Attach 5_PWS Patient Transport Services 22 Aug 2023.docx

PERFORMANCE WORK STATEMENT PATIENT TRANSPORT SERVICES

BROOKE ARMY MEDICAL CENTER (BAMC) JOINT BASE SAN ANTONIO

FORT SAM HOUSTON, TEXAS 22 August 2023

PART 1 GENERAL INFORMATION

1 GENERAL: This is a non-personal services contract, as defined in Federal Acquisition Regulation (FAR) 37.101, it is expressly agreed and understood that the services rendered by a contract service provider are rendered in their capacity as independent contractor or personnel of any independent company that may be a party to this contract. The Government may evaluate the quality of services provided but retains no control over the professional aspects of the services rendered. The Contractor shall be solely liable for and expressly agree to indemnify the Government with respect to any liability producing acts or omissions by its personnel or agents. This contract does not create an employer-employee relationship between the Government and any corporation, partnership, business association or other party or legal entity with which the individual contract service provider may be associated. This acquisition is under FAR 12 and 15.

Contract personnel rendering services are not subject, either by the contract terms or by the manner of its administration, to the supervision and control usually prevailing in relationship between the Government and its personnel.

1.1 DESCRIPTION OF NON-PERSONAL SERVICES: This is a non-personal services requirement to provide support for interfacility transport services for the Joint Base San Antonio (JBSA) area to include but not limited to the following military treatment facilities, civilian hospitals, and residences within 300 miles of San Antonio: Brooke Army Medical Center (BAMC), Wilford Hall Ambulatory Surgical Center (WHASC), the CPT Jennifer M. Moreno clinic, JBSA Behavioral Health Clinic, McWethy Troop Medical clinic, SPC Taylor Burk Clinic, Reid Clinic, Randolph Clinic, Schertz Medical Home, Westover Hills Medical Home, Gateway Bulverde Clinic, and Corpus Christi Army Depot Occupational Health Clinic; JBSA flightlines and San Antonio International Airport. This contract will also provide for ambulance transports of patients for air evacuation to or from BAMC, Lackland AFB annex (Kelly Airfield), Randolph AFB and San Antonio Airport. 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. The contractor shall provide all personnel with supervision and other items as defined in this Performance Work Statement except for those items specified as government furnished property. The contractor shall perform and shall adhere to the standards in this contract.

1.2 BACKGROUND: JBSA and partnering organizations consist of the Brooke Army Medical Center, Wilford Hall Ambulatory Surgical Center (WHASC), the CPT Jennifer M. Moreno Clinic, JBSA Behavioral Health Clinic, McWethy Troop Medical clinic, SPC Taylor Burk Clinic, Reid Clinic, Randolph Clinic, Schertz Medical Home, Westover Hills Medical Home, Gateway Bulverde, Corpus Christi Army Depot Occupational Health Clinic, JBSA flightlines and San Antonio International Airport. It will also include any additional MTFs built within a 300-mile radius in the future. The Brooke Army Medical Center (BAMC) is one of the nation’s premier medical facilities, offering highly sophisticated medical care for service members, family members, civilians, and veterans. BAMC is a 425-bed, state-of-the-art medical facility that plays a critical role in patient care, as well as taking care of Wounded Warriors in Transition from the Global War on Terrorism. The medical center is a Department of Defense (DoD) Level I Trauma Center and receives more than 5,700 emergency room visits each month. Co-located on the BAMC campus is the world-renowned Army Institute of Surgical Research, which operates the only DoD Burn Center — the Army’s Burn Center. Advanced rehabilitative services are provided at the Center for the Intrepid, a unique facility that is at the cutting edge of Warrior care.

1.3 OBJECTIVE: Provide interfacility transport service for Joint Base San Antonio as outlined in Performance Work Statement. To ensure interfacility transport services for the Joint Base San Antonio (JBSA) area. to include but not limited to the following military treatment facilities, civilian hospitals, and residences within 300 miles of San Antonio: Brooke Army Medical Center, Wilford Hall Ambulatory Surgical Center (WHASC), the CPT Jennifer M. Moreno clinic, JBSA Behavioral Health Clinic, McWethy Troop Medical clinic, SPC Taylor Burk Clinic, Reid Clinic, Randolph Clinic, Schertz Medical Home, Westover Hills Medical Home, Gateway Bulverde, Corpus Christi Army Depot Occupational Health clinic, JBSA flightlines and San Antonio International Airport have 24/7 quality, interfacility patient transport services in a timely fashion consistent with the Scope of Work provided.

