36C26020Q0545.docx

36C26020Q0545

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

36C26020Q0545 Niel Chase 360-816-2792 07-17-2020 14:00 36C260 Department of Veterans Affairs Network Contracting Office 20 5115 NE 82nd Ave, Suite 102 Vancouver

WA

98662 X Y 621910 $16.5 Million N/A X Department of Veterans Affairs Roseburg VA Medical Center 913 NW Garden Valey Blvd Roseburg

OR

97470 Y Department of Veterans Affairs Network Contracting Office 20 5115 NE 82nd Ave, Suite 102 Vancouver

WA

98662

Department of Veterans Affairs

FMS-VA-2(101)

Financial Services Center

PO BOX 149971

Austin

TX

78714-9971 See CONTINUATION Page This contract will provide emergent and non-emergent ground ambulance services for the Roseburg VA Healthcare system, to include; Roseburg VA Medical Center, Eugene Health Care Center, North Bend VA Clinic, and Brookings VA Clinic in accordance with the Statement of Work.

This is a Single Award IDIQ contract that will have annual Task Orders awarded as per the needs of the VA.

Period of Performance: 08/01/20 - 07/31/25 All Vendor questions concerning this Soliciation shall be submitted in writting by 10 July, 2020, to both;

Niel Chase @: niel.chase@va.gov and Jacob Jackson @: jacob.jackson2@va.gov Vendor Checklist for submittals is on page # See CONTINUATION Page X X

ONE

Jacob Jackson Contracting Officer Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

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

a. CONTRACTOR: TBD

b. GOVERNMENT: Contracting Officer 36C260

Department of Veterans Affairs Network Contracting Office 20 5115 NE 82nd Ave, Suite 102 Vancouver WA 98662

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

3. INVOICES: Invoices shall be submitted in arrears:

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

Department of Veterans Affairs

FMS-VA-2(101)

Financial Services Center

PO BOX 149971

Austin TX 78714-9971 ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

0.00

Base Rate for Advanced Life Support (ALS) (One-way only) Per trip Contract Period: Base POP Begin: 08-01-2020 POP End: 07-31-2021

0.00

ALS - Mileage

POP Begin: 08-01-2020

Rate for each mile traveled beyond the first 15 miles

0.00

Base Rate for Med Cab Secure - Psych Transport

0.00

Med Cab Secure - Psych Transport - Mileage

POP Begin: 08-01-2020

0.00

Base Rate for Specialty Care Transport (SCT) (One-way only) per trip.

0.00

SCT - Mileage

POP Begin: 08-01-2020

0.00

Waiting time - 15 minute increments

0.00

Base Rate for 911 Ambulance Service - per trip

0.00

911 Ambulance Service - Mileage

0.00

Base Rate for Advanced Life Support (ALS) (One-way only) Per trip Contract Period: Option 1 POP Begin: 08-01-2021 POP End: 07-31-2022

0.00

ALS - Mileage

POP Begin: 08-01-2021

0.00

Base Rate for Med Cab Secure - Psych Transport

0.00

Med Cab Secure - Psych Transport - Mileage

POP Begin: 08-01-2021

0.00

Base Rate for Specialty Care Transport (SCT) (One-way only) per trip.

0.00

SCT - Mileage

POP Begin: 08-01-2021

0.00

Waiting time - 15 minute increments

0.00

Base Rate for 911 Ambulance Service - per trip

0.00

911 Ambulance Service - Mileage

0.00

Base Rate for Advanced Life Support (ALS) (One-way only) Per trip Contract Period: Option 2

POP End: 07-31-2023

0.00

ALS - Mileage

POP Begin: 08-01-2022

0.00

Base Rate for Med Cab Secure - Psych Transport

POP Begin: 08-01-2022

0.00

Med Cab Secure - Psych Transport - Mileage

POP Begin: 08-01-2022

0.00

Base Rate for Specialty Care Transport (SCT) (One-way only) per trip.

0.00

SCT - Mileage

POP Begin: 08-01-2022

0.00

Waiting time - 15 minute increments

0.00

Base Rate for 911 Ambulance Service - per trip

0.00

911 Ambulance Service - Mileage

0.00

Base Rate for Advanced Life Support (ALS) (One-way only) Per trip Contract Period: Option 3 POP Begin: 08-01-2023 POP End: 07-31-2024

0.00

ALS - Mileage

POP Begin: 08-01-2023

0.00

Base Rate for Med Cab Secure - Psych Transport

0.00

Med Cab Secure - Psych Transport - Mileage

POP Begin: 08-01-2023

0.00

Base Rate for Specialty Care Transport (SCT) (One-way only) per trip.

