Attachment A - Altoona Ambulance PWS.docx

PERFORMANCE WORK STATEMENT (PWS)

1.0. INTRODUCTION

1.1. The Government requires a contract for ambulance services. The services are to be all-inclusive to include medical equipment necessary for the transportation of Veterans of the James E. Van Zandt, Altoona VA Medical Center (Altoona VAMC). The use of James E. Van Zandt, Altoona VAMC throughout this document shall be interpreted as the Altoona VA Medical Center. The Contractor shall be state certified by the Pennsylvania Department of Health and Human Service and Bureau of Emergency Medical Services. Altoona VAMC consists of one main campus/location: James E. Van Zandt, Altoona VA Medical Center, 2907 Pleasant Valley Blvd. Altoona, PA., 16602, which includes but is not limited to, a medical center, behavioral health, and Urgent Care Center (UCC). The hours of operation for the Medical Center are Monday through Friday from 8:00 AM to 4:30 PM with no weekend or holiday access. The Contractor shall provide ambulance coverage for the Altoona VAMC, Urgent Care Center 24 hours per day/7 days per week, 365 days per year. This will include all major holidays observed by the Government. The Period of Performance will be 9/1/2023 thru 8/31/2028.

2.0. DESCRIPTION / SCOPE / OBJECTIVE

2.1. Ambulance: The Contractor shall provide all vehicles, supplies, materials, equipment, labor, personnel, supervision, management, and transportation to furnish Basic Life Support and Advanced Life Support (BLS/ALS) ground ambulance emergency transport services to eligible VA beneficiaries of the Altoona VAMC. The Contractor shall provide response in BLS/ALS vehicles transports within the time frames specified in the contract. The Contractor's ambulance vehicles used in the performance of this contract shall meet the current specifications of Federal Specification KKK-A-1822E. The Contractor shall comply with all licensing and other applicable requirements of federal, state, and local government regarding the operation of patient transport ambulance services. Contractor care shall cover the full range of ambulance services as provided in the local community. Paramedics responding shall bring equipment/supplies required by state regulations. The Contractor shall supply ALS equipment and medication to include, but not limited to, ventilators, cardiac monitoring, intubation equipment, automated external defibrillator (AED), laryngoscope, pulse oximetry, glucometer, portable 02, protective clothing, and written procedures. Contractor shall make available, the appropriate number of ambulance vehicles to provide services in a timely manner as outlined within the PWS. Performance shall be in accordance with the requirements contained in this PWS and standards of the Pennsylvania Department of Health and Human Service, Bureau of Emergency Medical Services, and the Joint Commission. The Contractor shall complete all required training by the Altoona VAMC to include, but not limited to, Privacy Training and Computer Security Training.

2.2. Performance Location and Hours: All services shall be provided twenty-four (24) hours a day, seven (7) days a week, three hundred and sixty-five (365) days a year, including government holidays. Service shall include transportation to points dictated by the Altoona VAMC, for beneficiaries located within catchment areas of the facility. Ambulance transportation services shall be furnished on an as needed basis.

2.3. Period of Performance: The period of performance will be five years, 9/1/2023 thru 08/31/2028, with task orders funding services annually.

3.0. APPLICABLE DOCUMENTS.

3.1. The following laws, regulations, policies, and procedures in effect on date of contract issuance and all subsequent changes or updates apply:

KKK-A-1822F

STAR-OF_Life AMBULANCE(everyspec.com)

1695_D_2019-09-18.pdf

28 Pa. Code Part VII. Emergency Medical Services (pacodeandbulletin.gov)

Pennsylvania Department of Health Pennsylvania Department of Health and Human Service, Bureau of Emergency Medical Services.

EMSAct_37_Chapter 81.pdf (pa.gov)

4.0. DEFINITIONS:

4.1. Administrative Officer of the Day (AOD): VA official that works in the admissions area during evenings and nights; and monitor hospital activities during other than normal working hours. This person is located at Altoona VAMC and acts as hospital administrator during off-hours.

4.2. Advanced Life Support (ALS) — Emergency: When medically necessary, the provision of ALS services, as specified above, in the context of an emergency response. An emergency response is one that, at the time the ambulance provider or supplier is called, they shall be on site (Altoona VAMC) within 20 minutes from the time of call for services. An immediate response is one in which the ambulance provider/supplier begins as quickly as possible to take the steps necessary to respond to the call.

4.2.1. For all trips ALS from Altoona VA Medical Center to Pittsburgh VA Medical Center, mileage is included.

4.3. Ambulance: Vehicles for emergency medical care provide a driver compartment and a patient compartment that will accommodate an Emergency Medical Technician (EMT), a Paramedic (or RN as needed), equipment and supplies for emergency care at the scene as well as during transport, and communication device and equipment for light rescue procedures. The ambulance is designed and constructed to afford relative safety and comfort, and to avoid aggravation of the patient's condition. Transports requiring higher level of care than a Basic Life Support (BLS) transport are those equipped with an Advance Life Support (ALS) System and qualified staff.

