A.02 Performance Work Statement Ambulance Services 2024.docx

PERFORMANCE WORK STATEMENT (PWS)

AMBULANCE SERVICES

FORT BUCHANAN, PUERTO RICO

SECTION # 1

General Information

1. GENERAL: This is a non-personnel services requirement to provide Ambulance Services at Fort Buchanan, US Army Garrison (USAG), Puerto Rico. The Government shall not exercise any supervision or control over the contract service providers performing the services herein. Such contract service providers shall be accountable solely to the Contractor who, in turn is responsible to the Government in accordance with all terms and conditions in the contract. Except as otherwise limited herein, the Contractor may use or disclose Protected Health Information on behalf of the Government for treatment, payment, or healthcare operations purposes, in accordance with the specific use and disclosure provisions. Such use or disclosure of Protected Health Information should not violate the HIPAA Privacy Rule, the HIPAA Security Rule, DoD 6025.18-R or DoD 8580.02-R.

1.1. Description of Services: The contractor shall provide personnel, vehicles, equipment, supplies, facilities, transportation, tools, materials, supervision and all necessary to perform Advance Life Support (ALS) Ambulance Services at Fort Buchanan, USAG as defined in this Performance Work Statement except for those items specified as government furnished property and services. The contractor shall perform to the standards in this contract.

1.2. Objectives: To provide comprehensive ambulance coverage for all beneficiaries within its scope and area of responsibility upon dispatch by Directorate of Emergency Services (DES)

1.3. Scope: The Contractor shall provide personnel, materials, equipment, tools, insurance and incidentals, supervision and all necessary to perform Ambulance Services at Fort Buchanan, PR. The Ambulance Services shall be available twenty four (24) hours daily, seven (7) days a week providing Advance Life Support (ALS) ambulance service on Fort Buchanan and area of responsibility; routine transports from the Rodriguez Army Health Clinic to a local hospital in/and around the metropolitan area (San Juan, Bayamon, Cataño, Carolina, and Guaynabo). Services outside the metropolitan area are not to be paid by the US Government and are not part of the services under this contract; however the contractor may directly bill patients for transport outside the metropolitan area (San Juan, Bayamon, Cataño, Carolina, and Guaynabo). (See paragraph 5.6. Billing). The ambulance shall be stationed at the Fire Station (Bldg 399) in Fort Buchanan.

1.3.1. The Contractor services shall include personnel who are competent, qualified and adequately trained to perform the assigned duties of Emergency Medical Technician Paramedic (EMT-P) with a fully operational Type III ambulance.

1.3.2. The contractor shall always provide a fully operational backup ambulance on Fort Buchanan within twenty (20) minutes of notification, with medical service personnel in each ambulance, consisting of one Emergency Medical Technician Basic (EMT-B) and one Emergency Medical Technician Paramedic (EMT-P).

1.4 Purpose: To provide comprehensive ambulance coverage for all beneficiaries within its scope and area of responsibility upon dispatch by Directorate of Emergency Services (DES), Fire Department.

1.5 Period of Performance: Base Year and four (4) 12-month option years, if exercised by the Government.

1.6. Quality Control: The Contractor shall establish and maintain a Quality Control Plan to assure the requirements of the contract are provided as specified and shall provide one copy of the Plan to the Contracting Officer within 5 Calendar days of award. The designated Government personnel will review the Quality Control Plan and make proposed changes and return to contractor for revision, if necessary. An updated copy shall be provided to the Contracting Officer. The plan shall include procedures to implement all requirements of the contract.

1.6.1. An inspection method should be specified in the QCP covering all services required by this contract which must specify the areas to be inspected on either a scheduled or unscheduled basis, how often inspection will be accomplished and documented, or the title of the individual (s) who will perform the inspection.

1.6.2. The Contractor shall establish an internal policy and procedures for ensuring the designated Field Treatment Protocols are being followed, and shall create and provide proof to the Contracting Officer of an annual training program on the designated Field Treatment Protocols. The Contractor shall provide established policies and procedures for personnel who do not comply with the designated Field Treatment Protocols. Proof of training shall be provided within 5 Calendar days of award and once a year thereafter.