0.00

SCT - Mileage

POP Begin: 08-01-2023

0.00

Waiting time - 15 minute increments

0.00

Base Rate for 911 Ambulance Service - per trip

0.00

911 Ambulance Service - Mileage

0.00

Base Rate for Advanced Life Support (ALS) (One-way only) Per trip Contract Period: Option 4 POP Begin: 08-01-2024 POP End: 07-31-2025

0.00

ALS - Mileage

POP Begin: 08-01-2024

0.00

Base Rate for Med Cab Secure - Psych Transport

0.00

Med Cab Secure - Psych Transport - Mileage

POP Begin: 08-01-2024

0.00

Base Rate for Specialty Care Transport (SCT) (One-way only) per trip.

0.00

SCT - Mileage

POP Begin: 08-01-2024

0.00

Waiting time - 15 minute increments

0.00

Base Rate for 911 Ambulance Service - per trip

0.00

911 Ambulance Service - Mileage

B.3 DELIVERY SCHEDULE

0.00

0.00

0.00

0.00

0.00

0.00

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36C26020Q0545

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B2. STATEMENT OF WORK

B.2.1. PurposeStatement:

The purpose of the contract is to provide Ambulance service for eligible beneficiaries of the Roseburg VA Health Care System (RVAHCS). This will also include Roseburg VA Medical Center (RVAMC), Eugene Health Care Center (EHCC), North Bend VA Clinic (NBVAC), and Brookings VA Clinic (BVAC).

The Contractor shall furnish all necessary personnel, vehicles, management, supplies, transportation, equipment, and reports necessary to provide emergent and non-emergent ground ambulance services. Location addresses are as follows:

· Roseburg VAMC: 913 NW Garden Valley Blvd, Roseburg, OR97471

· Eugene HCC: 3355 Chad Drive, Eugene, OR97408

· North Bend VA Clinic: 2191 Marion Street, North Bend, OR97459

· Brookings VA Clinic: 840 Railroad Street, Brookings, OR97415

Areas of service also include transports to and from VISN 20 VA Medical Centers, and VA Authorized community care partners for the eligible beneficiaries who have been sent by RVAHCS to outside medical care facilities for VA authorized medical care and treatment.

The Contractor shall make Specialty Care Transport (SCT), Advanced Life Support (ALS), Basic Life Support(BLS),MedCabSecure–Psychiatricservices,and911responsesinareaswherethecontractor isthe911provider.Allpreviouslylistedserviceswillbeavailabletwenty-four(24)hoursperday,seven

(7) days per week, including all holidays. Performance shall be in accordance with, but not limited to, therequirementscontainedinthisStatementofWork,standardsoftheJointCommission,andapplicable staterequirements.

The vehicles, personnel, and services rendered shall conform to all Federal, state, and local statutes, rules, and regulations including, but not limited to, ORS 677, ORS 682, OAR 333, OAR 847-035, and other applicable ORS and OAR (http://www.leg.state.or.us andhttp://arcweb.sos.state.or.us/banners/rules.htm)andotherstaterequirementsofOregon,Washington,or California.

Each patient will be treated with the utmost of respect and concern with a professional approach to his/her dignity as an individual and patient. All communication, both verbal and non-verbal, with and in the presence of the patient, will be conducted in a professional manner. The Contractor’s personnel will practice the utmost discretion when discussing the patient’s condition with hospital professionals in the presence of the patient and relatives. The Contractor will maintain the highest quality standards of both patient and medical care.

The“care”willbe,ataminimum,consistentwithcurrent“communitystandards”ofmedicalpracticeas establishedbytheOregonStateCodeandthestandardsestablishedbythemedicalstaffoftheRVAHCS. Patientandmedicalcarepracticeswhichappeartobeinconsistentwiththequalitylevelofcareexpected bytheRVAHCSmedicalstaffwillbeevaluatedbyateamofRVAHCSclinicalstaff.Theresultsofthis evaluation will be communicated to the Contractor and their Medical Advisor through the Contracting Officer or Contracting Officer’s TechnicalRepresentative

CONTRACT DEFINITIONS AND ACRONYMS

(a) Advanced Life Support (ALS)- ALS shall be provided by ambulance vehicles containing at a minimumanon-boardEMT-P,cardiacmonitoring,AdvancedCardiacLifeSupport(ACLS)drugsand procedures,advancedairwaymanagementandmedicationmonitoringandadministration.Ambulances forALSservicesshallbestaffed,certifiedandlicensedinaccordancewithcurrentlawsandregulations governing the certification and licensure of private ambulances by the respective states of service, and allALSservicesshallbeinaccordancewithcurrentlawsandregulationsbytherespectivestatesof

Page 1 of Page 1 of service.

(b) Base Rate- Base Rate is defined as the rate paid for one-way transportation from a designated pick uppointtoadesignateddeliverypoint.Thisratewillbepaidforallauthorizedone-waytripsordered under this contract action. The Base Rate shall constitute full compensation for one-way trips which do not exceed the "MileageThreshold".

