36C26020Q0834.docx

36C26020Q0834 A.1 VAAR 852.219-74 LIMITATIONS ON SUBCONTRACTING—MONITORING AND COMPLIANCE (JUL 2018)

(a) This solicitation includes FAR 52.219-4 Notice of Price Evaluation Preference for HubZone Small Business Concerns.

(b) Accordingly, any contract resulting from this solicitation is subject to the limitation on subcontracting requirements in 13 CFR 125.6, or the limitations on subcontracting requirements in the FAR clause, as applicable. The Contractor is advised that in performing contract administration functions, the Contracting Officer may use the services of a support contractor(s) retained by VA to assist in assessing the Contractor's compliance with the limitations on subcontracting or percentage of work performance requirements specified in the clause. To that end, the support contractor(s) may require access to Contractor's offices where the Contractor's business records or other proprietary data are retained and to review such business records regarding the Contractor's compliance with this requirement.

(c) All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the Contractor's business records or other proprietary data reviewed or obtained in the course of assisting the Contracting Officer in assessing the Contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs.

(d) Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the Contractor to protect proprietary information as required by FAR 9.505-4, Obtaining access to proprietary information, paragraph (b). The Contractor is required to cooperate fully and make available any records as may be required to enable the Contracting Officer to assess the Contractor's compliance with the limitations on subcontracting or percentage of work performance requirement.

(End of Clause)

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

36C26020Q0834 10-08-2020

JAMES HARRIS

3605537618 10-21-2020 16:00 Department of Veterans Affairs Network Contracting Office 20 5115 NE 82nd Ave, Suite 102 Vancouver

WA

98662 X 621910 $16.5 Million N/A X 36C668 Department of Veterans Affairs SPOKANE VA Medical Center

4815 N ASSEMBLY ST

SPOKANE

WA

99205-6185 36C260 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

NON EMERGENT AMBULANCE TRANSPORTATION SERVICES FOR THE

SPOKANE VA HEALTH CARE SYSTEM IN ACCORDANCE WITH INCLUDED

PERFOMANCE WORK STATEMENT.

THIS WILL BE A SINGLE AWARD IDIQ CONTRACT FUNDED BY

INDIVIDUAL TASK ORDERS AS NEEDED BY THE DEPARTMENT OF

VETERANS AFFAIRS.

PERIOD OF PERFORMANCE IS 11/1/2020 THROUGH 10/31/2025.

ALL VENDOR QUESTIONS REGARDING THIS SOLICITATION SHALL BE

SHALL BE SUBMITTED IN WRITING BY 4:00 PM ON 10/14/2020 TO

JAMES.HARRIS13@VA.GOV AND JACOB.JACKSON2@VA.GOV

QUESTIONS AND OFFERS ARE TO BE SUBMITTED ELECTRONICALLY ONLY

TELEPHONE CALLS WILL NOT BE ACCEPTED.

See CONTINUATION Page X X X

ONE

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:

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:

36C26020Q0834

Page 1 of Page 1 of

B.2 PERFORMANCE WORK STATEMENT

Contractor shall furnish Advance Life Support (ALS) and Basic Life Support (BLS) ambulance services on a 24 hour per day 365 day per year for the Beneficiaries of the Department of Veterans Affairs, Spokane, Washington and Wenatchee CBOC.

A.1 NUMBER OF PATIENTS: It is understood and agreed that only ONE patient will be transported on a trip unless specifically authorized by VAMC. When more than one patient is transported on a trip, reimbursement will be made at the rate not exceeding the cost of transporting a single patient. When loaded mile is involved, the longest distance over which a patient is transported may be claimed when more than one patient is transported in a single ambulance concurrently. Contractor shall ensure that pick-ups and drop-offs are scheduled so that the total distance traveled will result in the most economical charge to the Government.

A.2 WAITING TIME: For time lost in waiting at either end or both ends of a trip due to causes beyond the Contractor's ā control, the contractor shall be reimbursed at the rate proposed. This charge applies if the crew is delayed longer than 15 minutes at time of pickup or delivery. The proposed rate will be charged in 15-minute increments. If pickup is other than VAMC the contractor will contact the VAMC Travel Office or Administrative Officer on duty as soon as the contractor anticipates that a delay for which contractor expects to claim reimbursement. This call is only for the purpose of verifying the contractor’s arrival time at the pick-up point (verification is made by confirming the time of pickup with the VA Staff, or the patient when the pickup is made off the VA Campus) and is not necessary if the contractor anticipates no delay for which the contractor will claim reimbursement.