1.6.3. The Contractor shall develop a method of identifying and preventing defects and negative trends in transportation runs, patient care, patient disposition/ diversion before the level of performance becomes unacceptable.

1.6.4. The Contractor shall develop a method for identifying and preventing vehicle breakdowns. The contractor shall ensure that all vehicles and equipment designated for this contract are maintained in a safe, sanitary, and in properly functioning condition. The interior of the vehicle shall be in a clean state prior to the start of each shift. Develop a detailed procedure for alternative transportation of patients in the event of mechanical breakdown of ambulance.

1.7. Drug-Free Work Force: The Contractor agrees to institute and maintain a program for achieving the objective of a drug-free work force. The contract should incorporate the clause found at DFARS 252.223-7004, see also AR 600-85, paragraph 5-11e.

1.8 Process Improvement: The contractor Medical Director shall review the services field treatment reports and all deficiencies shall be immediately reported to the U.S. Government Contracting Officer Representative.

1.8.1. Quarterly meetings will be held with representatives from both the Contractor and the U.S. Government present to address current issues and evaluate the policies, procedures, training requirements, equipment issues, and any other business the parties find pertinent.

1.8.2. A designated Government representative may conduct random inspections of the vehicles and personnel according to the accepted medical industry standards. An initial inspection after contract award will be conducted by the Government on vehicle conditions and medical compliance for ambulance operation.

1.8.3. The contractor shall participate with the U. S. Government in collecting data to establish and monitor utilization trends, conducting chart and record reviews to ensure adequate documentation and adherence to standards of care, and investigating and resolving all unusual incidents, patient complaints and unanticipated adverse patient outcomes.

1.9 Other Considerations: The contractor shall maintain all confidentiality of any patient records, and shall not release such without express permission of the DES Fire Department, Fire Chief.

1.9.1. The contractor shall not release historical, biographic or demographic data without prior approval of an authorized Government representative.

1.9.2. Electronic Contract Manpower Reporting Application (eCMRA): “The Office of the Secretary of Defense (OSD) memorandum, “Revised Department of Defense Contractor Manpower Reporting Initiative,” dated October 16, 2019, provides new implementing direction for contractor reporting of manpower data with regard to the performance of DoD services contracts consistent with the requirements of title 10, U.S.C, section 235 and 2330a, as amended. Effective in FY 2020, the Department of Defense will no longer require contractors to report into the ECMRA. Contractors will begin reporting manpower data relating to the performance of services contracts into SAM, consistent with existing service contract reporting requirements under the FAR Subpart 4.17—Service Contracts Inventory, that is currently applicable only to Federal civilian agencies. The Department is drafting a Defense FAR Supplement rule (DFARS Case 2018-D063) that will include a contract clause to implement this change. The eCMRA require contractors to report data in SAM on an annual basis when they are awarded a DoD contract that is valued in excess of $3 million in obligations or deobligations. Contractors shall report annually by 31October and shall notify the KO after the SCR is submitted on www.sam.gov.”

1.9.3. Quality Assurance: The government shall evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan. This plan is primarily focused on what the Government must do to ensure that the contractor has performed in accordance with the PWS and all terms and conditions. It defines how the performance standards will be applied and the frequency of surveillance.

1.9.4. Place of Performance: The services under this contract will be performed at Fort Buchanan, Puerto Rico.

1.9.5. Type of Contract: The government will award a Firm-Fixed Price Contract.

1.9.6. Security Requirements: Contractor personnel performing work under this contract shall have a Puerto Rico Certificate of Good Conduct at the time of proposal submission, and must maintain the level of security required for the life of the contract. Upon award, the contractor shall furnish a list of employees requiring installation passes to the Contracting Officer. Every ninety- (90) days thereafter, the contractor is required to provide a revised personnel roster to the Contracting Officer’s Representative if necessary to keep abreast of personnel changes.

1.9.7. Physical Security: The Contractor shall be responsible for safeguarding all government equipment, information and property provided for contractor use.

