Solicitation Attach D. Performance Work Statement 20APR2020 (Revised).docx

75H71220Q00001

EMERGENCY MEDICAL SERVICES,

PAIHS, HOPI HEALTH CARE CENTER, POLACCA, AZ

SCOPE OF WORK

This requirement is for emergency need of services as a result of the COVID-19 pandemic. Emergency Medical Services (EMS) ground ambulance transportation services to be provided to the Hopi Health Care Center (HHCC), Milepost 388 Arizona Highway 264, Polacca, AZ. The Hopi Health Care Center is located in a remote area with ambulatory, level IV ER, and inpatient services, but lacking acute care clinical services such as an ICU, OR, or high-end specialty care, including trauma care. The nearest major medical center is located 123 miles from HHCC in Flagstaff, AZ. Patients that cannot be cared for in Flagstaff are transported to Phoenix, AZ, 254 miles distant. The majority of patient transport to outlying medical facilities occurs via helicopter transport via an asset located on-site at the HHCC; however, helicopter transport guidelines preclude some patients from traveling via this method and require transport via fixed wing and/or ground ambulance methods. Currently, there is not a functional airport in close proximity to the facility. The nearest airstrips available for transport via fixed-wing air ambulance are located 69 miles from HHCC in Winslow, AZ, 78 mils from HHCC in Tuba City, AZ and 130 miles from HHCC in Flagstaff, AZ, respectively. This poses a unique challenge for providing emergency services requiring transport for patients that present to the HHCC in need of acute medical transport to facilities outside a 90 mile radius. Current prehospital emergency medical response within the boundaries of the Hopi Reservation is provided by Hopi Emergency Medical Services. The purpose of this solicitation is to obtain emergency ground ambulance transport from the HHCC to off-reservation medical centers and air ambulance rendezvous points. This contract will service as a supplement to transport services currently provided within the boundaries of the Hopi Reservation by and will not duplicate or replace these services.

Population served: Hopi Service Unit Users: 12,000

Participating contractors shall provide all necessary resources, personnel, drugs, supplies, equipment, facilities, and other items and expertise necessary for, or incidental to, providing medically necessary ground medical transportation services for patients referred by the Hopi Health Care Center. The Contractor shall place an Advanced Life Support (ALS) Ambulance at the Hopi Health Care Center, Polacca, AZ, for response to requests for ground emergency ambulance services twenty-four (24) hours per day, seven (7) days per week for the full term of this contract.

Accommodations are provided with an EMS garage and parking located adjacent to the Hopi Health Care Center. Quarters and small office space available within HHCC adjacent to ER is available for use.

Estimated Quantity: The IHS does not guarantee or imply that any fixed amount of transports will be placed under this contract. The quantities identified herein are annual estimates only. The actual quantities will be based upon the number of patients who are determined to be eligible to receive such services and may be greater or less than quantities furnished. The number of Transports is estimated to be five (5) transports/day.

Location for transports: Ground ambulance transport would be from the Hopi Health Care Center (HHCC), Milepost 388 Arizona Highway 264, Polacca, AZ. Primary locations for transport are to airstrip locations within a 1320 mile radius: Chinle, Winslow, Tuba City for transfer to fixed wing air ambulance services. Transports may also include ground transport to medical facilities outside of the Hopi Reservations, when air transport is unavailable. Arizona locations may include receiving hospitals Flagstaff; Camp Verde, Phoenix, Tuba City, Chinle and Prescott, AZ, all within a 230 mile radius.

Ambulance staffing requirements: Advanced Life Support (ALS). All ambulances providing prehospital advanced emergency ambulance services under this agreement will be staffed and equipped to provide Advanced Life Support (ALS) care. A paramedic shall be the primary caregiver with ultimate responsibility for all patients.

