Attachment 1 - PWS- Patient Transport.pdf

PATIENT TRANSPORT SERVICES

PERFORMANCE WORK STATEMENT

30th MEDICAL GROUP

VANDENBERG SFB, CA

27 Jun 2022

TABLE OF CONTENTS

1. Description of Services

1.1 Background

1.2 Specific Tasks

1.3 General Requirements

1.4 Vehicle Maintenance Requirements

1.5 Security Requirements

1.6 Criminal Background Check Requirements

1.7 Quality Assurance

1.8 Freedom of Information Act (FOIA)

1.9 Compliant Process and Denial/Termination of Privileges

1.10 Emergency Healthcare

1.11 Continuation of Services during Crisis or Emergency

1.12 Compliance with Federal and California OSHA

1.13 Environmental

2. Service Summary

3. Government-Provided Property and Services

3.1 General

3.2 Government Provided Property

3.3 Services

4. Appendix A. Publications and Commercials Manuals B. Acronyms C. Workload Estimates D. Required Reports E. Response Zone Map

F. Emergency Response Exemption Document

1. DESCRIPTION OF SERVICES

1.1. BACKGROUND

This contract is a non-personal health care services contract, as defined in Federal Acquisition Regulation 37.101, under which the contractor is an independent contractor. Non-personal services contract means a contract under which the personnel rendering the services are not subject, either by the contract’s terms or by the manner of its administration, to the supervision and control usually prevailing in relationships between the Government and its employees. The Government may evaluate the quality of professional and administrative services provided, but retains no control over the medical or professional aspects of services rendered (e.g., professional judgments, diagnosis for specific medical treatment performance shall be according to the requirements contained in this Performance Work Statement [PWS] and the professional pre-hospital emergency medical service protocols applicable to state and county of Santa Barbara, California. (Reference Appendix A).

1.2. SPECIFIC TASKS

1.2.1. GENERAL. The contractor shall furnish all management, supervision, equipment, vehicles, labor, training, and documentation to provide Paramedic and Emergency Medical Technician (EMT) Services to respond to requests for emergency medical services, patient treatment, and stabilization as required. The Paramedic may be required to perform only basic first aid or any level beyond to include Advanced Life Support (ALS). The contractor shall provide 24-hour uninterrupted response coverage, to include response to in-flight emergencies (IFE’s). The contractor shall respond to medical incidents within Vandenberg Space Force Base, (VSFB) property. The contracted ambulance service response jurisdiction covers South Vandenberg, North Vandenberg, Vandenberg Tracking Stations, S-20 North from Santa Lucia Road, S-20 West to Highway 1, the Lompoc-Casmalia Road to the Southern Pacific Railway, and up to but not including the United States Penitentiary. The base is approximately 99,400 acres in size, or 155 square miles of land. The contracted ambulance service transfer boundaries are dictated by the availability of care within the civilian community and at other in-state military facilities. The receiving hospital will be determined by patient needs, bed availability, transferring provider preference, and accepting physician. The patient transfer may need to be facilitated by the ambulance service attendant and the transfer of care report should be communicated through the transporting ambulance attendants. The contractor shall provide all evaluations, treatments, and interventions as appropriate to the protocols of Santa Barbara County, as approved by the County appointed Medical Director, and the State of California. The contractor must establish and maintain a system to ensure back up support is provided in the event of simultaneous responses, equipment failures, or other unforeseen circumstances.

Services must always be available. All employees shall have required certifications by Santa Barbara County Emergency Medical Services (EMS) Agency prior to performing services on this contract.

1.2.2. TRAINING OF AMBULANCE PERSONNEL. The contractor shall ensure that the Paramedics and EMT’s providing emergency response services to VSFB maintain appropriate licensure and certification within the state and county. Additionally, paramedics and EMTs must adhere to the recurring training and certification requirements in accordance with Santa Barbara Public Health Department Emergency Medical Services Policies (Reference Appendix A). Due to low call volume at Vandenberg SFB the contractor will ensure they have a plan to prevent EMT and paramedic skills degradation.