(c) Basic Life Support (BLS)- BLS is defined as services required for non-critical patient care in which patient requires an ambulance, which has been staffed, certified, and licensed in accordance with current laws and regulations governing the certification and licensure of private ambulances by the respective states of service, and all BLS services shall be in accordance with current laws and regulations by the respective states of service. The ambulance at a minimum shall be staffed with a vehicle operator and an Emergency Medical Technician (EMT) - Basic Ambulance, and with basic airway management and IV's at KVO (keep vein open) withoutadditives.

(d) Med Cab Secure or Ambulance - Psychiatric Transports– Confined wheelchair van or Ambulance with psychiatric transport of a mental health patient.The type of vehicle will be determined by the Provider who enters the travel consult. Staff transporting will complete 4 hours of mental health patient transportation trainingannually.

(e) 911 Ambulance Service –Contractor with RVAHCS is also the 911 responding ambulance service, the contracted rate or the County/City price scale will be charge for 911 ambulance service, the contractor will provide the price list for the areas that have a required set fee that must be charged for 911service.

(f) Beneficiary- Veterans and other members determined to be eligible for benefits by the Veterans Health Administration(VHA).

(g) Business Hours/Days - Business hours/days are defined as the time of 8:00AM to 4:30PM, Monday through Friday, except Federalholidays.

The Federal Government observes the following days as holidays.

*If the date falls on a Saturday, the Government holiday is the preceding Friday. If the date falls on a Sunday, the Government holiday is the following Monday.

In addition to the days designated as holidays, the Government observes the following days: Any other day designated by Federal Statute

Page 1 of Page 1 of Any other day designated by Executive Order Any other day designated by the President’s Proclamation Off Business hours/days are defined as the time of 4:31PM to 7:59AM, Monday through Friday, all day Saturday and Sunday and Federal holidays.

(h) Contracting Officer (CO)– Veterans Administration official with the authority to enter,administer, and/or terminate contracts and make related determinations and findings. Any changes to a resultantcontractmayonlybemadethroughawrittenmodificationaspreparedandexecutedbytheCO.

(i) Contracting Officer’s Point of Contact (POC)- RVAHCS official responsible for providing contract oversight and technical guidance to the Contracting Officer. POC responsibilities will include, but not be limited to: surveillance of services required under this contract; determining the adequacy of Contractor performance according to the specifications of this contract; acting as the Government's representative; ensuring compliance with contract requirements insofar as the work is concerned, certification of invoices, placing orders for service, providing technical guidance, overseeing technical aspects of the contract, serving as a member on the vehicle inspection team. The POC cannot authorize deviationsfromthespecificationsandrequirementsofthiscontract.IntheeventtheContractordeviates without approval from the CO, such deviation shall be at the risk of the Contractor and any cost related theretoshallbebornebytheContractor.ThePOCwillbedesignatedinwritingbytheCOaftercontract award.

(j) Contractor- The term "Contractor" as used herein refers to both the prime Contractor and his employees,andanysubcontractorsandtheiremployees.TheContractorshallberesponsibleforassuring that his subcontractors comply with the provisions of thiscontract.

(k) Dry Run -A dry run is defined as a request for service by authorized RVAHCS personnel, whereby the Contractor arrives at the designated pick-up point and no patient is transported due to a changeintheRVAHCSneeds.TheContractorwillbeentitledtotheapplicablebaserateonlywhendry runs are encountered due to no fault or negligence of theContractor.

(l) Joint Commission -A national organization dedicated to improving the care, safety and treatment of patients in a health care facility andenvironment.

(m) Mileage Rate- Mileage rate for ambulance services is the rate paid for each mile traveled beyondthespecifiedMileageThreshold.Thisrateappliestoone-waytransportationonly.Innoevent, shall the Contractor receive this rate for miles traveled within the specified MileageThreshold.

(n) No-Patient Charge- Fee allowed to Contractor for scheduled pick-ups for which, due to circumstances beyond the contractor's control (i.e. patient refuses pick-up, patient not home, patient not medically/mentally suitable for transport, etc.), no patient is transported. This charge shall only be assessedonactualtripstothepatientpick-uppoint,andshallnotbeassessedonscheduledpick-ups,that are cancelled in advance by RVAHCS and/or thepatient.

(o) Quality Assurance- Those actions taken by the Government to assure services meet the requirements of thiscontract.

(p) Quality Assurance Evaluator(s)- Government personnel responsible for surveillance of Contractorperformance.

(q) Quality Assurance Surveillance Plan- An organized written document used for quality assurance surveillance. The document contains specific methods for performing surveillance of the Contractor's continuous performance (See Attachment III to theSolicitation)

(r) Quality Control- Those actions taken by the Contractor to control the production of goods or services so they will meet the requirements of acontract.