Ambulance licensure and certification requirements: Throughout the terms of this contract, the Contractor shall maintain accreditation through the Commission on Accreditation of Ambulance Services (CAAS)

Period of Performance: 60 days Options: 60 day extension

A. The Contractor shall provide all medically necessary ground medical transportation. Services that are normally and reasonably provided to the public.

B. The Contractor shall provide the levels and types of ground medical transport services that they routinely provide to the public. The types of services are identified/described in the following levels:

b. Advanced Life Support (ALS): Acute or non-acute conditions

c. Specialty Care Missions: Neonatal, Obstetric, infectious diseases, and others

d. ALS is defined as a patient having any of these conditions singly or in combination:

ALS is defined as a patient having any of these conditions singly or in combination:

· Any invasive procedures or equipment including intravenous (IV) therapy, chest tube, endotracheal intubation, crichothyrotomy, pacemaker, and nasogastric (NG) tube;

· Supplemental oxygen dependency;

· Cardiac monitoring;

· Ventilator;

· Pulse oximetry required to monitor pulmonary/respiratory status; and/or

· Any complaint involving the head, neck, chest or abdomen except for superficial involvement.

· Cardiopulmonary resuscitation

· Cardiac defibrillation

Awardee is responsible for providing quality pre-hospital emergency medical care and emergency transportation to all individuals on The Hopi Tribe reservation.

A. Manpower shall:

1. Provide pre-Hospital Emergency Medical Care and transportation for the residents and visitors of the Hopi Tribe.

2. Maintain and follow the EMS operations plan and chain-of-command, including EMS protocols, standing orders, training standards, job descriptions, communications, disaster plans, and base station rules and regulations.

3. Ensure all ambulances are staffed with AZ DHS-certified paramedic and EMT staff capable of providing Advanced Life Support (ALS) care 24/7 and shall include at least one paramedic 24/7 who shall be the primary caregiver for all patients. two certified AZ DHS EMT and or Paramedics 24/7 Comment by Russell, Marie A (IHS/PHX): Don’t we require at least 1 paramedic for ACS? Comment by Towne, Jana (IHS/PHX): Good catch. I have paramedic staffing above and sent as a requirement but missed that they hadn’t made the change here.

4. Maintain all requirements with Department of Health Services (DHS) Base Station policies and procedures for certification and re-certification requirements for EMTs and Paramedics. EMS Director will maintain EMS certification.

5. Ensure all personnel have fingerprint clearance, background screening, and drug screening within 60 days of employment and are supervised at all times until fingerprints and background screenings are completed and cleared.

B. Training EMS shall:

1. Provide and assist EMS personnel with appropriate Basic Life Support (BLS) and Advanced Life Support (ALS) classes, training, and in-services to meet (DHS) recertification requirements.

2. Assist the Hopi Base Station with in-services and run reviews to meet continuing education credit. The Base Hospital will aim to provide 10-11 continuing education sessions per year.

3. Mandate all Base Hospital continuing education requirements. All EMTs and Paramedics must attend five (5) run reviews per year to maintain base station ambulance privileges.

4. Encourage and support all EMTs to upgrade their skills to an Advance Life Support provider or become CPR, First Aid, and EMT instructors.

5. Mandate the Emergency Vehicle Operator Certification (EVOC) course. This course is to train EMTs and Paramedics to appropriately and safely operate an emergency vehicle during stressful and emergency situation.

6. Mandate and provide annual in-house training to include:

a. Occupational Safety and health Administration (OSHA) blood-borne pathogen prevention.

b. OSHA safe lifting procedures.

c. Health Insurance Portability and Accountability Act (HIPAA) certification.

d. Tuberculosis mask fitting.

e. Tuberculosis screening.

C. Medical Direction

1. Contracted EMS shall continue under the administrative and medical direction of their established Advanced Life Support Base Hospital command.

2. Contracted EMS Base Hospital supervision must be provided by a certified Advanced Life Support Base Hospital by the Arizona Bureau of Emergency Medical Services & Trauma System.

