36C26121R0007_3.docx

36C26121R0007

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

36C26121R0007 01-25-2021 Jason T. Hill Jason.hill@va.gov 02-24-2021

2:00 PM

PST

612MCP

Department of Veterans Affairs VA Sierra Pacific Network (VISN 21) VA Northern California HealthCare System 10535 Hospital Way Sacramento CA 95655-4200 X X 485999 $16.5 Million N/A X VA Northern California Healthcare System 10535 Hospital Way Sacramento CA 95655

612MCP

Department of Veterans Affairs Department of Veterans Affairs VA Northern California HealthCare System 10535 Hospital Way Sacramento CA 95655-4200

SEE PWS SECTION 1.6

See CONTINUATION Page

SPECIAL NEEDS GROUND TRANSPORTATION SERVICE FOR

VA Northern California Health Care System (VANCHCS) ALL QUESTIONS MUST BE SUBMITTED WITHIN 7 DAYS of RFP CLOSE.

This is a 100% SDVOSB set-aside. Offerors must be verified in VIP at the time of proposal submission and shall continue to be registered until time of award, during performance, and through final payment of any contract resulting from this solicitation. Offerors that are not verified in VIP at the time of proposal submission or at anytime prior to award may not be further evaluated for award.

GOVERNMENT ANTICIPATES MULTIPLE AWARDS AS A RESULT OF THIS

SOLICITATION. REFER TO FAR 52.212-1 AND 52.212-2 AND THEIR

ADDENDA FOR INSTRUCTIONS TO OFFERORS AND THE BASIS FOR

AWARD(S).

See CONTINUATION Page X X

MARK BULTMAN

CONTRACTING OFFICER

Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

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

a. CONTRACTOR: TBD

b. GOVERNMENT: Contracting Officer 36C261 Department of Veterans Affairs VA Sierra Pacific Network (VISN 21) VA Northern California HealthCare System 10535 Hospital Way Sacramento CA 95655-4200

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.

SEE PWS SECTION 1.6

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

B.2 IDIQ CONTRACT MINIMUM AND MAXIMUM VALUES

Referenced FAR Clause, 52.216-22 (Indefinite Quantity), the following minimum and maximum values are provided for the purpose of paragraph (b) of the clause:

(a) The minimum amount for the life of the contract including options is $2,000. The Government will obligate the minimum guarantee at the time of awarding the basic contract, by issuing a task order with an amount that is equal to or greater than the minimum guarantee.

(b) The cumulative maximum value for all awardees over the life of the contract including options will be $49,000,000.00. The Government does not guarantee that it will place any orders under this contract in excess of the guaranteed minimum award amount.

Ordering Year 1 – June 1, 2021 to May 31, 2022

Per Mo

Price

Total

Estimated Sub Total

Estimated Sub Total

Ordering Year 1 Total

Ordering Year 2 – June 1, 2022 to May 31, 2023

Per Mo

Price

Total

Estimated Sub Total

Estimated Sub Total

Ordering Year 2 Total

Ordering Year 3 – June 1, 2023 to May 31, 2024

Per Mo

Price

Total

Estimated Sub Total

Estimated Sub Total

Ordering Year 3 Total

Ordering Year 4 – June 1, 2023 to May 31, 2024

Per Mo

Price

Total

Estimated Sub Total

Estimated Sub Total

Ordering Year 4 Total

Ordering Year 5 – June 1, 2024 to May 31, 2025

Per Mo

Price

Total

Estimated Sub Total

Estimated Sub Total

Ordering Year 5 Total

BASE YEAR TOTAL: $______________________________

36C26121R0007

B.3 PERFORMANCE WORK STATEMENT

1. DESCRIPTION/SPECIFICATIONS/WORK STATEMENT

The contractor shall provide all Non-Emergency, Special Mode Ground Transportation services as identified within the performance work statement (PWS) for beneficiaries of Veteran Affairs Northern California Health Care System (VANCHCS) Veteran Health System, and its associated healthcare facilities. The Contractor shall provide all transport vehicles, personnel, management, supplies, transportation, fuel, equipment, reports, and anything else necessary to successfully furnish Non-Emergency SMT service as identified in the Price and Cost Schedule and the PWS in accordance with all terms, conditions, and provisions stated herein. The contractor’s responsibility shall cover non-emergent medical transportation services with VA Northern California Health Care System. Contractor shall furnish assisted medical transportation for Wheelchair Van, Gurney Van, and Secure Car w/attendant. The successful vendor is required to continuously be compliant with the requirement contained herein, and meet or exceed the standards of, but not limited to the Joint Commission and California State Department of Health Regulations. The following facilities shall be covered under this PWS; however, their physical addresses may change during the life of the contract, and this list may expand in conjunction with the Mission Act:

