36C25724Q0815 0001 Amendment.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 NUMBERED 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 amendment, 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)

36C257 Department Of Veterans Affairs Network Contracting Office 17

5441 Babcock Road Ste. 302 San Antonio TX 78240

To all Offerors/Bidders

36C25724Q0815 07-30-2024

X

X

August 8,2024 @ 11:00AM CST See CONTINUATION Page

The purpose of this amendment is to provide all offerors with the questions and answers.

This amendment is extending the due date for solicitation # 36C25724Q0815 in order to give all parties enough time to submit accurate and precise proposals.

The initial due date was 08/02/2024 @11:00AM CST. The new due date for this solicitation 36C25724Q0815 is 08/08/2024

@ 11:00AM CST.

The updated Performance Work Statement based on the Governments responses to questions.

Complete Section 15A - C Below

///SEE CONTINUATION PAGES///

Mr. Shawn R. Reinhart Contracting Officer

36C25724Q0815-0001 CONTINUATION PAGES

QUESTIONS WITH ANSWERS

1. On December 21, 2023, the VA released solicitation 36C25724Q0087 as a 100% Small Business Set-Aside under NAICS 621910 with a size standard of $22.5M. On February 26, 2024, Amendment 0001 of this solicitation stated that “The purpose of this amendment is to cancel Request for Quote (RFQ) 36C25724Q0087. The requirement will be re-solicited under 36C25724Q0386.” When solicitation 36C25724Q0386 was released on June 04, 2024, it was released as an Unrestricted Competition under the same NAICS. This was also cancelled after proposals were submitted. When this current solicitation (36C25724Q0815) was released on July 19, 2024, it was also released as an Unrestricted Competition under the same NAICS as the previous two. During our review of the CLINs and scope of work required by the previous two solicitations and the current one, we noted that the services remain almost identical as the solicitation released on December 21, 2023, which had been released as a Small Business acquisition. FAR Subsection 6.203(b) states that “No separate justification or determination and findings is required under this part to set aside a contract action for small business concerns.” Our questions are the following:

a. Could the government please clarify the reasoning in the change in acquisition strategy for this upcoming requirement from 100% Small Business in the previous solicitation to Unrestricted in the current one?

The acquisition strategy was changed as follows:

When solicitation 36C25724Q0087 closed only two (2) small business’s responded that were capable and qualified to fulfill the requirements responded. One offeror was considered not technically capable and the other offeror’s price was not considered fair and reasonable as it was 300% higher than the IGCE. The small business set-aside was dissolved and resolicited as unrestricted.

When solicitation 36C25724Q0386 was cancelled due to administrative errors noted in the solicitation after offerors were received.

b. Can the Government explain its rationale for, and the means and/or manner that it conducted industry research for "establishing or maintaining alternative sources" under FAR 6.202 (a) through (b)?

Market research was conducted utilizing the Small Business Administration’s Veteran Small Business Certification, Small Business Administration’s Dynamic Small Business Search, and a Sources Sought.

2. CLINs related to Mileage for Trips Outside the Base Rate for Advanced Life Support (ALS) and Basic Life Support (BLS) (i.e., 0003, 0004,1003, 1004, 2003, 2004, 3003, 3004, 4003, and 4004) all list 3,400 miles each. However, the quantity of ALS trips is capped at 24 each (i.e., CLINs 0001, 1001, 2001, 3001, 4001) and the quantity of BLS trips is capped at 1,500 each (i.e., CLINs 0002, 1002, 2002, 3002, 4002). The ratio of calls in this scenario is approximately one (1) ALS call for every 63 BLS calls. Our questions are the following:

a. Could the government clarify the rationale used to determine that ALS and BLS trips would require an equal amount of Mileage for Trips Outside the Base Rate per option year?

The rational used to determine ALS and BLS trips is based upon an average from the historical data of the number of trips over the previous two (2) years. Because the Government does not know the exact number of trips each CLIN states “ESTIMATED QUANTITY”.

b. Assuming CLIN allocations per unit of measure do not change between the BLS and ALS mileage ratio disparity, is there a government contingency plan to shift mileage (i.e., unit of measure) allocations from between CLINs if necessary, as funding runs out of any particular mileage CLIN?