4.4. Base Rate: Base Rate is defined as the rate paid for one-way transportation from a designated pick-up point to a designated delivery point. This rate will be paid for all authorized one-way trips ordered under this contract action, with employees receiving at minimum the Department of Labor Service Contract Act wage rates (included under attachments), during all phases of the trip made on behalf of the Government. That Base Rate shall constitute full compensation for one-way trips which includes the initial 25 miles. Altoona VA Medical Center to VA Pittsburgh Medical Center trips are not to be included in this definition.

4.5. Basic Life Support (BLS) — Emergency: When medically necessary, the provision of BLS services, as specified above, in the context of an emergency response. An emergency response is one that, at the time the ambulance provider or supplier is called, they shall arrive on site (Altoona VAMC), within 45 minutes from the time of the call for services. An immediate response is one in which the ambulance provider/supplier begins as quickly as possible to take the steps necessary’ to respond to the call.

4.5.1. For all trips BLS from Altoona VA Medical Center to Pittsburgh VA Medical Center, mileage is included.

4.6. Beneficiary: Veterans and other members determined to be eligible for benefits by the VA.

4.7. Business Hours/Days: Business hours/days defined as the time of 8:00AM to 4:30PM, Monday through Friday, except Federal holidays. Federal holidays include but not limited to – New Year’s Day, Martin Luther King Day, President’s Day, Memorial Day, Juneteenth Day, Independence Day, Labor Day, Columbus Day, Veterans’ Day, Thanksgiving Day, Christmas Day, and other specifically designated days by the President of the United States to be a federal holiday. Off business hours/days are defined as the time of 4:30 p.m. to 7:59 a.m., Monday through Friday, all day Saturday and Sunday and Federal holidays.

4.8. Contractor Administrative Representative (Contact Person). The Contractor awarded this contract shall provide the name, address, telephone number and facsimile number of authorized Contractor representative(s) who have the binding authority to act on behalf of the Contractor on administrative and/or performance matters pertaining to this contract. The Contractor shall maintain this list and submit any changes thereof to the POC. If additional space is needed, use a separate sheet of paper, and identify as a continuation of Section C, Item 25.)

4.9 Contracting Officer (CO): VA official with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings.

4.10 Contractor: The term “Contractor’ as used herein refers to both the prime Contractor and his/her employees, and any subcontractors and their employees. The Contractor shall be responsible for assuring that his/her subcontractors comply with the provisions of this contract.

4.11 Dry Run These trips are defined as either a request for service by authorized Medical Center personnel, whereby the Contractor arrives at the designated pick-up point and no patient is transported due to a change in the Medical Center’s needs or scheduled pick-ups for which due to circumstances beyond the Contractor’s control (i.e., patient refuses pick-up, patient not home, patient not medically/mentally suitable for transport, etc.). The Contractor will be entitled to the applicable base rate only due to no fault or negligence of the Contractor. No charge shall be assessed on scheduled pick-ups that are cancelled by the VA and/or the patient prior to the departure of the transport.

4.12 Joint Commission on the Accreditation of Healthcare Organization (JCAHO) Standards: A national organization dedicated to improving the care, safety, and treatment of beneficiaries in a health care facility and environment.

4.13. KKK Specification: Each ground ambulance used in the performance of this contract must meet the current specifications of Federal Specification KKK-A-1822E.

4.14. Mileage Rate: Mileage for ground ambulance services is the rate paid for each mile traveled beyond the specified Mileage Threshold of 25 miles, with the source being the origination facility (Altoona VAMC). This rate applies to one-way transportation only, whether loaded or unloaded. In no event shall the Contractor receive this rate for miles traveled within the 25-mile threshold.

4.15. Mileage Threshold: The mileage threshold for the Altoona VAMC is a 25-mile radius from the designated pick-up point for each trip (i.e., Contractor is required to pick up beneficiaries at the Altoona VAMC, the mileage threshold would be a—25 miles radius from the Altoona VAMC). Charges for travel within this mileage threshold shall be inclusive with the base rate. One-way mileage for travel beyond the 25-mile mileage threshold shall be claimed under the applicable mileage rate. Altoona VA Medical Center to VA Pittsburgh Medical Center trips are not to be included in this definition.

4.16. No-Patient Charge: Fee allowed to Contractor for scheduled pickups for which due to circumstances beyond the Contractor’s control, (i.e., Veteran refuses pick-up, Veteran not home, Veteran not medically/mentally suitable for transport, etc.) are not completed. This charge shall only be accessed on actual trips to the Veteran pickup point and shall not be assessed on scheduled pickups that are cancelled by the VA and /or the Veteran.

4.17. Point of Contact (POC). The POC responsibilities include, but not be limited to surveillance of services required under this contact; determining the adequacy of Contractor performance according to the specifications of this contract; acting as the Government's representative; ensuring compliance with contract requirements insofar as the work is concerned; and advising the Contracting Officer of any contract issues. The POC cannot authorize deviations from the terms and conditions of this contract. In the event the Contractor deviates without written approval from the Contracting Officer, such deviation shall be at the risk of the Contractor and any cost related thereto shall be borne by the Contractor. The POC will be designated at the time of contract award and appointed in writing by the Contracting Officer to assist in the discharge of their responsibilities when s/he is unable to be directly in touch with the contract work.

