Statement of Work Transportation_.doc

STATEMENT OF WORK

SPECIALIZED TRANSPORTATION (Non-ADHC)

1. DESCRIPTION OF SERVICE

The Contractor shall provide all vehicles, fuel, personnel, management, transportation, materials, supplies and equipment necessary to perform contract services as defined and specified herein. The purpose of this service contract is to provide transportation to Veterans with limited mobility for appointments or hospital transfers.

Services provided under this contract shall strictly adhere to all current laws and regulations applicable to the State of Minnesota unless supplemented to exceed those requirements as specified herein.

The service requirement is for non-emergent transport of patients with limited mobility (ambulatory, wheelchair bound, or litter) to the St. Cloud VA Health Care System, health care appointments in the local community, and/or hospital transfers to St. Cloud Hospital or Minneapolis VA.

The quantities of “trips” indicated are estimated based on historical data. The Government makes no guarantee that these estimates will become actual quantities.

2. DEFINITIONS:

“VA beneficiary” a person determined eligible for beneficiary travel by the Department of Veterans Affairs.

“Ambulatory” describes a patient who is able or strong enough to walk alone, with the assistance of a cane, a walker, or with minor assistance from another person. An ambulatory patient may be medically and /or physically insecure but able to walk.

“Wheelchair Bound” describes a patient who requires the use of a wheelchair for basic mobility.

“Litter” describes a patient who requires the use of a litter or stretcher.

“Attendant/Caregiver” is an assistant who accompanies a patient as requested who provides extra attention to the patient because of psychiatric and/or mental, or other medical problems and renders assistance to the patient as needed. The driver of the vehicle shall not serve as the Attendant.

“Trip” is defined as the one-way transportation of VA beneficiaries from the pick-up location to the final authorized location per the dispatched transportation order form the VA.

“Responsible party” is defined as any driver, professional staff at medical center or clinic, or the patient’s concerned other/caregiver.

HOURS OF SERVICE

The majority of services will be provided during the medical center’s primary hours of service: Monday - Friday, 0700 – 1630. 11 Federal Holidays listed in paragraph 12 (see below).

CONTRACTOR FACILITY/VEHICLES AND EQUIPMENT

Incorporated by Reference: Code of Federal Regulations (CFR) Title 49, Section 38 Part A and Part B. (The Contracting Officer will provide a copy of referenced material upon written request.)

A. The VA St. Cloud Health Care System reserves the right to thoroughly inspect and investigate the vehicles, establishment, facilities, business reputation and other qualifications of the contractor. Scheduled and unannounced inspections of the Contractor’s vehicles or establishment may be made during the contract performance period.

B. VA reserves the right to inspect contractor's equipment and vehicles or require documentation of compliance with contract specifications, and State laws, rules, regulations, and guidelines governing transport vehicles. VA inspections of contractor facilities shall in no way constitute a warranty by VA that the contractor's vehicles and equipment are properly maintained.

The vehicles and equipment with which the Contractor renders the above services must meet all State of Minnesota (or Equal) requirements for insurance, registration, and equipment and are to include, but not be limited to the following, where applicable:

1) Comfortable seating surfaces to accommodate VA beneficiaries and caregivers for the duration of the trip.

2) Vehicles must be able to safely accommodate patient oxygen systems that patients may bring with them during a trip.

3) Contractor must have vehicles equipped with a hydraulic lift that is integral to the vehicle for placing the patient into the van and a suitable means of fastening the wheelchair to the van. Loading platform shall have raised edges, is counter balanced, self adjusting to curbs and sidewalks, and self-storing. When not in use, platform shall be securely stored so as not to block the vision of the driver or inconvenience the patient. The ramp or lift must have a slip proof surface.

4) Any vehicle used to transport wheelchair bound patients must be handicapped accessible and meet all applicable Federal and State Motor Vehicle Safety Standards.

All vehicles must have an approved system for wheelchair securement devices and a tool designed for cutting securement straps in case of emergency.

Safety requirements for seat belts and handling of manual, motorized or electric wheelchair.

5) Contractor must furnish shoulder/chest harness for double amputee patients when applicable.