Mileage will not be shifted between CLINs. The rational used to determine ALS and BLS mileage is based upon an average from the historical data of the number of trips over the previous two (2) years. Because the Government does not know the exact number of miles each CLIN states “ESTIMATED QUANTITY”.

3. Page 20 of the solicitation lists Hudspeth, Culberson, Presidio, Dona Ana, Alamogordo, and El Paso as the Area of Coverage for this requirement. Does the government have historical data or estimates of the number of transports to each of these areas of coverage per year?

The current historical data for the period 1 July 2023 to 1 July 2024 shows there is approximately 220 trips. The majority of the trips (estimation 90%) are for El Paso area with the remainder being for the Las Cruces, NM area.

4. Page 16 of the solicitation states that the VA is requesting “BLS and/or ALS and/or CCT ambulance services” as part of the Ambulance Transportation Services that cover the ELPVAHCS catchment area for this upcoming requirement. Page 19 states that “The contractor shall provide all Advanced Life Support (ALS) ambulance service and all Basic Life Support (BLS) ambulance service or CCT, 24 hours per day, 365 days per year, as required per the terms and conditions contained herein.” While the CLINs on section B.2 of the solicitation list BLS CLINs separate from ALS CLINs, we do not see any Critical Care Transport (CCT) category listed in the CLINs. CCT ambulance services are a separate category from ALS ambulance services, since CCT services require specialized care and equipment that is not present in ALS services. As such, will the government consider including additional CLIN items to reflect CCT services?

PWS has been revised to remove any references to CCT.

5. ALS and BLS transportations are presently being conducted for the VA by one or many EMS agencies in the local area. By what request mechanism/s (e.g., by contract or by private VA requests) are BLS, ALS, and CCT life support ambulance transports presently being fulfilled?

Currently ALS and BLS transportation requests are being fulfilled on an as needed basis based upon VA requests.

6. Does the VA presently utilize a preferred provider list of local ambulance transport agencies for servicing existing present-day patient transportation demands?

No the VA does not presently utilize a preferred provider list. The VA has seven (7) companies in the El Paso catchment area that they call to check availability.

7. Given the limited IDIQ funding threshold covering all CLIN items, what is the government's contingency plan for continued CLIN funding (across all CLINs) in the event threshold values may be foreseeably exceeded?

If there is an increase in the current estimated quantity of patients to be transported a modification to the Contract will be executed increasing the quantities.

(END OF QUESTIONS WITH ANSWERS)

PERFORMANCE WORK STATEMENT (PWS)

(UPDATED 30 JULY 2024)

RESPONSIBILITY OF THE CONTRACTOR

The El Paso VA Health Care System (ELPVAHCS) has requirements for special mode and paramedic life support transportation. The scope of work includes Basic Life Support (BLS) and/or Advanced Life Support (ALS). Special mode for the purposes of this requirement is defined as Ambulance Transportation Services that cover the ELPVAHCS catchment area. Contractor shall provide all vehicles, personnel, and equipment required to provide BLS and/or ALS ambulance services 24 hours a day, 7 days a week (24/7), including weekends and holidays, to beneficiaries of ELPVAHCS in accordance with the terms, schedule and referenced materials of this agreement.

The contractor shall be responsible for providing all management, equipment, vehicles, and personnel necessary to meet all BLS transport requirements throughout various cities/counties within the State of Texas for eligible Department of Veterans Affairs, El Paso VAHCS beneficiaries. The contractor will furnish bariatric equipment and stretchers to meet the needs of El Paso VAHCS eligible veteran beneficiaries.

Services provided under this contract shall strictly adhere to all current laws and regulations applicable to the state of Texas unless supplemented to exceed those requirements as specified herein. In no circumstances, will any section or clause of this contract authorize the contractor to provide care and/or equipment below established guidelines.

Should the VA determine that immediate transportation is essential to prevent loss of life or serious bodily harm, as in calling 911, emergency transportation services may be procured without referral to the ambulance contractor.