1.2.2.1 EMERGENCY AMBULANCE LICENSE. The contractor shall ensure that all ambulance drivers performing services on Vandenberg SFB are licensed to operate an emergency ambulance in the State of California; license to include an ambulance endorsement.

1.2.3. FIRST RESPONDERS. As a First Responder on VSFB, the contractor is responsible for and shall obtain First Responder HAZMAT Training. Additionally, during Chemical, Biological, Radiological, Nuclear or High Yield Explosive (CBRNE) incidents requiring decontamination, the contractor agrees to transport patients after gross decontamination at the scene has been accomplished. Contractor operational procedures regarding CBRNE casualty management and transportation will be in accordance with Santa Barbara County Public Health policy and local facility agreements. Contractor personnel must also complete Air Field Driving computer-based training. In an occasion in which the contractor is called to respond to an airfield emergency, they shall wait to be escorted onto the airfield by the appropriate military personnel.

1.2.4. PROCEDURE GUIDANCE: The contractor shall perform procedures within the scope of care for which they are trained. The contractor shall follow Santa Barbara County Emergency Medical Services protocols; Santa Barbara Public Health Department Emergency Medical Services Policy and Procedures Chapter 5, Medical Control, Field Policies, and Treatment Protocols. For aero medical emergencies, flight surgeon consultation and guidance shall be provided. In the event that transportation of an in-flight emergency crew member is required, the ambulance crew will allow a flight surgeon to accompany the patient when possible.

1.2.5. SPECIAL EVENTS & EXERCISES

1.2.5.1 SPECIAL EVENTS. The contractor shall provide additional coverage as required to support special events, for example, space and missile launches as determined by the Space Launch Delta 30 (SLD 30) and the 30th Medical Group (30 MDG), health fairs, and dedication ceremonies. Hours for special events will be ordered and funded as required. Historical estimates and information are included by attachment. (Reference Appendix C)

1.2.5.2. EXERCISES. The contractor shall participate, as required, (approximately 10 per year) in exercises in support of the SLD 30 and the 30 MDG. Real world situations supersede exercise scenarios; therefore, no additional coverage is required during exercises. If the need for contractor participation is requested for exercise purposes, it must be coordinated prior to the event and will serve as an additional special event.

1.2.6. INSURANCE BILLING. The contractor shall not bill the insurance providers of any person, or persons, while executing this contract. The 30 MDG reserves the right to bill the individual’s insurance provider(s).

1.2.7. DOCUMENTATION. The contractor shall provide monthly documentation to the 30 MDG relating to all transports. The documentation shall be timely, legible, accurate, and signed by contractor personnel. The required report is due by the 5th calendar day of the following month. The documentation shall include but is not limited to: date, time call is received, time arrived on scene, total response time, type of run (Code 2 and Code 3), all available patient information, full name, military (last 4 of SSN) or civilian, patient condition, address responded to, name of hospital transported to, and an explanation of any exceptions to response times in Section 1, Para. 1.7.4. Additionally, all refusals must also be documented to the same level, notwithstanding hospital transport. All documentation must be submitted to the 30 MDG no later than the 5th calendar day of the following month (i.e. All January information received by 30 MDG Contracting Officer Representative (COR) no later than February 5th).

(REQUIRED REPORT A001)

1.2.8. RECORDS. The contractor personnel shall be responsible for creating, maintaining, and disposing of Government required records. If requested by the Government, the contractor personnel shall provide the original record, or a reproducible copy, of any such records within one duty day or receipt of the ambulance response. The contractor is also responsible for furnishing all records related to their response times dictating the time the ambulance unit is notified by dispatch, the time arrived on scene, total response time, and code designation for the call. (Reference Table 2, Item 3)

1.2.9. PATIENT LISTS. Regardless of its development, all patient lists shall be treated as privileged information. Lists and/or names of patients shall not be disclosed to, or revealed in any way, for any use outside the 30 MDG without prior permission by the Chief of Medical Staff for VSFB.

1.2.10. PATIENT SENSITIVITY: Contractor personnel shall respect and maintain the basic rights of patients, demonstrating concern for personal dignity and human relationships.