(s) Scheduled Trip(s)- The term "Scheduled Trip" as used in this contract refers to those trips in whichtheContractorhasbeengivenadvancenotice(advancenoticeisdefinedasanoticegivenby4:00

Page 1 of Page 1 of p.m. the prior business day) of required services and a specific pick-up time.

(t) SpecialtyCareTransport(SCT)–Theterm“SpecialtyCareTransport”asusedinthiscontract refers to an inter-facility transportation of a critically injured or ill beneficiary by a ground ambulance vehicle,includingmedicallynecessarysuppliesandservice,atalevelofservicebeyondthescopeofthe EMT-Paramedic.ThisisaclinicaldeterminationpriortotransportthatSCTismedicallyrequireddueto the beneficiary’s condition required ongoing care that must be furnished by one or more health professionalinanappropriatespecialtyarea,forexamplenursing,emergencymedicine,respiratorycare, cardiovascularcare,oraparamedicwithadditionaltraining.Anyskillormedicationinadditiontoornot found in the Department of Transportation curriculum for EMT-Paramedics would be defined as additional training and is defined by the EMS MedicalDirector.

(u) UnscheduledTrips(s)-Theterm"UnscheduledTrip"asusedinthiscontractreferstothose trips required on an as needed basis and advance notice is notgiven.

(v) Vehicle(s)- The term "Vehicle(s)" as used in this contract refers to all modes of transportation provided under the requirements of this contract, unless a specific mode of transportation isidentified.

(w) Waiting- Waiting as used in this contract is defined as the time required and verified by authorizedmedicalfacilitypersonnel(authorizedemployeeswillbeidentifiedperParagraphB.2.14.), fortheContractortowaitatdesignatedpick-upand/ordeliverypointsinperformingcontractservices.

(x) Waiting Grace Period - The waiting grace period is defined as fifteen (15) minutes prior tothetimewaitingchargescommence.Thebaserateforambulanceservicesshallincludeafifteen

(15) minute waiting grace period at origin anddestination.

B.2.2 CONTRACTOREMPLOYEES

(a) Contractor employees shall not be considered Government employees for any purpose. RVAHCSreservestherighttorestrictanycontractoremployeefromperformingservicesunder thiscontractwhodoesnotmeettherequiredqualificationsfortheserviceshe/sheisrequiredto performandwhoviolatesFederalregulationsorisidentifiedasapotentialthreattothesecurity, safety,healthand/oroperationalmissionoftheVAanditspatientpopulation.Therestrictionof such contractor personnel shall not relieve the Contractor from performing all the required services, in accordance with all terms, conditions, and schedules containedherein.

(b) The Contractor shall furnish qualified personnel as required by contract specifications to accomplish all services under thiscontract.

(c) Contractor personnel performing services to RVAHCS shall always conduct themselves in a professional manner, maintain personal hygiene, wear clean, neat uniforms and be identified by having the company name, and employee name affixed to the uniform. The Contractor shall be responsibleforfurnishingallvehicles,personnel,equipmentandsupplies,vehiclefuel,uniforms, nametags and/or badges for performance of services under this contract. Employee identifications (that associate the employee with the Contractor) shall be worn in clear view above the waist. Contractor personnel shall not smoke in facilities or on the ambulance ramp to the Emergency Care Unit. There shall be no smoking within the vehicles by Contractor, patient or any otherpassenger.

(d) Each patient shall be treated with the utmost of respect and concern, with a professional approach to his/her dignity as an individual and patient. All communication, both verbal and non-verbal,byContractor'spersonnelwithandinthepresenceofthepatient,willbeconducted in a professional manner. The Contractor's personnel shall practice the utmost discretion when discussing the patient's condition with hospital professionals in the presence of the patient, relatives, and/orcaregivers.

Page 1 of Page 1 of

B.2.3 CONTRACTOR PERSONNELQUALIFICATIONS:

(a) All Contractor personnel performing contract services shall meet the qualifications as specified in this contract, as well as any qualifications required by Federal, State, County and local government entities from the place in which they operate. Contractor personnel shall meet these qualifications alwayswhileperformingcontractservices.Recordofeachemployeeastoname,level,andcertification to perform the duties of an ambulance driver or attendant shall be maintained and made available for inspectionuponrequest.TheVArequiresthatallcontractorpersonnelreceiveaphysicalverificationof safe driving record and drivers check every 2 years, and safety training one time peryear.

(b) During the contract period of performance, if the Contractor proposes to add on or replace personnel to perform contract services, the Contractor shall submit the required evidence of training,certifications,licensingandanyotherqualificationstothedesignatedPOC.Atnotime, shalltheContractorutilizeadd-onorreplacementpersonneltoperformcontractserviceswhodo not meet the qualifications under the terms and conditions of thiscontract.

