Questions - Ground Ambulance Palo Alto - UPDATED 2 AUGUST.docx

1. FAR 52.223-99 – Federal courts have recently issued injunctions on this FAR clause; as well, guidance issued by GSA in Feb 2022 that application of this clause can be stricken. In light of this multi county coverage which competes with services under multiple Operations, Labor environments and County policies for COVID adherence.

QUESTION: Would the contracting officer consider removal of this FAR Clause from the solicitation?

Language to replace it could set expectations that ground provider will adhere to the county regulations of COVID adherence per the County Department of Public Health – or other similar language.

Reference: COVID-19 (Coronavirus) | ANSWER: VHA Supplemental Contract Requirements for Combatting COVID-19 replaces FAR 52.223-99.

VHA Supplemental Contract Requirements for Combatting COVID-19

1. Contractor employees who work in or travel to VHA locations must comply with the following:

1. Documentation requirements:

0. If fully vaccinated, contractors shall show proof of vaccination.

0. NOTE: Acceptable proof of vaccination includes a signed record of immunization from a health care provider or pharmacy, a copy of the COVID-19 Vaccination Record Card (CDC Form MLS-319813_r, published on September 3, 2020), or a copy of medical records documenting the vaccination.

0. If unvaccinated, contractors shall show negative COVID-19 test results dated within three calendar days prior to desired entry date. Test must be approved by the Food and Drug Administration (FDA) for emergency use or full approval. This includes tests available by a doctor’s order or an FDA approved over-the-counter test that includes an affiliated telehealth service.

0. Documentation cited in this section shall be digitally or physically maintained on each contractor employee while in a VA facility and is subject to inspection prior to entry to VA facilities and after entry for spot inspections by Contracting Officer Representatives (CORs) or other hospital personnel.

0. Documentation will not be collected by the VA; contractors shall, at all times, adhere to and ensure compliance with federal laws designed to protect contractor employee health information and personally identifiable information.

1. Contractor employees are subject to daily screening for COVID-19 and may be denied entry to VA facilities if they fail to pass screening protocols. As part of the screening process contractors may be asked screening questions found on the COVID-19 Screening Tool. Check regularly for updates.

1. Contractor employees who work away from VA locations, but who will have direct contact with VA patients shall self-screen utilizing the COVID-19 Screening Tool, in advance, each day that they will have direct patient contact and in accordance with their person or persons who coordinate COVID-19 workplace safety efforts at covered contractor workplaces. Contractors shall, at all times, adhere to and ensure compliance with federal laws designed to protect contractor employee health information and personally identifiable information.

1. Contractor must immediately notify their COR or Contracting Officer if contract performance is jeopardized due to contractor employees being denied entry into VA Facilities.

1. For indefinite delivery contracts: Contractor agrees to comply with VHA Supplemental Contract Requirements for any task or delivery orders issued prior to this modification when performance has already commenced.

2. San Joaquin Volume in Lot 4 states “Stockton, CA VA to San Joaquin Community Hospital (226 miles)”. Mi

QUESTION: These locations are only 2 miles apart. Please clarify/correct - ANSWER: This has been corrected to 1/8 mile. The two sites are right next door to each other.

3. No Volume in pricing / volume / estimated loaded miles for pick up location VA PA. Previous experience is that the majority of volume is for pick up at VAPA. This scenario is not included in rate sheet.

QUESTION: will volume for VAPA as location of pickup be added to be covered by this contract?

ANSWER: CLIN 4 covers routes not specified in Price Schedule.

4. San Benito County Lot 6 - No location / no volume listed for San Benito

QUESTION: without this can San Benito by stricken from the solicitation?

ANSWER: CLIN 4 covers routes not specified in Price Schedule.

5. Santa Cruz County Lot 6 – Location is listed but no volume

QUESTION: Will there be volume added to this location and if not, will it be stricken?

ANSWER: CLIN 4 covers routes not specified in Price Schedule.

6. Fremont locations are in the contract with no volume tied to it in the Pricing Schedule.

QUESTION: Will there be volume added to this location and if not, will it be stricken?

ANSWER: CLIN 4 covers routes not specified in Price Schedule.

7. QUESTION: Authorized Beneficiary – Is it assumed that if the requesting party identifies themselves as the “VA” that the trip is authorized to be billed to the contract?