A.3 RATES: Payment for mileage traveled beyond the Spokane and Wenatchee city limits will be limited to "one-way only" for the distance which the patient is transported. Such mileage cost will be paid in addition to the applicable rate per trip for any trip entirely within the city limits. A one-time flat rate will be charged for any trip within the city limits per the rates in the pricing schedule. If a trip goes beyond the city limits the mileage charge in the pricing schedule will be used starting with the first completed mile outside the city limits which will be added to the flat rate trip charge for that city. All trip charges are one-way only.

A.4 ORDERS: Requests for services shall be made in writing or by telephone from authorized VA personnel. The Government will not be held liable for those services performed by the Contractor(s) which are ordered by people who are unauthorized. The list of authorized personnel is listed on page 11, C.7. The request will specify a range of dates and times for acceptable delivery of a transported patient. The Contractor shall notify the VAMC within 15 minutes after receiving a request if they are able to provide the service. If the Contractor cannot provide the service requested the VA reserves the right to obtain the service from another source and will charge the contractor any excess cost resulting there from. It will be at the VAMC sole discretion as to when orders for service from another source will be needed and with whom those orders are placed. Contractor shall be informed of the condition of the patient at the time of request for service. The Contractor will be required to assign appropriate personnel for the transportation of patient. It is required that the contractor shall furnish an EMT on all requests, however the VAMC reserves the right to request the services of a Paramedic if appropriate in lieu of the EMT.

A.5 LIFE THREATENING EMERGENCY CALLS: Contractor shall dispatch ambulance no later than five (5) minutes after notification by VAMC authorized personnel of a life-threatening emergency call. If the Contractor is unable to provide an immediate pickup (within fifteen minutes after notification) in a threatening emergency situation, the Contractor shall immediately obtain services for the VA through 911 system. Any additional costs incurred for the 911 services shall be borne by the contractor.

A.6 AUTHORIZING PERSONNEL:

The following VAMC personnel are authorized to request or authorize ambulance services for VAMC Spokane:

· Chief of Staff

· Medical Officer of the Day (MOD)

· Chief, Health Care Administration Service (HCAS)

· Chief, EAOS

· Mobility Manager/Travel Clerk

· Administrative Officer of the Day (AOD) The following VAMC personnel are authorized to request or authorize ambulance services for Wenatchee Community Based Outpatient Clinic (CBOC):

· Chief of Staff

· CBOC Medical Director

· CBOC Administrator

· Chief, HCAS

· Chief, EAOS

· Mobility Manager/Travel Clerk

· Administrative Officer of the Day (AOD) A.7 LOADING/UNLOADING PATIENTS: Contractor(s) shall be required to assist patient from point of pickup to ambulance and from ambulance to point of destination.

A.8 REIMBURSEMENT: Spokane VA Medical Center will review each invoice for transport. The VA will only reimburse those veteran patients eligible for transportation. Contractor shall invoice each transportation call separately. For the purpose of this contract the city limits are defined as those boundaries established by the City of Spokane and Wenatchee. It is agreed and understood that the prices quoted in the schedule do not include any Ferry, Bridge, Tunnel, or Road toll charges. Any such legitimate toll charges incurred shall be limited to ONE WAY and shall be listed separately on Contractors invoices.

A.9 QUALIFICATIONS: The contractor shall be licensed as both an advanced and basic life support ambulance service by the State of Washington is required to provide Emergency Medical Services. The contractor shall maintain licensure/certification with the State of Washington is required throughout the life of the contract as required. License/certification lapses or expiration is grounds for termination of the contract or discontinuance of further ordering from the contractor. The contractor shall maintain documentation demonstrating they meet all requirements of Federal, State, County, or City codes regarding operation of this type of service. Documentation shall be made available to the VA immediately upon request for the duration of this contract. The contractor shall comply with the provisions of the Privacy Act of 1974, the Health Insurance Portability and Accountability Act (HIPAA) of 1996, as well as all applicable VHA regulations pertaining to fire safety and blood borne pathogens, which will be provided by the Contracting Officer's Representative (COR).