4.18 Program Point of Contact (POC): VA official responsible for providing contract oversight and technical guidance to the Contracting Officer. Responsibilities include certification of invoices, placing orders for service, providing technical guidance, overseeing technical aspects of the contract, and are a member of the vehicle inspection team. All administrative functions remain with the Contracting Officer.

4.19 Quality Assurance: Those actions taken by the Government to assure services meet the requirements of this contract.

4.20 Quality Assurance Evaluator: Government personnel responsible for surveillance of Contractor performance.

4.21 Quality Assurance Surveillance Plan (QASP): An organized written document used for quality assurance surveillance. The document contains specific methods for performing surveillance of the Contractor’s continuous performance.

4.22Quality Control: Those actions taken by the Contractor to control the production of goods or services so they will meet the requirements of a contract.

4.23 Standby: Standby shall commence after the waiting grace period fifteen (15) minutes. Waiting time shall be required and verified prior to invoicing.

4.24 Unscheduled Trip(s): The term “Unscheduled Trip” as used in this contract refers to those trips required on an as needed basis and advance notice is not given.

4.25. Veteran: A Beneficiary, VA employee, or visitor to Altoona VAMC receiving services from the Contractor under this Contract.

4.26. VetRide: A hosted VTS platform created by Kevadiya Inc for managing Veteran's trip requests to and from VA healthcare facility. The platform allows Veterans to register for VetRide services, request a ride and receive notifications about status of their rides. This mobile friendly platform enables veterans to operate their account from their desktop as well as smart devices. Since VTS VetRide services are available to all eligible veterans free of charge or with little cost, veterans using this benefit are required to abide by following Rules of Behavior.

4.27. Waiting: Waiting, as used in this contract, is defined as the time required (and verified by authorized medical facility personnel) for the Contractor to wait at designated pick-up and/or delivery points while performing contract services.

4.28. Waiting Grace Period: The waiting grace period is defined as fifteen (15) minutes prior to the time waiting charges commence. The base rate for ambulance services shall include a fifteen (15) minute waiting grace period at origin and destination.

5.0. PERFORMANCE REQUIREMENTS:

5.1. Contractor Employees:

5.1.1. Under this contract, Altoona VAMC reserves the right to demand corrective action for unsatisfactory performance or misconduct by contractor employees providing services to the Altoona VAMC. Unsatisfactory performance and misconduct are determined at the Altoona VAMC’s sole discretion. The Contracting Officer may proceed with all remedies available to it under this contract and applicable law, including termination, if corrective actions are not taken and the performance of the contract is endangered.

5.1.2. The Contractor shall furnish qualified personnel as required by the contract specifications to accomplish all services under this contract.

5.1.3. Contractor personnel performing services to the Altoona VAMC shall at all times, conduct themselves in a professional manner, maintain personal hygiene, wear clean, neat uniforms, and be identified by having the company name, and employee name affixed to the uniform. The Contractor shall be responsible for furnishing all vehicles, personnel, equipment and supplies, vehicle fuel, uniforms, nametags and/or badges for performance of services under this contract. Employee identifications shall be worn in clear view above the waist. Contractor personnel shall not smoke in vehicles at any time or while transporting VA beneficiaries.

5.2. Contractor Personnel Qualifications:

5.2.1. All Contractor personnel performing contract services shall meet the qualifications as specified in this contract, as well as any qualifications required by Federal, State, County, and local government entities from the place in which they operate. Contractor personnel shall always meet these qualifications while performing contract services. See Paragraph 3.1 for the websites pertaining to the States’ requirements for personnel and ambulance.

5.2.2. During the contract period of performance, if the Contractor proposes to add-on or replace personnel to perform contract services, the Contractor shall submit required evidence of training, certifications, licensing, background and security clearances, and any other qualifications to the designated POC. At no time shall the Contractor utilize add-on or replacement personnel to perform contract services who do not meet the qualifications under the terms and conditions of this contract.

5.2.3. Within seven (7) days after receipt of award notification and annually, the contractor shall provide evidence of required training, certifications, licensing, and qualifications of personnel who will be performing services under this contract. The initial documentation shall be provided to the Contracting Officer and POC.

5.2.4. The Contractor shall comply with the provisions of the Privacy Act of 1974, the Health Insurance Portability and Accountability Act (HIPAA) of 1996, as well as all applicable (Veterans Health Administration) VHA regulations pertaining to Fire and Safety, VA Directive 7701, Occupational Safety and Health. Issued March 2003 VA Handbook 7701.1, Occupational Safety and Health Program Procedures. Current Joint Commission Standards and Department of Labor’s Occupational Safety and Health Administration (OSHA) Policy on Blood Airborne Pathogens issued March 2003.