· VA Northern California Health Care System 10535 Hospital Way Mather, CA 95655

· VA Northern California Health Care System 150 Muir Road Martinez, CA 94553

· VA Fairfield Outpatient Clinic David Grant Medical Center103 Bodin Circle Travis AFB, Fairfield, CA 94535

· McClellan CBOC at McClellan 5342 Dudley Blvd, Bldg 98 McClellan, CA 95652

· Redding CBOC 351 Hartnell Avenue Redding, CA 96002

· Chico CBOC 1601 Concord Avenue Chico CA 95928

· VA CBOC, 101 East Oberlin Road, Yreka CA 96097

· Mare Island CBOC Walnut Ave, Bldg, #201 Vallejo, CA 94592

· Oakland CBOC 2221 Martin Luther King Jr. Wy Oakland, CA 94612 (will transition to San Francisco VA Medical Center on 10/1/2021)

· Marysville/Yuba CBOC 1231 Plumas Street Yuba City CA 95991

· Sierra Foothills VA Outpatient Clinic 11985 Heritage Oak Pl Ste 100 Auburn, CA 95603

2. CONTRACT DEFINITIONS/ACRONYMS AND TERMS

a) Catchment Area – defined as all areas located within the list of the locations shown above.

b) Ambulatory Patient – A non-emergency VA beneficiary who does not require the use of a handicap ambulance, wheelchair, or Gurney van, who can utilize normal forms of transportation such as taxi or hired car but have been determined as needing transportation assistance for medical reasons. A VA clinician determines if the patient requires special mode transportation based on a medical impairment or special need (to include but not limited to: mental health deficiency.

c) Gurney Patient – A non-emergency patient whose severe mobility impairment requires him or her to remain in a lying position, unable to sit in an upright position for prolonged periods of time. A VA clinician determines the patient’s need for Gurney transport.

d) Wheelchair Patient- A non-emergency VA beneficiary confined to a wheelchair, using a wheelchair for mobility or with mobility impairments, whose handicap prevents use of normal modes of transportation such as car, van or taxi. A VA clinician determines the patient needs wheelchair transport.

e) Attendant/Escort – A medical attendant may be required to assist with transportation, when deemed necessary by a VA physician. An escort is a non-medical attendant which can be a caregiver, family member, medical technician or VA employee that may accompany the patient in addition to the driver.

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

g) Base Rate – Base Rate is defined as the rate paid for one-way transportation from a designated pick-up point to a designated delivery point. This rate shall be paid for all authorized one-way trips ordered under this contract action, with employees (included in Section Contract Documents, Exhibits, or Attachments) during all phases of the trip made on behalf of the Government. The attached Service Contract Act wage determination shall be updated for each option when/if new revisions are issued. The Base Rate shall constitute full compensation for one-way trips as shown in the Price and Cost Schedule for the medical facility.

h) Cancellation - A cancellation is defined as a request for service by authorized Medical Center personnel whereby the Contractor arrives at the designated pick-up point and no patient is transported due to a change in the Medical Center’s needs. Attendant fees for cancellation/no shows will be begin at the point of picking up the veteran. A flat rate will be assessed for the attendant for cancellation/no shows.

i) Mileage Rate – Mileage rate for special mode is the rate paid for each mile traveled. This rate applies to one-way transportation only. Reimbursement for mileage shall be at the mileage rate stated in the price/cost schedule and shall be based upon the miles from the pick-up point and the specified destination. Distances areas of coverage shall be calculated using current www.bing.com/maps. Reimbursement shall not include the third part of the trip, mileage back to the contractor’s place of business.