A.10 COMMISSION ON ACCREDITATION OF AMBULANCE STANDARDS: The contractor shall perform required services in accordance with the standards of the Commission on Accreditation of Ambulance Services, established principles and ethics of the medical profession established by the American Medical Association (AMA) and American College of Emergency Physicians (ACEP). The contractor, upon request, shall provide quality data and information related to services provided and participate in Spokane VA Medical Center Performance Improvement Programs when requested to do so. Upon request the contractor shall also provide documentation of the competency of staff that will be providing the contracted services. The contractor shall be responsible for ensuring contractor employees providing work on this contract are fully trained and completely competent to perform the required work; they will also be required to maintain records that document competence/performance level of employees working on this contract. Upon request the contractor shall provide a current copy of the competence assessment checklist and annual performance evaluation to the Contracting Officer's Representative (COR) for each contractor employee working on this contract.

A.11 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA): The contractor shall comply with the provisions of the Privacy Act of 1974, the Health Insurance Portability and Accountability Act (HIPAA) of 1996, as well as all applicable VHA regulations, which are obtainable at: http://www.hipaa.org/ and http://www1.va.gov/vhapublications/. The contractor shall not maintain and/or share sensitive or patient identifiable information in any form for any purpose, other than what is needed to perform its obligation under the established business agreement.

A.12 CONTRACTOR PERSONNEL: The contractor shall ensure that the following personnel (Emergency Medical Technicians [EMT], Paramedic, Non-Emergency Attendant/Drivers) requirements are met: Ensure and certify that personnel performing the services required under this contract are properly licensed and fully trained in the use of the vehicle and equipment that will -be used in the carrying out contracted services. The contractor shall ensure minimum staffing requirements as mandated by the State of Washington are met. Each vehicle shall be operated with sufficient personnel for adequate patient care, at least one of whom shall be an Emergency Medical Technician (EMT). Contractor must maintain records of each employee as to character and physical capabilities of performing the services of a driver and/or attendant. A record of each employee as to character, physical capabilities, and qualifications performing the duties of an ambulance driver or attendant must be maintained at the contractor's establishment and made available for inspection upon request of the contracting officer or COR. A roster of Paramedics, Registered Nurses (RN), Emergency Medical Technicians (EMT), and Non-Emergency Attendant Drivers (EMTs and LPNs if used to provide these services) shall be furnished to the contracting officer or COR upon request, and shall contain the following:

· Name

· Paramedic or EMT license number

· Driver's license number

· Date of initial training

· Date of refresher training A.13 USE OF SUBCONTRACTORS: The contractor is free to subcontract service in order to satisfy the VA's requirements. All companies utilized as subcontractors are subject to approval of the VA and must meet all requirements of this contract. The contractor shall disclose use of any subcontractors and ensure all certification and training requirements are in compliance with Federal, State, and County regulations governing ambulance services. The contractor shall be responsible for all subcontracting services provided under this contract. Subcontractor's invoices shall not be submitted directly to the VA, but rather shall be incorporated as part of the prime contractor's regular monthly invoicing.

A.14 TRAINING: Emergency Medical Technicians providing emergency services on this contract must meet the following training requirements: Have completed training in accordance with the standards published by the US Department of Health and Human Services (PL 93-154) and follow State of Washington Statutes requiring a minimum of 110 hours, with at least 20 hours of supervised clinical supervision, including 10 hours in a hospital emergency department. EMTs must also meet ongoing re-certification requirement standards determined by the State of Washington. Evidence of the "equivalent" training program successfully completed by the EMT must be submitted to the contracting officer before award. Failure to provide the requested evidence of training will result in an offeror being determined non-responsive and that offer will not be considered for award. The EMT must be certified, licensed or otherwise officially recognized by the Local, State, or Regional government or public entity where the emergency ambulance service is operated or by which it is governed. Current and updated certifications of EMTs providing service under this contract must be submitted to the contracting officer.