(c) TheContractorshallprovideevidenceofrequiredtraining,certifications,licensingandanyother qualifications of any personnel performing services under this contract. This documentation should be consistent with the Oregon Health and Sciences curriculum for Emergency Medical Technicians Levels B, P, and SCT (as addressed in paragraph (d)below)

(d) Emergency Medical Technician-Paramedic (EMT-P) and EmergencyMedical

Technician-Basic (EMT-B) Qualifications. EMT-P and EMT-B providing services under this contract shall have the following qualifications, in addition to those required by Federal, State, and Local Government:

1. HavecompletedtraininginaccordancewiththestandardspublishedbytheDepartment ofHealthandHumanServices(http://egov.oregon.gov/DHS/ph/ems/certific/index.shtml).Suchtrainingprogramsmustalsobeacceptableundertheregulatingrequirementsforlocal EMSSystemssupportedbyDHHSunderPL93-154.

(http://history.nih.gov/research/downloads/PL93-154.pdf)

2. Shall submit evidence of equivalent training program successfully completed to the ContractingOfficer.

3. Shall be certified, licensed or otherwise officially recognized by the local, state or regionalgovernmentorpublicentitywheretheemergencyambulanceserviceisoperated or by which it isgoverned.

Shall attend (at their own expense) all refresher continuing education, or advance 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

2. (http://www.nhtsa.dot.gov/portal/site/nhtsa/template.MAXIMIZE/menuitem.2a0771e91315babbbf30811060008a0c/?javax.portlet.tpst=4670b93a0b088a006bc1d6b760008a0c _ws_MX&javax.portlet.prp_4670b93a0b088a006bc1d6b760008a0c_viewID=detail_view&itemID=1822abcc80c81010VgnVCM1000002c567798RCRD&overrideViewNam e=Article).

(e) AmbulanceDriver:Driversshallhaveavalidoperator'sorchauffeur'slicenseinaccordancewith Federal, State and local government requirements for their place of operation, for the services they perform. Drivers shall have EMT-B certification as aminimum.

Page 1 of Page 1 of

(f) Prices quoted in the Schedule include all personnel providing services; specifically, there must be a qualified driver (minimum EMT-B) and a qualified level of EMT rear attendant (EMT-I or EMT-P) on any ambulance assignment. Prices quoted for SCT include the services of EMT-SCT and/or CC. All attendants/van drivers on duty must be qualified to administer oxygen and shall have successfully completed the Standard and Advance First Aid Courses of the American Red Cross or U.S. Bureau of Mines, or equivalent. Proof in the form of a current or unexpired certificate that such first aid training has been successfully completed must be available uponrequest.

B.2.4 CONTRACTOR EQUIPMENT, VEHICLES ANDINSPECTION:

(a) RVAHCSreservestherighttoinspectcontractor'sequipmentandvehiclesorrequiredocumentation of compliance with contract specifications, and State laws, rules, regulations and guidelines governing emergency medical transport vehicles (ambulances). RVAHCS inspections of contractor facilities shall in no way constitute a warranty by RVAHCS that the contractor's vehicles and equipment are properly maintained.RVAHCSreservestherighttorestricttheContractor'suseofequipmentandvehicleswhich need repair, unclean, unsafe, damaged on the interior or exterior body, and are not in compliance with contract requirements. 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 toRVAHCS.

(b) Ambulances shall meet all current applicable Federal, State and local specifications and regulations including, but not limited to, licensing, registration, and safety standards, by the respective states ofservice.

(c) Vehiclesshallbecleanandmaintainedingoodrepairinaccordancewithmanufacturer'sinstructions and specifications always during the performance of this contract and shall contain-

1. An emergency safetykit,

2. Portable oxygenunit(s),

3. Fire suppressionequipment

4. Appropriate road emergency warningequipment.

5. Written emergencyprocedures.

6. Protective clothing required for the protection of contractor employees where patient care is expected, such as - i) gowns, ii) gloves, iii) masks,etc.

(d) BLS vehicle shall, in conjunction with the above, also provide on-board EMT-B, perform basic airway management, and provide IV at KVO withoutadditives.

(e) ALSvehicleshall,inconjunctionwiththeabove,alsoprovideanon-boardEMT-P,performcardiac monitoring, provide Advanced Cardiac Life Support (ACLS) drugs and procedures, and perform advanced airway management and medication monitoring and administration. Advanced airway management means the ability to intubate a patient and provide appropriate respiratory care, including emergencycricothyroidotomy.

(f) Specialty Care Transport (SCT) will be staffed by licensed Oregon State Registered Nurse or Oregon State Certified Paramedic with Respiratory and Ventilator Certification in accordance with the SCT.

