, which addresses marketing, admission, transfer, referral, discharge processes, and billing issues.

Care of Patients: Contract work shall consist of transportation of patients with varying medical needs. Medication control, security and safety shall be maintained at all times. Medications shall only be dispensed, prepared, and administered to patients by appropriately licensed and competent individuals. Verbal, written or electronic communication between any VA staff and contracted staff shall not be restricted by the Contractor. VA policies and procedures shall prescribe which information (i.e. Advance Directive, allergies, or treatment plan) is to be shared among care settings at time of admission, discharge, referral or transfer. No samples shall be accepted from vendors or given to patients. All care provided shall be based on assessed patient needs. Findings from assessment and reassessment shall be clearly documented in the medical record, which is used by all members of the interdisciplinary care team in care planning and treatment. All required documentation shall be fully completed within VA-required timeframes.

Patient Safety: Patient Safety shall be a primary focus of the Contractor. The Contractor shall comply with all National Patient Safety Goals found at http://www.jointcommission.org/PatientSafety/NationalPatientSafetyGoals . Every effort shall be made by the Contractor to prevent medication errors, falls and patient injury caused by acts of commission or omission in the delivery of care. The VA shall inform the Contractor of all applicable Sentinel Events or other patient Safety Alerts received by the VA. For every applicable alert, the Contractor shall take the necessary steps to redesign processes to prevent occurrences, and provide written feedback to the COR describing prevention actions taken. All events related to patient injury, medication error and other breeches of patient safety shall be documented utilizing the Contractor’s format, and reported to the COR. The Contractor shall maintain a safe environment at all times and follow all safety and emergency preparedness policies. Compliance with all safety management plans shall be continually demonstrated. The VA shall provide the Contractor with VA Sentinel Event definitions in the start-up phase. The Contractor shall verbally notify the VA COR immediately when a Sentinel Event has occurred, which is to be followed by written notification within three working days. The VA shall determine when a Root Cause Analysis (RCA) is required of the Contractor. The Contractor shall conduct all RCA’s according to VA policy, and within established timeframes. Completed RCA’s shall be provided to the VA COR.

Environment of Care: The VA shall approve the Contractors Emergency Preparedness Plan prior to the provision of patient care. The Contractor shall conduct annual fire and disaster drills. The Contractor shall conduct monthly fire extinguisher inspections and ensure annual maintenance is performed. Routine and recurrent preventive maintenance inspections shall be the responsibility of the contracted ambulance service. All significant problems identified shall be reported verbally to the COR within twenty-four hours. A written corrective plan of action shall be submitted to the COR within five working days. Timeframes and priorities for completion of action plan items shall be mutually agreed upon by the Contractor, Contracting Officer and the VA Safety Officer. An annual compliance report addressing preventive maintenance inspections, as well as Safety, Environmental, and Infection Control inspections shall be reported to the COR in the month of June. Environmental safety shall be the responsibility of the Contractor, who shall provide vehicle upkeep and stocking of the emergency vehicle. Contracted staff shall complete all VA-required Safety education and training, to include VA Privacy and Security Training, as evidenced by attendance records and/or training certificates provided to the COR on an annual basis. Privacy and Security Training shall be completed through the VA Talent Management System (TMS) at http://www.tms.va.gov/.

Human Resources: Competency Assessments and annual reviews are required for VA accreditation by The Joint Commission (formerly known as JCAHO) and shall be maintained on site for all Contractor personnel.

The Contractor shall submit a copy of the competency assessment standards, a current competency assessment checklist and the most recent competency assessment review for each employee to the COR for approval prior to starting work under this contract.

Infection Control: Contracted patient care activities shall be integrated into the VA Infection Control program, and contract staff shall adhere to VA Infection control policies and procedures. The VA Infection Control Plan shall identify for the contractor how risks will be identified, methods to be used to reduce risk, identification and reporting of community-acquired and nosocomial infections, and data collection and reporting requirements. Reports of surveillance, control, prevention and monitoring activities performed by the VA will be provided, on a routine basis, to the contractor.

Performance Improvement: The Contractor shall fully participate in the VA Performance Improvement (PI) program. This shall entail monitoring of clinical processes, patient outcomes and satisfaction, data analysis and collaborative design and operationalization of improvement opportunities. Contractor PI activities may be directed by the VA, VISN or VHA, as well as accreditation or licensing bodies. The Contractor shall abstract, compile, format report, and reporting deadlines shall be defined by the VA. It is noted that PI activities are dynamic and subject to change, as driven by current priorities and resources. In all cases, the Contractor shall continually assess for, and act upon, clinical and administrative improvement opportunities. High priority shall be given by the Contractor to the prevention of risk for the patient. The Contractor shall implement process-related internal controls to prevent risk to the veteran. Monitoring for continuous compliance with The Joint Commission standards shall be directed by VA staff and communicated to the Contractor through the COR. Measures related to contract compliance shall be identified by the COR.

QUALITY REQUIREMENTS: The COR shall require the contractor to submit an annual report.

The following shall be monitored: number of veterans arresting during transport, number of arresting patients with an Advance Directive, number of veteran arrests where the Advance Directive was honored, use of double identifiers, free-flow protection of IV pumps, routine testing and preventive maintenance of clinical alarms, medication errors, lack of VA ambulance transport form or pertinent medical information, percentage of staff with current driver’s license, BLS certification, ACLS certification, competency testing, and VA orientation.