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

Have completed all of the required emergency medical technician and paramedic re-certification training. The rules shall provide that all re-certification training equals at least 700 hours of training that provide didactic and skills practice components, including a field internship experience aboard an advanced life support permitted ambulance. The Paramedic must be certified, licensed or otherwise officially recognized by the Local, State, or Regional government or public entity where the emergency ambulance service is operated or by which it is governed. Must possess an EMT-P Card (Paramedic). Evidence of the "equivalent" training program successfully completed by the Paramedic with a copy of State of Washington Certification Certificate must be submitted to the contracting officer or COR. Drivers: Drivers providing service under this contract shall have a valid ambulance personnel license with a driver designation as required by Federal, State and local law. Contractor shall ensure each ALS and BLS driver who operates a permitted vehicle meets qualifications as required by the State of Washington, and shall be responsible for assuring that its drivers are knowledgeable and competent in emergency vehicle operations and thoroughly familiar with the vehicles assigned; Ambulance drivers must complete all State of Washington licensing requirements. Attendants/drivers must have successfully completed standard and advanced first aid courses including use of cardiopulmonary resuscitation techniques (CPR) of the American Red Cross, US Bureau of Mines, or equivalent; be able to safely use all associated equipment, such as wheelchair lifts, and fire extinguishers; and been fully briefed and trained in passenger assistance techniques. Proof in the form of a current certificate that first aid training has been successfully completed must be available upon request. All contractor employees shall be enrolled periodically in "refresher" continuing_ education or advanced training programs as approved and required by the State of Washington, Department of Health Bureau of Emergency Medical Services. Such refresher training shall be submitted to the contracting officer upon request for verification of compliance. In no instance may this continuing education training be less frequent than every two years.

A.15 VEHICLES: The ambulances used under the terms of this contract shall be licensed and meet the minimum requirements governing emergency vehicles that is mandated by the State of Washington or other states as required to service this contract. Licensure must be maintained in current status throughout the term of the contract and a copy of updates provided accordingly. The contractor shall have an adequate number of vehicles to meet the requirements of this contract, along with the evidence of satisfactory vehicle inspection prior to use under this contract. Every ambulance operated must have at least two personnel. At least one person shall be licensed in cardiopulmonary resuscitation or first aid and the person in the emergency compartment shall be certified as an emergency medical technician - basic. BLS vehicles shall have at a minimum an emergency medical technician (EMT) attending the patient and a driver meeting minimum ambulance driver requirements of the State of Washington. ALS vehicles shall have at a minimum a paramedic attending the patient and an EMT, meeting requirements as a driver. Vehicles and equipment used in the performance of this contract must be clean, orderly, and in excellent operating condition at all times. Records of maintenance/preventive maintenance must be made available for inspection upon request. All vehicles shall be smoke free and have "No Smoking" signage posted. The contractor shall notify the contracting officer of any vehicle and equipment added/changed/deleted after award of contract. The Department of Veterans Affairs reserves the right to thoroughly inspect contractor vehicles prior to award and at any time during performance of any awarded contract. Mechanical defects noted at the time of inspection must be corrected and the ambulance(s) re-inspected prior to use under the contract.

Every ambulance in service under this contract shall be equipped as required by the State of Washington and any other state as required to service this contract and carry at least the minimal equipment necessary for the type of service provided, as determined by standards adopted by the State of Washington. Each emergency care vehicle shall have patient compartment facilities, oxygen and suction systems and equipment, environmental climatic equipment communications and additional systems equipment accessories and supplies as required by the applicable codes, rules and regulations established by Federal, State and Local regulating authorities.

A.16 INSURANCE COVERAGE: Throughout the effective period of this contract, the contractor shall possess insurance coverage in the minimum amounts to satisfy contract clause 852.237-71, Indemnification and Insurance, or Washington State requirements, whichever are higher. Any lapse in required coverage could result in discontinuance of further ordering. Prior to the start of contract performance, the contractor must submit to the contracting officer their certificate of insurance coverage evidencing required levels.

A.17 RESPONSE TIME: Response time shall be calculated from the receipt of the telephonic request for service. At the time of the request, the contractor shall acknowledge their ability to provide the service with the requested response time. If the contractor cannot provide the service for any reason, they must notify the VA staff person requesting the service of their inability to provide the service. STAT Orders are urgent orders that require response times quicker that standard orders. Response times for STAT Orders: Contractor shall arrive at the pickup no later than 30 minutes from the time of request.