5.2.5. The Contractor must provide the POC an annual statement of certification of state driving records, license verification, and insurance. This shall include an annual statement that drivers are screened, trained, and competent to safely transport beneficiaries. This annual statement of the driver competency must include any advanced certifications, such as Advanced Cardiac Life Support or specialized training to assist and secure beneficiaries by stretcher.

5.2.6. The Contractor shall certify all paramedics on direct emergency medical response processes, upon notice of contract award and annually thereafter. The Contractor will submit the list of paramedics to the POC.

5.2.7. The Contractor shall assess competence and performance of personnel who will be performing services under this contract upon notice of award and annually thereafter, per Department of Health and Human Services, Emergency Medical Services.

5.3. Paramedic Qualifications: Paramedics providing services under this contract shall have the following qualifications, in addition to those required by Federal, State, and Local Government:

5.3.1. The Contractor shall have completed training in accordance with the standards published by the Department of Health and Human Services with the minimum curriculum or equivalent including an in-hospital training period. Such training programs must also be acceptable under the regulating requirements for local EMS Systems supported by DHHS under PL 93-154, Federal Register 39:24304. (1974).

5.3.2. The Contractor shall submit evidence of re-certifications and equivalent training program successfully completed to the POC annually and upon request.

5.3.3. The Contractor shall be certified, or otherwise officially recognized, by Bureau of Emergency Medical Services Office, Pennsylvania Department of Health.

5.3.4. The Contractor shall attend all refresher continuing education, or advance training programs as required by the local or state government entity in which service is rendered. In no instance shall this be less frequent than every two (2) years. Such refresher training shall be equivalent to that developed by the Department of Transportation, National Highway Safety Administration.

5.4. Ambulance Driver Qualifications: Drivers shall have a valid operator’s or chauffeur’s license in accordance with Federal, State, and local government requirements for their place of operation, for the services they perform, be capable of administering oxygen and have successfully completed the Standard and Advanced First Aid Course for the American Red Cross or U.S. Bureau of Mines or equivalent and be capable of providing necessary medical assistance.

5.5. Authorized Medical Center Personnel: Prior to performance, the Contracting Officer shall provide the Contractor with a list of names or position titles and phone numbers of authorized Government personnel who may request services and receive calls from Contractor regarding contract performance. This list will be updated and submitted to the Contractor as changes occur. The Contractor shall ensure that requests for services are received from authorized medical center personnel. Services rendered in response to requests from other than authorized personnel shall be at the risk of the Contractor and any cost related thereto shall be borne by the Contractor.

5.6. Contractor Equipment, Vehicles, and Inspection:

5.6.1. The Altoona VAMC reserves the right to inspect contractor’s equipment and vehicles or require documentation of compliance with contract specifications, and State laws, rules, regulations, and guidelines governing emergency medical transport vehicles (ambulances). Altoona VAMC inspections of contractor facilities shall in no way constitute a warranty by the Altoona VAMC that the contractor’s vehicles and equipment are properly maintained. The Altoona VAMC reserves the right to restrict the contractors use of equipment and vehicles which need repair, unclean, damaged on the interior or exterior body, and are not in compliance with contract requirements, determined by the sole discretion of the Altoona VAMC. The restriction of such equipment and vehicles shall not relieve the contractor from performing in accordance with the strict intent and meaning of the contract and without additional cost to the Altoona VAMC. If any ambulance equipment is added or replaced after inspection, after the award of this contract, it shall be inspected and approved by the POC or his/her representative before being placed in use under this contract. All vehicles used in this contract shall be maintained in accordance with applicable State laws, rules, regulations, and guidelines for that vehicle.

5.6.2 All vehicles shall meet all current applicable Federal, State and local specifications and regulations including, but not limited to, licensing, registration, and safety standards, specifically a copy of the Certificate of Public Convenience and Necessity (CPCN) from the Public Utility Commission of Ohio as well as a Certificate of Public Convenience from the Pennsylvania Public Utility Commission (PAPUC) See Paragraph 3.1 for the websites pertaining to the States’ requirements for personnel and ambulance.

5.6.3. All ambulances shall be clean and maintained in good repair in accordance with manufacturer’s instructions and specifications, always during the performance of this contract, and shall contain but not limited to An emergency safety kit, Portable oxygen unit (s), Fire suppression equipment, Appropriate road emergency warning equipment.

5.6.4. BLS ambulance transports shall, in conjunction with the above, be equipped with stretchers to accommodate beneficiaries over 500 lbs. and have an on-board EMT or Paramedic, qualified to perform basic airway management. Overweight or obese patient transport rates shall be the same as those for non-overweight patients.

5.6.5. ALS ambulance transports shall, in conjunction with the above, be equipped with pulse oximetry and on-board Paramedic, perform cardiac monitoring, provide Advanced Cardiac Life Support (ACLS) drugs and procedures, and perform advanced airway management and medication monitoring and administration. Advanced airway management means the ability to intubate a patient and provide appropriate respiratory care, which does not include tracheotomies, cricoidectomies, or cricotracheotomies.

