36C26024R0088 Air Broker DRAFT RFP watermarked.pdf

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. UEI: EFT:

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. NOV 2021)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

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

36C26024R0088 06-18-2024

Krystal Weeks 253-209-3726 08-12-2024

2:00 PM PDT

36C260 NCO 20 Network Contracting Office

ATTN: V4CONT

1601 E. Fourth Plain Blvd Bldg.17, Suite B428 Vancouver WA 98661

X 100

X

481211

1500 Employees

N/A

X

Department of Veterans Affairs To be determined at the Task Order level

36C260

NCO 20 Network Contracting Office

ATTN: V4CONT

1601 E. Fourth Plain Blvd Bldg.17, Suite B428 Vancouver WA 98661

FMS-VA-2(101)

Financial Services Center PO Box 149971 Austin TX 78714-9971

See CONTINUATION Page

The Department of Veterans Affairs seeks to establish one (1) to five (5) Indefinite Delivery Indefinite Quantity (IDIQ) contracts to provide Air Ambulance Broker services.

See Performance Work Statement (PWS) for description of the requirement. See Section E for specific instructions regarding proposal submittals.

This solicitation is 100% set-aside for small business concerns.

See CONTINUATION Page

X X

36C26024R0088

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 PERFORMANCE WORK STATEMENT (PWS)

B.3 SERVICE AREAS- REGION DEFINITIONS

B.3 QUALITY ASSURANCE SURVEILLANCE PLAN (QASP):

B.4 PRICE/COST SCHEDULE

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (NOV 2023)

C.2 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.3 52.216-18 ORDERING (AUG 2020)

C.4 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.5 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.6 52.216-32 TASK-ORDER AND DELIVERY-ORDER OMBUDSMAN (SEP 2019)

C.7 52.219-6 NOTICE OF TOTAL SMALL BUSINESS SET-ASIDE (NOV 2020)

C.8 52.219-14 LIMITATIONS ON SUBCONTRACTING (OCT 2022)

C.9 VAAR 852.211-76 LIQUIDATED DAMAGES – REIMBURSEMENT FOR DATA BREACH COSTS

(FEB 2023) ALTERNATE I (FEB 2023)

C.10 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV 2018)

C.11 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020)

C.12 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR

EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (FEB 2024)

C.13 MANDATORY WRITTEN DISCLOSURES

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

BUSINESS ASSOCIATE AGREEMENT BETWEEN THE DEPARTMENT OF VETERANS AFFAIRS

VETERANS HEALTH ADMINISTRATION, , AND

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES (SEP 2023)

E.2 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998)

E.3 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS AND VIDEO

SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

E.4 52.204-29 FEDERAL ACQUISITION SUPPLY CHAIN SECURITY ACT ORDERS—

REPRESENTATION AND DISCLOSURES (DEC 2023)

E.5 52.207-6 SOLICITATION OF OFFERS FROM SMALL BUSINESS CONCERNS AND SMALL

BUSINESS TEAMING ARRANGEMENTS OR JOINT VENTURES (MULTIPLE-AWARD CONTRACTS)

(DEC 2022)

E.6 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.7 52.216-1 TYPE OF CONTRACT (APR 1984)

E.8 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.9 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018)

E.10 52.212-2 EVALUATION—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (NOV

2021)

E.12 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES (FEB 2024)

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 NCO 20 Network Contracting Office

ATTN: V4CONT

1601 E. Fourth Plain Blvd Bldg.17, Suite B428 Vancouver WA 98661

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

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

[X] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Negotiated at the Order Level

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.

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

AMENDMENT NO DATE

B.2 PERFORMANCE WORK STATEMENT (PWS)

SPECIAL NOTE: The Air Ambulance Contractor must be a “Covered Entity” as defined by Medicare. The Health Insurance Portability and Accountability Act (HIPAA) Rules apply to covered entities and business associates. Individuals, organizations, and agencies that meet the definition of a covered entity under HIPAA must comply with the Rules' requirements to protect the privacy and security of health information and must provide individuals with certain rights with respect to their health information.

1.0 Objective: The purpose of this Indefinite Delivery/Indefinite Quantity (IDIQ) contract is to furnish Air Ambulance Broker Services for VHA beneficiaries in the United States. The Contractor will arrange air ambulance service twenty-four (24) hours per day, seven (7) days per week, including all holidays for beneficiaries of the VA. For this IDIQ, patients shall be transported by Air Transport only if the patient requires Advanced Life Support (ALS) or the physician designates a patient as a critical care transport. It is further understood that a minimum of two medical personnel, licensed according to state or national requirements, must provide direct patient care in addition to the vehicle operator. For ALS transport, a paramedic is required as primary care provider. For critical care transports, the primary care provider must be a physician, advanced practice nurse, registered nurse, physician assistant or paramedic with a minimum of 3 years of critical care experience in accordance with the standards of the Commission on Accreditation of Medical Transport System (CAMTS) and National Accreditation Alliance Medical Transport (NAAMTA Global), for any critical care transport.