SCT will also meet the following criteria:

Page 1 of

· Nurses have current Emergency Department and/or Critical Care Unit experienced Nurses and Paramedics certified inSCT

· Inverters allow transport of complex hospital monitoring and/or life support equipment All ambulances are equipped and licensed more than the Department of Health BLSrequirements

(g) All vehicles are to be equipped in accordance with the laws and regulations covering BLS, ALS, MedCabPsychTransportsandSCTpromulgatedbytherespectivestatesofservice(Oregon,Washington and/or California). Radios shall be adequately powered to provide communication within the Roseburg area as aminimum.

(h) AllvehiclesmustremainlockedwhennotattendedbyContractoremployeestoavoidunauthorized entrance. Vehicles (when not attended) shall NOT remain running, due to exhaustfumes.

(i) The Contractor that is providing ambulance services shall provide oxygen when it is requested by authorized RVAHCS facility personnel or required by the patient's medical condition. Oxygen required for ambulance services shall be at the rate and priceschedule.

(j) Apart from intravenous administration pumps, the Contractor shall not be permitted to borrow medical equipment from the RVAHCS facilities. The Contractor shall provide all medications required while in transport, sheets and blankets and other equipment and supplies required for use while in transport,fordirectpatientcare.Anexceptionwillbemadeformedicationswhichareoutsidetherealm ofwhatiscarriedinthevehicleandarecase-specifictothepatientneeds.Contractorshallatnotimeand under any circumstances exchange supplies, equipment and/or medications with RVAHCS (apart from intravenous administration pumps, as determined by the transporting facility). The prices quoted in the Price Schedule (B.1.) shall be inclusive of consumables used in transport. All vehicles used for critical patient care (i.e. ALS, BLS), shall include, but not be limited to, monitors, defibrillator with external pacemaker, intubation equipment, intravenous equipment, medications, patient compartment facilities, oxygenandsuctionsystemequipmentincludingportableoxygensuctionandaccessories.Uponapproval by the transporting facility, the Contractor will be allowed to transport the intravenous administration pumps that are delivering a fluid or medication to a patient during transfer. The Contractor shall return the pumps to the lending facility within 72 hours of patientdelivery.

(k) The Contractor shall submit a letter, in duplicate, fully describing the make, model and year of the vehicle which he/she agrees to furnish under this contract and the location and telephone numbers of his/her establishment where calls are received and vehicles are dispatched. This letter shall contain information as to the metering devices or methods Contractor proposes to use in determining mileage. The Contracting Officer shall be notified, in writing, of any equipment added or deleted after award of contract.

(l) RVAHCS shall be provided with a formal written report regarding the ambulance vehicles utilized by the Contractor. The report shall identify the various ambulance levels, their staffing criteria, stock equipment and medications carried, andprocedures.

B.2.5 SUBCONTRACTORTERMS:

The Contractor will be authorized to utilize another ambulance service company, as a subcontractor (certifiedtobewithinallrequirementsofthiscontract)tocompletethesetransportationrequests.Allbills forthissubcontractorservicewillbepaiddirectlytothePrimeContractoratthecontractrate.ThePrime Contractor will be responsible for payment for any subcontractedservices.

B.2.6 ESCORT

Page 1 of RVAHCS reserves the right to have an escort, such as a relative, or care provider of a beneficiary or RVAHCS staff may accompany a beneficiary when RVAHCS determines that such an escort is in the best interest of the beneficiary. RVAHCS shall also be the sole judge in determining when an escort is required.ThereshallbenoadditionalchargetoRVAHCSwhenescortsareauthorizedtotravelwiththe beneficiary. Contractor shall only be required to transport the escort with the patient and will not be required to return the escort back to point of origin. The escort shall ride in the front passenger seat so the proper seat belt restraints can be utilized. At no time shall escorts or other personnel, except a physician,nurseorrespiratorytherapisttreatingthepatient,beallowedinthepatientcompartmentofthe ambulance while the vehicle inroute.

B.2.7 SUBSTITUTION OFBENEFICIARY

RVAHCS reserves the right to substitute the beneficiary requiring services at any time during the performance of this contract to prevent delays, cancellations, or dry runs. There shall be no additional charge to RVAHCS when such changes occur.

B.2.8 NUMBER OFPATIENTS

TheContractorshalltransportonlyonebeneficiarypertrip,underambulanceservices,unlessspecifically authorized by RVAHCS facility personnel (authorized employees will be identified) to transport more than one, and at no time shall the Contractor transport more than twobeneficiaries.

B.2.9 STANDARDS OFCARE

TheContractorshalladheretothehighestqualitystandardsofbothpatientandmedicalcare.Contractor shall adhere to the city, country and state protocols established for emergency medical care and transportation. In the States of Oregon, Washington, and California first response transportation (911) must be performed utilizing Advanced Life support Vehicles. However, RVAHCS may order specific levels of ambulance service to their campuses or to pick-up patients at other hospitals, nursing homes or patient homes when transporting toRVAHCS.

