Solicitation Attach D. Performance Work Statement (Revised).pdf

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75H71220Q00002

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 on-site parking located adjacent to the Hopi Health Care

Center. Quarters are located within 15 miles of the facility, and a 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 130 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

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Ambulance staffing requirements: Advanced Life Support (ALS). All ambulances providing 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: 1 year: 10/26/2020 – 10/25/2021

Options: 1 Year: 10/26/2021 – 10/25/2022

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:

1. LEVEL I: High Acuity Ground Ambulance to destination facilities.

a. Critical Care Life Support (CCLS): Acute conditions

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 emergency medical care and emergency transportation to all individuals on The Hopi Tribe reservation.

A. Manpower shall:

1. Provide 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.

4. Maintain all requirements with Department of Health Services (DHS) Base

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Station policies and procedures for certification and re-certification requirements for EMTs and Paramedics. EMS Director will maintain EMS certification.

B. 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.

C. Communications Contracted EMS shall:

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

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

E. 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.

F. 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.

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

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

HIPAA compliance.

G. 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.

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All EMS vehicles and indoor facilities will remain SMOKE FREE

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