1.2.11. RELEASE OF MEDICAL INFORMATION: The contract personnel shall only release medical information obtained during the course of the contract to destination civilian emergency room staff and to other 30 MDG staff involved in the care and treatment of that individual patient.

1.2.12. PATIENT PRIVACY/SECURITY: The contractor shall comply with all applicable aspects of the Health Insurance Portability and Accountability Act of 1996 to ensure the security and privacy of patient information. In addition to patient privacy, the contractor shall provide close hold on any information pertaining to base activities that are dispensed to the contractor in execution of their duties.

1.2.13. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT: Under this contract the contractor shall be considered a 'Business Associate' under the terms of the Health Insurance Portability & Accountability Act of 1996 (HIPAA), Public Law 104-191, and its implementing regulations, including DoDM 6025.18 Privacy of Individually Identifiable health Information in DoD Health Care Programs. In the performance of this contract, the contractor shall, when performing as a 'Business Associate', comply with all rules and requirements applicable to a 'Business Associate' under HIPAA and its implementing regulations, including DoDM 6025.18. Violation of HIPAA may result in the imposition of fines and/or imprisonment.

The contractor shall include the HIPPA notification and requirement in every subcontract for 'Business Associate' service.

1.3. GENERAL REQUIREMENTS

1.3.1. PERSONNEL

1.3.1.1. CONTRACT MANAGER. The contractor shall appoint a member of their management team who, irrespective of other responsibilities, shall have a defined responsibility and authority to make relevant project decisions. The name of this person and an alternate(s) who shall act for the contractor when the manager is absent shall be designated in writing to the Contracting Officer (CO) or his/her designated representative no later than the start of contract and within three (3) working days of any personnel change. (REQUIRED REPORT A002)

1.3.1.2. EMPLOYEES

1.3.1.2.1. The contractor shall only provide properly trained, duty qualified paramedics and EMTs with experience in related work areas. Personnel staffing the ambulance shall have all applicable paramedic and/or EMT certifications required by the law in the State of California, to include Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS).

The contractor shall ensure all certifications are current. The contractor must take specific action, including Primary Source Verification, to ensure contract personnel have the required prerequisites for privileging and do not have disqualifying impediments for privileges in the State of California prior to submitting credentials for hire.

1.3.1.2.2. In order to communicate with appropriate medical personnel, each Paramedic and EMT shall be able to read, write, and communicate clearly in the English language.

1.3.1.2.3. The contractor shall not employ any person who is an employee of the United States Government, including the United States Air Force (USAF) and the United States Space Force (USSF), if the employment of that person would create a conflict of interest or be contrary to any USAF/USSF policy and/or guideline. Additionally, the contractor shall not employ any person who is an employee of the USAF/USSF, either military or civilian, unless such person seeks and receives approval in accordance with the Joint Ethics Regulation, DoD 5500.7R.

1.3.1.2.4. Contractor personnel shall present a neat/clean appearance and be easily recognized as contractor employees. Employee clothing, accessories, and hair length shall be safe for the operations involved in contract performance.

1.4 VEHICLE MAINTENANCE REQUIREMENTS. The contractor shall ensure preventive maintenance is performed on vehicles used to support this contract. Additionally, the vehicles must be inspected by the California Highway Patrol at least annually, and be in compliance with California Vehicle Code Section(s) 2510-2512. Proof of compliance shall be forwarded to the COR within 30 days after completion of the annual inspection. (REQUIRED REPORT A003)

1.5. SECURITY REQUIREMENTS. The contractor shall be responsible for obtaining all necessary cards, passes, badges, buttons, decals, and/or other items required for access to the areas in which the work shall be performed. The contractor shall be required to apply for vehicle and individual identification media at the Security Forces Squadron, Pass and ID section. Upon completion of the contract, termination of the contract, or termination of an individual’s employment on the contract, the contractor shall retrieve all identification/access media issued and surrender it to the Security Forces Squadron, Pass and ID Section within 10 days. .