1.1 The Government’s intent is to establish a multiple-award IDIQ with air transportation brokers (or prime contractors with large operator networks) who can leverage multiple air ambulance assets nationwide. The brokers, or prime contractors, should be well positioned to deliver assets to move patients in the quickest time possible. The IDIQs will establish a price schedule, which allow the VHA Medical Center Healthcare transportation center to easily order services when needed.

2.0 Performance Requirements: Contractor/Broker shall furnish twenty-four (24) hour Air Ambulance Service for the beneficiaries of VHA. Services are required for the entire Continental United States (CONUS), Alaska, Puerto Rico, Hawaii, American Samoa, and Guam. Air ambulance flights are expected to be one-way trips to an authorized facility, though may be roundtrip (subject to subsequent medical considerations and VA authorization) for an authorized beneficiary.

2.1 Number and Type of Patient: It is understood and agreed that only one patient will be transported on a trip unless specifically authorized by an authorized individual of the VA. Under no circumstances will the VA order air ambulance services for more than two passengers for any one flight. Contractor will be expected to accept patients; for example, heart cases, the mentally disturbed, the critically ill, or communicable disease cases, but has the right to refuse when in the best interest of safety. The authorized ordering individual may, in the interest of the patient, allow a relative to accompany him/her at no extra charge to the Government.

2.2 Response Time: All response times are measured from the time the VA places an order for a pick-up to the time the VA acknowledges and accepts receipt of the fully scheduled flight.

2.2.1 On Demand Response: The broker/contractor shall be required to provide air ambulance arrangements within sixty (60) minutes of order for all orders submitted as STAT or Urgent.

Reed, Brian (OGC) This should be clarified further to make it clear that the intent is to award a stand-alone IDIQ contract for each of these regions. We should clarify that this will not be a MATOC (which implicated fair opportunity). The language in these two sections im plies a single IDIQ covering all areas.

Weeks, Krystal K. (NCO20) (she/her/hers) Revised to indicate multiple awards

Weeks, Krystal K. (NCO20) (she/her/hers) Clear up: authorized individual /COR, OO/ etc

Weeks, Krystal K. (NCO20) (she/her/hers) Commercial standard?

Weeks, Krystal K. (NCO20) (she/her/hers) Research indicates that some companies offer it at no cost and others charge - there is no primary standard here.

2.2.2 Standard Response Time: The broker/contractor shall be required to provide air ambulance arrangements within ninety (90) minutes of orders not designated as STAT or urgent.

2.3. Waiting Time: For time lost in waiting at either end or both ends of a trip due to causes beyond the contractor’s control that exceed thirty (30) minutes of the scheduled transport time, the Contractor will be reimbursed at the hourly rate established in the price schedule in thirty

(30) minute increments. If the pickup is other than at the VA Medical Center, the Contractor will call the Patient Transportation Coordinator or Medical Administrative Assistant on duty as soon as possible if they anticipate a delay may develop for which they expect to claim reimbursement. This call is only for the purpose of verifying arrival time at the pickup point and is not necessary if the Contractor anticipates no delay for which they will claim reimbursement.

2.4. Patient Medical Records:

The contractor shall maintain for a period of five (5) years, a record of each air ambulance operation, including but not limited to the following:

(1) Patient’s name.

(2) Date of flight.

(3) Diagnosis.

(4) Originating and termination points and patient’s condition upon departure and arrival.

(5) An in-flight medical attendant’s report of the patient’s status, including vital signs, level of consciousness, drugs administered, and details of therapeutic intervention.

(These notes can be vitally important to those who must provide subsequent care.)

(6) Unusual circumstances encountered during the flight, including inordinate altitudes flown, turbulence, times associated with these abnormal conditions, or other abnormal conditions, etc.

2.5. Operational Requirements:

2.5.1. Within three (3) business days after award and notification, the successful offer shall supply certifications, competencies, and qualifications with a list of all the personnel and their titles that will be involved in the performance of the resulting contract. Also included must be the names and telephone number to dispatcher/fax.

2.5.2 A Federal Aviation Administration (FAA) flight plan shall be filed for any aircraft used for an air ambulance flight under this contract. Wherever practical and possible, the pilot shall take advantage of all existing ground and air communication facilities.