1.4 SCOPE OF WORK: The contractor shall provide ground transport services 24/7 for patients requiring interfacility transportation and support for air evacuation missions for the Joint Base San Antonio (JBSA) area to include but not limited to the following military treatment facilities, civilian hospitals, and residences within 300 miles of San Antonio as previously mentioned above. The contractor shall provide Basic Life Support (BLS), Advanced Life Support (ALS), and Critical Care Transport (CCT). Types of vehicles used for transport shall include but are not limited to: Ambulances and/or ambulance buses capable of transporting combined loads of litter and ambulatory patients and wheelchairs in the event of a real-life mass casualty situation. Ambulance transportation services to other hospitals or treatment facilities shall be utilized only when deemed medically necessary and by a JBSA sending physician/clinician’s written authorization. The contractor shall transport patients to private homes/domiciles when patients have been discharged from the MTF or when deemed medically necessary by a JBSA sending physician/clinician’s written authorization. All requests shall be at the request and authorization of a JBSA sending physician/clinician. Air evacuation support shall include transport to and from San Antonio International Airport of JBSA flightlines and shall be authorized by the Patient Administration Division (PAD).

1.5 PERIOD OF PERFORMANCE: The period of performance shall be for one (1) Base Year of 12 months and four (4) 12-month option years.

The Period of Performance reads as follows:

1.6 QUALITY CONTROL PLAN: The contractor shall develop and maintain an effective quality control plan to ensure the requirements of the contract are performed within this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The contractor’s quality control plan is the means used to ensure that the provider’s work complies with contract requirements. The contractor shall provide a copy of the Quality Control Plan (QCP) to the KO with the initial proposal. The Contracting Officer (KO) shall review and return to contractor for revision, if necessary. A revised copy of the QCP shall be provided the KO prior to commencing work on the contract. Any proposed changes to the accepted QCP are required to be resubmitted for acceptance by the KO no later than seven (7) calendar days prior to the anticipated change and before implementation by the Contractor. The QCP shall include procedures to implement all requirements of the contract and shall include the following:

a. A chart showing the organizational structure and lines of authority, the names, qualifications, duties, responsibilities, and classification of each member of the Contractor's Quality Control Team.

b. How the Contractor will monitor work to ensure performance complies with all deliverables (e.g., timelines, deadlines, and goals).

c. How the Contractor will monitor work to ensure performance complies with all specifications and requirements of the contract, including the contract’s clauses.

d. Inspection procedures covering all services required by the contract. The inspection shall specify the service to be inspected, inspection procedures, frequency and schedule of the inspections.

e. Internal policies and procedures for skills assessments and physical agility testing of all contractor personnel. The contractor shall specify skill level of Emergency Medical Technician (EMT), Advanced Emergency Medical Technician (AEMT), and paramedic at initial and annual assessment, and name and title of the individual performing the assessment.

f. How the Contractor will identify, investigate, and correct any non-conforming performance and prevent similar deficiencies in the future

g. How the Contractor will file and save all Quality Control related documents for the life of the contract plus five (5) years.

h. The Contractor shall inform the COR of issues (or potential issues) that might affect the performance within 24 Hours of identifying those issues. Verbal reports shall be followed up by written reports within seven (7) calendar days

1.7 The contractor shall provide management and operation plans (safety procedures, staff training plans, etc.) to include start up time needed between notice of award and start of service.

1.8 The contractor shall provide a Contingency Plan detailing provisions for inclement weather, breakdown, insufficient drivers and emergency evacuation.

1.9 RECOGNIZED HOLIDAYS: The following legal holidays are observed by this post whereby services shall be required:

NOTE: Any of the above holidays falling on a Saturday shall be observed on the preceding Friday; holidays falling on a Sunday shall be observed on the following Monday.

1.10 HOURS OF OPERATION: The contractor shall provide services 24 hours a day, 7 days a week, 365 days a year, to include Federal holidays, regardless of national emergencies. The Contractor shall at all times maintain an adequate workforce for the uninterrupted performance of all tasks defined within this PWS. When hiring or terminating personnel, the contractor shall keep in mind that the stability and continuity of the workforce are essential.

1.11 PLACE OF PERFORMANCE: The contractor shall provide ground transportation services 24/7 for patients requiring interfacility transportation for the Joint Base San Antonio (JBSA) area to/from within 300 miles of San Antonio including but not limited to: Brooke Army Medical Center, Wilford Hall Ambulatory Surgical Center (WHASC), the CPT Jennifer M. Moreno Clinic, JBSA Behavioral Health Clinic, McWethy Troop Medical Clinic, SPC Taylor Burk clinic, Reid clinic, Randolph Clinic, Schertz Medical Home, Westover Hills Medical Home, Gateway Bulverde, Corpus Christi Army Depot Occupational Health Clinic, JBSA flightlines, and San Antonio International Airport. This contract will also provide for ambulance transports of patients for air evacuation to or from BAMC, Lackland AFB annex (Kelly Airfield), Randolph AFB and San Antonio Airport. It will also include any future MTFs built within a 300-mile radius. The contractor shall provide one dedicated unit and crew on standby 24/7 on the BAMC campus. This unit shall be immediately replaced by a second unit when called into service.