1.10. Special Qualifications: All contractor employees must maintain a valid Puerto Rico Department of Health Certification with control number, a valid Puerto Rico Certificate of Authorization and License issued by the Public Service Commission, a valid Puerto Rico Driver’s license, a valid Puerto Rico or National Registry Emergency Medical Technician-Paramedic (EMT/P) or Emergency Medical Technician-Basic (EMT) certification, and valid CPR certifications at time of proposal and during the life of the contract. The offeror shall submit a copy of all personnel certifications with the proposal.

1.11 Post Award Conference/Periodic Progress Meetings: The Contractor agrees to attend any post award conference convened by the contracting activity or other authorized representative. The Contracting Officer, Contracting Officers Representative (COR), as appropriate, may meet periodically with the contractor to review the contractor's performance. At these meetings the contracting officer will apprise the contractor of how the government views the contractor's performance and the contractor will apprise the Government of problems, if any, being experienced. Appropriate action shall be taken to resolve outstanding issues. These meetings shall be at no additional cost to the government.

1.12 Contracting Officer’s Representative (COR): The (COR) will be identified by separate letter. The COR monitors all technical aspects of the contract and assists in contract administration. The COR is authorized to perform the following functions: assure that the Contractor performs the technical requirements of the contract: perform inspections necessary in connection with contract performance: maintain written and oral communications with the Contractor concerning technical aspects of the contract: monitor Contractor's performance and notifies both the Contracting Officer and Contractor of any deficiencies; coordinate availability of government furnished property, provide site entry of Contractor personnel, ensure the Contract Manpower Reporting is completed and certify payments in the Wide Area Work Flow (WAWF). A letter of designation issued to the COR, a copy of which is sent to the Contractor, states the responsibilities and limitations of the COR, especially with regard to changes in cost or price, estimates or changes in delivery dates. The COR is not authorized to change any of the terms and conditions of the resulting contract.

1.13. Key Personnel: Upon contract award, all personnel listed will be considered key personnel by the government. The contractor shall designate a Project Manager who shall be responsible for the performance of the work. The name of the Project Manager and an alternate who shall act for the contractor when the manager is absent shall be designated in writing to the contracting officer.

1.14. Identification of Contractor Employees: All contract personnel attending meetings, answering Government telephones, and working in other situations where their contractor status is not obvious to third parties are required to identify themselves as such to avoid creating an impression in the minds of members of the public that they are Government officials. They must also ensure that all documents or reports produced by contractors are suitably marked as contractor products or that contractor participation is appropriately disclosed.

1.15. Data Rights: The Government has unlimited rights to all documents/material produced under this contract. All documents and materials, to include the source codes of any software, produced under this contract shall be Government owned and are the property of the Government with all rights and privileges of ownership/copyright belonging exclusively to the Government. These documents and materials may not be used or sold by the contractor without written permission from the Contracting Officer. All materials supplied to the Government shall be the sole property of the Government and may not be used for any other purpose. This right does not abrogate any other Government rights.

SECTION# 2

DEFINITIONS & ACRONYMS

2. DEFINITIONS AND ACRONYMS:

2.1. DEFINITIONS:

2.1.1. ADVANCE LIFE SUPPORT. Emergency medical care for sustaining life, including defibrillation, airway management, drugs and medications.

2.1.2. CONTRACTOR. A supplier or vendor having a contract to provide specific supplies or service to the government. The term used in this contract refers to the prime.

2.1.3. CONTRACTING OFFICER. A person with authority to enter into, administer, and or terminate contracts, and make related determinations and findings on behalf of the government. Note: The only individual who can legally bind the government.

2.1.4. CONTRACTING OFFICER'S REPRESENTATIVE (COR). An employee of the U.S. Government appointed by the contracting officer to administer the contract. Such appointment shall be in writing and shall state the scope of authority and limitations. This individual does NOT have authority to change the terms and conditions of the contract. The COR provided guidance to the contractor.

2.1.5. DEFECTIVE SERVICE. A service output that does not meet the standard of performance associated with the Performance Work Statement.

2.1.6. DELIVERABLE. Anything that can be physically delivered but may include non-physical things such as meeting minutes.

2.1.7. KEY PERSONNEL. Contractor personnel that are evaluated in a source selection process and that may be required to be used in the performance of a contract by the Key Personnel listed in the PWS. When key personnel are used as an evaluation factor in best value procurement, an offer can be rejected if it does not have a firm commitment from the persons that are listed in the proposal.