C. VA reserves the right to restrict the Contractor’s use of equipment and vehicles which need repair, or are unclean, unsafe, damaged on the interior or exterior body, or are not in compliance with contract requirements. The restriction of such equipment and vehicles shall not relieve the contractor from performing in accordance with the strict intent and meaning of the contract.

All additional items such as first aid kits, flashlights, warning triangles, ice scrapers, blankets, etc. shall be secured and stored below the level of seat backs.

Vehicles must be equipped with a dry chemical fire extinguisher that is securely mounted in a bracket and readily accessible to the driver in an emergency. Extinguishers shall be serviced annually and bear a tag indicating date of service.

D. Heater(s) / Air conditioners will be of sufficient capacity to maintain patients’ comfort based on seasonal weather conditions.

STANDARDS FOR MAINTENANCE

A. All vehicles will be maintained in a clean and orderly condition, free from debris and any accumulations which may constitute an accident, injury, or fire hazard. Windows and lights must be kept clean. The interior of the vehicles must be clean and in good repair.

Vehicles must be maintained in accordance with manufacturer’s recommended maintenance schedule, or an improved schedule based on actual vehicle operating conditions.

B. Contractor shall correct a deficiency that might interfere with safe operation of a vehicle before the vehicle is placed in service.

Wheelchair lifts must be maintained in conformance with operation/maintenance manual instructions provided by lift manufacturer. When a vehicle is serviced, the mechanic or service facility must inspect, repair, or service the lift in accordance with the manufacturer’s instructions.

C. Contractor will maintain (and furnish upon request) procedures that outline preventive maintenance and/or repairs on each vehicle in an individual vehicle file.

DRIVER QUALIFICATIONS

All drivers of specialized transportation shall:

1) Have a valid State Operator’s license. Possess a driver’s license which is valid for the class of vehicle driven and if required under Minnesota Statutes, (or other state equal), evidence of a special transportation service vehicle permit, or endorsement issued by the State of Minnesota.

2) Have proof in the form of a current certificate that first aid training and CPR certification has been successfully completed. Certificates must be available upon request by the Contracting Officer’s Representative (COR).

3) Be capable of providing courtesy assistance, if needed, to VA beneficiary to enter and exit vehicle.

4) Be trained on methods of handling patients in wheelchairs; receive instruction in the operation of fire extinguishers, vehicle lift/ramp operation and wheelchair securement devices; and will know what to do and whom to call in a medical emergency or accident.

5) All drivers are expected to be neat and clean in appearance and shall display courtesy and tact at all times when transporting VA beneficiaries.

Has no current medical condition which interferes with the ability to drive safely.

6) Must be able to perform a vehicle safety inspection.

A. Contractor shall maintain a record of each employee as to character and physical capabilities of performing duties of specialized transportation service.

B. VA reserves the right to restrict any contractor employee from performing services under this contract who do not meet the required qualifications for the services they are required to perform and who violates Federal regulations or are identified as a potential threat to the security, safety, health and/or operational mission of the VA and its’ beneficiaries. The restriction of such contractor personnel shall not relieve the contractor from performing all the required services, in accordance with all terms, conditions, and schedules contained herein.

C. The Contractor shall furnish qualified personnel as required by contract specifications to accomplish all services under this contract. During the contract period of performance, if the Contractor proposes to add-on or replace personnel to perform contract services, the Contractor shall submit the required evidence of training, certifications, licensing, and any other qualifications to the designated COR. At no time, shall the Contractor utilize add-on or replacement personnel to perform contract services who do not meet the qualifications under the terms and conditions of this contract.

D. Contractor will be required to submit evidence of having obtained the necessary training and operating licenses indicated in paragraph 6. “Driver Qualifications” for all employees prior to start of contract.

PATIENT RIGHTS

The Contractor represents the VA when performing services on behalf of the VA. The driver, support staff, and any other associated contractor employee shall exhibit the highest level of professional courtesy to VA beneficiaries and VA staff in the performance of their duties.

A. The contractor shall notify the COR in writing within 24 hours of any complaints made by the patients with regards to service. The contractor may provide recommendations for improved services along with the patient complaints for the VA’s review. No recommendation shall be construed as being effective until and unless it is provided as a written modification to the contract from the Contracting Officer.