The contractor shall transact business as described herein, with the Contracting Officer (CO) and/or the Contracting Officer’s Representative (COR) as appropriate. The contractor shall under no circumstances correspond or directly interact with any patient (or beneficiary) or solicit from any patient (or beneficiary) of the VA.

1. DEFINITIONS/ACRONYMS:

ALS – Advanced Life Support - Advanced Life Support shall be provided by ambulance vehicles containing at a minimum an onboard Paramedic, Cardiac monitoring, Advanced Life Support drugs and procedures, Advanced airway management and Medication monitoring and administration, and provide restraint and seclusion management when needed.

Beneficiary – Veterans and others determined to be eligible for benefits by the VA.

BLS – Basic Life Support- Basic Life Support shall be provided by ambulance vehicles containing at a minimum, an on-board Emergency Medical Technician (EMT), Basic airway management, and IV keeping vein open (KVO) without additives. The contractor shall also provide restraint and seclusion management when needed.

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

CBOC – Community-Based Outpatient Clinic

Contractor - The term “contractor” as 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 his subcontractors comply with the provisions of this contract.

COR – Contracting Officer’s Representative – VA official responsible for providing technical guidance to the contractor and Contracting Officer. Responsibilities include certification of invoices, providing technical guidance, overseeing technical aspects of the contract, and are a member of the vehicle inspection team.

Emergency Medical Technician - a person who is specially trained and certified to administer basic emergency services to victims of trauma or acute illness before and during transportation to a hospital or other healthcare facility.

Medical Transportation Organization (MTO) - MTO has the same meaning as an emergency medical service organization as defined in division (H) of section 4766.01 of the Revised Code.

Not to Exceed (NTE) – The price and/or quantity that the contract or purchase order shall not exceed.

Paramedic - a specially trained medical technician licensed to provide a wide range of emergency services (such as defibrillation and the intravenous administration of drugs) before or during transportation to a hospital.

Patient Business Service (PBS)-, an administrative department that processes patients' medical records, appointments, etc.

Quality Assurance – Those actions taken by the Government to assure the services provided by the contractor meet the requirements of the contract.

Quality Control – Those actions taken by the Contractor to monitor/control the production of goods or services so they will meet the requirements of the contract.

Run sheet – Clinical documents showing what occurred during the ambulance trip. PBS requires a copy of the patient's chart.

Scheduled Trip(s) – The term "scheduled trip" as used in this solicitation/contract, refers to those trips in which the contractor has been given advance notice (advance notice is defined as a notice given by 4:30 p.m. the prior business day) of required services and a specific pick-up time.

The Joint Commission – A national organization dedicated to improving the care, safety, and treatment of patients in a healthcare facility and environment.

Waiting – Waiting, as used in this solicitation/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 commencing after the required arrival check-in with the individual(s) scheduling the travel.

Waiting Grace Period – The Waiting Grace Period is defined as fifteen (15) minutes before the time waiting charges commence. The base rate for ambulance services shall include a fifteen (15) minute waiting grace period at the origin and destination. After the 15-minute grace period charges are applied in 15-minute increments.

2. GENERAL REQUIREMENTS: The contractor shall provide ambulance transportation services for patients (or beneficiaries) of the Department of Veterans Affairs as established above and herein. The contractor shall provide all services necessary to execute the full range of paramedic and ambulance services as provided in the local community. Performance shall be continuously compliant with the requirements contained within this PWS to include the standards established by the Joint and the Division of Emergency Medical Services, Texas Emergency Medical Services, and all applicable Federal, State, and local rules, regulations, and procedures.

· Reference: Texas Administrative Code- Title 21, Part 1, Chapter 157, Emergency Medical Care.

http://info.sos.state.tx.us/pls/pub/readtac$ext.ViewTAC?tacview=5&ti=258pt=18ch=157&sch=A&rl=Y

3. CONTRACT ADMINISTRATOR: The contractor shall contact the Contracting Officer on all matters pertaining to the contract. The Contracting Officer is the only person authorized to obligate the VA, to issue any changes, which affect the price, quantity, quality, or delivery terms of this contract. The Contracting Officer Representative (COR) will be included on all communications between the contractor and the Contracting Officer, and the COR shall be responsible for validation/reconciliation of claims and authorization for payment.