· Response times for Standard Orders: Contractor shall arrive at the point of pickup no later than 45 minutes from the time of request.

· Response time for Long Hauls: Contractor shall arrive at the point of pickup no later than 2 hours from the time of request.

· If the contractor fails to furnish service within the required response times, the VA reserves the right to obtain this service from another source and may charge the contractor with any excess cost which may result and could be deducted from their monthly invoice. It will be at the VAMC sole discretion as to when orders for service from another source will be needed and with whom those orders are placed. Repeated failure to meet required response time may result in termination of the contract or discontinuance of further orders. Response time will be calculated from the contractor's receipt of the telephone/fax request for service.

· The contractor shall not charge the VA a cancellation fee when cance11ations are made prior to the ALS.BLS vehicle embarking upon the dispatch.

A.18 ORIGIN AND DESTINATION: Contractor shall provide ambulance services to beneficiaries of the Spokane VAMC to or from any designated location within the defined service area, encompassing the State of Washington, Idaho, Oregon, and Montana. The VA staff will specify the points of origin and the destination of every trip.

A.19 PATIENT CONDITION UPON ARRIVAL: Upon arrival at the patient pickup point, if the contractor determines the condition of the patient scheduled for pickup is different than what was stated on the travel request, the contractor shall contact the Travel Office or Administrative Officer of the Day (AOD) for further instructions. Name and number of this individual will be provided by the VA when placing individual orders.

A.20 TRIP DOCUMENTATION: The contractor shall document each VA authorized transport with an appropriate document that specifies the date, patient name and identification #, time of pickup, destination, time of drop off, mileage, and any notes regarding issues particular to the specific transport, including recording oxygen, cardiac monitoring and other services provided (i.e., material items, supplies). The Contractor shall transmit a copy of the trip ticket within 24 hours of providing the service. These forms will serve as documentation of the transport and will be a source document for reconciliation of the contractor's requests for payment.

A.21 NON-PICKUP OF PATIENT: When ambulance service under the terms of this contract involves a trip to or from a VA facility, but due to unforeseen circumstances the patient is not available for pickup, the contractor shall collect for the trip at the rates applicable under the pricing portion of this contract. The VA reserves the right to substitute beneficiary requiring service at any time during the performance of the contract to prevent "Unloaded Trips", delays and cancellations. There shall be no additional charge to the VA when such changes occur.

A.22 ESCORTS: Subject to limitations of current regulations, the VA reserves the right to have an escort, such as a relative, or care provider of beneficiary or VA staff accompany beneficiary when the VA determines that such as escort is in the best interest of the beneficiary. The VA will also be the final judge in determining when an escort is required. There shall be no additional charge to the VA when escorts are authorized to travel with beneficiary. Contractor shall only be required to transport escort with patient and shall not be required to return the escort back to point of origin.

A.23 INVOICE PROCEDURES: The contractor shall use an itemized billing format, with the resources furnished when submitting ambulance services invoices. Invoices shall be submitted no later than fifteen (15) calendar days, following the end of the month of services and are to include all contract services furnished for the preceding month. Invoices shall specify the contract number, patient name, date of service, pickup and delivery point, and an itemized list of charges allowed under the contract, such as; pickup charge, mileage charge, and any additional materials, items, and services necessary (oxygen, etc.). The date of payment will be computed from the date a proper invoice is received by the VA. When non-authorized service runs are referenced on an invoice, the VA Travel Clerk, after discussion with the contractor, may delete and initial the service. This will assist the contractor in expediting the invoices. Invoices are to be submitted to the following address: Spokane VA Medical Center Travel Department (136B), 4815 N. Assembly Street Spokane, WA 99205. The VA will review and reconcile invoices with travel forms and VA logs. Unauthorized charges will be suspended pending investigation. Unauthorized charges are those that are being disputed or have not been pre- approved by authorized VA personnel, and that are not allowable under the contract. A final determination will be made within 30-days, after notifying the contractor of charges being suspended. However, if an item or service is required on a trip that is not specifically listed in the pricing section of this contract, it must be approved by the contracting officer and paid under a separate contract or purchase order.

A.24 INSPECTIONS: Before award or during the effective period of the contract, the VA reserves the right to thoroughly inspect and investigate the establishment, facilities, business reputation, and other licensure and qualifications of the contractor.