Before each flight, the pilot shall obtain the latest information relative to weather, airport conditions, and navigational facilities and, further, shall be satisfied that all conditions are such that they will not constitute a hazard. In the event a flight is interrupted short of the destination, the contractor shall immediately notify the VA Facility POC requesting the transport and make necessary arrangements.

2.5.3. All operations under the contract must be supervised by competent trained personnel who adhere to safe practices. Precautions shall be taken to keep passengers and spectators away from the aircraft in accordance with commercial standards. The patient should be sufficiently isolated from the cockpit to minimize in-flight distractions and interference, which would affect flight safety.

2.5.4. Passengers shall not be allowed to board aircraft when engines are running.

2.5.5. The contractor shall ensure each air ambulance is staffed with an aircrew in accordance with the Commission on Accreditation of Medical Transport System (CAMPS) criteria. Additional contractor team members may accompany the aircrew at the discretion of the contractor, at no additional cost to the VA.

2.6. Information Relayed Between Pilot and Medical Attendant:

2.6.1. As a minimum, the pilot will provide the following information to the Medical Flight Attendant:

a. ETA (Estimated Time of Arrival).

b. Planned flight altitude.

c. Significant and/or expected weather.

2.6.2. The Medical Flight Attendant will provide, at a minimum, the following information to the pilot:

a. Brief appraisal of the patient’s problem and condition.

b. Patient’s environment needs such as pressurization, temperature, etc.

c. Significant changes in the patient’s condition during flight.

d. Care/medication administered during flight.

2.7 All work related to this contract shall be performed in accordance with any applicable FAA, U.S. Department of Transportation (DOT), Occupational Safety Health Administration (OSHA) regulations, as well as applicable State health and safety regulations.

All aircraft used in the performance of this agreement must be maintained in an airworthy condition in accordance with all applicable FAA Regulations procedures by means of an established inspection and maintenance plan. Line inspections shall be performed at least once in the twenty-four (24) hour period preceding a flight. Aircraft shall be handled exclusively by trained personnel.

Weeks, Krystal K. (NCO20) (she/her/hers) fix

Define once

2.8 This solicitation applies to non-scheduled operations of air transportation conducted under:

• 14 CFR Part 121 (“Supplemental Operations”) http://rgl.faa.gov/RegulatoryandGuidanceLibrary/rgFAR.nsf/MainFrame?OpenFrameSet

• 14 CFR Part 135 (“Commuter and On-Demand Operations”) http://rgl.faa.gov/RegulatoryandGuidanceLibrary/rgFAR.nsf/MainFrame?OpenFrameSet

2.9 Medical Standards – refer to Federal Aviation Regulations (FARs) Part 61.23, Subpart A:

“Medical Certificates: Requirement and Duration”

• Medical Class (1st, 2nd, or 3rd)

• Medical Date (FAA certified physician check)

2.10 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 SCLS 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.

3.0 Term of Agreement: This will be a firm fixed price IDIQ. This agreement shall be effective for the term of the Contract including any possible extensions.

3.0.1 Non-Personal Services: The Government will neither supervise contractor employees nor control the method by which the contractor performs the required tasks.

Under no circumstances will the Government assign tasks to, or prepare work schedules for, individual contractor employees. It shall be the responsibility of the contractor to manage its employees and to guard against any actions that are of the nature of personal services or give the perception of personal services.

http://rgl.faa.gov/RegulatoryandGuidanceLibrary/rgFAR.nsf/MainFrame?OpenFrameSet http://rgl.faa.gov/RegulatoryandGuidanceLibrary/rgFAR.nsf/MainFrame?OpenFrameSet fix

3.0.2 If the contractor believes that any actions constitute, or are perceived to constitute personal services, it shall be the contractor's responsibility to notify the Contracting Officer (CO) immediately.

3.1 Contract Administration and Management:

3.1.1 The CO is responsible for the administration of this IDIQ. The CO is the only individual authorized, to extent indicated in this contract, to take actions on behalf of the Government, which may result in changes in the contract terms, to include deviation from the statement of work, details, and performance schedules. Communications pertaining to contractual matters shall be addressed to the CO. No changes in or deviation from the scope of work shall be affected without a written modification to the contract executed by the CO. No oral statements of any person whosoever will in any matter or degree, modify or otherwise affect the terms of this contract.

3.1.2 Designation of Contracting Officer Representative (COR) - The Contracting Officer (CO) will appoint a COR to perform tasks related to the execution and surveillance of this contract. The COR will be designated to represent the CO in furnishing technical guidance and advice under this contract. The foregoing is not to be construed as authorization to interpret or furnish advice and information to Contractor relative to the financial or legal aspect of the contract. Those matters are the responsibility of the CO and will not be delegated.