4. GENERAL DESCRIPTION: The contractor shall provide all Advanced Life Support (ALS) ambulance service and all Basic Life Support (BLS) ambulance, 24 hours per day, 365 days per year, as required per the terms and conditions contained herein. The contractor shall furnish vehicles sufficient to provide full and complete coverage for the pick-up and delivery of all veteran patients requiring transport by ambulance to/from the El Paso VAHCS, 5001 N. Piedras St, El Paso, Texas 79912 and at the various counties within the state of Texas as shown in the table 1 below.

NOTE: If at any point performance occurs outside of the stated catchment area, the contractor shall immediately notify the Contracting Officer for inclusion of the applicable Department of Labor Wage Determination into the contract.

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 § 4.155:

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.

Prior to contract performance, the COR shall provide the contractor with a list of names (or position titles) and phone numbers of authorized Government personnel who may request services. This list will be updated and submitted to the contractor as changes occur. Services rendered in response to requests from other than authorized personnel shall be at the risk of the contractor and any costs related thereto shall be borne by the contractor.

Pick-up and deliveries will also be required from community hospitals and VA facilities within and outside the service area to include the patient’s residence as requested by the COR per the procedures specified within this PWS. The trip rate provided in any category shall be all-inclusive regardless of the time of day as agreed to in the price schedule of the resultant award.

Table 1: Area of Coverage: The El Paso VAHCS and surrounding VA facilities, utilize special mode transport services approximately 1524 times annually. The contractors shall provide coverage in the following counties listed and outside of the catchment area for patients of the Texas area as follows:

EL Paso

Table 1: - El Paso VAHCS Catchment Area by County

NOTE: If at any point performance occurs outside of the stated catchment area, the Contractor shall immediately notify the Contracting Officer for inclusion of the applicable Department of Labor Wage Determination into the contract. 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 § 4.155: 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.

5. PERIOD OF PERFORMANCE: The period of performance is for five-years with five (5) separately priced ordering periods.

6. INVOICING: The Contractor shall submit invoices through Tungsten Network located at www.fsc.va.gov/einvoice.asp:

The Contractor’s invoice shall include:

• Contract Number

• Date of Trip

• Authorization number(s) and Beneficiary’s name

• Pick-up and drop-off location of the Beneficiary

• Base Rate

• Name and “Last Four” of Social Security number of Beneficiary transported.

• Documentation of circumstances when billing for waiting time

• Any miscellaneous charges for which the Contractor is expecting reimbursement i.e., Toll charges, Waiting Time, etc.

• VA authorizing official’s name

• Healthcare Procedure Coding System/National Level II (HCPCS)

• The Contractor shall provide a receipt or copy of the receipt for all miscellaneous charges. (Waiting time, etc.)

The Contracting Officer Representative (COR) will suspend unauthorized charges. Unauthorized charges are those that have not been pre-approved by authorized VA personnel. Supporting documentation may be provided and submitted for payment consideration. Unauthorized charges will be reviewed by the Contracting Officer Representative (COR) as to the validity of the charges and as to whether the payment will be made. A final determination will be made within 30 days after notifying the Contractor of the charges, which are being suspended.

Under no circumstances are VA beneficiaries, third party insurances, Medicare, or Medicaid to be billed for the services performed under this contract.

7. VEHICLES AND EQUIPMENT: Ambulance vehicles and equipment with which the Contractor renders all services must meet Federal and State of Texas (or equal) requirements for insurance, licensing, registration, and equipment. All vehicles used to provide Ambulance vehicles (ALS/BLS) transportation services shall meet the following requirements:

· Texas Health & Safety Code-Chapter 773.Emergency Health Care Act. http://www.statutes.legis.state.tx.us/Docs/HS/htm/HS.773.htm Texas Administrative Code- Title 21, Part 1, Chapter 157, Emergency Medical Care https://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=4&ti=25&pt=1&ch=157

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

· Be equipped with operational air conditioning/heating systems.