5.6.6. The Contractor shall provide all medications required while in transport, sheets and blankets and other equipment and supplies required for use while in transport, for direct beneficiary care. The Contactor shall at no time and under any circumstances exchange supplies, equipment and/or medications with Altoona VAMC. The prices quoted in the schedule of supplies or services and price/costs shall be inclusive of consumables used in transport. All vehicles used for critical patient care (i.e., ALS, BLS), shall include, but not be limited to, monitors, defibrillator with external pacemaker, intubation equipment, intravenous equipment, medications, patient compartment facilities, oxygen and suction equipment and accessories.

5.7. Request for Services:

5.7.1. Altoona VAMC Travel Office or the Administrative Officer of the Day (AOD) will make requests for services. ALS or BLS mode of transport shall be discussed and determined by the VA clinician providing the level of care. The Contractor shall transport per its policies and standard industry practices.

5.7.2. Authorized personnel will place scheduled and unscheduled transportation requests to the contractor’s dispatch office. All requests will be placed against pertinent schedule items, on a unit price basis in accordance with Schedule B and will be verified against invoices. The Contractor is responsible for providing all routing and directions to drivers prior to arrival at the pickup location and shall use the most direct route. When ordering services, (whether it is by telephone and/or e-mail), the Altoona VAMC will provide the Contractor with the following type of information:

Mode of transportation required, Required date and time of arrival, Name of beneficiary, Pick-up and delivery point, Any other special instructions.

5.7.3. Requests for transportation services will be made to the Contractor dispatch personnel 24hours a day/ 7 days a week. Identified below:

Company:

Address:

City/State/Zip:

Contact Person:

Normal Hours Telephone No.:

After Hours Contact Person:

After Hours Services Telephone No:

5.7.4. The Contractor shall be required to transport non-ambulatory Veterans, who are not in need of emergency transportation or medical attention, on gurneys, litters.

5.7.5. When transporting a beneficiary to a local hospital, upon arrival at the hospital, the driver shall give the hospital the copy of the medical information accompanying the beneficiary and the history of present illness, vital signs, and medical actions or medications provided during transport.

5.7.6. Altoona VAMC will be transferring to a new national software system VETRIDE, in the near future, and the Contractor shall comply with the new software. VA will provide the contractor with training opportunities.

· VA Creates a Trip and sends it to the third-party portal

· Third-Party accepts or rejects Trip request sent from VA

· Third-Party accepts Trip

· Print out a paper manifest of the daily trips w/ QR codes

· Provide the drivers with the paper manifests for their trips

· Drivers will scan QR codes with VendorPass app. They will complete their trips within the app

· Third Party confirms trip information and manually completes each trip in Third Party portal

5.7.7 Electronic Transmissions: Each Contractor shall indicate if there is e-mail availability for their company to complete communications with the Altoona VAMC (use of this communication system will be mutually agreed upon after award of contract before any communications are completed in this manner).

5.8. Contractor Notification:

5.8.1. The Contractor shall be responsible for providing all transports, vehicle, and manpower necessary to meet all ALS and BLS requirements and may find it necessary to utilize another service provider. If the Contractor utilizes another company, as a subcontractor, to complete any transport requests, the subcontractor must follow all laws, regulations, policies, and procedures and all subsequent changes or updates as referenced in 3.1 of the performance work statement. All invoices for this subcontracted service will be paid directly to the Contractor at the contract rate, and the contractor shall reimburse the subcontractor at their agreed rate. In the event, the Contactor is unable to perform services or have services performed as required the Contractor shall immediately notify the Altoona VAMC Travel Office or AOD. The Altoona VAMC reserves the right to re-procure services which cannot be performed by the Contractor, in accordance with the terms, conditions, and schedule of this contract. The Contractor shall indemnify and reimburse the Altoona VAMC for all costs associated with excess re-procurement costs. Payment of re-procurement costs shall not relieve the Contractor from any terms and conditions in this contract. The Altoona VAMC will be the sole judge in determining when services will be re-procured. The failure of the contractor to perform services within the required time frames and in accordance with terms and conditions may also provide cause for termination of the contract for “Default”.

5.8.2. Should the Altoona VAMC determine that immediate transportation is essential to prevent loss of life or serious bodily harm, transportation services may be procured without referral to the ambulance contractor.

5.8.3. There are occurrences when a beneficiary will be scheduled for appointments requiring transportation from different VA facility, nursing home, or beneficiary place of residence. At no time shall a beneficiary be required to wait arrival of a pre-scheduled trip beyond thirty (30) minutes. Failure of the vehicle to arrive at the beneficiary’s residence or VA facility /nursing home within the allotted time frame (30 minutes) may result in automatic cancellation of the trip, and services may be secured from other sources which may result in action taken against the Contractor, up to and including default.

5.9. Response Time:

5.9.1 Unscheduled Ambulance Service Response Time: The Contractor shall respond to all calls for unscheduled ground ambulance transport service by being on-site at the designated point of pick-up within 20 minutes of notification for an Advanced Life Support (ALS) vehicle and/ or within 45 minutes for Basic Life Support (BLS) vehicle and 20 minutes of notification for a psychiatric transport to the designated destination. The Contractor shall respond to all calls immediately for emergency ground ambulance transport. The Contractor shall provide service 24 hours per day/7 days a week, 365 days of the year to include all observed federal holidays.