1.6. CRIMINAL BACKGROUND CHECK REQUIREMENT

1.6.1. The contractor shall conduct criminal background checks on all Paramedics and EMTs under this contract. Background checks shall be based on fingerprints of individuals obtained by a Government law enforcement officer and inquiries conducted through the Federal Bureau of Investigation (FBI) and state criminal history repositories.

1.6.2. With the consent of the CO, a contractor’s employee may provide services prior to completion of background checks. However, at all times while children are in the care of that employee, he/she shall be within sight and continuous supervision of contractor personnel whose background check has been completed, a chaperone, or a parent/guardian.

1.6.3. Individuals shall have the right to obtain a copy of any background check pertaining to them and to challenge the accuracy and completeness of the information contained in the report.

1.6.4. Individuals who have previously received a background check shall provide to the COR proof of the check. HealthCare Operations Squadron, Medical Logistics

1.7. QUALITY ASSURANCE

1.7.1. QUALITY MANAGEMENT SYSTEM. The contractor shall develop and maintain an inspection system acceptable to the Government covering services under this contract. The contractor shall develop and implement procedures to identify and prevent defective services from recurring. As a minimum, the contractor shall develop quality control procedures that address the areas identified in the PWS and Service Summary. The contractor shall prepare a contractor quality control plan (CQCP) that will describe the approach to developing and implementing a quality system that will encompass all aspects of the contract. The contractor shall complete, implement and make the CQCP available to the Government for review no later than 10 days after contract award. All subsequent changes to the CQCP must be coordinated with the 30 MDG COR and the CO within 10 days of changes. (REQUIRED REPORT A004)

1.7.2. PERFORMANCE EVALUATION MEETINGS. The contractor shall meet with the 30 MDG COR, and/or the CO, and/or the Contract Specialist once a week during the first month of the contract. Meetings will be as often as necessary thereafter as determined by the CO and or

COR.

1.7.3. The contractor shall render services in compliance with the standards of Santa Barbara County Emergency Medical Services Policies and Procedures. The contractor shall, upon request, supply quality data and information related to services provided that support both the Performance Improvement Program and Risk Management.

1.7.4. RESPONSE TIMES. The contractor must adhere to Department of Defense Instruction (DoDI) 6055.06 DoD Fire and Emergency Services (F&ES) Program, Table E3.T1 Minimum Level of Service Objectives- Operations for ground response times. The contractor must be able to navigate the geographical landmarks to provide timely and effective pre-hospital emergency services. The contractor shall adhere to the following ground response times: For all codes requiring a transport unit with Basic Life Support (BLS) and Automated External Defibrillator (AED) capability, and/or ALS capability the response time shall not exceed: 12 minutes. This applies to all areas of VSFB as designated on the map included. (Reference Appendix E)

1.7.5 EXEMPTION POLICY. Per DoDI 6055.06 the minimum response times shall be on time for an average of 90% of all calls. The 90% threshold will be calculated based on the aggregate of all responses annually, not including calls cancelled in route. As determined by the appointed COR, in some cases, late responses may be exempted from unsatisfactory performance reviews and response time compliance reports. These exemptions will be for good cause only, as reasonably determined by the COR. The burden of proof that there is good cause for the exemption shall rest with the contractor. The contractor must file an extended emergency response report (Reference Appendix F) in order to request an exemption for a call in any month.

This document shall be filed with the COR within five (5) days of the end of the previous month.

Such request shall list the date, the time, and the specific circumstances causing the delayed response. The alleged good cause must have been a substantial factor in producing the excessive response time and must be documented in the exception report per EMS Policy. Good cause for an exemption may include, but is not limited to the following scenarios:

1) Inaccurate dispatch information when unedited records or tapes verify the following:

a) Dispatcher gave incorrect call priority, address, or map coordinates that had a negative effect on response time;

b) Incorrect or inaccurate dispatch information received from a calling party or 911

Public Safety Answering Point;

c) Disrupted voice or data transmission;

d) Dispatcher failure to document/record times;

2) Inability to locate address due to non-existent or inaccurate address;

3) Unavoidable delay caused by traffic congestion when there is no reasonable alternate access to the incident;