3.1.3 The Contractor will receive a copy of Delegation Letter which will identify the COR appointed by the CO. The COR will be included on all communications between the contractor and the Contracting Officer, and the COR shall be responsible for the validation/reconciliation of claims and authorization for payment.

3.2. Task Order Procedures:

3.2.1 The VA will specify individuals who are authorized to place orders under this contract. Fulfilling orders from persons other than the CO or the authorized ordering individual may result in loss or delay in payment for supplies/services provided under such orders. Orders will be placed via VetRide Vendor Portal or other VA approved ordering method. All requests for services made during normal business hours will be made via the VetRide Vendor Portal or VA-approved software. If necessary due to exigent circumstances, requests may be made by telephone. If the request is made by telephone, written documentation of the request and response and response time will be provided to the Mobility Manager or the VA Transportation Coordinator within the first three (3) hours of the next business day.

3.2.2 An authorization number will be provided to the Contractor at the time the order is placed or within 48 hours of transport. A unique authorization number will be used for each trip. The Contractor will commence the flight at the scheduled times unless prevented from doing so by conditions outside of the contractor’s control (weather, national emergency, etc.) in which case the contractor must immediately notify the OO or designee.

3.2.3 Medical orders will be issued to the contractor upon patient pick-up as well as a travel authority. It is the contractor’s responsibility to complete the delivery of transfer paperwork to the receiving facilities’ accepting patients.

3.2.4 Orders, requests, or changes to transportation requests will only be made by authorized Ordering Officers (OOs). Under no circumstances is there to be any deviation. This authorization cannot be redelegated. In addition, no deviation will be made by the Contractor.

3.2.5 The contractor will be provided with a list of individuals authorized to request transportation services. Individuals not on this list are not authorized to order services.

The Government will not be responsible for persons requesting services who are not on the list. The CO will furnish the contractor with the names of individuals delegated OO authority by separate letter upon issuance of the contract or agreement. When COs appoint OOs after award, the CO will furnish the contractor with an updated list of individual OOs authorized to place orders against the contract or agreement. OOs may not negotiate contract terms and conditions, determine price reasonableness, or determine best value. OOs are responsible for issuing and administering orders placed under the contract or agreement identified in the appointment letter. OOs do not have authority to modify any of the terms and conditions in the contract or agreement.

3.2.6 The contractor shall accept orders against the contract or agreement only from the CO or authorized OOs. Fulfilling orders from persons other than the CO or OO may result in an unauthorized commitment.

3.2.7 Payment will be based upon Type of Air Ambulance aircraft used price/block hour.

In case a circuitous route must be employed for reasons of safety (such as unfavorable terrain or weather), a copy of the flight log showing with justification necessitating the detour from the most direct route will be provided to the VA as an itemized list of additional hour/s.

4.0 Additional Requirements:

4.1 VetRide or VA-Approved Transportation Software Utilization and Invoicing:

The contractor agrees to utilize the VetRide Vendor Portal and Vendor Pass or VA-Approved Transportation Software with every patient transported under this contract.

Department of Veteran Affairs will provide the software and access to the VetRide Vendor Portal or VA-Approved Transportation Software for the vendor/contractor in this contract.

The Contractor will utilize the VetRide Vendor Portal or VA-Approved Transportation Software fully as instructed:

a) Receive and respond to electronic trip requests

b) Receive, use, and ensure the use of the Vendor pass by the dispatcher and aircrew.

renumber

c) Submit claims via the electronic HCFA 1500 in the VetRide Vendor Portal or VA- Approved Transportation Software system.

d) All invoices must be submitted within 30 calendar days of date of service in accordance with 38 CFR 70 to be considered timely submission.

i. The contractor’s invoice must be on the HCFA 1500 to include:

ii. Contract Number

iii. Date of Service (to include Box 24 A-J)

iv. Authorization number(s)

v. Pick-up and drop-off location of the patient

vi. Base Rate

vii. Name (Last, First and Middle Initial (if any)) and Full Social Security number (Box

1a) of patient transported

viii. Date of Birth and Sex

ix. Diagnosis Codes or Nature of Illness or Injury

x. Documentation of circumstances when billing for waiting time

xi. Any miscellaneous charges for which the contractor is expecting reimbursement i.e., Tool charges, waiting time, etc.

xii. VA authorizing official’s name

xiii. Healthcare Procedure Coding System/National Level II (HCPCS)

e) An invoice with unauthorized charges will be rejected by the Government.

Unauthorized charges are those that have not been pre-approved by authorized VA personnel.

Supporting documentation may be provided and submitted for payment consideration.

f) Charges under question will be reviewed by the Government to ensure they are valid to ensure payments will be made. A final determination will be made within 30 days after notifying the Contractor of the charges.