5.9.2. If the time for pick-up, stated herein, is physically impossible due to location of veteran beneficiary, the Contractor shall contact the Altoona VAMC Travel Office and/or AOD and inform him/her of the anticipated time required for pick-up and delivery of said beneficiary.

5.9.3. The Contractor shall provide and respond to all emergency calls in accordance with Federal, State, and Local regulations, governing dispatch of emergency medical (ambulance) vehicles and medical care of on-board beneficiaries, to include the use of sirens and other measures to ensure timely arrival at the designated Altoona VAMC Medical facility.

5.9.4. Immediate Notification: It is the responsibility of the Contractor to immediately notify the Altoona VAMC Travel Office when unable to make a pick-up or delivery by the exact time specified for previously scheduled trips, or unable to dispatch an ambulance to a designated pick-up point within the required time frame for unscheduled request for services. The immediate notification shall include the reason for the delay and whether the pick-up or delivery can be made at a later time and if so, specification of that time. However, it shall be the sole discretion of the Altoona VAMC Travel Office to accept the later pick-up or delivery time or pursue services from another source. If the Altoona VAMC Travel Office orders the services from another source, the excess paid to another ambulance company will be deducted from the total invoice of the Contractor.

5.9.5. Response Time Compliance Rate: The Contractor shall maintain at a minimum, a 95% compliance rate on responses to pick-up or deliver during the contract year. Travel office and/or AOD will track reported late pick up or delivery. This will be accomplished by Validated User/Customer Complaints and reviewing trip tickets with medical center requests. Failure of the contractor to perform in accordance with this compliance rating may constitute sufficient cause for termination of the contract.

5.10. Waiting Time:

5.10.1. For scheduled trips, waiting charges shall commence fifteen (15) minutes from the scheduled pick-up time or from the time the Contractor actually arrives at the designated pick-up point, whichever is later.

5.10.2. If the designated pick-up and/or delivery points are at locations other than the VA Medical facilities and waiting beyond the required fifteen (15) minute grace period is anticipated, the Contractor shall notify the Travel Office or AOD. This call is only for the purpose of verifying and documenting the contractor’s time for a record of arrival at pick-up and/or delivery points and is not necessary if the Contractor does not anticipate a delay for which waiting charges will be claimed. The Contractor’s failure to notify the Travel Office or AOD when waiting beyond the grace period shall result in non-payment for waiting time.

5.11. Substitution of Beneficiary: The Altoona VAMC reserves the right to substitute the beneficiary requiring services at any time during the performance of this contract, to prevent delays, cancellations, or dry runs. There shall be no additional charge to the Altoona VAMC when such changes occur.

5.12. Number of Beneficiaries:

5.12.1. The contractor shall transport one Veteran beneficiary per trip.

5.12.2. The Contractor shall at no time during the transport, make any additional stops along the way. The Contractor is expected to transport the Veteran from pickup location to destination drop off with no stops in-between.

5.13. Origin and Destination Pricing:

5.13.1. Beneficiaries may be transported to or from Altoona VAMC facilities or between the VA facility and a facility that provides care under VA auspices (i.e. Contract Nursing Home, Community Outpatient Clinics,) and/or between the home of the beneficiary receiving travel services and the VA facility. The Altoona VAMC Travel Office or AOD will specify the points of origin and the destination of every trip.

5.13.2. Direct Patient Transfer: All patient transfers between Altoona VAMC facilities shall be direct transfers. Direct Patient Transfer does not include trips between the Veteran’s home and a facility that provides care under VA auspices.

5.13.3. Reimbursement for Mileage outside of Mileage Threshold Areas of Coverage (25 miles): Reimbursement for mileage outside the contract Mileage thresholds of coverage, shall be at the mileage rate stated in the price/cost schedule, and shall be based upon the miles from the pick-up point and the specified destination. Distances beyond the contract mileage threshold areas of coverage shall be calculated using the shortest route from Google Maps. Allowable charges for mileage outside the contract mileage threshold areas of coverage shall not exceed +5% of the current Google Maps.

5.13.4. Should the Altoona VAMC make a determination that a previously scheduled trip may be cancelled, and a vehicle has already been dispatched to the designated pick-up point, Altoona VAMC may notify the Contractor to cancel the order. For orders that are cancelled while the Contractor is already in route to the designated pick-up, the Contractor shall be entitled to receive the base rate for the trip, as provided in Schedule of Supplies or Services and Prices/Costs. This charge shall not include any mileage charge.

5.13.5. Should the Contractor arrive at the destination before Altoona VAMC cancels the order, or if the Contractor is unable to perform a scheduled pick-up, because of Altoona VAMC or beneficiaries such as incorrect address, beneficiary absence, or beneficiary refusal then the Contractor shall receive the base rate for the trip as provide in Schedule of Supplies or Services and Prices/Costs, and applicable mileage if outside contract mileage threshold areas of coverage.