1.12

1.13 SECURITY REQUIREMENTS: Work under this contract is unclassified. The Contractor shall comply with all applicable DoD security regulations and procedures during the performance of this contract. The Contractor shall not disclose and shall safeguard procurement sensitive information, computer systems and data, Privacy Act data, and Government personnel work products obtained or generated in the performance of this contract. The contractor shall comply with all applicable DoD security regulations and procedures during the performance of this contract. The contractor shall safeguard and not disclose sensitive information, computer systems and data, information protected by the Privacy Act and Health Information Portability and Accountability Act (HIPAA). The contractor shall comply with DoD Regulation 5400.07 DoD Freedom of Information Act (FOIA) program requirements. The Freedom of Information Act sets policy and procedures for the disclosure of records to the public and for marking, handling, transmitting and safeguarding CUI materials. Contractor personnel shall not disclose or cause to disseminate any information concerning operations of military activities. Such action(s) could result in violation of the contract and possible legal actions. All inquiries, comments or complaints arising from any matter observed, experienced, or learned of as a result of or in connection with the performance of this contract, the resolution of which may require the dissemination of official information, shall be directed to the COR and the Contracting Officer. The Contractor shall only conduct business with designated CORs listed as points of contact. US Government records, copies of original results and reports, verified original data, corrected data and corrected supporting final reports remain the property of the U.S Government.

1.14 CRIMINAL BACKGROUND CHECK REQUIREMENT: The government shall conduct criminal background checks on individuals providing services under this contract to include childcare services during transport under this contract, using the procedures set forth in DoD Instruction 1402.05. Background checks shall be based on fingerprints of individuals obtained by a government law enforcement agency and inquiries conducted through the Federal Bureau of Investigation (FBI) and state criminal history repositories.

a. Contractors accessing Joint Base San Antonio (JBSA) installations in support of the contract shall complete BAMC Form 1047, Badge and Parking Permit Request, and SF 85 Questionnaire for Non-Sensitive Positions to initiate the background check. Upon favorable completion of the background check, contractors shall be issued CAC identifications and BAMC badges for access to JBSA installations.

b. Contractor personnel may provide services under this contract prior to the completion of their background check with the consent of the Contracting Officer (KO) and after receiving a pre- investigative letter or LOSS (Line of Sight Supervision) memorandum. However, while in the care of children, contractors working under LOSS, shall be observed and continuously supervised by a contractor whose background investigation has been completed and has received a Release from LOSS memo.

c. The contractor shall ensure that no minor children, under the age of 18 years, are transported without a chaperone, parent/guardian, or Military Treatment Facility (MTF) staff personnel.

d. Individuals have the right to obtain a copy of any background check pertaining to themselves and to challenge the accuracy and completeness of the information contained in the report. Questions regarding the validity and accuracy of the background check shall be addressed with the appropriate government agency, or law enforcement agency. Documentation of criminal background checks for contractor personnel shall be maintained by the contractor and available for inspection by the COR at any given time.

1.15 ACCESS AND GENERAL PROTECTION/SECURITY POLICY AND PROCEDURES: Contractors providing services within an Army controlled installation, facility, or area, shall provide information required for background checks to meet installation access requirements to be accomplished by the installation Provost Marshal Office and the Security Office. The contractor workforce shall comply with all personal identity verification requirements (FAR clause 52.204-9, Personal Identity Verification of Contractor Personnel) as directed by DoD, Defense Health Agency (DHA) and/or local policy. Should the Force Protection Condition at any facility or installation change, the Government may require changes in contractor security matters or processes. The contractor shall comply with Random Antiterrorism Measures and local search/identification requirements.

1.16 REPORTING REQUIREMENTS: The contractor shall comply with DoD 5200.02 Procedures for the DOD Personnel Security Program and AR 380-67 Department of the Army Personnel Security Program Regulation. Contractor shall report any information or circumstances which may pose a threat to DoD or contractor personnel, resources, or DoD information to the BAMC Security Manager.

1.17 HEALTH REQUIREMENTS: All contract personnel shall have pre-employment physical/health examination at the contractor’s expense within the previous 12 months, or prior to commencing work. Physical/health examinations shall be re-accomplished at two- year intervals. The contractor is responsible for employing personnel that meet the physical requirements for the duties/position they were hired and removing contractors who do not meet the physical requirements. Contractor shall maintain documentation of a complete physical examination for all contract personnel. Documentation shall state the date the examination was completed, physician’s name who performed the examination, and a general statement concerning the physical/ health of the individual. The certification shall also contain the following statement: “(name of contract personnel) is not suffering from any communicable diseases that would affect their ability to safely perform their duties to include, but not limited to Tuberculosis and disseminated contagious skin diseases.”