Payment by VA under this contract to a provider of air ambulance transportation services authorized under this contract extinguishes any and all liability on the part of the VA BENEFICIARY for that transportation service. UNDER NO CIRCUMSTANCES ARE VA BENEFICIARIES, THIRD PARTY INSURANCES, MEDICARE, OR MEDICAID TO BE BILLED FOR THE SERVICES PERFORMED UNDER THIS

CONTRACT

Upon Notification of the contracting officer, the vendor must receive training and begin implementation of invoices via VetRide Vendor Portal within 30 days.

VetRide Invoice Deliverables: The contractor’s invoice must be on the HCFA 1500 to include:

(A) Contract Number and Purchase Order Number

(B) Date of flight and number of statute miles flown

(C) Authorization number(s)per order

(D) Pick-up and drop-off location of the patient

(E) Flight Rate per contract

(F) Name and phone number of the authorized ordering officer and facility.

(G) Originating and termination points.

(H) Name and social security number of each patient.

(I) Name(s) of ambulance companies providing ground transportation.

(J) An in-flight medical attendant’s report of the patient’s status, including vital signs, level of consciousness, drugs administered, details of therapeutic intervention, and the names and qualifications of all attendants working under the delivery order.

(K) Any unusual circumstances encountered during the flight, including, but not limited to, inordinate altitudes flown, turbulence, and times associated with these abnormal conditions.

(L) Documentation of circumstances when billing for waiting time

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

4.2 A transportation request is defined as one incidence of a request for one-way Air- Ambulance service. No more than one patient will be transported per order unless approved by an authorized VA staff. Transportation requests will be made through VetRide or VA-Approved Transportation Software Utilization. Contractors must have the capability to receive orders, update ride status, and input trip costs and other required data through this portal. Contractors must have dedicated staff available to monitor this portal 24/7. Travel Program Staff/authorized VA employees will be available to assist with account setup and training for the Contractor’s Staff. In the event VetRide or other VA-Approved Transportation Software Utilization is down, other methods of communication (i.e., telephone, facsimile) will be used to place Transportation requests.

4.3 Travel Program Staff/or authorized VA employees will work with the Contractor the following business day to reconcile any transportation requests that were placed outside of VetRide or VA-Approved Transportation Software Utilization.

4.4 The Contractor must update VetRide or VA-Approved Transportation Software Utilization with any data and/or notes in real time that deviate from the original order such as invoicing for additional mileage due to a road closure, wait time, reason for no load, etc. Travel Program Staff/or authorized VA employees may place a “hold” on payment of this order until it has been reconciled.

4.5 The only VA staff authorized to place, cancel, or make changes to transportation requests are VA Contracting Officers or individuals delegated by the Administrative Contracting Officer (ACO) as Ordering Officers (OOs).

The Contracting Officer will furnish the Contractor with the names of individuals above, who are authorized as OOs, by separate memorandum upon issuance of the contract. The Contracting Officer will update this list throughout the life of the contract as OOs change.

Ordering Officers are responsible for issuing and administering orders placed under this contract. Ordering Officers have no authority to modify any term of this basic contract. Any deviation from the terms of the basic contract must be approved in writing by the Contracting Officer responsible for this contract. The Contractor shall accept orders against this contract only from the Contracting Officer and/or authorized ordering officers. Fulfilling orders from persons other than the Contracting Officer or ordering officer may result in loss or delay in payment for supplies/services provided under such orders.

Non-authorized VA employees and private agencies (e.g., nursing homes) are not considered authorized to place transportation requests.

5.0 Infection Control Requirements

5.1 Health tests. Health tests apply to any contractor or subcontractor personnel who will be performing the contract and have contact with patients. Contractor attests that assigned personnel have fulfilled all testing and screening requirements as described below prior to first duty shift. Evaluations and tests shall be current within the past year, except as noted. At the VA’s request, Contractor shall provide proof that all requirements are current and fully met as described within 2 business days of request.

5.2 Tuberculosis Screening and Testing.

5.2.1 If indicated for an operational area according to Centers for Disease Control and Prevention’s (CDC) updated Tuberculosis Screening, Testing, and Treatment of U.S.

Health Care Personnel: Recommendations from the National Tuberculosis Controllers Association and CDC, 2019, with previous documented positive Purified Protein Derivative (PPD) test results: All Contractor personnel shall provide a note from their physician, dated within the past three months stating they are free of any signs and symptoms of tuberculosis. This evaluation will be renewed annually.