A.25 INCIDENT/ACCIDENT REPORT: Any adverse events involving the welfare of a VA beneficiary while in the care of the contractor during transport shall be recorded and reported to the COR or the AOD after normal business hours (4:30PM - 8:00AM) within 24 hours of the event. The contractor shall make initial contact immediately after the event via telephone, fax, or email notifying the VA of any incident, accidents, or medication or transfusion errors involving injury to VA patients during transport. The VA will provide POC's and phone numbers after contract award and prior to service start. The contractor shall prepare and submit a detailed incident report with all information necessary to conduct a full review (date, time, patient, place of pickup, place of incident, names of parties involved, a detailed summary of events, etc.) with recommended/implemented corrective action within 24 hours of such incident to the contracting officer with a copy to the Patient Administration Program Manager of Spokane VA Medical Center.

A.26 PATIENT RIGHTS: The contractor shall be courteous to VA beneficiaries under their care. Any substantiated mistreatment of patients in the performance of this contract may be cause for termination of the contract, or discontinuance of further placement of orders. The VA reserves the right to request driver removal from transporting VA patients if mistreatment is substantiated. Drivers must be courteous and considerate of all patients they are transporting. The contractor shall notify the COR, in writing, within 24 hours of any complaints made by the patients regarding service issues, providing recommendations for improved service.

A.27 SAFETY REQUIREMENTS: In order to protect the lives and health of patients, the contractor shall take such safety precautions as the contracting officer or COR may determine to be reasonably necessary. The contracting officer or COR will notify the contractor of any safety non-compliance and the action to be taken. The contractor shall, after receipt of such notice, immediately correct the conditions to which attention has been directed. If the contractor fails or refuses to comply promptly, the contracting officer may issue an order stopping all or any part of the work and discontinuance of further order placement.

A.28 INFECTION CONTROL: Contractor employees shall receive ongoing training on universal precautions and infection control as appropriate to their duties. Contractor drivers and attendants shall use universal precautionary measures at all times for the prevention and control of the spread of infectious agents to all persons. The contractor shall delay using drivers and/or attendants who have a cold, flu, chickenpox, measles, or have been around someone who is sick on trips until well or no longer symptomatic. The VA Infection Control Manual can be accessed at:

http://vaww/Departments/hospitalwide/Infection%20Control/index.asp A.29 DISPOSAL OF HAZARDOUS WASTE: Contractor employees shall be trained on how to handle bio-hazardous waste during transport and how to properly dispose of bio-hazardous waste in designated containers, including how to dispose in designated containers when onsite at Spokane VA Medical Center. The contractor shall not dispose of any bio- hazardous materials at any location on the premises except as specified by the contracting officer.

A.30 CONTRACTOR'S QUALITY CONTROL PROGRAM {QCP): The contractor shall establish and maintain a complete QCP to assure the requirements of this contract are provided as specified, during the life of the contract. The contractor's QCP shall include the following: An inspection plan covering all services required by this contract: The inspection plan must specify the type of inspections (i.e., scheduled, unscheduled), areas for inspection, frequency of inspections and documentation of inspections, and who will conduct the inspections, with his or her title specified. On-site records of all inspections conducted by the Contractor: The inspection records must note findings and necessary corrective action. Taken, the timeframe, and follow-up responsibility/issues. The VA reserves the right to request copies of any and/or each inspection. Internal procedures for updating medical service protocols: The contractor must have established internal procedures for updating medical service protocols, which have been revised, requires changes and/or incorporation of new protocols since licensing. The changes to processes, equipment, and/or protocol that may affect performance of contract must be communicated in writing to the Contracting Office. Methods for identifying and preventing deficiencies: The contractor must have quality improvement mechanisms in place that allows the business to evaluate the quality of services performed by using established methods for identifying and preventing deficiencies before the level of performance becomes unacceptable. Specific organizational monitoring functions and areas must be identified with levels of responsibility associated, noting intermediate supervisory responsibility and overall management responsibility for ensuring total acceptable performance. An On-Site competency records of each employee: The contractor must have employee records available on- site that identifies the character, physical capabilities, certifications, and ongoing training records of each employee performing services under this contract. On-Site records for tracking of customer complaints and actions taken: The contractor shall keep on-site records for tracking customer complaints or problems with the procedures or initiatives implemented for correction and/or elimination of the problem before negative effects caused interruption of performance on contract.