1.18 IMMUNIZATIONS: All contractor personnel performing direct health care services shall receive a yearly influenza immunization unless contraindicated by an allergy to eggs (see AR40-562, 3-4). The contractor shall arrange for the immunizations at their own expense. Documentation of all health requirements or exemption to immunization, as stated above shall be maintained by the contractor and available for periodic inspection by COR at any given time

1.19 PHYSICAL SECURITY: The contractor shall be responsible for safeguarding all government property provided for contractor use, such as office equipment provided by the Patient Administration Division (PAD), keys and badges provided by the Provost Marshall Office (PMO) and the security forces office, and all loaned medical equipment from the wards. The contractor shall safeguard information of confidential or sensitive nature. Neither the contractor nor any of its contract personnel shall disclose or cause to disseminate any information concerning the operation of the organization that could result in or increase the likelihood of the possibility of a breach of security or interrupt the continuity of operations or which breach the requirements of the Federal Privacy Act of 1974.

1.20 TERMINATION OF EMPLOYMENT: Upon termination of contractor employment, the contractor will notify the COR within 24 hours or next business day of termination and return all government property to include CAC and BAMC badge.

1.21 KEY & BADGE CONTROL: The contractor shall abide by all current BAMC key and badge control procedures. The contractor shall safeguard all keys and badges issued by BAMC’s PMO and the security forces office, and ensure they are used only by authorized contractor personnel. Installation access badge is issued by the security forces office and the PMO badge provides access to hospital wards and BAMC clinics. The contractor shall not duplicate issued office or cabinet keys.

a. The contractor shall be charged for lost or stolen keys, as well as lost or stolen badges. Unauthorized personnel shall not be allowed entry into locked areas.

Badges shall not be used to open work areas for personnel other than those engaged in performance of their duties and with proper security clearance. Contractor staff shall use badges issued to them to open areas only as directed by the COR and/or functional area chief.

b. Lost keys and/or badges shall be reported to the issuing party and COR immediately upon recognition of the loss. The COR shall notify the PMO of the lost key or badge. Reimbursement shall be provided before the Government replaces lost keys or badges. The Contractor shall establish and implement methods to ensure all keys or badges issued to the Contractor by the Government are not lost, misplaced, or used by unauthorized persons.

c. The contractor shall prohibit the opening of locked areas by contractor personnel to allow entrance of persons other than contractor personnel engaged in the performance of assigned work in those areas, or personnel authorized.

1.22 SPECIAL QUALIFICATIONS: The contractor shall comply with DHAPM 6025.13, Clinical Quality Management in the Military Health System, volume 4 and AR-40-3 Medical Services when the DHAPM falls silent on guidance. The Contractor shall provide certified and licensed contract personnel at all times. Licensure shall be granted by the Texas Department of State Health Services (DSHS). Per the Texas Administrative Code (Title 25, part 1, Chapter 157, Subchapter C, Rule §157.34), contractors shall possess and maintain current Texas Department of Health (TDH) Emergency Medical Service Provider certification and licensure for each level of ambulance service:

a. Basic Life Support (BLS). Contractors shall be certified and licensed as an Emergency Medical Technician-EMT) with current certification for BLS and Automatic External Defibrillator (AED) use. All BLS personnel shall have a minimum of twelve (12) months experience within the past 2 years.

b. Advanced Life Support (ALS) and Critical Care Transport (CCT). Contractors shall be certified and licensed as a paramedic, Advanced Cardiac Life Support (ACLS), and Pediatric Advanced Life Support (PALS). All ALS personnel shall have a minimum of twelve (12) months experience within the past 2 years.

c. Contractors serving in the capacity of a paramedic shall maintain current American Heart Association Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS) certification.

d. Continuing Education Units (CEUs) shall be maintained by all certified contractors in the performance of this contract in order to remain current (licensed and certified) at no additional cost to the government.

e. Documentation of training, certification, licensure and CEUs for contractor personnel shall be submitted to the COR with E-QIP documentation and request for Personnel Security clearance. Certification, licensure and CEU shall be current and in good standing at all times and available for inspection by the COR at any given time.

f. BLS CREWS. BLS crews shall consist of two (2) personnel certified and licensed at the EMT level. Crew members with higher levels of certification may function in this capacity; however, the contractor shall bill the BLS service rate. Additional crew members may be required when a sending physician/clinician determines it is medically necessary.

g. ALS CREWS. ALS crews shall consist of two (2) personnel. One certified and licensed at the paramedic level, and the other certified and licensed at the EMT, AEMT, or paramedic level. Crew members with higher levels of certification may function in this capacity; however, the contractor shall bill the ALS service rate. Additional crew members may be required when a sending physician/clinician determines it is medically necessary.

h. CCT CREWS. CCT crews shall consist of two (2) personnel. One certified and licensed at the paramedic level with additional training in specialized equipment, and the other certified and licensed at the EMT, AEMT, or paramedic level. One of the paramedics shall be able to provide evidence of successful completion of post-paramedic training and appropriate periodic skills verification in management of patients on ventilators, 12 lead EKG and/or other critical care monitoring devices, drug infusions pumps, cardiac and/or other critical care medications, or any other specialized procedures or devices determined at the discretion of the contractor’s physician medical director. Crew members with higher levels of certification may function in this capacity; however, the contractor shall bill the CCT service rate.

i. The contractor shall ensure that there is an identified EMS Medical Director for this contract. The EMS medical director shall be a physician and meet the specific requirements of the DHAPM 6025.13, volume 4 as well as the Texas Administrative Code (Title 25, part 1, Chapter 157, Subchapter B, Rule §157.11) and guidelines set forth by DSHS.