QUALITY CONTROL SYSTEM: The Contractor shall implement and maintain a Quality Control (QC) System that results in prevention and/or correction of potential and actual problems throughout contract performance. The QC System shall contain processes for corrective actions without dependence upon Government direction and shall maintain records of all Contractor QC inspections and corrective actions.

HIPAA COMPLIANCE, PRIVACY AND CONFIDENTIALITY: Contractor shall comply with to the provisions of Public Law 104-191, Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the National Standards to Protect the Privacy and Security of Protected Health Information (PHI). A Business Associate Agreement (BAA) is required to be executed by the Contractor and VA prior to commencement of performance under this contract. Please refer to Section D of this solicitation/contract. Contractor shall comply with applicable confidentiality statutes, including 38 U.S.C. 5701, 38 U.S.C. 5705, 38 U.S.C. 7332, and 5 U.S.C. 552a (Privacy Act).

TRIP REPORT: The Contractor shall document each VA authorized transport with the following information:

Date Patient Name Patient identification number Pick-up Origin Time of Pick-up Destination Time of Delivery Mileage

Any notes regarding issues particular to the specific transport, including recording oxygen, cardiac monitoring, and other services provided (i.e. material items, supplies).

The Contractor shall include a copy of this report with all invoices and also provide the trip documentation form upon request by the VA. Trip reports must be submitted through regular mail or fax. Trip reports shall not be transmitted via e-mail. These reports shall serve as documentation of the transport and shall be a source document for reconciliation of the Contractor’s requests for payment.

The Travel Clerk or Contracting Officer’s Representative (COR), or designee shall be the point of contact for service requests, followed by the Administrative Officer of the Day (AOD). If medical consultation is required, the COR or designee will set up a conference call with the appropriate medical staff.

E-MAIL TRANSMISSIONS: Any e-mail transmission from the contractor which includes patient-sensitive information must be transmitted via secured/encrypted e-mail.

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SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (JAN 2017)

(a) Inspection/Acceptance. The Contractor shall only tender for acceptance those items that conform to the requirements of this contract. The Government reserves the right to inspect or test any supplies or services that have been tendered for acceptance. The Government may require repair or replacement of nonconforming supplies or reperformance of nonconforming services at no increase in contract price. If repair/replacement or reperformance will not correct the defects or is not possible, the Government may seek an equitable price reduction or adequate consideration for acceptance of nonconforming supplies or services. The Government must exercise its post-acceptance rights—

(1) Within a reasonable time after the defect was discovered or should have been discovered; and

(2) Before any substantial change occurs in the condition of the item, unless the change is due to the defect in the item.

(b) Assignment. The Contractor or its assignee may assign its rights to receive payment due as a result of performance of this contract to a bank, trust company, or other financing institution, including any Federal lending agency in accordance with the Assignment of Claims Act (31 U.S.C. 3727). However, when a third party makes payment (e.g., use of the Governmentwide commercial purchase card), the Contractor may not assign its rights to receive payment under this contract.

(c) Changes. Changes in the terms and conditions of this contract may be made only by written agreement of the parties.

(d) Disputes. This contract is subject to 41 U.S.C. chapter 71, Contract Disputes. Failure of the parties to this contract to reach agreement on any request for equitable adjustment, claim, appeal or action arising under or relating to this contract shall be a dispute to be resolved in accordance with the clause at FAR 52.233-1, Disputes, which is incorporated herein by reference. The Contractor shall proceed diligently with performance of this contract, pending final resolution of any dispute arising under the contract.

(e) Definitions. The clause at FAR 52.202-1, Definitions, is incorporated herein by reference.

(f) Excusable delays. The Contractor shall be liable for default unless nonperformance is caused by an occurrence beyond the reasonable control of the Contractor and without its fault or negligence such as, acts of God or the public enemy, acts of the Government in either its sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions, strikes, unusually severe weather, and delays of common carriers. The Contractor shall notify the Contracting Officer in writing as soon as it is reasonably possible after the commencement of any excusable delay, setting forth the full particulars in connection therewith, shall remedy such occurrence with all reasonable dispatch, and shall promptly give written notice to the Contracting Officer of the cessation of such occurrence.

(g) Invoice.

(1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include—

(i) Name and address of the Contractor;

(ii) Invoice date and number;

(iii) Contract number, line item number and, if applicable, the order number;

(iv) Description, quantity, unit of measure, unit price and extended price of the items delivered;

(v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading;

(vi) Terms of any discount for prompt payment offered;

(vii) Name and address of official to whom payment is to be sent;

(viii) Name, title, and phone number of person to notify in event of defective invoice; and

(ix) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the invoice only if required elsewhere in this contract.

(x) Electronic funds transfer (EFT) banking information.

(A) The Contractor shall include EFT banking information on the invoice only if required elsewhere in this contract.

(B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the Contractor shall have submitted correct EFT banking information in accordance with the applicable solicitation provision, contract clause (e.g., 52.232-33, Payment by Electronic Funds Transfer—System for Award Management, or 52.232-34, Payment by Electronic Funds Transfer—Other Than System for Award Management), or applicable agency procedures.

(C) EFT banking information is not required if the Government waived the requirement to pay by EFT.

(2) Invoices will be handled in accordance with the Prompt Payment Act (31 U.S.C. 3903) and Office of Management and Budget (OMB) prompt payment regulations at 5 CFR part 1315.

(h) Patent indemnity.