A.31 Drug Testing Policy:' The contractor shall have internal policies and procedures for addressing drug and alcohol abuse.

A.32 Patient Satisfaction Survey: Contractor shall develop a patient satisfaction survey for the VA's approval. Once approved contractor shall report results of the survey semi-annually.

A.33 MISCELLANEOUS: Contractor employees shall always conduct themselves in a professional manner while on VA premises and while transporting VA patients and conducting business for the VA. Vehicles transporting VA beneficiaries must be dedicated exclusively to VA transports. The contractor may not carry private patients with VA beneficiaries under this contract. All employees shall be dressed in uniform with a name badge displayed.

A.34 FEDERAL LEGAL HOLIDAYS: The following Federal legal holidays are observed by this facility:

*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 Any other day designated by Executive Order or Any other day designated by the President’s Proclamation

A.35 DEFINITIONS:

CONTRACTING OFFICER'S REPRESENTATIVE (COR): ls the designee to represent the Contracting Officer in furnishing technical guidance and advice or generally administer the work being performed under this contract. The foregoing is not to be construed as authorization to interpret or furnish advice and information to the Contractor(s) relative to financial or legal aspects of the contract. Enforcement of these segments is vested in and is the responsibility of the Contracting Officer.

BASIC LIFE SUPPORT (BLS):

· Staffed by two Washington State Certified Emergency Medical Technicians (EMT).

· Transport the sick and injured non-life-threatened patient.

· Transport patients requiring oxygen therapy and extrication.

· BLS units can transport patient with clear lV fluids.

· BLS units cannot start I.V. lines or transport medicated lines unless on a locked-out pump.

ADVANCED LIFE SUPPORT (ALS):

· Staffed by a Washington State Certified Paramedic and Washington State Emergency Medical Technician (EMT).

· Heart monitor with defibrillator and pacing capabilities.

· Establishing or maintaining IV. accesses to include antiarrhythmics, narcotics, vasopressors, and IV. fluids.

· Monitoring/maintaining respiratory status to include intubation and pulse oximetry as needed.

A.36 CONFIDENTIALITY OF PATIENT RECORDS: The Parties agree to hold all individually identifiable health information as that term is defined in the Health Insurance Portability and Accountability Act and regulations promulgated thereunder (collectively, "HIPAA") that is after April 14, 2003, shared with, transferred or transmitted to, or otherwise obtained by contractor on or from or on behalf of the VA in the course of contractor providing the services under this Agreement ("Protected Health Information") strictly confidential;, and provide protections to prevent the unauthorized disclosure of such information, including, but not limited to the protection required by applicable Federal, State and Local laws and/or regulations regarding the security and the confidentiality of patient health care information including, but not limited to, HIPAA. Specifically, contractor agrees as follows: (1) to maintain safeguards as necessary to ensure that the Protected Health Information is not used or disclosed except as required to perform its obligations under this Agreement, as expressly permitted herein or as required or permitted by law; (2) to ensure that any subcontracts or agents to whom it provides Protected Health Information agree to the same restrictions and conditions that apply with respect to such information; (3) to make available its internal practices, books and records relating to the use and disclosure of Protected Health Information to the Department of Health and Human Services or its agents as required by HIPAA; (4) to incorporate any amendments or corrections to Protected Health Information when notified by the VA that the information is inaccurate or incomplete; (5) at termination of this Agreement, if feasible, to return or destroy all Protected Health Information that it still maintains in any form and not to retain any such Protected Health Information in any form, (6) to ensure that, as to any Protected Health Information held by contractor, contractor policies are in place to allow access to that Protected Health Information by subject of that information as required by HIPAA; and (7) to report to the VA any use or disclosure of Protected Health Information which is not allowed under the terms of the Agreement. If at any time after the effective date of this Agreement it is determined that either party is in breach of this Section, the other party, in its sole discretion, may immediately terminate this Agreement.