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

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

· Be equipped with stretcher tie-down straps and effective secure devices to secure both stretcher and wheelchair beneficiaries.

· 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 and have a backup for all lift capacity.

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

· Driver shall ensure stretcher locks are secured and seat belts and shoulder harnesses are in place before the vehicle is driven.

8. STANDARDS FOR MAINTENANCE: The objective of Standards for Maintenance is to protect veterans and to cause no harm to any party.

a) The Contractor shall maintain all vehicles in a clean and orderly condition, free from debris and accumulations which may create an accident, injury, or fire hazard.

b) The Contractor shall ensure they are compliant with the CDC Coronavirus guidance: https://www.cdc.gov/coronavirus/2019-ncov/index.html

c) The Contractor shall maintain vehicles per the manufacturer’s recommended maintenance schedule, or an improved schedule based on actual vehicle operating conditions.

d) The Contractor shall correct any deficiency that might interfere with the safe operation of the vehicle before the vehicle is placed in service.

e) The Contractor shall ensure vehicle windows are free of obstructions and lights are kept clean so that they can be easily seen when in operation.

f) The Contractor shall keep the interior of vehicles clean and in good repair.

g) The Contractor shall maintain (and furnish upon request) procedures that outline preventive maintenance and/or repairs on each vehicle in an individual vehicle file and in chronological order, latest service on top. A statement from the Contractor indicating compliance with vehicle maintenance files is in place should be submitted at the time of offer for evaluation purposes. The requested submission and verification of these documentation requirements will be a quality assurance procedure during the contract period.

h) Maintenance procedures shall adhere to all requirements listed for the state the Contractor is based. Example: Texas Medical Transportation Board Administrative Code, SECTION 380.501. Standards for Motor Vehicles.

All motor vehicles used to provide transportation services must:

· meet or exceed warranty and component standards for both state and federal safety mechanical operating and maintenance standards.

· be identified with the transportation provider name and vehicle number using letters that are at a minimum of six inches in height; and

· be equipped with:

- Functioning, clean, and accessible seat belts for each passenger seat position that must be stored off the floor when not in use.

- An operating speedometer and odometer. Working interior lights within the passenger compartment.

- Adequate interior sidewall padding and ceiling covering

- Two exterior rear-view mirrors, one on each side of the vehicle.

- An interior mirror, which should be used for monitoring the passenger compartment.

- A clean interior and exterior (which must be free of broken mirrors or windows, excessive grime, rust, chipped paint, and major dents);

- A functional fire extinguisher (which must be secured within reach of the motor vehicle operator and visible to passengers);

- A first aid kit (which must include at a minimum latex glove, hazardous waste disposal bags, scrub brush, disinfectant, and deodorizer);

- Working heating and cooling systems adequate for the heating, cooling, and ventilation needs of both the motor vehicle operator and the passengers; and

- Signage posted within the vehicle that reads: "No Smoking, Eating or Drinking."

"All passengers must wear seat belts." "Concealed Weapons Prohibited."

All motor vehicles used to provide transportation services must comply with all applicable state and federal laws, including the Americans with Disabilities Act (ADA) Accessibility Guidelines for Transportation Vehicles (36 C.F.R. 1192), Federal Motor Vehicle Safety Standards (49 C.F.R. 571), and Chapter 547 of the Texas Transportation Code.

9. DRIVER QUALIFICATIONS: The Department of Veterans Affairs Medical Center (VAMC) reserves the right to restrict any contractor employee from performing services under this contract who does not meet the required qualifications for the services they are required to perform, and who violates Federal regulations or is identified as a potential threat to the security, safety, health and/or operational mission of the VA and its veteran population. The restriction of such contractor personnel shall not relieve the contractor from performing all the required services, by all terms, conditions, and schedules contained herein.

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

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

c) The company will employ personnel, who are fluent in English. They need to be able to speak and understand English to transport the patients successfully.

d) Staff will ensure that the patient is secure to the stretcher/cot and that the stretcher/cot is secure in the back of the ambulance before the vehicle moves.