j) No Show - is defined when the beneficiary receiving services is not present at the time of transport or declines to go with the contracted service. Attendant fees for cancellation/no shows will begin at the point of picking up the veteran. No Shows will be treated as Cancellations and will be covered under the Cancelled Trips CLIN for invoicing purposes.

k) No-Patient Transport – The Contractor shall not assess charges on scheduled pick-ups that are cancelled in advance by the VA and/or the patient cancels due to being unable to arrive for scheduled appointment in time.

l) Routine Services – Trips scheduled in advance by the VA, typically one day prior to travel. Beneficiary, caregiver, or significant others cannot contact the Contractor directly to schedule routine trips.

m) Wait Time – Is the time a vehicle is waiting at a medical provider’s facility, to which the transportation provider transported the beneficiary to transport the beneficiary to another destination, during the same trip.

n) Cognitive Impairment - A cognitive impairment affects a person’s ability to reason, understand, and learn.

o) Disability – The term “disability means, with respect to an individual means:

1) A physical or a mental impairment that substantially limits one or more of the major life activities of such individual;

2) A record of such impairment

3) Being regarded as having such impairment

p) Hearing Impairment - Hearing impairments range from a mild hearing loss to total deafness. Those who are hard of hearing often use their residual hearing and lip read when communicating face-to-face. People who are deaf may use American Sign Language or lip-read and may speak for themselves or use a sign-language interpreter.

q) Mobility Impairment - Mobility impairment refers to the inability of a person to use one or more of his/her extremities, or a lack of strength to walk, grasp, or lift objects. The use of a wheelchair, crutches, or a walker may be utilized to aid in mobility.

r) Speech Impairment - Speech impairments range from problems with articulation or voice strength to complete voiceless. People with speech impairments may have difficulty in projection, articulation and fluency. Some people with speech impairments may use assistive devices or an interpreter to communicate.

s) Visual Impairment - A visual impairment affects a person’s ability to see and includes: (1) inability to see images clearly and distinctly; (2) loss of visual field; (3) inability to detect small changes in brightness; (4) color blindness; and (5) sensitivity to light. A cane or sight dog may be used to assist with mobility, and/or Braille may be used to read.

t) Durable Medical Equipment (DME) - Medical equipment that is ordered by a doctor for use in the home, such as walkers and wheelchairs.

u) Joint Commission (JC) (Formerly Joint Commission on Accreditation of Healthcare Organizations) – A national organization dedicated to improving the care, safety and treatment of patients in a health care facility and environment.

v) Quality Control and Quality Control Plan (QCP) – Those actions taken by the Contractor to control the production of goods or services, so they shall meet the requirements of the contract.

w) Contracting Officer (CO) – VA official with the authority to enter, administer, and/or terminate contracts and make related determinations and findings.

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

y) Scheduled Trip(s) – The term "Scheduled Trip" refers to those trips in which the Contractor has been given notice by 4:30 PM., the prior business day of required services and a specific pick-up time.

z) Contractor – The term "Contractor” as used herein refers to both the prime Contractor and his/her employees, and any sub-contractor and their employees. The Contractor shall be responsible for assuring that his/her subcontractors comply with the provisions of this contract.

aa) Administrative Officer of the Day (AOD) - VA official that works in the admission/ Emergency Department area during evenings and nights and monitors hospital activities during other than normal working hours. This person authorized transports.

bb) Beneficiary Travel Department – Department within the VA that oversees the Beneficiary Travel Program and its entitlements. This includes transportation such as the SMT services.

cc) Beneficiary Travel Department Supervisor - Individual who manages the employees working within the Beneficiary Travel Department.

dd) Beneficiary Travel (BT) Department Personnel – An individual designated by the Contracting Officer for the medical facility, who is authorized to commit and obligate the government through the life of the contract, with consent from the Contracting Officer.

ee) Federal holidays include New Year’s Day, Martin Luther King Day, Presidents Day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans Day, Thanksgiving Day, Christmas Day and other specifically designated days by the President of the United States to be a national holiday. When a holiday falls on a Sunday, the following Monday shall be observed as a legal holiday. When a holiday falls on a Saturday, the preceding Friday is observed by U. S. Government agencies.

ff) Secure Car w/attendant – A non-emergency VA beneficiary who is an ambulatory patient that uses normal modes of transportation such as a car, van, or taxi. A VA clinician determines the patient needs a secure car/attendant.

gg) Special Mode Ground Transportation – Special Mode Transportation (SMT) are modes of transportation that are clinically required. Special Mode Ground Transportation is Special Mode Transportation provided via ground vehicles. Special Mode Transportation is further defined in VHA Handbook 1601B.05, Beneficiary Travel.