ANSWER: Yes, the solicitation on page 7 section D 1. States that an authorization will come from a designated VA staff member. (by direction of a VA physician).

8. Critical Care section speaks to transporting VA staff for IABP – however VA does not allow this anymore.

QUESTION: Can these two sentences be removed from the solicitation: For patient transport involving PCI (Percutaneous Coronary Intervention) with Intra-aortic Balloon Pump Transport, an oversize “big box” ambulance will be required, response time from call to pick up: 15 minutes. The oversize ambulance must be capable of accommodating the following VA staff: MD, Nurse, Respiratory Therapist and Cardiopulmonary Resuscitation (CPR) Performer. - ANSWER: Yes, they are deleted.

9. Clarify is the use of Standard to be used if the request is called in hours or days ahead of time? In this scenario the on-time compliance would never fall to 120 minutes and would need to measure to our ETA being within a time frame. Industry standard is for calls with agreed upon ETA the provider is measured to ETA accuracy of on scene +/- 15 minutes.

QUESTION: Would the VA consider changing compliance for all Standard to ON TIME ETA versus 120 minutes from time of call? We have updated the PWS so that it now states that the two hour Standard Response does not apply to requests made hours or days in advance.

10. Long distance trips require 24 hours’ notice to perform

QUESTION: would the VA be willing to add language stating 24 hours’ notice would be given whenever possible for a long-distance trip?

ANSWER: Yes, this has been added.

11. URGENT is reserved for clinically critical and time sensitive going to a higher level of care.

QUESTION: Will the use of URGENT be defined in the contract?

ANSWER: Yes, it has been added.

12. QUESTION: Please clarify the application of this sentence to the contract expectations. Does this allow a bidder to just put in for the counties and services we can serve exactly to the compliance metrics To be determined. The bidder should not limit their bid for that reason. The metrics can determined later.

13. Prior Authorization for each trip. Current state per the COR is that if the requesting person states they are a VA REP we consider it a contracted call. VA has never provided a “list of names” as the contract alludes to.

QUESTION: Can you verify the authorization by the VA is equivalent to the requesting party stating they are a VA representative?

ANSWER: VA will provide a Delegation of Authority memo with a list of VA staff authorized to order ambulances.

14. QUESTION: is the VA willing to make exemptions for calls with intake delay on the part of the VA requestor? Yes.

15. Current Vendor is not serving the VA as an exclusive provider of services – but in a preferred only capacity – to provide ease of one call and rate applied for the majority of the transports.

QUESTION: Is the interpretation of the VA that this sentence equates to when requested vendor is to let the requesting person know we cannot serve it; allowing the VA to move to other options – and this request would not be included in performance expectation? That is correct.

16. There is no Wait time charge nor explanation of who from the VA can authorize the wait time being incurred real-time during the transport.

QUESTION: Can vendor add Wait time charges to the pricing schedule and assume the sending clinician at the VA Location is adequate approval to incur Wait Time if they ask us to stay during a long pick up (this occurs when we arrive and patient not ready)? Yes.

17. This statement would apply for dedicated ambulances and staff. Because this is served with nondedicated ambulances and staff due to the low and inconsistent volume – this would not be possible. Current multi county services cover thousands of clinical staff as well as subcontractors who change staff routinely.

QUESTION: Can this be stricken or changed to – staff information may be requested by the COR from time to time? Yes, this has now been changed, as requested.

18. Solicitation states a 50% BASE for Cancelled after enroute and 100% BASE for cancelled after arrival – Price schedule is silent.

QUESTION: Will the Contracting officer accept vendor adding these prices to each LOT? Yes.

19. QUESTION: Will URGENT requests be exempted from compliance if they are not found to be “Clinically Critical and time sensitive” Yes.

20. QUESTION: Will STANDARD request compliance change to measure to the ETA agreed to as previously brought forth instead of the 2 hour threshold? Yes.

21. QUESTION: will the VA allow for sharing of transport metrics with the Local EMS Agency as required to maintain our county licensure to operate? Yes.

22. We are not accessing VA computer systems.

QUESTION: Is the VA willing to clarify this as only if contractor is accessing computer systems OR strike this altogether? Yes, that is correct. This would only apply to staff accessing computer systems, and there are none doing so.

23. QUESTION: Is the contractors internal Privacy Training adequate to meet this requirement? Yes.