4) Weather conditions which impair visibility or create other unsafe driving conditions;

5) Unavoidable delays caused by road construction and/or closure;

6) Unavoidable delays caused by trains;

7) Off-road or off-paved road locations;

8) Unusual system overload;

9) A declared state of emergency or disaster;

10) Other situations requiring an exemption as determined/approved by the COR

1.8. FREEDOM OF INFORMATION ACT (FOIA). All official Government records affected by this contract are subject to the provisions of the FOIA (5 U.S.C. 552/DoD 5400.7- R/AF Supplement). Any request received by the contractor for access/release of information from the records to the public (including Government/contractor employees acting as private citizens), whether oral or in writing shall be immediately brought to the attention of the CO. The CO will, in turn, forward this information to the Base FOIA Manager to ensure proper processing and compliance with the Act.

1.9. COMPLAINT PROCESSES AND DENIAL/TERMINATION OF PRIVILEGES.

Complaints validated by the COR and Functional Requirements Evaluator Designee (FRED) shall be reported in writing to the CO and the contractor for action. Failure of the contractor to correct validated complaints brought up by 30 MDG staff and the CO shall be considered a failure to perform, and may result in an adverse performance appraisal that could lead to termination of contract.

1.10. EMERGENCY HEALTHCARE. VSFB has no Medical Emergency Services available.

The contractor shall be responsible for patient transportation for emergency medical care to the nearest appropriate and available Emergency Room.

1.11. CONTINUATION OF SERVICES DURING CRISIS OR EMERGENCIES. This service is considered “Mission Essential”. Services identified within this PWS are determined to be mission essential for performance during crisis, and due to the critical nature of patient transport services, all services in this PWS shall continue during a declared crisis.

1.12. COMPLIANCE WITH FEDERAL AND CALIFORNIA OCCUPATIONAL

SAFETY AND HEALTH ADMINISTRATION (OSHA)

1.12.1. The contractor shall comply with all applicable Federal and California OSHA requirements, where applicable. Additionally, the contractor shall safeguard USSF personnel and property during the conduct of their services, including compliance with base traffic regulations under normal circumstances.

1.12.2. As a condition of employment, OSHA requires that all contract personnel who will have occupational exposure to blood or body fluids, or other potentially infectious materials, shall receive Hepatitis B vaccine, sign a voluntary declination, or have documented proof of immunity of Hepatitis B infection. Contractor personnel who sign declinations may change their minds at any time and receive the Hepatitis B vaccine without penalty.

1.12.3. It is the contractor personnel’s responsibility to report to the 30 MDG, Public Health Office, all information necessary to assure hospital records can be maintained correctly and therefore complies with The Joint Commission, OSHA, and Center for Disease Control (CDC) health record requirements.

1.13. ENVIRONMENTAL

1.13.1. ENVIRONMENTAL MANAGEMENT. The contractor shall comply with all applicable and the most stringent latest federal, state, county and local environmental laws and regulations to include, but not limited to: Air Force Instructions (AFIs), policies, guidelines, environmental compliance documents, and environmental management plans. The contractor shall maintain an awareness of changing environmental regulatory requirements to avoid any environmental deficiencies.

1.13.2. ENVIRONMENTAL AGENCY COORDINATION. The contractor shall be liable for Notice of Violations (NOVs), enforcement actions, fines, penalties, and corrective actions imposed by federal, state, or local environmental regulatory agencies. The contractor shall provide verbal notification to the 30th Civil Engineer Squadron, Environmental Flight (30 CES/CEIE), (805) 606-1921, the COR, and the CO within 24-hours of receiving a NOV, enforcement action, fine or penalty; followed by written notification to 30 CES/CEIE, the COR, and the CO within three (3) workdays. The contractor shall implement any corrective actions to prevent a reoccurrence of the environmental deficiency.

1.13.3. HAZARDOUS AND BIOLOGICAL WASTE REQUIREMENTS. All hazardous and biological wastes generated or collected by the contractor shall be disposed of off-base abiding by all laws and regulations associated with each unique waste.