Each driver shall:

· Possess a driver’s license that is valid for the class of vehicle driven and, if required under Texas Statutes (or another state equal), evidence of a special transportation service vehicle permit, or endorsement issued by the commissioner of public safety.

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

· For the past three years:

· Have not had a driver’s license canceled or suspended under Texas Statutes, (or other states equal).

· Have a driving record clear of convictions for operating a motor vehicle or motorcycle without insurance as required by Texas Statutes, (or other states equal);

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

· Have a driving and criminal record clear of convictions for driving under the influence of alcohol or a controlled substance under Texas Statutes (or another state equal)

· Have a record clear of criminal convictions of crimes or pending criminal indictments against persons, and crimes or anticipatory crimes reasonably related to providing special transportation services. This must be documented by a formal background check.

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

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

· https://dshs.texas.gov/emstraumasystems

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

· Shall submit evidence of an equivalent training program, which has been completed, to the Contracting Officer.

· Shall 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.

· Shall attend all refresher continuing education, or advanced training programs as required by the local or state government entity in which service is rendered. In no instance shall this be less frequent than every two (2) years. Such refresher training shall be equivalent to that developed by the Department of Transportation, National Highway Safety Administration. http://search.usa.gov/search?utf8=%E2%9C%93&affiliate=dot-nhtsa&query=refresher+training+&searchCommit=Search

10. PASSENGER TRANSPORTATION: It is understood that the patient plus one (1) additional passenger, family member, or caregiver at the discretion of the transport crew to be transported on a trip will be based on the size of the vehicle and authorization by VAMC.

Passengers should be transported in compliance with CDC standards: https://www.cdc.gov/coronavirus/2019-ncov/infection-control/infection-prevention-control-faq.html

a) Drivers and passengers shall always use seat belts/securement devices.

b) There shall be no smoking by the driver, attendants, or passengers while in the vehicle or on the Medical Center Campus unless in a designated smoking area.

c) The contractor is required to provide “through-the-door service” for patients to and from their designated appointments. Through the door service” is defined as patients being picked up either on the ward, in their homes, in their clinic, or at other stated areas and taken to their stated destination or appointment with the proper transfer of patient care to an equal or higher level of care. On the return trip, the contractor will return the patient to either the designated ward, inside his/her home or other stated areas.

d) No unauthorized stops shall be permitted. An unauthorized stop is any stop not necessary for patient care. In the event, an emergency arises while in transit, the contractor shall transport the patient to the closest facility that can mitigate the emergency.

e) The contractor shall be required to transport non-ambulatory veterans on gurneys and litter who do not require emergency transportation or medical attention.

f) Upon delivery or pick-up of a patient, the contractor shall log in the patient on a log sheet at the location designated at the facility. The contractor shall provide the following information on the log sheet:

· Patient name,

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

· Time of delivery or pick-up,

· Point of origin or destination, and

· Name of Contractor personnel picking or delivering patient.

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

h) An authorized official of the VA Medical Center, the COR, or the Mobility Manager may, in the best interest of the patient, allow one (1) relative of the concerned other to accompany the patient at no additional cost to the Government. The relative or concerned other only is to be transported home with the beneficiary if approved by an official of the VA Medical Center. The beneficiary will also be allowed to carry with her or him one (1) bag of luggage during his or her transport. Before contract performance, the COR shall provide the contractor with a list of names (or position titles) and phone numbers of authorized Government personnel who may request services. This list will be updated and submitted to the contractor as changes occur. Services rendered in response to requests from other than authorized personnel shall be at the risk of the contractor and any costs related thereto shall be borne by the contractor.

i) The contractor is required to notify the COR of any unusual events, including but not limited to accidents, safety problems, and deviations in transportation that occur and involve any VA beneficiary being transported under this contract. This notification will be made within 15 minutes by telephone to the COR and AOD during normal working hours. A written report using email or company letterhead of the event will be delivered to the COR within 24 hours. Failure to comply with this provision may be grounds for default.

j) The patient pick-up/drop-off location at the _TBD____ of the medical center scheduled appointments. The patient pick-up/drop-off location for any CBOC will be the main entrance of that the respective CBOC. If the waiting time is necessary, the vehicle must park in the appropriately designated general parking lot areas.