B.2.10 RESERVED

B.2.11 HOURS OF PERFORMANCE AND RESPONSETIMES

(a) HoursofPerformance.ContractorshallprovideallALSandBLSgroundambulanceservices for patient beneficiaries asrequested.

(b) In the event of unusual circumstances, where the Contractor is unable to perform services, the Contractor shall immediately notify the RVAHCS Travel Section and provide a justification for non-performance.RVAHCSreservestherighttore-procureserviceswhichcannotbeperformed by the Contractor, in accordance with the terms, conditions, and schedule of thiscontract.

i. Response Time.The Contractor will be required to dispatch a vehicle and be onsite at the point of patient pickup within a reasonable timeframe commensurate with the distance of travelrequired.

ii. Should RVAHCS determine that immediate transportation is essential to prevent loss of life or serious bodily harm, transportation services may be procured without referral to the ambulance contractor. However, in these extremely rare cases, no charge shall be levied against theContractor.

iii. The Contractor shall provide and respond to all emergency calls in accordance with all Federal,State,andLocalregulationsgoverningdispatchofemergencymedical(ambulance) vehicles and medical care of on-board patients, to include the use of sirens and other measures to ensure timely arrival at the designated VA Medicalfacility.

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iv. If a BLS or ALS unit is requested and dispatched and after arrival at the pick-up point the crew feels a SCT unit is needed, approval must be granted by an official of the RVAHCS prior to transporting the patient if SCT rates are to beapplied.

(c) Response Time Compliance Rate.The Contractor shall maintain at a minimum, a 95% compliance rate on responses to pick-up or deliver during the contract year. Failure of the Contractortoperforminaccordancewiththiscomplianceratingmayconstitutesufficientcausefor termination of the contract for "cause," (see FAR clause52.212-4(m)).

(d) If the Contractor's place of business is located beyond the local telephone call zone of RVAHCS, the Contractor shall install and provide to RVAHCS, a toll-free number for accepting RVAHCS calls. It is estimated that 70% of all requests for service will be placed by telephone and 30% by fax. Requests for service may also be in writing or oral from an authorized representative of RVAHCS (authorized employees will be identified), and may be completed by telephone, mail, e- mail, or in person (by giving a written or verbalrequest).

(e) Electronic Transmissions.The Contractor shall, always during the contract period, have on his/herpremisesafunctioningfaxmachinetocommunicaterequirementswithRVAHCS(i.e., patient incidents, requests for service, special correspondence, etc.). The Contractor shall indicate if there is e-mail availability for their company to complete communications with RVAHCS (use of this communication system shall be mutually agreed upon after award of contract before any communications are completed in thismanner).

B.2.12 WAITINGTIME

(a) A reasonable timeframe will be determined by the distance of travel required as well as the stability of the patient. A 60-minute wait time will be expected based on a 50-mile distance. In cases where the patient requires immediate transport, services will only be ordered through the contract holder when the vendor can pick up a patient within a shortertimeframe.

(b) RVAHCS reserves the right to procure other transportation in rare circumstances when is in the best interest of the RVAHCS or the patient. These circumstances would include, but not be limited to, the need for immediate transport due to the patient’s condition, or to meet the timeliness requirements of theRVAHCS.

(c) Under no circumstance shall a patient wait for transportation service for more than thirty (30) minuteswithoutcorrectiveactionbeinginitiated.IftheContractorfailstodispatchavehiclefor therequestedservicewithinthirty(30)minutesafterreceivingarequestoranyorder,RVAHCS reserves the right to re-procure, or obtain the service from another source and to charge the Contractor, and costs incurred more than the awarded contract price, will be deducted from a future invoice. RVAHCS shall be the sole judge in determining when services will be re- procured. Alternative transportation will be initiated by RVAHCS at the time of need and Contractor will be notified after thefact.

(d) In addition, if RVAHCS needs to initiate a call for an alternate contractor, because the contract carrier failed to dispatch a vehicle, a dry run fee equivalent to the price in the contract’s Section B Pricing Schedule, will be deducted from a contract carrier’s futureinvoice.

(e) Trips shall be scheduled by Contractor so that patients are not held at any point to meet another vehicle for the purposes of carpooling unless authorized by the RVAHCS travel personnel or AOD.

B.2.13 AUTHORIZED RVAHCS PERSONNEL

Authorized personnel will be full time staff employed by RVAHCS. Authorized personnel should be calling directly from Government telephones from within the facility.

Prior to performance, the Contracting Officer will provide the Contractor with a list of names or position

Page 1 of Page 1 of titles and phone numbers of authorized Government personnel who may request services and receive calls from Contractor regarding contract performance. This list will be updated and submitted to the Contractor as changes occur. The Contractor shall ensure that requests for services are received from authorizedmedicalcenterpersonnel.Servicesrenderedinresponsetorequestsfromotherthanauthorized personnel shall be at the risk of the Contractor and any cost related thereto shall be borne by the Contractor.