2.1.8. PHYSICAL SECURITY. Actions that prevent the loss or damage of Government property.

2.1.9. QUALITY ASSURANCE. The government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.

2.1.10. QUALITY ASSURANCE Surveillance Plan (QASP). An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance.

2.1.11. QUALITY CONTROL. All necessary measures taken by the Contractor to assure that the quality of an end product or service shall meet contract requirements.

2.1.12. SUBCONTRACTOR. One that enters into a contract with a prime contractor. The Government does not have privities of contract with the subcontractor.

2.1.13. WORK DAY. The number of hours per day the Contractor provides services in accordance with the contract.

2.1.14. WORK WEEK. Is defined as 7 days a week and 24 hours a day.

2.2. ACRONYMS

SECTION# 3

GOVERNMENT FURNISHED PROPERTY, EQUIPMENT, AND SERVICES

3. GOVERNMENT FURNISHED ITEMS AND SERVICES:

3.1. Services: DES Fire & Emergency Services will provide and monitor emergency radio frequency or telephone communications with ambulance crew, provide ambulance personnel with on post driving operations and procedures, coordinate post access with Fort Buchanan Law Enforcement personnel, and arrange for the ambulance to be parked in a safe, secured location.

3.2. Facilities: The Government will provide the necessary workspace and new furniture for the contractor staff to provide the support outlined in the PWS.

3.3. Utilities: The Government will provide all utilities in the facility to support the performance of tasks outlined in this PWS. For any utilities furnished, the Contractor shall instruct employees in conservation practices. The contractor shall be responsible for operating under conditions that preclude the waste of utilities, which include turning off the water faucets or valves after using the required amount to accomplish cleaning official emergency vehicles and equipment. The personal use of utilities for cleaning or washing non-emergency vehicles (i.e. POV’s) is strictly prohibited.

3.4. Equipment: The Government will provide a telephone line.

3.4.1. Two Portable radios will be hand receipted to the Contractor for official use only to communicate with the Fort Buchanan Fire Department Dispatch during emergencies and routine vehicle and personnel movement.

3.4.2. The Government will provide Standard Operating Procedures, Policies, and Army/MEDCOM approved BLS Protocols.

SECTION # 4

CONTRACTOR FURNISHED ITEMS AND SERVICES

4. CONTRACTOR FURNISHED ITEMS AND RESPONSIBILITIES:

4.1. General: The Contractor shall furnish all supplies, equipment, facilities and services required to perform work under this contract that are not listed under Section# 3 of this PWS.

4.2. Materials: The Contractor shall provide Patient Transporters and all expendable supplies/medications used in the transport of patients necessary to meet the requirements under this PWS.

4.3. Equipment: The Contractor shall provide Ambulance vehicles with all certificates and items for use in ambulances, Suction Units, Defibrillators/ECG Monitors, Pulse Oximeters, Battery support systems for cardiac monitors, Pediatric sized equipment, etc. to meet the requirements under exhibit #1 of this PWS.

SECTION # 5

SPECIFIC TASKS

5. SPECIFIC TASKS:

5.1. Basic Services: The Contractor shall provide comprehensive ambulance services coverage, Advance Life Support (ALS) and routine transports to all beneficiaries of Fort Buchanan, Puerto Rico upon dispatch or notification by DES Fire & Emergency Services. The offeror shall be in full compliance with all laws governing licensing and/or accreditation of their ambulance service and shall provide proof with the proposal.

5.2. Ambulance: The Contractor shall provide an updated list of available resources and capabilities to the Fort Buchanan Fire Department.

5.2.1 The Contractor shall provide a Type III ambulance capable of supporting the complete spectrum of emergency services required, and shall be available on site twenty four (24) hours daily, 7 days a week.

5.2.2. The Contractor shall always provide a Backup ambulance on Fort Buchanan within twenty (20) minutes of notification ready to respond to emergencies while the main ambulance is off post. The Backup ambulance must be equipped the same as the primary ambulance.