1.20 POST AWARD CONFERENCE/PERIODIC PROGRESS MEETINGS: The Contractor agrees to attend any post award conference convened by the contracting activity or contract administration office in accordance with Federal Acquisition Regulation Subpart 42.5. The KO, COR, and other Government personnel, as appropriate, may meet periodically with the contractor to review the contractor's performance. At these meetings the contracting officer shall inform the contractor of how the government views the contractor's performance and the contractor shall inform 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.

1.21 IDENTIFICATION OF CONTRACTOR PERSONNEL: All contract personnel shall receive a Common Access Card (CAC) that gives them installation access to all JBSA military installations. This CAC is issued by the RAPIDS ID Card Office. The second badged is issued by the PMO, this badge provides access to BAMC wards and clinics. These badges clearly distinguish contractors from Government personnel. Badges shall be always worn on the outer garment in full view. The Contractor shall ensure all personnel and any contractor representative entering any JBSA Military installation abide by all security regulations and/or directives to include being subject to security checks. Any violation of JBSA installation regulations, or of state or federal statutes may result in the termination of the privilege to enter one or more military installations. The Contractor shall be responsible for the control and safe keeping of all Government issued badges and shall ensure these are returned to the COR upon termination of personnel or the contract end date. The contractor shall ensure all personnel are aware that in the event either of the badges are lost or stolen that they are to advise the COR and their company supervisor immediately upon discovery. The contractor shall ensure that the COR is notified the same day the personnel reports a badge lost or stolen. For the purpose of this contract, no access to government computers shall be granted.

1.22 REMOVAL OF CONTRACT PERSONNEL: The government reserves the right to require immediate temporary or permanent removal of any individual whose actions raise reasonable suspicion that patient care or services may be compromised in any way or that pose a threat of harm to other contractor/government personnel or self. The contractor personnel may be required to submit to drug/ alcohol testing. The government reserves the right to require temporary or permanent removal of any individual who refuses testing. Notification of all removals shall be made by the COR. Removal of any individual does not relieve the contractor of any performance requirement. Contractor shall return CAC and BAMC badge to COR within 24 hours of removal, or next business day.

1.23 DRIVING RECORD: All contractors responsible for driving shall have a current Texas Driver’s License and complete the Emergency Vehicle Operations Course (EVOC). Drivers shall not have any reckless/dangerous driving citations within the previous 24-month period or Driving While Intoxicated (DWI) or Driving under the Influence (DUI) convictions in the previous five (5) years. Drivers cannot have been assessed more than 6 points a year under the Department of Motor Vehicle’s Point System (www.dmv.org).

a. Ambulance bus drivers shall be required to have at a minimum commercial class B license with passenger Commercial Driver’s License (CDL). Non- medical vehicle operators shall be certified in First Aid and Cardiopulmonary Resuscitation.

b. Documentation of licensing requirements and training shall be maintained by the contractor and available for inspection by the COR at any given time.

1.24 INVESTIGATION REQUIREMENTS: The Contractor shall ensure all personnel performing under the contract maintain a minimum of a favorably adjudicated Tier 1 formerly known as National Agency Check with Inquiries (NACI) for IT Level III access or Tier 3 formerly known as a National Agency Credit and Law Check (NACLC) for IT-II access. U.S. citizenship shall be verified by presenting an original or certified copy of birth certificate, certificate of citizenship/naturalization issued by United States Citizenship and Immigration Services (USCIS) or born abroad certificate (Form FS-240 or DS- 1350). All derogatory information, to include law enforcement issues, mental health issues, or alcohol/drug related issues shall be reported to the COR and to the BAMC Personnel Security Office.

The Contractor will complete the complete the Electronic-Questionnaires for Investigations Processing (e-QIP) for review/processing by the military treatment facility (MTF) Security Manager’s Office for validation through the Defense Information Security System (DISS).

The COR will submit an SF86 Questionnaire for Public Trust Positions for a Local Background Check through the Provost Marshall. The contractor shall not be allowed to begin working, have installation access, or patient contact, prior to being cleared by both the BAMC Security Office and the Provost Marshall.

1.25 MANDATORY TRAINING: Contractor personnel shall complete OPSEC, Antiterrorism and iWATCH training within 30 calendar days of reporting to duty and annually in accordance with Army Regulation 530-1 and 525.13. OPSEC, AT Level I awareness training and iWATCH training links are available at https://www.mepcom.army.mil/Home/Contractors/. Training will be documented in the contractor’s file and available for COR periodic inspection.