5.2.2 For those with previously negative PPD skin test results: All Contractor personnel shall provide proof of a negative reaction to PPD testing, performed in accordance with the latest CDC standards and CDHC/California Tuberculosis Controllers Association guidelines, within the past 6 months. This test shall be renewed annually.

5.2.3 For PPD skin converters (a change from a previously negative skin test to positive;

defined as an increase in duration of 10mm or more with 2 years): An evaluation from their physician within 30 days of the positive test stating they are free from signs/symptoms of TB and indicating whether prophylactic treatment is indicated. If treatment is indicated, a note from the physician stating it was satisfactorily completed.

5.2.4 Rubella Testing. All Contractor personnel shall provide proof of immunization for measles, mumps, rubella, or a rubella titer of 1.8 or greater. If the titer is less than 1.8, a rubella immunization shall be administered with a follow-up documentation provided to the COR.

5.2.4.1 Varicella (Chicken Pox) Testing. Provide a history of Varicella or vaccination or if unknown, titer results.

6.0 Security Requirements:

6.1. Contractors, contractor personnel, subcontractors, and subcontractor personnel shall be subject to the same Federal laws, regulations, standards, and VA Directives and Handbooks as VA and VA personnel regarding information and information system security. Service contractor is expected to perform functions that may require access to VA sensitive information.

In the course of providing services, it will be necessary for the service contractor to, view and receive protected health information (PHI), and personnel identifiable information (PII).

6.2. All contractors, subcontractors, and third-party servicers and associates working with VA information are subject to the same investigative requirements as those of VA appointees or employees who have access to the same types of information. The level and process of background security investigations for contractors must be in accordance with VA Directive and Handbook 0710, Personnel Suitability and Security Program. The Office for Operations, Security, and Preparedness is responsible for these policies and procedures.

6.2.1 A prohibition on unauthorized disclosure: “Information made available to the contractor or subcontractor by VA for the performance or administration of this contract or information developed by the contractor in performance or administration of the contract shall be used only for those purposes and shall not be used in any other way without the prior written agreement of the VA’ See VA Handbook 65006, Appendix C, paragraph 3.a.

6.2.2 A requirement for data breach notification: Upon discovery of any known or suspected security/privacy incidents, or any unauthorized disclosure of sensitive information, including that contained in system(s) to which the contractor /subcontractor has access, the contractor/subcontractor shall immediately and simultaneously notify the COTR, the designated Information System Security Officer (ISSO), and Privacy Officer (PO) for the contract. The term ‘security incident’ means an event that has, or could have, resulted in unauthorized access to, loss or damage to VA assets, or sensitive information, or an action that breaches VA security procedures. See VA Handbook 6500.6, Appendix C, paragraph G.

6.2.3 A requirement for annual security/privacy awareness training: ‘Before being granted access to VA information, all contractor employees and subcontractor employees requiring such access shall complete on an annual basis either

(i) the VA security/privacy awareness training (contains VA’s security/privacy requirements) within 1 week of the initiation of the contract, or

(ii) security awareness training provided or arranged by the contractor that conforms to VA’s security) privacy requirements as delineated in the hard copy of the VA security awareness training provided to the contractor. If the contractor provides their own training that conforms to VA’s requirements, they will provide the COTR or CC, a yearly report (due annually on the date of the contract initiation) stating that all applicable employees involved in VA’s contract have received their annual security/privacy training that meets VA’S requirements and the total number of employees trained. See VA Handbook 6500.6, Appendix C, paragraph 9.

6.2.4 A requirement to sign VA’s Rules of Behavior: “Before being granted access to VA information, all contractor employees and subcontractor employees requiring such access shall sign on an annual basis an acknowledgment that they have read, understand, and agree to abide by VA’s Contractor Rules of Behavior which is attached to this contract.” See VA Handbook 6500.6, Appendix C, paragraph 9, Appendix D, Note:

If the vendor anticipates that the services under the contract will be performed by 10 or more individuals, the Contractor Rules of Behavior may be signed by the vendor’s designated representative. The contract must reflect by signing the Rules of Behavior on behalf of the vendor that the designated representative agrees to ensure that all such individuals review and understand the Contractor Rules of Behavior when accessing VA’s information. The contractor or subcontractor must notify the Contracting Officer immediately when an employee working on a VA system or with access to VA information is reassigned or leaves the contractor or subcontractor’s employ. The Contracting Officer must also be notified immediately by the contractor or subcontractor prior to an unfriendly termination.

7.0 VA Information Custodial Language:

7.1. Information made available to the contractor or subcontractor by VA for the performance or administration of this contract or information developed by the contractor/subcontractor in performance or administration of the contract shall be used only for those purposes and shall not be used in any other way without the prior written agreement of the VA. This clause expressly limits the contractor/subcontractor's rights to use data as described in Rights in Data- General, FAR 52.227-14(d) (1).