3. JOINT COMMISSION ON THE ACCREDITATION OF HEALTHCARE ORGANIZATION (JCAHO) STANDARDS

a) The Contractor shall perform required services in accordance with the standards of the Joint Commission on the Accreditation of Healthcare Organization (JCAHO) and the established principles and ethics of the medical profession established by the American Medical Association (AMA) and American College of Emergency Physicians (ACEP).

The Contractor shall adhere to the Department of Veteran Affairs policies, procedures, and a regulation that governs the Beneficiary Travel Program is Title 38 Code of Federal Regulations (CFR) Section 70.

b) The Contractor shall comply with the provisions of the Privacy Act of 1974.

c) Portability and Accountability Act (HIPAA) of 1996 and VA Directive and Handbook 0710. The Contractor shall not maintain and/or share sensitive or patient identifiable information in any form or for any purpose, other than what is needed to perform its obligation under the established business associate agreement (BAA). By entering this contract, the Contractor certifies they comply with HIPAA as it pertains to general patient information, HIV, drug and alcohol abuse, and sickle cell anemia.

d) The contractor shall, always during the contract period, have on his/her premises a functioning fax machine, email and telephone to communicate requirements with the VA (i.e., patient incidents, requests for service, special correspondence, etc.

4. PERFORMANCE AND QUALIFICATIONS

a) The Contractor shall provide non-emergency transportation services on an “as needed” basis. Services may be required 24-hours per day/7-day a week, 365 days a year, within the State of California. The contractor shall provide all manpower, equipment, vehicles, fuel, materials and supplies to include all PPE required even in health pandemics at no additional cost. The contractor will provide supervision necessary to perform all tasks.

Vehicles shall have appropriate fuel capacity to complete the transport without stopping for refueling, unless making a transport beyond the capability of the fuel tank of the vehicle.

b) The Contractor shall provide oxygen tanks when transporting patients requiring. The VA will notify the Contactor when a patient requires oxygen. The standard oxygen tank volume will be approximately 24 CF. The size and dimensions of the oxygen tank shall fit the vehicle used in transporting the patient. The standard oxygen tank is approximately 26 inches by 4.5 inches in diameter. The contactor’s driver shall assist the patient with the connecting and disconnecting the tubes from the oxygen tank and as needed during transport. The contractor shall always store and secure the oxygen tank safely in the vehicle.

c) The Contractor shall adhere to the Department of Veteran Affairs regulations and the policies, procedures, and regulations of NCHCS.

d) The Contractor, upon request, shall provide quality data and information related to services for participation in NCHCS Performance Improvement Programs when requested to do so. Upon request the contractor shall also provide documentation of the competency of staff that shall be providing the contracted services. The Contractor shall ensure employees providing work on this contract are fully trained and competent to perform the required work; they shall also maintain records that document competence/performance level of employees working on this contract. Upon request, the contractor shall provide a current copy of their competency assessment checklist and annual performance evaluation to the Contracting Officers’ Representative (COR) for each contractor employee working on this contract.

e) The Contractor shall provide a minimum of a toll-free telephone and/or a locally dialed telephone number for accepting VA calls. It is estimated that 100.00% of all requests for Beneficiary/Patient Transportation Services shall be placed initially by electronic email followed by a written request via secure Facsimile. Requests for service may also be in writing or oral from an authorized representative of the VA, and may be completed by telephone, facsimile.

f) The contractor shall install and provide a toll-free number, for accepting the NCHCS calls.

g) The contractor shall, always during the contract period, have on his/her premises a functioning telephone to communicate requirements with the VA (i.e., patient incidents, requests for service, special correspondence, etc.). Use of this communication system shall be mutually agreed upon after award but prior to contract performance.

h) Secure/Encrypted Email - The Contractor shall acquire compatible Public Key Infrastructure (PKI) to transmit encrypted email with personally identifiable information and receive similar encrypted email from the VA.