1.26 HIPAA and Privacy Act Training: Per DHA Privacy Policy DoDM 6025.18, section 7.1.b. Training, Contractor workforce members who have access to PHI in performing their functions shall receive training. Contractor will ensure that their workforce members or subcontractors receive appropriate training prior to beginning work on the contract. Documentation of training will be maintained by the contractor for periodic inspection by the COR.

1.27 SEXUAL ASSAULT: The contractor shall comply with OTSG/MEDCOM Policy Memo 21-040, Sexual Harassment/Assautl Response and Prevention (SHARP) Program under the Department of Defense Directive (DoDD) 6459.02, Volumes 1 & 2, Sexual Assault Prevention and Response (SAPR) Program Procedures.

The contractor shall require all Contract Service Providers with knowledge of an incident of sexual assault occurring on a Government facility, to include a Government leased facility where the contractor is providing services under this contract, to report the incident to the contractor who shall immediately (within 24 hours) report the incident in writing to the government's COR. This reporting policy also applies to sexual assault incidents involving MEDCOM personnel that occur on the contractor’s owned or leased facility under this contract. All incidents shall be reported whether they involve contractor personnel or Government personnel, or other individuals, when the incidents occur on a Government facility, or a Government leased facility. The contractor shall be provided with a digital copy of this memo upon contract award. The SAPR reporting requirements apply only to knowledge obtained by contractor personnel while performing services under this contract.

1.28 PHASE- IN TRANSITION PERIOD: To minimize any decreases in productivity and to prevent possible negative impacts on additional services, the Contractor shall become familiar with performance requirements to commence full performance of services on the contract starting date. The objective is to minimize the disruption of emergency medical services. The government estimates a phase-in transition period of up to 30 days.

PART 2

DEFINITIONS & ACRONYMS

2. DEFINITIONS: The following terms shall have the meaning set forth below:

a. ADVANCED LIFE SUPPORT (ALS). Requires more advanced in route medical equipment and medical care. Examples of such medical care include but are not limited to management or administration of intravenous medications/fluids, cardiac monitoring, or advanced airway management. These missions require at least one paramedic on the transport team.

b. ADVANCED LIFE SUPPORT MASS CASUALTY. Transport of large number of casualties by ambulance/ambulance bus arising from a man-made or natural disaster.

c. AIR EVACUATION. Refers to patient transport to or from local military airfields or commercial airports. Transport loads may consist of one to 28 patients in the event of a mass casualty. Air evacuation missions may require the use of an ambulance bus or large passenger carrying vehicles with combined loads of ambulatory or litter patients.

d. AIR EVACUATION RECEPTION TEAM. Team comprised by BAMC clinical staff, contractor staff, and administrative personnel coordinating the arrival or departure of an air evacuation mission of one or multiple patients.

e. AMBULANCE BUS. A bus configured to transport combinations of litter and ambulatory patients. The bus shall provide for transport of 16 litter patients or at least 28 ambulatory patients or any combination thereof.

f. AMBULATORY. A patient capable of moving around; able to walk with or without assistance; not bed- confined.

g. AUTHORIZED BENEFICIARIES. For the purpose of this contract authorized beneficiaries shall consist of active-duty members, dependents of active-duty members, retired active-duty members and their dependents, DOD civilians while in the performance of official duties, and civilians being treated at the MTFs.

h. BASIC LIFE SUPPORT (BLS). Requires an EMT level clinician, including but not limited to procedures such as bandaging, splinting, basic first aid, oxygen, and performing cardiopulmonary resuscitation (CPR).

i. CIVILIAN. Private citizen, as distinguished from a person belonging to the armed services.

j. COMMON ACCESS CARD (CAC). A common access card (CAC) is a United States Department of Defense (DOD) smart card for multifactor authentication. CACs are issued as standard identification for active-duty military personnel, reserve personnel, civilian personnel, non-DoD government personnel, state personnel of the National Guard and eligible contractor personnel. In addition to its use as an ID card, a CAC is required to access government buildings and computer networks.

k. CONTRACT LIAISON OFFICER (CLO). The CLO shall be employed by the contractor to provide on- site assistance to the COR and BAMC medical staff.

l. CONTRACTING OFFICER (KO). A person duly appointed with the authority to enter into, administer, and terminate contracts on behalf of the government.

m. CONTRACT OFFICER REPRESENTATIVE (COR). Government personnel responsible for evaluating the administrative performance of the contractor.

n. CONTRACTOR MANPOWER REPORTING (CMR). Designed to collect information on funding source, contracting vehicle, organization supported, mission and function performed, labor hours and cost for contracted efforts providing services to the Department of the Army from contractors and Army activities requiring contracted services from supporting contracting offices. Contractors are responsible for entering order data, contact data, and location data.

o. CRITICAL CARE TRANSPORT (CCT). The movement of critically ill patients from facilities where the patient’s needs exceed available resources to places that meet their needs, while maintaining a specialized level of care. Requires a paramedic with advanced training as part of the transport team.