1.13.4. SPILL AND RELEASE REQUIREMENTS. If applicable, the contractor shall comply with, but not limited to: 30 SW Plan, 32-4002-C, Spill Prevention Control and Countermeasures Plan; 30 SW Plan, 32-7043A, Hazardous Waste Management Plan; and 30 SW Plan 32-7086, Hazardous Material Management Plan.

1.13.5. SPILL AND RELEASE NOTIFICATION. The contractor shall immediately notify the Command Post, (805) 606-9961, and 30 CES Damage Control Center, (805) 606-1856, and the COR of a spill or release. 30 CES/CEIE will determine if an environmental regulatory agency Incident Release Report will need to be prepared and submitted based on the reportable quantity of the contractor's spill or release.

1.13.6. SPILL AND RELEASE INCIDENT REPORTING INFORMATION: The contractor shall provide a completed copy of the Community Awareness and Emergency Response (CAER) Hazardous Materials Incident Reporting Form and any other required documentation to 30 CES/CEIE through the COR within 24-hours for each spill or release on VSFB. Note: The CAER form is provided in the 30 SW 32-7043-A, Hazardous Waste Management Plan. The contractor shall provide required final clean-up documentation for their spill or release to 30 CES/CEIE through the COR.

1.13.7. SPILL AND RELEASE CLEAN-UP ACTION: The contractor shall take immediate actions involving hazardous material spill or release to properly contain, clean-up, and make required notifications. When the contractor is unable to conduct proper clean-up activities from a spill or release, then the Government reserves the right to conduct the mandatory clean-up. All costs incurred by the Government until the contractor is capable of taking control of the clean-up operations are the contractor's responsibility. The contractor shall be responsible for the characterization and disposal of clean-up materials or hazardous waste generated from its spill or release clean-up activities.

1.13.8. AFFIRMATIVE PROCUREMENT PROGRAM: The contractor’s affirmative procurement program shall use specified Comprehensive Procurement Guideline (CPG) materials with recycled and recovered content as the minimum standard. The contractor shall also consider other green materials and products not listed, but commonly used by industry outside of the Government as a means of further reducing hazardous waste and solid waste. The Government's affirmative procurement programs are mandated to use recycled and recovered materials and products identified on the Environmental Protection Agency’s CPG product lists (http://www.epa.gov/cpg/products).

2. SERVICE SUMMARY (SS). The SS defines the standard of performance for each listed service and sets forth the maximum allowable deviation from standard performance for that service that may occur.

Performance Objective PWS Para

Performance Threshold

1. Contractor shall provide 24-hour uninterrupted response coverage.

1.1 1.2.1

95% of coverage shall be provided from the base with all remaining coverage arranged from local area per requirements as outlined by Santa Barbara County Public Health Department.

2. The contractor shall adhere to the following ground response times: For all codes requiring a transport unit (BLS with AED) and or ALS capability the time shall not exceed: 12 minutes. This standard applies to all areas of VSFB.

1.7.4 1.7.5

Minimum response time shall be met or exceeded 90% of the time based on all responses annually (not including calls cancelled in route) unless properly justified as determined by the COR.

3. The contractor shall provide monthly documentation to 30 MDG relating to all transports.

1.2.7

90% of reports submitted by the 5th calendar day of following month.

4. The contractor shall participate, as required, in exercises and special events supporting the SLD 30 and the 30 MDG.

1.2.5 1.2.5.1

90% coverage of each special event.

No unjustified absences.

3. GOVERNMENT-PROVIDED PROPERTY AND SERVICES

3.1. GENERAL. The Government shall provide the following facilities, equipment, materials, and/or services listed here.

3.2. GOVERNMENT-PROVIDED PROPERTY

3.2.1. GOVERNMENT-FURNISHED FACILITIES: The Government will provide a facility on VSFB for the contractor’s use. Currently, Building 1707 is being utilized to support patient transport operations. The facility location may change at a later date to a more centralized location near the VSFB main gate, but at this time Building 1707 is still the primary location for patient transport operations. This facility shall be used only for the performance of the contract.