7.2. VA information should not be co-mingled, if possible, with any other data on the contractors/subcontractor’s information systems or media storage systems in order to ensure VA requirements related to data protection and media sanitization can be met. If co-mingling must be allowed to meet the requirements of the business need, the contractor must ensure that VA’s information is returned to the VA or destroyed in accordance with VA’s sanitization requirements. VA reserves the right to conduct onsite inspections of contractor and subcontractor IT resources to ensure data security controls, separation of data and job duties, and destruction/media sanitization procedures are in compliance with VA directive requirements.

7.3. Prior to termination or completion of this contract, contractor/subcontractor must not destroy information received from VA, or gathered/created by the contractor in the course of performing this contract without prior written approval by the VA. Any data destruction done on behalf of VA by a contractor/subcontractor must be done in accordance with National Archives and Records Administration (NARA) requirements as outlined in VA Directive 6300, Records and

Information Management and its Handbook 6300.1 Records Management Procedures, applicable VA Records Control Schedules, and VA Handbook 6500.1, Electronic Media Sanitization. Self-certification by the contractor that the data destruction requirements above have been met must be sent to the VA Contracting Officer within 30 days of termination of the contract.

7.4. The contractor/subcontractor must receive, gather, store, back up, maintain, use, disclose and dispose of VA information only in compliance with the terms of the contract and applicable Federal and VA information confidentiality and security laws, regulations, and policies. If Federal or VA information confidentiality and security laws, regulations and policies become applicable to the VA information or information systems after execution of the contract, or if NIST issues or updates applicable FIPS or Special Publications (SP) after execution of this contract, the parties agree to negotiate in good faith to implement the information confidentiality and security laws, regulations, and policies in this contract.

7.5. The contractor/subcontractor shall not make copies of VA information except as authorized and necessary to perform the terms of the agreement or to preserve electronic information stored on contractor/subcontractor electronic storage media for restoration in case any electronic equipment or data used by the contractor/subcontractor needs to be restored to an operating state. If copies are made for restoration purposes, after the restoration is complete, the copies must be appropriately destroyed.

7.6. If VA determines that the contractor has violated any of the information confidentiality, privacy, and security provisions of the contract, it shall be sufficient grounds for VA to withhold payment to the contractor or third party or terminate the contract for default or terminate for cause under Federal Acquisition Regulation (FAR) part 12.

7.7. If a VHA contract is terminated for cause, the associated BAA must also be terminated and appropriate actions taken in accordance with VHA Handbook 1600.01, Business Associate Agreements. Absent an agreement to use or disclose protected health information, there is no business associate relationship.

7.7. Except for uses and disclosures of VA information authorized by this contract for performance of the contract, the contractor/subcontractor may use and disclose VA information only in two other situations: (i) in response to a qualifying order of a court of competent jurisdiction, or (ii) with VA’s prior written approval. The contractor/subcontractor must refer all requests for, demands for production of, or inquiries about, VA information and information systems to the VA contracting officer for response.

7.9. Notwithstanding the provision above, the contractor/subcontractor shall not release VA records protected by Title 38 U.S.C. 5705, confidentiality of medical quality assurance records and/or Title 38 U.S.C. 7332, confidentiality of certain health records pertaining to drug addiction, sickle cell anemia, alcoholism or alcohol abuse, or infection with human immunodeficiency virus. If the contractor/subcontractor is in receipt of a court order or other requests for the above-mentioned information, that contractor/subcontractor shall immediately refer such court orders or other requests to the VA contracting officer for response.

8.0 Security Incident Investigation:

8.1 The term “security incident” means an event that has, or could have, resulted in unauthorized access to, loss, or damage to VA assets, or sensitive information, or an action that breaches VA security procedures. The contractor/subcontractor shall immediately notify the COTR and simultaneously, the designated ISSO and Privacy Officer for the contract of any known or suspected security/privacy incidents, or any unauthorized disclosure of sensitive information, including that contained in system(s) to which the contractor/subcontractor has access.

8.2 To the extent known by the contractor/subcontractor, the contractor/subcontractor’s notice to VA shall identify the information involved, the circumstances surrounding the incident (including to whom, how, when, and where the VA information or assets were placed at risk or compromised), and any other information that the contractor/subcontractor considers relevant.

8.3 With respect to unsecured protected health information, the business associate is deemed to have discovered a data breach when the business associate knew or should have known of a breach of such information. Upon discovery, the business associate must notify the covered entity of the breach. Notifications need to be made in accordance with the executed business associate agreement.