5. ORDERING SERVICE

a) Prior to performance, the Contracting Officer or Contracting Officer Representative will provide the Contractor with a list of names or position titles and p hone number sof authorized Government personnel who may request services and receive calls from Contractor regarding contract performance. This list will be updated and submitted to the Contractor as changes occur. The Contractor shall ensure that requests for services are received from authorized VA medical center personnel, most commonly, Beneficiary Travel transportation assistants, transportation manager, or AOD after hours. The VA will provide and update a list of those individuals authorized to request transportation. Requests from unauthorized individual will be referred back to the VA. Services rendered in response to requests from other than authorized personnel shall be at the risk of the Contractor and any cost related thereto shall be borne by the Contractor.

b) Drivers shall return patients in the order that they are requested. Drivers shall not skip departing patients to cover a longer distance versus a shorter distance. Only with the approval of the Travel Section Supervisor will this be authorized. Repeated instances of skipping may lead to termination of the contract or discontinuance of further order placement. Invoices for payment shall include a copy of the trip ticket and the name of the trip requester to ensure payments.

c) Request(s) for VA Beneficiary/Patient special mode transportation services shall be provided to the Contractor as soon as it is known by the Beneficiary Travel Department, and/or Administrator Officer on Duty (AOD). The authorized VA staff must obtain a written authorization in the form of a Beneficiary Travel consult.

d) Request for services shall be made from authorized personnel by Email or Fax. A list of authorized personnel shall be provided to the contractor. Telephonic requests shall be followed with either email/fax or admission/discharge packets.

e) The Contractor shall ensure that requests for services are received from Beneficiary Travel Department, and/or Administrator Officer on Duty (AOD). Services rendered in response to requests from other than authorized personnel shall be at the risk of the Contractor and any cost related thereto may be borne by the Contractor.

f) When transporting patient(s) leaving the medical facility, the Contractor shall be required, if necessary, to transport a maximum of three items (boxes or luggage) of the patient’s personal effects at no additional cost to the VA. Weight and size of these items shall be limited to that which one person can reasonably pick up and load into the vehicle. All patients (including mental health) shall have belongings inventoried and maintained separately while being transported.

g) The Contractor shall submit an invoice summary to account for all requests for services.

The summary shall indicate the date and time of service call, name of beneficiary requiring services, type of transportation requested, designated pick-up and delivery points and actual time of arrival at the pick-up and delivery points. Copies of invoice summary shall be provided along with the invoices sent for payment.

h) The Contractor shall submit an invoice summary that includes the contract number, invoice date, invoice number, dates of service, total amount due and billable rates per the price schedule. Each charge on invoice will reference the contract line item number stated on the price cost list.

i) All patient transportation requests shall be placed per the contract line items and pricing as listed in Section B and shall be verified against invoices and trip tickets. When ordering services, the VA medical facility shall provide the following information:

1. Mode of transportation required;

2. Required date and time of arrival;

3. Name of beneficiary;

4. Pick-up and delivery point;

5. Type of equipment required;

6. Last four of the patient's Social Security Number;

7. Any special instructions.

8. Patients may be transported to or from any designated location within the defined Catchment Area, encompassing the state of California, to include county to county transports and within the county. All transports shall be between VA facilities or between the VA facility and a facility that provides care under VA auspices (i.e. Contract Nursing Home, Care in the Community Outpatient Clinics,) and/or between the home of the beneficiary receiving travel services and the VA facility.

The VA staff shall specify the points of origin and the destination of every trip.

j) When transporting patients to a VA or Community nursing home and/or Assisted Living Facility, upon arrival at the nursing home the driver shall give the VA Nursing Home Packet that accompanies the patient to the responsible nursing home staff member. If there are any discrepancies between the address listed on the Nursing Home Packet and the address listed in the trip request, the driver shall clarify the correct destination address with the Beneficiary Travel Department or the Administrator of the Day (AOD).

k) The contractor shall provide and respond to all special mode transportation calls in accordance with all Federal, State, and Local regulations governing dispatch of special mode/handicap transportation vehicles and medical care of on-board patients, to include measures to ensure timely arrival at the designated healthcare facility.