A.37 CONFIDENTIALITY: Any contract resulting from this solicitation will be subject to the Privacy Act of 1974. Federal Acquisition Regulations 52.224-1, Privacy Act Notification, and 52.224-2, Privacy Act, are incorporated by reference. The Contractor shall be responsible for providing responsible management of medical care. Care provided will respect and integrate the patient's beliefs, values and cultural influences. The Contractor shall involve the patient in care decisions by keeping him/her fully informed about the diagnosis, plan of care and treatment goals, risks and benefits of proposed treatment, and prognosis; shared decision making shall be pursued.

A.38 DISPOSITION OF RECORDS: The Contractor shall dispose of archived records in accordance with IPAA and the ambulance company’s accreditation standards. JACHO and VA regulations:

· Records Control Schedule (RCS) 10-1, Section XXVI.

· MI, Part I, Chapter 5, Patient Records.

· Joint Commission on the Accreditation of Healthcare Organizations (JACHO), Standard IM.2 and IM.3.

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

BLS Trip within Spokane City limits.

All quantities listed are estimates based on available historical data.

Ordering Period one: 11/01/2020 to 10/31/2021

BLS Rate per mile beyond Spokane city limits, one way.

ALS trip within Spokane city limits

ALS rate per mile beyond Spokane city limits, one way only

Medical Oxygen when required

Waiting Time when required (PER 1/4 HR)

Flat Rate to transport patient from Spokane VAMC to Seattle VAMC

Flat rate to transport patient from Spokane VAMC to Portland VAMC

Flat Rate to transport patient from Wenatchee VAMC to Seattle VAMC

Flat rate to transport patient from Wenatchee VAMC to Portland VAMC

Flat rate to transport patient from Wenatchee VAMC to Spokane VAMC

Walla Walla BLS Base Rate

Walla Walla ALS Base Rate

Walla Walla city limits ALS/BLS Mileage Rate

BLS Trip within Spokane City limits.

Ordering Period one: 11/01/2021 to 10/31/2022

BLS Rate per mile beyond Spokane city limits, one way.

ALS trip within Spokane city limits

ALS rate per mile beyond Spokane city limits, one way only

Medical Oxygen when required

Waiting Time when required (PER 1/4 HR)

Flat Rate to transport patient from Spokane VAMC to Seattle VAMC

Flat rate to transport patient from Spokane VAMC to Portland VAMC

Flat Rate to transport patient from Wenatchee VAMC to Seattle VAMC

Flat rate to transport patient from Wenatchee VAMC to Portland VAMC

Flat rate to transport patient from Wenatchee VAMC to Spokane VAMC

Walla Walla BLS Base Rate

Walla Walla ALS Base Rate

Walla Walla city limits ALS/BLS Mileage Rate

BLS Trip within Spokane City limits.

Ordering Period one: 11/01/2022 to 10/31/2023

BLS Rate per mile beyond Spokane city limits, one way.

ALS trip within Spokane city limits

ALS rate per mile beyond Spokane city limits, one way only

Medical Oxygen when required

Waiting Time when required (PER 1/4 HR)

Flat Rate to transport patient from Spokane VAMC to Seattle VAMC

Flat rate to transport patient from Spokane VAMC to Portland VAMC

Flat Rate to transport patient from Wenatchee VAMC to Seattle VAMC

Flat rate to transport patient from Wenatchee VAMC to Portland VAMC

Flat rate to transport patient from Wenatchee VAMC to Spokane VAMC

Walla Walla BLS Base Rate

Walla Walla ALS Base Rate

Walla Walla city limits ALS/BLS Mileage Rate

BLS Trip within Spokane City limits.

Ordering Period one: 11/01/2023 to 10/31/2024

BLS Rate per mile beyond Spokane city limits, one way.

ALS trip within Spokane city limits

ALS rate per mile beyond Spokane city limits, one way only

Medical Oxygen when required

Waiting Time when required (PER 1/4 HR)

Flat Rate to transport patient from Spokane VAMC to Seattle VAMC

Flat rate to transport patient from Spokane VAMC to Portland VAMC

Flat Rate to transport patient from Wenatchee VAMC to Seattle VAMC

Flat rate to transport patient from Wenatchee VAMC to Portland VAMC

Flat rate to transport patient from Wenatchee VAMC to Spokane VAMC

Walla Walla BLS Base Rate

Walla Walla ALS Base Rate

Walla Walla city limits ALS/BLS Mileage Rate