8.4 In instances of theft or break-in or other criminal activity, the contractor/subcontractor must concurrently report the incident to the appropriate law enforcement entity (or entities) of jurisdiction, including the VA OIG and Security and Law Enforcement. The contractor, its employees, and its subcontractors and their employees shall cooperate with VA and any law enforcement authority responsible for the investigation and prosecution of any possible criminal law violation(s) associated with any incident. The contractor/subcontractor shall cooperate with VA in any civil litigation to recover VA information, obtain monetary or other compensation from a third party for damages arising from any incident, or obtain injunctive relief against any third party arising from, or related to, the incident.

9. Liquidated Damages for Data Breach:

9.1. Consistent with the requirements of 38 U.S.C. §5725, a contract may require access to sensitive personal information. If so, the contractor is liable to VA for liquidated damages in the event of a data breach or privacy incident involving any SPI the contractor/subcontractor processes or maintains under this contract.

9.2. The contractor/subcontractor shall provide notice to VA of a “security incident” as set forth in the Security Incident Investigation section above. Upon such notification, VA must secure from a non-Department entity or the VA Office of Inspector General an independent risk analysis of the data breach to determine the level of risk associated with the data breach for the potential misuse of any sensitive personal information involved in the data breach. The term

'data breach' means the loss, theft, or other unauthorized access, or any access other than that incidental to the scope of employment, to data containing sensitive personal information, in electronic or printed form, that results in the potential compromise of the confidentiality or integrity of the data. Contractor shall fully cooperate with the entity performing the risk analysis. Failure to cooperate may be deemed a material breach and grounds for contract termination.

9.3. Each risk analysis shall address all relevant information concerning the data breach, including the following:

(1) Nature of the event (loss, theft, unauthorized access).

(2) Description of the event, including:

(a) date of occurrence.

(b) data elements involved, including any PII, such as full name, social security number, date of birth, home address, account number, disability code.

(3) Number of individuals affected or potentially affected.

(4) Names of individuals or groups affected or potentially affected.

(5) Ease of logical data access to the lost, stolen or improperly accessed data in light of the degree of protection for the data, e.g., unencrypted, plain text.

(6) Amount of time the data has been out of VA control.

(7) The likelihood that the sensitive personal information will or has been compromised (made accessible to and usable by unauthorized persons).

(8) Known misuses of data containing sensitive personal information, if any.

(9) Assessment of the potential harm to the affected individuals.

(10) Data breach analysis as outlined in 6500.2 Handbook, Management of Security and Privacy Incidents, as appropriate; and

(11) Whether credit protection services may assist record subjects in avoiding or mitigating the results of identity theft based on the sensitive personal information that may have been compromised.

9.4 Based on the determinations of the independent risk analysis, the contractor shall be responsible for paying to the VA liquidated damages in the amount of $37.50per affected individual to cover the cost of providing credit protection services to the affected individuals consisting of the following:

(1) Notification.

(2) One year of credit monitoring services consisting of automatic daily monitoring of at least 3 relevant credit bureau reports.

(3) Data breach analysis.

(4) Fraud resolution services, including writing dispute letters, and initiating fraud alerts and credit freezes, to assist affected individuals to bring matters to resolution.

(5) One year of identity theft insurance with $20,000.00 coverage at

$0 deductible; and

(6) Necessary legal expenses the subjects may incur to repair falsified or damaged credit records, histories, or financial affairs.

10. Security Controls Compliance Testing:

On a periodic basis, the VA, including the Office of Inspector General, reserves the right to evaluate any or all of the security controls and privacy practices implemented by the contractor under the clauses contained within the contract. With 10 working days’ notice, at the request of the government, the contractor must fully cooperate and assist in a government-sponsored security controls assessment at each location wherein VA information is processed or stored, or information systems are developed, operated, maintained, or used on behalf of VA, including those initiated by the Office of Inspector General. The government may conduct a security control assessment on shorter notice (to include unannounced assessments) as determined by VA in the event of a security incident or at any other time.

11. Training:

11.1. All contractor employees and subcontractor employees requiring access to VA information and VA information systems shall complete the following before being granted access to VA information and its systems:

(1) Sign and acknowledge (either manually or electronically) understanding of and responsibilities for compliance with the Contractor Rules of Behavior, Appendix E relating to access to VA information and information systems.

Double check

(2) Successfully complete the appropriate VA privacy training and annually complete required privacy training; and

(3) Successfully complete any additional cyber security or privacy training, as required for VA personnel with equivalent information system access [to be defined by the VA program official and provided to the contracting officer for inclusion in the solicitation document – e.g., any role-based information security training required in accordance with NIST Special Publication 800-16, Information Technology Security Training Requirements.]

11.2. The contractor shall provide to the…