5.13.6. Other Charges- The prices listed in the accepted Schedule of Supplies or Services and Prices/Costs shall be inclusive of any and all ferry, bridge, tunnel, or road toll charges. Contractor shall not bill the Altoona VAMC for any such charges separately.

5.14. Invoice Procedure:

5.14.l. Provide to the Altoona VAMC Travel Office invoices and copies of trip tickets that provide all aspects of the transports with regards to the Veteran name, pickup point and time, destination with arrival time, type of transport and any additional services provided to include wait time, if applicable, as described in the price schedule. This information shall be submitted via secured correspondence (electronic or standard) no later than ten (10) calendar days following the end of the month of services and are to include all contract services furnished for the preceding month. Contractor shall also provide to the Altoona VAMC Travel Office daily, a list of transports which consists of Veterans name; last four of SSN; type of transport call (emergency, ALS/BLS/ wheelchair, etc.); date of service; pick up location; destination and name of the scheduler.

5.14.2. Payment to the Contractor shall be made monthly, in arrears, upon receipt of a properly prepared invoice. Payment for services will be at the rates specified in the Price/Cost Schedule. All monthly invoices from the contractor will be electronically submitted through the Tungsten Network within 10 days following the end of the month of services.

The information page for the Financial Service Center (FSC) of the Department of Veterans Affairs that includes information regarding electronic invoice submission can be referenced at:

http://www.fsc.va.gov/einvoice.asp

Department of Veterans Affairs Financial Services Center PO Box 149971 Austin TX 78714-8971 Customer Support Help Desk (877-353-9791)

Invoices must be approved by the benefit travel team/supervisor or POC prior to payment release. Invoices without the required information will be rejected.

Failure to comply with all terms and conditions of this contract shall result in invoices/claims submitted for reimbursement during that period to be considered incomplete. Interest penalties imposed under the Prompt Payment Act shall not apply to incomplete invoices or invoices received after the established invoice due date.

Contractor will identify and assign personnel to be the liaison for billing purposes.

Billings rendered by the Contractor to the ALTOONA VAMC for services furnished a VAMC beneficiary under the terms of this contract shall be billings in full. Neither the beneficiary his insurer, nor any third party shall be billed. Billed services will be verified by VA staff and POC.

A password protected copy of the billing items below will be submitted via email to the POC prior to invoices being sent to FSC:

Patient’s name Trip date Pick up point name and address Pick-up point arrival time Pick-up point departure time Drop off point name and address Drop off point arrival time Number of miles outside Contract Base Mileage Rate Contract Number and Current Purchase Order (obligation number) Base charge plus any additional Mileage Rate, if applicable, and name of VA Official who authorized trip.

Contractor Remittance Address: All payments by the Government to the Contractor will be made by Electronic Funds Transfer (EFT).

5.14.3. Unauthorized Commitments/charges will be suspended pending investigation. Unauthorized charges are those that are being disputed or have not been pre-approved by designated authorized government personnel, delegated the authority to commit government funds. If it is determined that a trip was the result of either an unauthorized commitment and/or transport of an individual ineligible for Government coverage, such payment will not be made, and the ineligible person transported and/or person/entity that made the unauthorized commitment becomes responsible for payment for the transport. The Government may authorize the Contractor to collect the payment directly.

5.15. Infection Control Procedures: The Contractor shall follow the Altoona VAMC Infection Prevention and Control policies and procedures to prevent and control the spread of infectious agents to all persons.

VHA Supplemental Contract Requirements for Combatting COVID-19

5.15.1 Contractor employees who work in or travel to VHA locations must comply with the following:

a. Documentation requirements:

1) If fully vaccinated, contractors shall show proof of vaccination.

i. NOTE: Acceptable proof of vaccination includes a signed record of immunization from a health care provider or pharmacy, a copy of the COVID-19 Vaccination Record Card (CDC Form MLS-319813_r, published on September 3, 2020), or a copy of medical records documenting the vaccination.

2) If unvaccinated, contractors shall show negative COVID-19 test results dated within three calendar days prior to desired entry date. Test must be approved by the Food and Drug Administration (FDA) for emergency use or full approval. This includes tests available by a doctor’s order or an FDA approved over-the-counter test that includes an affiliated telehealth service.

3) Documentation cited in this section shall be digitally or physically maintained on each contractor employee while in a VA facility and is subject to inspection prior to entry to VA facilities and after entry for spot inspections by Program Point of Contact (POCs) or other hospital personnel.

4) documentation will not be collected by the VA; contractors shall, at all times, adhere to and ensure compliance with federal laws designed to protect contractor employee health information and personally identifiable information.

5.15.2 Contractor employees are subject to daily screening for COVID-19 and may be denied entry to VA facilities if they fail to pass screening protocols. As part of the screening process contractors may be asked screening questions found on the COVID-19 Screening Tool. Check regularly for updates.

a. Contractor employees who work away from VA locations, but who will have direct contact with VA patients shall self-screen utilizing the COVID-19 Screening Tool, in advance, each day that they will have direct patient contact and in accordance with their person or persons who coordinate COVID-19 workplace safety efforts at covered contractor workplaces. Contractors shall, at all times, adhere to and ensure compliance with federal laws designed to protect contractor employee health information and personally identifiable information.