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

l) If or when a patient’s medical records are transported, the contractor shall ensure that Health Insurance Portability and Accounting Act (HIPAA) guidelines are followed.

m) Patients will be entitled to transport one certified trained service animal. No pets are to be transported at any time. A. VHA Directive 1188, Animals on Veterans Health Administration (VHA) Property, dated August 26, 2015.

11. ORDERS: All patient pick-up(s) and drop-off(s) shall be authorized via “orders” which shall only be issued by the designated ordering officers. When placing orders for services, the ordering officer shall contact the designated contractor point of contact(s) to provide the following information:

· Mode of transportation required,

· Required time of arrival and/or within a 20-minute timeframe.

· Name of the beneficiary,

· Pick-up and delivery point,

· Type and number of additional medical care specialists required,

· Type of equipment required,

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

· Any other special instructions?

12. HOURS OF PERFORMANCE AND RESPONSE TIMES: Hours of Performance: This is a full-service contract, 24 hours per day, 365 days per year. The contractor shall provide all ALS/BLS services as stated in the performance work statement for veteran beneficiaries when requested by the VA.

a) The Contractor shall furnish and maintain vehicles to ensure timely pick-up and delivery service to all veterans serviced by the VA.

b) The Contractor shall respond to all calls for ambulance transport service by being on-site at the designated VA facility within 1 hour after notification. STAT notifications require a 20-minute response time. Should the time for pick-up, stated herein, be physically impossible due to the location of the veteran beneficiary, the Contractor shall contact the appropriate individual at the VA (from a list of extensions which shall be provided to the Contractor from the PBS department and the CBOC locations) and proceed to inform him/her of the anticipated time required for pick-up and delivery of the said Beneficiary.

c) The Contractor shall provide and respond to each call-in accordance with all Federal, State, and Local regulations governing the dispatch of emergency medical (ambulance) vehicles and medical care of onboard Beneficiaries, including the use of sirens and other measures to ensure timely arrival at the designated location.

Electronic Transmissions: The contractor shall, always during the contract period, have on his/her premises both the ability to receive, read, and transmit emails to and from the VA and a functioning fax machine to communicate with the VA. If PII or PHI is to be transmitted, an approved encrypted email must be used.

13. CONFORMITY TO REGULATIONS:

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

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

c) The contractor shall have the appropriate permits/licenses to perform the required services.

d) All services provided by the contractor shall comply with applicable current laws, regulations, and standards of the appropriate regulatory body.

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

15. WAGE RATES: Wage Determination(s) as listed in Section D in this solicitation apply to any resulting contract. The contractor certifies by signature on this offer that the salaries to be paid to workers involved in the performance of the contract are equal to or greater than those specified in the attached Wage Determination(s). The Department of Labor has held that contractors must pay their employees the Service Contract Act waged while they are driving both to and from destinations for the VA. The Wage Determination is attached in Section D.

16. INSPECTIONS: The VA reserves the right to inspect the contractor's equipment and vehicles and/or require documentation of compliance with contract specifications, and State laws, rules, regulations, and guidelines governing emergency medical transport vehicles (ambulance). VA inspections of Contractor facilities shall in no way constitute a warranty by the VA that the Contractor's vehicles and equipment are properly maintained. Inspections shall take place at the outset of the contract and on an as-needed basis thereafter. To be in and remain in compliance, the contractor shall adhere to the Texas Department of State and Human Service and the Texas Department of Motor Vehicles.

The VA reserves the right to restrict the contractor’s use of equipment and vehicles which need repair, are unclean, unsafe, damaged on the interior or exterior body, and are not in compliance with contract specifications. The restriction of such equipment and vehicles shall not relieve the Contractor from performing in accordance with the strict intent and meaning of the contract without additional cost to the VA.