p. EMERGENCY MEDICAL DISPATCHER (EMD). A trained medical dispatcher having State of Texas certified credentials, responsible for dispatch and administrative control of ambulance and crew in the field.

q. EMERGENT (Interfacility transportation). Emergent interfacility transfers are for conditions that are time-sensitive and require immediate transfer to maximize patient care and safety. The EMS service should arrive at the sending facility within 30 minutes for this type of call. The ultimate authority on the classification of the transport will be at the discretion of the sending physician/clinician. These are different from 911 EMS services in that the call for services shall initiate from an MTF.

r. MASS CASUALTY. A situation arising from a man-made or natural disasters which generates a large number of casualties in relatively short periods of time or large.

number requiring medical treatment. Man- made or natural disasters include, but are not limited to flood, drought, chemical spill, fire, earthquake, storm, hurricane, or other catastrophes.

s. MEDICAL TREATMENT FACILITY (MTF). Department of Defense medical treatment facilities, including all activities providing outpatient and/or inpatient health care services for authorized personnel.

t. MILEAGE. The amount of mileage from point of pick-up location to drop-off destination (one way).

u. HOME/RESIDENCE/DOMICILE. The place where a patient resides temporarily or permanently.

v. NON-EMERGENT. Non-emergent interfacility transfers are for conditions that are relatively stable and do not need immediate transport. The EMS service should arrive at the sending facility within 2 hours for this type of call. The ultimate authority on the classification of the transport will be at the discretion of the sending physician/clinician.

w. PERFORMANCE WORK STATEMENT (PWS). A document that accurately describes the service requirements and performance standards of the service.

x. QUALITY ASSURANCE (QA). Action taken by the Contractor and Contracting Officer to ensure standards and quality of performances are measured, standardized, and documented.

y. QUALITY ASSURANCE/RISK MANAGEMENT (QA/RM) PLAN. An organized document which describes the methods utilized when performing quality assurance (QA) reviews within the MTF. It designates the areas of responsibility and accountability for the QA program and the mechanisms for monitoring and evaluating patient care. It is consistent with The Joint Commission (TJC) monitoring and evaluation (M&E) approach and Army risk management (RM) efforts.

z. RESPONSE TIME: The response time will be defined by the time from completion of the call for service until the time the EMS unit arrives at the sending MTF.

aa. RUN. A single transport from point A to point B.

ab. SENDING PHYSICIAN/CLINICIAN: A licensed and credentialed clinician (usually a physician, physician’s assistant, nurse practitioner) primarily responsible for a patient’s care who is initiating the transfer by EMS to another facility.

aa. TROOP MEDICAL CLINIC (TMC). A medical annex of Brooke Army Medical Center, located at building 1279, providing medical care primarily to soldiers attending basic military training.

bb. WAIT-TIME. When the ambulance crew is required to wait to transport a patient, at no fault of the contractor. This is invoiced in fifteen-minute increments.

2.1 ACRONYMS:

PART 3

GOVERNMENT FURNISHED PROPERTY, EQUIPMENT, AND SERVICES

3. GOVERNMENT FURNISHED ITEMS AND SERVICES: The contractor shall not use the property provided by the government for any purpose other than in the performance of this contract. The government shall provide the property and services listed below:

3.1 OFFICE EQUIPMENT AND TELEPHONE SERVICE: The government shall provide limited office space, telephone, and copy and fax machines which shall be located within PAD at no charge to the contractor. The office space, telephone, copy and fax machines shall be used by the Contract Liaison Officer (CLO) for the purpose of providing onsite assistance to BAMC wards and clinics to facilitate the coordination of patient transport. The CLO shall also provide monitoring of ambulance transports, missions, and other responsibilities outlined in CLO Duties.

3.2 COMPUTER EQUIPMENT: All computer equipment and programs used by the CLO shall be furnished by the contractor. The COR shall provide limited patient information required for the care and transport of patients. The CLO shall not access government computer systems at any time. Contractor- owned computer equipment shall not be connected to the BAMC infrastructure at any time, maintained, or serviced by the government.

3.3 PARKING: Marked ambulance vehicles bearing the contractor company name shall park in areas designated for emergency vehicles long enough to load and unload patients. Vehicles shall then be moved to a designated parking space. Contractors shall abide by BAMC’s parking regulations at all times.

3.4 UTILITIES: Office space includes adequate air conditioning and heat, electricity, water, and sanitary facilities. Utilities are provided at no cost to the contractor in the performance of CLO duties. The CLO is expected to establish energy conservation practices to minimize the use of utilities. Failure of the Government to furnish utilities at any time during the performance of the contract due to outages or other service interruptions shall not be considered by the contractor as a basis for a claim against the government.

3.5 ADMINISTRATIVE AND PATIENT CARE RECORDS: All documents and records used in administration of the contract provided by the government shall remain government property. The COR shall provide guidance in the maintenance and disposal of records in accordance with Records Disposition Procedures and Responsibilities according to HIPAA requirements.