5.3 Personnel: The Contractor shall provide medical service personnel consisting of two Emergency Medical Technician-Paramedic (EMT-P) in the primary ambulance, and one Emergency Medical Technician-Paramedic (EMT-P) with one Emergency Medical Technician-Basic (EMT) in the Backup ambulance. All personnel must be qualified according to Section 1.10 of this PWS. The contractor shall submit personnel certifications with the proposal.

5.3.1 All contract personnel shall be able to accurately speak, read and write in both English and Spanish. Daily business will be conducted in English.

5.3.2. All contract personnel shall maintain professional standards of grooming and appearance by wearing the appropriate uniform designated by the Contractor.

5.3.3. All contract personnel shall maintain their Contractor and EMT Credentials visible at all times.

5.4. The Fort Buchanan Fire Department will follow Army/MEDCOM approved Basic Life Support (BLS) Protocols.

5.5. Miscellaneous Tasks: The Contractor Shall be thoroughly familiar with the Fort Buchanan Emergency Management Plan, contingency plans, regulations and other pertinent documents.

5.5.1. Provide the DES Fire and Emergency Services, with an Essential Services Plan which defines the ambulance’s scope of care, and describes operational instructions and services with the proposal.

5.5.2. Ensure that each vehicle, all emergency medical equipment, and two-way communication radios are in proper working order at the beginning of each shift.

5.5.3. The ambulance shall be inspected and inventoried at the beginning of each shift and serviced in accordance with medical industry standards by a qualified technician in the event of a breakdown.

5.5.4. Maintain documentation regarding the ambulance’s inspection and equipment inventory at all times and produced to the COR upon request.

5.5.5. Maintain Patient Care Reports (PCR) permissible under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and a copy shall be provided to the Fire Department within twenty-four (24) hours if requested for Freedom of Information Act (FOIA) requests. Under no circumstance will the contractor provide Patient Care Reports (PCR) to personnel or customers unless they are requested through the proper channels.

5.5.6. Facility access control to authorized personnel is only for the performance of this PWS.

5.6. Billing: All billing shall be for services as stated in this PWS. The contractor may elect to provide services and directly bill individual patients for transport to Health Care Facilities outside the metropolitan area (San Juan, Bayamon, Cataño, Carolina, and Guaynabo) (See paragraph 1.3). The Contractor shall not bill the US Government for patient’s transport services from Fort Buchanan, P.R. to medical facilities outside the metropolitan area nor will the Government be liable for such transportation costs the Contractor was not paid for by individual patients, since these services are not part of this contract.

5.7 Summary of the Contractor responsibilities during incidents:

5.7.1. The ambulance shall immediately respond to the emergency location, and concurrently request a replacement ambulance from the contractor’s dispatcher.

5.7.2. The ambulance crew shall call in to report arrival at the scene and patient contact to DES Fire Department dispatcher.

5.7.3. The ambulance crew will initiate emergency evaluation and treatment in accordance with accepted medical treatment protocols and established standards, principles and ethics of the profession, and applicable professional specialty organizations, applicable DoD, Army specific regulations, directives and policies, and MTF specific policies, procedures, and job descriptions.

5.7.4. If required, the ambulance crew shall execute the transport to an approved medical facility and notify the DES Fire Department dispatcher upon disposition.

5.7.5. The ambulance crew shall coordinate a Backup ambulance to cover Fort Buchanan while transporting the patient. The Contractor shall always provide a Backup ambulance on Fort Buchanan within twenty (20) minutes of notification. The Backup ambulance shall be provided with one Emergency Medical Technician Basic (EMT-B) and one Emergency Medical Technician Paramedic (EMT-P).

5.7.6. Upon arrival, the Backup ambulance crew will report to The Fire Department Dispatcher.

5.7.7. Upon arrival at any designated emergency room, the Contractor shall continue to render emergency care until patient is turned over to the care of the attending physician.

5.7.8. The Contractor shall document the care provided at the site, en-route to, and in the healthcare facility by completing a Patient Care Report (PCR) within thirty minutes after being released by the attending physician. All care shall be provided in accordance with pre-hospital protocols.

5.7.9. For routine transports from Rodriguez Army Health Clinic (RAHC) to a Medical Treatment Facility (MTF), the Contractor shall NOT use the primary ambulance, as specified in Part #1 of this PWS. The routine transport shall be coordinated with the Contractor’s Dispatcher. Please refer to Section 5.6 (Billing) to ensure the Government is not held liable for such transportation costs.