No alteration to the facility may be made without written coordination from the 30 MDG COR and authorization from 30 CES. The contractor shall return the facilities, including grounds, to the Government in the same condition as received, fair wear and tear and approved modifications excepted.

3.3. SERVICES

3.3.1. UTILITIES: The Government shall furnish electricity, water, sewage, phone, and heating.

3.3.2. REFUSE COLLECTION: The Government shall provide dumpsters for refuse. The Government shall provide containers for collection of recycling materials. The contractor may not dispose of medical waste in these containers. Furthermore, the contractor shall be responsible for the proper disposal of all medical waste and hazardous waste.

3.3.3. PROTECTION SERVICES: The Government shall provide Security Forces and Fire Protection.

3.3.4. COMMUNICATION EQUIPMENT: The contractor must provide all equipment (i.e.

phones, radios, and computers) necessary to conduct operations in accordance with Santa Barbara County requirements.

3.3.5 VANDENBERG COMMUNICATION EQUIPMENT: The Government will provide radios so the contractor can communicate with Fire Dispatch and other emergency response agencies on Vandenberg SFB. The 30 MDG will maintain an inventory list of issued equipment for accountability purposes. The current list of issued equipment includes two (2) truck mounted mobile radios (One for the ambulance, and one for the Supervisors vehicle), and three (3) hand held radios for the crews. The contractor will sign an Air Force Information Management Tool 1297 (AF IMT 1297) to acknowledge receipt of the issued equipment. Additionally by signing the AF IMT 1297 the contractor assumes responsibility for the equipment and will reimburse the Government the value of the equipment in the case of lost, stolen, or damaged equipment. In any case of lost, stolen, or damaged equipment the contractor must immediately notify the contract COR so a report of survey can be initiated.

APPENDIX A

PUBLICATIONS AND COMMERCIAL MANUALS

PUBLICATIONS: It is the responsibility of the contractor to establish continuing requirements with the Publications Distribution Office or other office of Prime Responsibility. Revisions, supplements, and changes may be issued during the life of the contract. The contractor must requisition all additional documents, which shall be in full force and effect immediately upon receipt. It is the contractor’s responsibility to ensure that all documents on hand are posted and up to date. All of the following publications are mandatory. The contractor is obligated to follow mandatory documents, to the extent specified. Mandatory documents are “all inclusive” unless otherwise indicated.

AFIs & AFMANs (Found at https://www.e-publishing.af.mil/)

AFGM 32-7001_AFGM2020-01 Environmental Management AFM 32-7002 Environmental Compliance and Pollution Prevention

SLD 30 Plans, Instructions & Base Wide Permit to Operate (PTO), Forms

30 SW 32-7043A-Hazardous Waste Management Plan 30 SW 32-7086-Hazardous Materials Management Plan 30 SW 32-4002C-Spill Prevention Control and Countermeasures 30 SW Form 332-Base Civil Engineer Work Request

California Emergency Medical Services Authority

California Code of Regulations, Title 22, Social Security, Division 9. Prehospital Emergency Medical Services

Information available at http://www.emsa.ca.gov

Santa Barbara County Public Health Department Emergency Medical Services Policies and Procedures

The contractor is required to meet all applicable Santa Barbara County Public Health Department emergency medical services policies and procedure to include organization, management, certifications, accreditations, response, equipment, facilities, documentation, public information, as well as all other applicable items related to this service.