The VA reserves the right to have VA personnel, such as the Contracting Officer and Contracting Officer's Technical Representative, or their designee, observe and inspect contractor operations at any time during the term of this contract. The VA shall conduct scheduled or unscheduled site visits to observe and inspect contractor operations. A scheduled site visit is defined as a visit that the contractor is made aware of in advance. An unscheduled site visit is defined as a visit without advance notice.

17. BENEFICIARY RIGHTS:

a) The Contractor shall be courteous to VA beneficiaries and shall not smoke/play loud music while transporting Beneficiaries. Beneficiaries may bring medical equipment, such as a folding wheelchair and one bag.

b) The Contractor is required to notify the COR and CO of any unusual events, including but not limited to accidents, safety problems, and deviations in transportation that occur and involve any VA beneficiary being transported under this contract. This notification will be made within 15 minutes by telephone to the COR and AOD during normal working hours. A written report using email or company letterhead of the event will be delivered to the COR and CO within 24 hours. Failure to comply with this provision may be grounds for default. http://vaww.va.gov/vaforms/va/pdf/VA2162.pdf

c) The Contractor shall notify the COR, in writing, within 24 hours of any complaints made by the Beneficiaries about the ambulance service. http://vaww.va.gov/vaforms/va/pdf/VA119.pdf.

The Contractor shall provide recommendations for improved services along with the Beneficiary complaints for the VA’s review. No recommendation shall be construed as being effective until a written modification to the contract is executed by the Contracting Officer.

d) Upon delivery or pick-up of a beneficiary, the Contractor shall log in the Beneficiary on a log sheet at the location designated at the facility. The contractor shall provide the following information on the log sheet:

· Beneficiary name,

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

· Time of delivery or pick-up,

· Point of origin or destination, and

· Name of Contractor personnel picking or delivering Beneficiary.

18. REQUIRED SUBMITTALS, REPORTS AND DOCUMENTS: Within fifteen (15) days after the contract award, the contractor shall provide the following:

a) Contractor Personnel Roster: In this document, the contractor shall identify the employee:

a. Name,

b. Position,

c. Title, and

d. Work assignment area.

Thereafter, all changes shall be submitted to the COR within two (2) business days after the change(s) occur.

a) Within seven (7) business days after receipt of award notification and/or upon written request from CO, the Contractor shall provide evidence of required training, certifications, licensing, and any other qualifications of any personnel performing services under this contract. Thereafter, all changes shall be submitted to the COR within two (2) business days after the change(s) occur.

b) License, certifications, and qualifications: A record of each employee as to license, certifications, other required qualifications shall be submitted to the contracting officer (CO) and contracting officer representative (COR) with contract proposal and twice per year (Oct / Jun). The Contractor shall forward a list of Contractor employees directly supporting this contract. This list shall provide the Contractor the employees’ name, position(s), and licenses and/or applicable certifications held and shall include their current certification number.

c) At the time of delivery, the Contractor shall provide a Beneficiary care report as part of the Beneficiary's permanent record. This Beneficiary care report shall include a record of the Beneficiary’s vital signs, medications used, oxygen use, and any changes in the Beneficiary’s condition. The list stated here shall not be construed as all-inclusive, and the Contractor shall provide all pertinent information.

d) All invoices will be submitted electronically via through Tungsten Network located at www.fsc.va.gov/einvoice.asp.

19. NUMBER OF PATIENTS: The contractor shall not exceed vehicle capacity for the patient and one (1) passenger transported in vehicles.

20. WAITING TIME:

a) Waiting charges shall commence 15 minutes from the time the contractor arrives at the designated pick-up and/or delivery points. For scheduled trips, waiting charges shall commence 15 minutes from the scheduled pick-up time. Vendor must call to obtain approval of wait times.

b) If the designated pick-up/delivery points are at other than the Medical Centers and waiting beyond the required 15-minute grace period is anticipated, the contractor shall notify the individual requesting the travel as defined by the lists of points of contact stated in the solicitation. This call is only to verify the contractor's time of arrival at pick-up and/or delivery points and is not necessary if the contractor does not anticipate a delay for which waiting charges will be claimed.

21. SAFETY REQUIREMENTS: In the performance of this contract, the contractor shall take additional safety precautions as determined necessary by the CO or COR.