PASSENGER TRANSPORTATION

A. The normal drop off and pick up point is the St. Cloud VA Health Care System, 4801 Veterans Drive, St. Cloud, MN 56303, Building B48/49 entrance. Changes to the drop off or pickup location will be communicated directly to the Contractor’s dispatch no later than 2 hours prior to the requested pick up/drop off time.

B. Routes will be planned and executed with the greatest level of efficiency possible. Picking up multiple riders on one trip is acceptable but routes will be planned to limit excessive ride times. Excessive ride times are defined as greater than 30 minutes.

Drivers and passengers shall use seat belts/securement devices at all times.

C. There shall be no smoking by the driver, attendants, or passenger(s), all vehicles must be smoke free.

D. Contractor must provide “through the door service” for patients from the pick-up location to the final authorized location per the dispatched transportation order from the VA. When a patient is delivered to or departing from a destination (such as the patient’s home or the VA campus), a responsible party at the destination must be informed of the patient’s arrival by the driver or attendant. The Contractor (driver) will confirm acknowledgement of patient hand off both physically and verbally with the corresponding VA staff or other responsible party at the drop off point. This is a critical patient care service and must be done every time with every patient.

If a VA beneficiary being transported declines to be properly belted or removes the securement devices himself/herself, the driver will notify the COR immediately. The Contractor is not required to transport any patient who refuses to be properly secured. Refusal of a patient to comply with safety protocol or a patient who is otherwise disruptive to safe and orderly transport will be reported immediately to the COR.

E. Based on the needs of the patient, the Contractor will allow one (1) caregiver or attendant (as defined in paragraph 2) to accompany the patient at no additional cost to the Government.

The COR shall provide the Contractor with a list of names (or position titles) and phone numbers of authorized Government personnel who may request services and receive calls from Contractor regarding contract performance. This list will be updated and submitted to the Contractor as changes occur. The Contractor shall ensure that requests for services are received from authorized medical center personnel only. 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.

This notification will be made within one (1) hour by telephone and a written report of the event will be delivered to the COR and the Contracting Officer by close of business the next working day. Failure to comply with this provision may be grounds for default.

F. The contractor shall notify the Contracting Officer Representative of any incidents or accidents involving VA beneficiaries within 2 hours. A written report of the event will be delivered to the COR by close of business the next working day. Examples may include slips, falls, uncooperative patients, failure of equipment (tie downs, ramps, lifts, etc.) or vehicle accidents. This reporting is required regardless of the severity. Failure to comply with this provision may be grounds for default.

G. Patients using motorized wheelchairs or electric carts will be secured in accordance with Federal and State regulations for transport or transferred to a manually operated wheelchair before being loaded in the vehicle. The motorized cart or wheelchair will be loaded separately and must be secured to the vehicle during transport.

3. NUMBER OF PATIENTS

A. The Contractor will plan manifests based on patient needs and locations. The number of patients transported at one time is dependent upon vehicle capacities and the vehicle’s ability to accommodate wheelchairs or other mobility devices.

4. RATES

A. The VA is requesting a firm-fixed price for a one-way “trip”. Rates of a one-way trip are to include vehicle, fuel, mileage, and the services of a qualified driver. If the VA beneficiary is picked up from their home and brought to the VA that is considered one trip. If the VA beneficiary needs to be picked up from the VA and brought back to their home that is considered one trip. Total of 2 trips for that patient.

REQUEST FOR SERVICES AND USE OF THE VETRIDE THIRD PARTY PORTAL

A. The Contractor agrees to utilize VetRide Third Party Portal and Vendor Pass with every passenger transported under this contract.

B. Department of Veterans Affairs will provide the software and access to the VetRide Third Party Portal for the vendor/contractor in this contract.

C. The Contractor will utilize VetRide Third Party Portal 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 crew.

c. Submit claims via the electronic HCFA 1500 in the VetRide Third Party Portal.