3.6 EMERGENCY HEALTH CARE: The Government shall provide emergency health care to prevent loss of life or limb and prevent suffering for contract personnel for injuries or illness occurring in the performance of the contract at BAMC. These services shall be billed to the contractor at the current full reimbursement rate.

3.7 EXPOSURE TO COMMUNICABLE DISEASE: All contractor personnel performing services under this contract, who are potentially exposed to a communicable disease (e.g., pertussis or meningitis) shall receive prompt medical evaluation to determine the need for prophylaxis or treatment. The immediate prophylaxis/treatment can be provided by BAMC and the contractor shall be billed at full reimbursement rate. BAMC shall provide the contract personnel with post-exposure prophylaxis and treatment. If disease is identified, it shall be the contractor’s responsibility to ensure their contractor is referred for appropriate medical treatment and subsequent follow-up.

3.8 INFECTION CONTROL:

a. CULTURES- BAMC may take clinical specimens for outbreak investigation from contract personnel when required by the BAMC’s Infection Control Committee (ICC) at no cost to the contractor personnel. The type of clinical specimen shall be dictated according to the type of investigation.

b. BLOODBORNE PATHOGEN EXPOSURE- All contractor personnel performing direct health care services under the contract, who experience a parental (e.g., needle-stick or cut) or mucous membrane (e.g., splash to the eye or mouth) or cutaneous exposure (e.g., intact or non-intact skin) to blood or body fluids shall receive prompt treatment. Treatment shall be provided by BAMC and the contractor shall be billed at the full reimbursement rate.

c. BAMC shall provide the following:

i. Standardized risk assessment and counseling post-exposure.

ii. Evaluation of the source patient for Hepatitis B, Hepatitis C, and Human Immunodeficiency Virus.

iii. Baseline laboratory testing of the contractor per BAMC’s Blood borne Pathogen Exposure Protocol.

iv. A three-day supply of HIV post-exposure prophylaxis as recommended by Center for Disease Control (CDC) and Public Health service guidelines. A report of findings and recommended follow-up shall be provided to the contractor and their personnel.

v. Immune Globulin or Hepatitis B Immune Globulin.

3.9 SPECIAL EQUIPMENT: Special equipment required by order of the sending physician/clinician which is not part of the contractor’s normal inventory shall be provided by the MTF (if part of the hospital’s medical equipment inventory) to the contractor by hand receipt. Equipment loaned to the contractor by hand receipt shall be returned to MTF’s hospital inventory immediately after use. The contractor shall be responsible for the items while in their possession and shall ensure the item is returned in the same condition as loaned. Any change or substitutions to special equipment orders shall be coordinated with the sending physician/clinician. It is the contractor’s responsibility to immediately notify the sending physician/clinician or MTF medical staff if the equipment requested is not part of the contractor’s inventory.

PART 4

CONTRACTOR FURNISHED ITEMS AND SERVICES

4. CONTRACTOR FURNISHED ITEMS AND SERVICES: The contractor shall furnish items and services required to perform the services of the contract with the exception of items or services to be furnished by the government stated in Part 3. Items and services include, but are not limited to qualified personnel (paramedics, EMTs, etc.), drivers, ambulance transport vehicles, medical equipment, stretchers, expendable medical supplies (drugs, IV tubing, bandages, etc.) and gases used in transport, GPS and roadmaps, etc. The contractor shall ensure all equipment and vehicles meet federal, state and local requirements in the provision of emergency patient transport and the quality of care designated by its physician medical director in their protocols/guidelines.

4.1 PERSONNEL: Contractor personnel shall read, write and speak English fluently. The contractor shall employ only U.S. citizens. Uniformed military and government civilian personnel shall not be employed to perform the services under this contract, unless such person receives approval in accordance with Department of Defense (DOD) Directive 5500.7 (November 2007) and applicable Army policies.

Key personnel consist of:

i. Contracting Officer (KO)

ii. Contract Specialist (KS)

iii. Contracting Officer Representative (COR)

iv. Contract Manager

v. Contract Liaison Officer (CLO)

4.2 WORK ATTIRE: Contractor personnel working under this contract shall practice high standards of personal hygiene, maintain a clean, neat and professional appearance while on duty and adhere to BAMC dress policy Memo 600-50. Uniforms shall be neat and clean, i.e., free from visible dirt and stains and it shall fit so as to provide a professional appearance in keeping with the normally accepted standards of dress for the work being performed. The Contractor’s personnel shall not present an unfavorable appearance, reflect discredit upon or embarrass the U.S. Government. Contractors shall be easily recognizable as contract personnel. This may be accomplished by wearing clothing bearing the name of the company and should be wearing appropriate badges or identification tags bearing the name of the contractor. The contractor shall be provided with a digital copy of this memo upon contract award.

4.3 WORK ROSTER: Names of contractor authorized personnel…