Information available at https://www.countyofsb.org/ceo/sbcoem.sbc

Vehicles- California Highway Patrol

California Highway Patrol Title 13, Section 1100 - 1109

California Vehicle Code 2510-2512

APPENDIX B

ACRONYMS

30 CES 30th Civil Engineering Squadron 30 CONS/PKB 30th Contracting Squadron/Services Flight 30 HCOS/SGGM 30th Health Care Operations Squadron/Logistics 30 MDG 30th Medical Group 30 OMRS/SGSX 30th Operational Medical Readiness Squadron/Aerospace Medicine 30 SFS 30th Security Forces Squadron ADC After Date of Contract AED Automated External Defibrillator AFI Air Force Instruction ALS Advanced Life Support BLS Basic Life Support CAER Community Awareness and Emergency Response CAP Collection Accumulation Point CCR California Code of Regulations CDC Center for Disease Control CO Contracting Officer COR Contracting Officer’s Representative DOD Department of Defense EMS Emergency Medical Services EMT Emergency Medical Technicians FBI Federal Bureau of Investigation FOIA Freedom of Information Act HAZMART Government Hazardous Material Supply System HAZMAT Hazardous Material IAW In Accordance With IFE In-Flight Emergencies NOV Notice of Violation OSHA Occupational Safety and Health Administration PWS Performance Work Statement SBCPHD Santa Barbara County Public Health Department SFB Space Force Base SLD 30 Space Launch Delta 30 SS Service Summary TJC The Joint Commission USSF United States Space Force VSFB Vandenberg Space Force Base

APPENDIX C

WORKLOAD ESTIMATES

AVERAGE RUNS. The spreadsheet below represents the average number of runs per month over a 12-month period. Please note that these numbers are based on historical information and could vary.

MONTH/ YEAR NUMBER OF RUNS

JAN 2021 11

FEB 2021 14

MAR 2021 20

APR 2021 12

MAY 2021 19

JUN 2021 19

JUL 2021 17

AUG 2021 19

SEP 2021 11

OCT 2021 14

NOV 2021 10

DEC 2021 17

12 MONTH AVG CALLS PER MONTH

SPECIAL EVENTS: The estimated number of special events is between 20 and 30 per every 12 months for a total of 80 estimated event hours. This number is based off of historical information and is subject to change (Within the last twelve months, there have been a total of 80 event hours). Future event hours could fluctuate from this number.

APPENDIX D

REQUIRED REPORTS

SEQUENCE

NO.

TITLE

CONTRACT

REFERENCE

or PWS

PARAGRAPH

AS OF

DATE

FREQUENCY

REQUIRING

OFFICE

A001 Transport Documentation

1.2.7 5th calendar day of following month

Monthly 30 OMRS/SGSX

A002 Contract Manager

Appointment

1.3.1.1.1 No later

than start of contract and within 3 working days of personnel changes

Initial & As Required

30 HCOS/SGGM

A003 Vehicle Maintenance

Proof of Compliance

1.4.1 Within 30

days after inspection is completed

Initial & Annual

30 HCOS/SGGM

A004 Contractor Quality

Control Plan

1.7.1 10 days

ADC

Initial & within 10 days of changes

30 HCOS/SGGM

A005 Proof of Insurance

FAR Clause 52.228-5

30 days

ADC

Initial & Annual

30 CONS/PKB

ADC – After Date of Contract

APPENDIX E

APPENDIX F

VANDENBERG SFB, 30TH MEDICAL GROUP

EMERGENCY RESPONSE EXEMPTION REQUEST

This report must be completed and submitted with supporting documents for all exemption requests.

DATE:

CODE LEVEL:

TIME CALL RECEIVED:

DISPATCHED TIME:

ENROUTE TIME:

TIME ARRIVED SCENE:

LOCATION OF INCIDENT:

NATURE OF CALL:

WEATHER:

ROAD CONDITIONS:

DRIVER INFO:

INCIDENT NUMBER:

Reason for Extended Response Time: (Check all that apply)

1.___ Dispatch error (Incorrect call priority, address, disrupted voice/data, or time record)

2.___ Inability to locate address (Non-existent or inaccurate address)

3.___ Unavoidable delay caused by traffic congestion without alternate route

4.___ Extreme weather conditions with impaired visibility or unsafe driving condition

5.___ Unavoidable delay by road construction and/or closure

6.___ Unavoidable delay by train

7.___ Unavoidable delay by off-road or off-paved locations

8.___ Unusual system overload/extraordinary ALS fire demand

9.___ Other

Detailed Explanation for Response Delay (Must be filled out/use additional sheets as needed)

Name/Title of Contractor Representative (Requestor)

REQUEST STATUS: APPROVED / DENIED (Circle one)

Reason: ______________________________________________________________________

Name/Title of 30th Medical Group Representative/Reviewer