D. The Contractor’s invoice must be on the HCFA 1500 and include:

a. Contract Number

b. Date of trip

c. Authorization number(s) and patient’s name

d. Pick-up and drop-off locations on the patient

e. Base Rate

f. Name and “Last Four” of Social Security Number of the patient transported

g. Documentation of circumstances when billing for waiting time

h. Any miscellaneous charges for which the Contractor is expecting reimbursement i.e., Toll charges, Waiting time, etc.

i. The contractor must provide a receipt or copy of the receipt for all miscellaneous charges

i. VA Authorizing Official’s name

j. Healthcare Procedure Coding System/National Level II (HCPCP) E. Unauthorized charges will be suspended by the Contracting Officer. 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. Suspended charges will be reviewed but the Contracting Officer’s Representative (COR) as to the validity of the charges and as to whether the payment will be made. A final determination will be made within 30 days after notifying the Contractor of the charges, which are being suspended.

G. In the event of a request or an update to a previous request where the Contractor may not have adequate time to receive or respond to the notification in the VetRide Third Party Portal, the request for service or update will be made via telephone by the COR or designated St. Cloud VA personnel. When ordering or updating services, the VA shall provide the Contractor with the same information required to enter a request in the VetRide Third Party Portal.

a. Upon completion of short-notice requests or updates, all information must be recorded manually in the VetRide Third Party Portal by both the VA personnel and the Contractor.

H. Generally, services provided under this agreement shall be scheduled in advance with the Contractor for specialized transportation services. Schedule requirements are defined as follows:

1) Scheduled Trips refers to those trips for which the Contractor has been given advance notice defined as notice given by 4:30 p.m. the previous day of pick up for required services and a specific pick-up time. These transports will always be on time for patient pick-up.

Unscheduled Trips are those trips required on an as needed basis and advance notice is not given. Response time for vehicle arrival at prescribed destination is within one-hour of notification of need.

Contractor must notify the COR/St. Cloud VA Veteran Transportation Services staff at least 15 minutes after notification of the need when Contractor believes he/she may be unable to meet the number of scheduled trips required.

In the case of inclement weather, the decision as to whether a VA beneficiary will be transported will be made mutually by the COR and the Contractor.

5. FEDERAL HOLIDAYS

Federal Holidays: The 11 holidays observed by the Federal Government are:

New Years Day

January 1

Martin Luther King’s Birthday

3rd Monday in January

Presidents Day

3rd Monday in February

Memorial Day

Last Monday in May Juneteenth National Independence Day

June 19 Independence Day

July 4

Labor Day

1st Monday in September

Columbus Day

2 Monday in October

Veterans Day

November 11

Thanksgiving Day

4th Thursday in November

Christmas Day

December 25

The President of the United States of America may declare additional days as a Federal holiday, and if so, this holiday will automatically be added to the list above. When a holiday falls on a Sunday, the following Monday shall be observed as a Federal holiday. When a holiday falls on a Saturday, the preceding Friday shall be observed as a Federal Holiday.

SAFETY REQUIREMENTS

In the performance of this contract, the Contractor shall take such safety precautions as the Contracting Officer or the COR may determine to be reasonably necessary to protect the lives and health of all persons affected by this contract. The Contracting Officer or COR will notify the Contractor of any noncompliance with the foregoing provisions and the action to be taken. The Contractor shall, after receipt of such notice, immediately correct the conditions to which attention has been directed. Such notice, when served on the Contractor or his/her representative at the site of the work, shall be deemed sufficient for the purposes aforesaid. If the Contractor fails or refuses to comply promptly, the Contracting Officer may issue an order stopping all or any part of the work and hold the Contractor in default.

6. REQUIRED REPORTS AND DOCUMENTS

Within ten (10) business days after contract award the contractor shall provide the following:

Contractor Personnel Roster - In this document, contractor shall identify all employees by name and position and provide training documentation with date and location of such training. Include contractor’s project manager with telephone, e-mail and fax number; include telephone, e-mail and fax numbers through which scheduling transport requests will be made.

A. Listing of all vehicles with VINs and documentation of insurance coverage; MNDOT or equivalent vehicle inspection documentation and statement indicating that all have been fully maintained and are currently safe to operate.

Any personnel or vehicle changes shall be submitted within three (3) business days after changes occur.

END OF STATEMENT OF WORK