6. INVOICING

a) Invoices will be submitted no later than 5 business days of the following month and should require no major revisions.

b) The Contractor shall submit an invoice summary to account for all requests for services.

The summary shall indicate the date and time of service call, name of beneficiary requiring services, type of transportation requested, designated pick-up and delivery points and actual time of arrival at the pick-up and delivery points. Copies of invoice summary shall be provided along with the invoices sent for payment.

c) The Contractor shall submit an invoice summary that includes the contract number, invoice date, invoice number, dates of service, total amount due and billable rates per the price schedule. Each charge on invoice will reference the contract line item number stated on the price cost list.

d) All patient transportation requests shall be placed per the contract line items and pricing as listed in Section B and shall be verified against invoices and trip tickets.

e) A trip ticket shall be provided by the Contractor for each trip payment requested on the invoice. Trip tickets shall be verified by Beneficiary Travel prior to payment that services being billed were authorized by Beneficiary Travel. Payment shall not be made or reimbursed if trip tickets are not provided or services that were not authorized prior to Veteran pickup are charged.

f) Contractor shall keep a running total of the aggregate amount spent on the contract and be aware of the ceiling limit and limit in respect to each task order placed so as to not exceed the yearly task order or ceiling limit of contract. The contractor will notify the Government once they have exceeded a percentage of 80% of the yearly task order and or ceiling limit.

g) Vendor Electronic Invoice Submission Methods - Facsimile, e-mail, and scanned documents are not acceptable forms of submission for payment requests. Electronic form means an automated system transmitting information electronically according to the accepted electronic data transmission methods below:

h) VA’s Electronic Invoice Presentment and Payment System – The FSC uses a third-party contractor, Tungsten, to transition vendors from paper to electronic invoice submission. Please go to this website: http://www.tungsten-network.com/US/en/veterans-affairs/ to begin submitting electronic invoices, free of charge. If you have question about the e-invoicing program or Tungsten, please contact the FSC at the phone number or email address listed below:

7. RESPONSE TIME

a) The Contractor’s vehicles must respond within the times listed below for scheduled transport.

b) The Contractor’s vehicles must respond within the times listed below for unscheduled transport.

VA Mather 2.5 hours

c) Response time will be calculated from the Contractor’s receipt of the telephonic/fax request for service. The Contractor is responsible for finding any replacement vehicles as necessary. Payment will be made in accordance with the applicable CLIN pricing.

d) For return trips from scheduled outpatient visits, the Contractor shall ensure Veterans and other beneficiaries do not wait more than one hour after notification for unscheduled return trips and 30 minutes for scheduled return trips, no matter where patient lives.

e) Patient pickups shall be completed within one hour after notification for unscheduled trips and 30 minutes for scheduled trips.

f) Repeated failure to meet required response timeframes may result in termination of the contract, or discontinuance of further orders.

g) Response time will be calculated from the Contractor’s receipt of the telephonic/fax request for service.

h) Contractor should acknowledge and inform the facility of the ability to provide the contracted services with the established response time for the specific request. If for any reason, they are unable to provide the service, they must notify the facility authorized requestor of their inability to provide the service.

i) The contractor shall miss no more than three patient pickups per 50. The COR will review the circumstances of each incident to determine who is at fault. A Letter of Concern shall be issued after every four missed pickups per 100 for which they are at fault, and the contractor shall provide a plan to prevent further instances.

j) Failure of the contractor to perform in accordance with this compliance rating may constitute sufficient cause for termination of the contract for cause [see FAR Clause 52.212-4(m), Termination for Cause].

8. PATIENTS RIGHTS

a) The Contractor shall be courteous to VA Beneficiaries/Patients and any Authorized Escort, Family Member passenger or Significant Other passenger and “SMOKING IS NOT PERMITTED” in the Contractors’ Vehicles.

b) Drivers must be courteous and considerate of all patients they are transporting. Any substantiated mistreatment of patients in the performance of this contract may be cause for immediate termination of the contract, or discontinuance of further ordering of services from the Contractor. Substantiated reports of mistreatment may be referred to appropriate law enforcement authorities as applicable. The VA reserves the right to request driver removal from transporting VA patients if mistreatment is substantiated.