B.2.14 REQUESTS FORSERVICES

(a) All requests shall be placed against pertinent schedule items, on a unit price basis, and will be verified against invoices and contractor’s request for service log submitted When ordering services (whether it be by telephone, facsimile, mail, e-mail and/or in person), the RVAHCS will provide the Contractor with the following type ofinformation:

1. Mode of transportationrequired;

2. Required date and time ofarrival;

3. Name ofbeneficiary;

4. Pick-up and deliverypoint;

5. Type and number of additional medical care specialistsrequired;

6. Type of equipment required;and

7. Last four digits of the patient's Social SecurityNumber

8. Patient’s Date ofBirth

(b) The Contractor shall be required to transport non-ambulatory patients who are not in need of emergency transportation or medical attention on gurneys, wheelchairs, litters or Gerichairs.

B.2.15 DISPATCHER

Requests for Transportation services shall be made to the contractor personnel identified below: Company:

Address:

City/State/Zip:

ContactPerson:

Normal Hours TelephoneNo.:

After Hours Contact Person:

After Hours Telephone No.:

B.2.16 INVOICES

Payments for services will bemonthly, in arrears, on certified invoices, typed or computerized, submitted within thirty (30) calendar days of the last day of each month. Contractor will send 911 transports to VTS office to review for eligibility status weekly. The VTS staff will return the report with a break down on which will be processed under contract and which will need a HCFA 1500 form prior to the close of the month. This will assist in correct invoicing and to expedite payment of the claims.Monthly Invoicesshall be submitted to the following addresses:

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for payment.

Acceptable invoices shall include the following information in addition to the times specified at clause 52.212-4(g):

· Date ofservice

· Name ofpatient

· Beginning and ending points for alltrips

Additional charges/ information to be listed and specified in all instances:

· Oxygen

· CardiacMonitors

· Number of miles traveled outside the "citylimits"

· Charges for "waitingtime"

· Intravenous medications andpumps

B.2.17 REIMBURSEMENT FOR MILEAGE OUTSIDE CONTRACTMILEAGE THRESHOLD AREAS OFCOVERAGE

a) Mileage Reimbursement.Reimbursement for mileage outside the contract Mileage Threshold of coverageshallbeatthemileageratestatedinthepricescheduleandshallbebaseduponthemiles fromthepick-uppointandthespecifieddestination.Anymileagefromtheplaceofbusinessand/or location of vehicle and the pick-up point, or from the delivery destination back to the place of business and/or location of next trip are not considered as a separate item of this reimbursement butshallbeincorporatedintothemileagerateaspartoftheadministrativecosts(orcostsofdoing business). Distances beyond the contract Mileage Threshold areas of coverage shall be calculated using current Rand McNally Standard Mileage Guide. Allowable charges for mileage outside the contractMileageThresholdareasofcoverage,shallnotexceed±5%ofthecurrentRandMcNally Standard MileageGuide.

b) Should RVAHCS decide that a previously scheduled trip may be cancelled, and a vehicle has already been dispatched to the designated pick-up point, RVAHCS may notify the Contractor to cancel the order. For orders that are cancelled while the Contractor is already in route to the designated pick-up, the Contractor will be entitled to receive 50% of the base rate for the trip, as provided in Schedule of Supplies or Services and Prices/Costs. This charge shall not include any mileagecharge.

c) Should the Contractor arrive at the destination before RVAHCS cancels the order, orif theContractorisunabletoperformascheduledpick-upforreasonsbeyondtheContractor'scontrol, (e.g., incorrect address, patient absence, patient refusal) then the Contractor shall receive 100% of base rate for a one-way trip as provided in the Price Schedule, and applicable mileage if outside contract Mileage Threshold areas ofcoverage.

d) The “Mileage Threshold” for the distance of a “Trip” referenced to the Base Ratefor

ALS (One-Way Only) and the Base Rate for BLS (One-Way Only), as priced in the “Section B - Price Schedule” shall be considered anywhere within the first 15 miles.

Other Charges.The prices listed in the accepted Schedule shall be inclusive of any and all ferry, bridge, tunnel or road toll charges. Contractor shall not bill RVAHCS for any such separate charges.

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Page 1 of B.2.18 PatientRights

(a) Contractor personnel shall not smoke in facilities or on the ambulance ramp to the Emergency Care Unit. There shall be no smoking within the vehicles by Contractor, patient or any other passenger.

(b) Patients may bring a reasonable amount of equipment, such as folding wheelchair, consumable medical supplies and personalsuitcase.

(c) Each patient shall be provided with safe and comfortable transportation to and/or from the RVAHCS.