5.7.10. Response time for routine transport services shall be no more than Three (3) hours from the origin of the request.

SECTION # 6

OPSEC

6. OPSEC

Section IV. Standard Contract Language/Contract Clause Applicability and/or Additional SOW Language.

6.1 AT Level I training. This standard language is for contractor employees with an area of performance within an Army controlled installation, facility or area. All contractor employees, to include subcontractor employees, requiring access Army installations, facilities and controlled access areas shall complete AT Level I awareness training within 30 calendar days after contract start date or effective date of incorporation of this requirement into the contract, whichever is applicable and annually thereafter. The contractor shall submit certificates of completion for each affected contractor employee and subcontractor employee, to the COR or to the Contracting Officer, if a COR is not assigned, within 5 calendar days after completion of training by all employees and subcontractor personnel. AT level I awareness training is available at the following website: http://jko.jten.mil

6.2. Access and general protection/security policy and procedures. This standard language is for contractor employees with an area of performance within Army controlled installation, facility, or area. Contractor and all associated sub-contractors employees shall provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency Services or Security Office. Contractor workforce must comply with all personal identity verification requirements (FAR clause 52.204-9, Personal Identity Verification of Contractor Personnel) as directed by DOD, HQDA and/or local policy. In addition to the changes otherwise authorized by the changes clause of this contract, should the Force Protection Condition (FPCON) at any individual facility or installation change, the Government may require changes in contractor security matters or processes.

6.3. iWATCH Training. This standard language is for contractor employees with an area of performance within an Army controlled installation, facility or area. The contractor and all associated sub-contractors shall brief all employees on the local iWATCH program (training standards provided by the requiring activity ATO). This locally developed training will be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to the COR. This training shall be completed within 30 calendar days of contract award and within 05 calendar days of new employees commencing performance with the results reported to the COR NLT 30 calendar days after contract award.

SECTION #7

APPLICABLE PUBLICATIONS

7. APPLICABLE PUBLICATIONS (CURRENT EDITIONS)

7.1. The Contractor must abide by all applicable regulations, publications, manuals, and local policies and procedures IAW AR 25-2, AR 530-1, FAR 52.212.1, 52.212.4. AR 240-1 DoDI 6055M

7.1.1 DoD Instruction 6055.6, “DoD Fire and Emergency Services Program”.

7.1.2 “Ambulance Services Regulation in Puerto Rico” published by the Commonwealth of Puerto Rico Public Service Commission.

7.1.3 Army/MEDCOM Approved Field Treatment Protocols

SECTION # 8

ATTACHMENT/TECHNICAL EXHIBIT LISTING

8. Attachment/Technical Exhibit List:

8.1 Attachment 1/Technical Exhibit 1 – Performance Requirements Summary

8.2 Attachment 2/Technical Exhibit 2 – History

8.3 Attachment 3/ Contract submittal listing

TECHNICAL EXHIBIT 1

PERFORMANCE REQUIREMENTS SUMMARY

Performance Objective

Method of Surveillance

Emergency Response Times:

First arriving responder

The COR will monitor response time for each emergency call.

Emergency Response Times:

Advanced Life Support Assignment

The COR will monitor response time for each emergency call.

100% of the time the contractor and contract service providers shall comply with standards, rules and procedures.

The COR will monitor response time for each emergency call.

Provide Medical Standards of Care per Field Treatment Protocols and IAW established standards, principles and ethics of the profession, professional specialty organizations, DoD/Army specific regulations, directives, and policies, and MTF specific policies and procedures.

Random inspection conducted by the COR.

Provide certified EMT’s to operate a Type III ambulance and provide emergency care at the Emergency Medical Technician Basic (EMT-B) and Emergency Medical Technician Paramedic (EMT-P) levels

TECHNICAL EXHIBIT 2

HISTORY

1. Estimated need of a replacement ambulance averaged 30-40 percent of an estimated total dispatch of 447 calls during a period of one (1) year.

ATTACHMENT 3

CONTRACT SUBMITTAL LISTING

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