c) The Contractor shall report any patient incident initially on a signed incident report within twenty-four hours of the incident to the Beneficiary Travel Department. An assessment of the incident and a signed contractor response to the incident to include training and process changes shall be submitted to the Supervisor within five days from the date of the incident. A signed final analysis to include education, training, and process changes to prevent future incidents shall be submitted within thirty days to the Travel Department Supervisor.

d) The Contractor shall not employ any persons for work on this contract if such employee is considered by the VA contracting officer to be a potential threat to the health, safety, security or operations of the VA. Contractor’s employees shall understand, speak, read, and write the English Language. No employee of the contractor can be a Federal employee, nor can they have any conflict of interest.

e) The Contractor shall display a visible means of a medium that allows the patient to provide feedback, positive and negative to the Contractor (comment cards). Contractor shall provide a quarterly report of patient feedback to the Contracting Officer Representative (COR).

9. PATIENT ESCORT/CAREGIVER

a) 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 an escort is in the best interest of the beneficiary. The VA will be the sole 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 will not be required to return the escort back to point of origin if patient is admitted to hospital (unless the escort is a VA attendant or authorized VA caregiver).

b) The NCHCS reserves the right to send an authorized official (Registered Nurse, Licensed Practical Nurse, Nursing Assistant, or Physician) to attend the patient in a transfer from our facility when deemed necessary to the patient’s welfare by medical staff.

c) Contractor is required to return VA attendant to the point of origin. Reimbursement shall be limited to mileage rates as stated in the Price Schedule. The furnishing of the VA attendant does not relieve the Contractor from furnishing a qualified attendant in accordance with this contract.

d) The Contractor shall provide an attendant upon request of the VA. An attendant is defined as a Contractor employee other than the driver on a given trip that meets the qualifications needed for medical transport. When completing a Gurney transport the vendor is responsible for ensuring that a Gurney is included with this run, with no extra charge to the VA. The Contractor shall ensure that each person employed is trained, qualified and certified to perform the duties required, including CPR certification.

10. RATES

a) The web-based application at www.bing.com/maps, using the shortest time driving option, shall determine trip mileage. For all one-way trips ordered under this contract, the Contractor shall receive Special Mode Transportation base rate quoted. The Special Mode Transportation rate, as defined in section B.2 Price/Cost Schedule, shall constitute full compensation for one-way trips as defined herein.

b) The same rates shall apply 24 hours per day. Payment for mileage traveled shall be limited to “one way only”, the distance over which the patient is transported. Such mileage costs shall be paid in addition to the pick-up charge per trip for any trip.

Allowable charges for mileage outside the contract Catchment Area shall not exceed +5% of the web-based application at www.bing.com.maps using the shortest time driving option shall determine trip mileage.

11. WAIT TIMES/TOLLS/NO SHOWS

a) “Waiting time” is billable for trips approved by the COR or authorized personnel.

This will be approved prior to trip. If vendor invoiced wait time is not pre-approved, payment shall be denied.

b) Waiting Grace Period. The waiting grace period is fifteen minutes prior to time waiting charges commence. The base rate for transportation services shall include a fifteen-minute waiting grace period at origin and destination.

c) If the Contractor arrives and has to wait past the 15 minute grace period Contractor shall call the authorized personnel/COR so that they can contact the veteran regarding the wait to avoid wait time charges.

d) If the pickup is other than NCHCS locations, the contractor shall call the Beneficiary Travel Office, during normal working hours, or the AOD, after-hours, as soon as the contractor anticipates that a delay may develop for which he/she expects to claim reimbursement. This call is only for verifying his arrival at the pickup point and is not necessary if the contractor anticipates no delay for the claimed pick-up point and is not necessary if the contractor anticipated no delay for which he/she shall claim reimbursement.

e) Transportation services listed in this Performance Work Statement includes ferry, bridge, or road toll charges.

f) If the VA decides that a previously scheduled trip may be cancelled, and a vehicle has already been dispatched to the designated pick-up point, the VA may notify the Contractor to cancel the trip. For orders that are cancelled while the Contractor is already in route before being notified, the Contractor shall be entitled to receive reimbursement in price schedule.

g) This charge shall not be allowed if authorized VA personnel cancelled the trip (2) hours prior to the scheduled pickup time.

h) If the Contractor arrives at the destination before the VA cancels the order, or if the Contractor is unable to perform a scheduled pick-up for reasons beyond the Contractor control, e.g., patient absence, or patient refusal, the Contractor shall receive 100% of the pick-up charge for a one-way trip, as provided in the schedule. Contractor shall not be entitled to mileage reimbursement.

i) In the event of a patient no show, the Contractor shall immediately call the Beneficiary Travel Office and notify there has been a no show. The Beneficiary Travel Office shall attempt to contact the Veteran and verify the Contractor has arrived at the correct address and shall authorize any wait times if Beneficiary Travel deems it necessary.