D. Communications Contracted EMS shall:

1. Continue the use and participation of the state wide EMSCOMM radio system until services become obsolete. Continue maintaining and updating the communication system.

2. Use of and access to radio frequencies with local emergency management teams to have EMS available as needed.

3. Maintain and upgrade local EMS frequencies and department radio equipment for direct communications with Hopi Emergency Department and all Tribal Public Safety Departments.

4. Maintain cellular phones in the ambulances as another means of direct communications with Hopi Emergency Department,

5. Maintain direct communications with online Medical Direction as well as offline directions and standard orders.

E. Transportation Contract EMS shall:

1. Maintain and operate 1-2 ambulance(s) 24/7 as follows:

a. 1-2 ambulance(s) in Hopi at the Hopi Health Care Center

b. Upon availability of staff and equipment, a back-up ambulance will be put in service during inclement weather, increased call volume, and emergent long distant transport.

c. EMS will maintain ALS coverage on all Ambulances upon availability of ALS personnel.

2. Continue coordination with HHCC to provide transportation as needed for patients being transferred to outside facilities, including but not limited to: transportation for emergency flights, transportation to area hospitals for surgical services or diagnostic imaging, long-distance ground transportation for inter-facility transfer to higher levels of care, when available. EMS will review on case-by-case basis Behavioral and Mental Health patients for interfaculty transport.

3. Review compassionate transports on a case-by-case basis, provided that personnel and essential equipment are available.

4. Continue participation and continuing education with license air medical services, including helicopter and fixed wing providers.

5. Maintain and enforce preventive maintenance for all EMS ambulances and office vehicles.

F. Facilities component Contract EMS shall:

1. Contracted EMS services shall work with Hopi EMS for regular maintenance of facilities.

2. Continue working with Hopi Health Care Center with further emergency medical care throughout the following components:

a. Emergency Department;

b. Outpatient Surgical Department;

c. Obstetrics Department;

d. Disaster Planning;

e. Training;

f. Access to care without the ability to pay.

G. Use of Public Safety Agencies Component Contract EMS shall:

1. Continue working with AZ DHS and Arizona Department of Public Safety with regards to licensing, certification and training.

2. Continue coordination with the Tribal Department of Public Safety with disaster planning consumer information, training, and education with the following departments:

a. Hopi Law Enforcement Services Police Department and Dispatchers;

b. Hopi Emergency Medical Services for coordination of transports and emergency medical services.

c. Hopi Fire and Rescue;

d. All other Hopi Tribal Public Safety Departments.

Accessibility to care with Ability to Pay Component EMS shall:

1. May be requested, dependent on need, Provide no-cost pre-hospital emergency care and ambulance service to Native Americans residents of the and non-Native American residents and visitors who are not eligible for Arizona Health Care Cost Containment System (AHCCCS) or other insurance. Per Emergency Medical Treatment and Labor Act (EMTALA) guidelines, anyone requesting transportation to the hospital shall be transported to the Hopi Health Care Center

H. Standard Medical Record Keeping Component Contract EMS shall:

1. Continue use of EMS developed Patient First Care Forms until electronic patient record charting (EPCR) is implemented. Software will be provided by AZ DHS.

2. Continue monthly review of Patient First Care Forms with the QA/QI plan to promote, enhance and, ensure quality emergency Medical care to our community at large, to be done by certified EMS Medical Director, EMS Nurse Educator, EMS Training Coordinator, EMS Paramedic Shift Supervisor and EMS Director.

3. Full participation and cooperation in state base station audits.

4. Collect monthly statistics and perform chart reviews according to policy.

5. Maintain HIPAA compliance.

I. Mutual aid agreement component Contract EMS shall:

1. Establish mutual aid agreement with area ambulance services and public safety agencies.

2. Patient Transfer Agreement.

3. Equipment exchange and retrieval.

4. Disaster preparation.

4 | Page All EMS vehicles and indoor facilities will remain SMOKE FREE