12. CONTRACTOR PERFORMANCE

a) At the time of the request, the Contractor shall acknowledge their ability to provide the service within the requested response time. If the Contractor cannot provide the services for any reason, they must notify the VA personnel requesting the service of their inability to provide the service. The Contractor shall not charge the VA a cancellation fee when cancellations are made prior to the SMT transportation dispatch.

b) The VA reserves the right to substitute the beneficiary requiring services at any time during the performance of this contract, to prevent delays, cancellations, or no-shows.

There shall be no additional charge to the VA when such changes occur.

c) The contractor employee shall determine upon arrival at the Beneficiary/Patient pick-up point. If the condition of the Beneficiary/Patient scheduled for pick-up is different than what was stated on the travel request, the contractor shall immediately notify the VA Travel Section and/or Administrative Officer of the Day (AOD) for further instruction in Patient Transport mode.

d) If a Beneficiary/Patient being transported declines to be properly seat-belted, he/she shall not be transported. The Transportation Assistants should be notified promptly and may discuss such safety requirement with the Beneficiary/Patient via Telephone and/or in person. If the patient removes the securing devices during the trip, the transportation office should be notified of this upon contractor employee’s arrival at destination. The Contractor is not required to transport any Beneficiary/Patient who refuses to be properly secured while being transported.

d) Contractor employee shall ensure proper loading/unloading techniques are followed always. Patients in wheelchairs shall be loaded onto ramps, ensuring all safety systems are working properly, e.g. roll back stops, and the driver must ride the lift with the patient during loading/unloading. NO patient shall be allowed to ride a motorized cart (scooter) on to the vehicle lift at ANY time. The contractor shall ensure that drivers receive appropriate safety training on loading/unloading techniques and such training shall be documented and made available to the COR or designee annually and/or prior to contract submission or renewal. Failure to comply with this provision may be grounds for Termination for Cause in accordance with FAR 52.212-4(m).

e) Contractor shall provide “through the door” assisted service for all patients to and from their designated appointments. Patients shall be picked up on the ward, in their homes, in the clinics, or at other areas designated by the VA and taken to the authorized destination or appointment. Assistance in maneuvering stairs and other barriers shall be provided by the driver and/or authorized attendant when necessary.

f) The Contractor’s driver (or authorized attendant) shall observe the patient during transport. Any indication of a significant change in the patient’s condition shall be communicated immediately to the VA Medical Center serving the patient. Emergent diversions to the nearest appropriate medical facility are allowed and shall be communicated to the VA immediately. All diversions from destination, emergent or otherwise, shall be reported by the Contractor to the COR or authorized designee within 1 hour and followed up with a patient safety report.

g) Contractor’s driver shall notify the COR or designee, of any unusual events, including but not limited to accidents, safety problems, patients un-belting themselves and other such incidents that occur, which involve any VA patient being transported under this contract. The COR or designee shall be notified within one (1) hour of the occurrence of the incident(s) by telephone and, if requested by the COR and/or Contracting Officer, a written report of the incident(s) will be delivered to the COR or his/her designee by close of business the next working day. Failure to comply with provisions may be grounds or Termination for Cause in accordance with FAR 52.212-4(m).

h) The Contractor shall provide an attendant upon request of the VA.

The VA shall put the Contractor on notice with medical condition and special needs to determine the training and qualifications that the attendant needed. Contractor is responsible to ensure that proper staffing is used when transporting bariatric in a timely matter. The Contractor shall ensure that each person employed is trained, qualified and certified to perform the duties required, including CPR certification and appropriate training for handling dementia patients, or other mental health problems.

i) The contractor shall have a contingency/backup plan in the event the…