5.15.3 Contractor must immediately notify their POC or Contracting Officer if contract performance is jeopardized due to contractor employees being denied entry into VA Facilities.

5.15.4 For indefinite delivery contracts: Contractor agrees to comply with VHA Supplemental Contract Requirements for any task or delivery orders issued in accordance with the resultant contract.

5.16 Privacy

5.16.1 All contractor employees and subcontractor employees supporting the contract and having access to patient care/transport and personal health information (PHI) are required to complete TMS Courses #10176 Privacy, Information Security & Rules of Behavior: and #10203 Privacy & HIPAA Training.

a. Copies of training certificates will be maintained by the POC.

b. If contractor staff has already completed this type training, a copy of the training will be submitted to the Privacy Officer for validation/comparison to VHA requirements; as with above requirement on TMS courses, POC will maintain copies if this method is approved.

c. Copies of the training certificates will be sent to the POC within 7 days of award and annually thereafter.

Note: Failure to complete the mandatory annual training and sign the Rules of Behavior annually, within the timeframe required, is grounds for suspension or termination or removal from work on the contract until such time as the training and documents are completed.

HIPAA Compliance:

BUSINESS ASSOCIATE AGREEMENT:

A Business Associate Agreement (BAA) is required as defined in Health Insurance Portability and Accountability Act (HIPAA), Public Law 104-191.

5.17. Incident/Accident Report:

5.17.1. Any adverse events involving the welfare of Altoona VAMC beneficiary while in the care of the contractor during transport shall be recorded and reported to the POC during normal business hours or to the AOD after normal business hours (8:00am - –4:30pm) within 24 hours of the event.

5.17.2. The Contractor shall make contact immediately notifying the Government of any incident, accidents, or medication or transfusion errors involving injury to ALTOONA VAMC beneficiaries during transport. The government will provide POC's’ and phone numbers after contract award and prior to service start.

5.17.3. The Contractor shall prepare and submit a detailed incident report with all information necessary to conduct a full review (date, time, beneficiary, place of pick, place of incident, names of parties involved, a detailed summary of events etc.) with recommended/implemented corrective action within 24 hours of such incident to the Contracting Officer, POC, and the Chief, Health Administration Service, Altoona VA Medical Center.

5.18. Origin and Destination Pricing:

5.18.1. Beneficiaries may be transported to or from Altoona VAMC facilities or between the VA facility and a facility that provides care under VA auspices (i.e. Contract Nursing Home, Community Outpatient Clinics,) and/or between the home of the beneficiary receiving travel services and the VA facility. The Altoona VAMC Travel Office or AOD will specify the points of origin and the destination of every trip.

5.18.2. Direct Patient Transfer: All patient transfers between Altoona VAMC facilities shall be direct transfers. Direct Patient Transfer does not include trips between the vet’s home and a facility that provides care under VA auspices.

5.18.3. Reimbursement for Mileage outside of Mileage Threshold Areas of Coverage(25 miles): Reimbursement for mileage outside the contract Mileage thresholds of coverage, shall be at the mileage rate stated in the price/cost schedule, and shall be based upon the miles from the pick-up point and the specified destination. Distances beyond the contract mileage threshold areas of coverage shall be calculated using the shortest route from Google Maps. Allowable charges for mileage outside the contract mileage threshold areas of coverage shall not exceed +5% of the current Google Maps.

5.18.4. Should the Altoona VAMC make a determination that a previously scheduled trip may be cancelled, and a vehicle has already been dispatched to the designated pick-up point, Altoona VAMC may notify the Contractor to cancel the order. For orders that are cancelled while the Contractor is already in route to the designated pick-up, the Contractor shall be entitled to receive the base rate for the trip, as provided in Schedule of Supplies or Services and Prices/Costs. This charge shall not include any mileage charge.

5.18.5. Should the Contractor arrive at the destination before Altoona VAMC cancels the order, or if the Contractor is unable to perform a scheduled pick-up, because of Altoona VAMC or beneficiaries such as incorrect address, beneficiary absence, or beneficiary refusal then the Contractor shall receive the base rate for the trip as provide in Schedule of Supplies or Services and Prices/Costs, and applicable mileage if outside contract mileage threshold areas of coverage.

5.18.6. Other Charges- The prices listed in the accepted Schedule of Supplies or Services and Prices/Costs shall be inclusive of any and all ferry, bridge, tunnel, or road toll charges. Contractor shall not bill the Altoona VAMC for any such charges separately.

5.19. Patient Rights:

5.19.1. The Contractor shall be courteous to Altoona VAMC beneficiaries and will not smoke while transporting beneficiaries. The Contractor shall not smoke on VA property.

5.19.2. Beneficiaries may bring a reasonable amount of equipment, such as folding wheelchair, consumable medical supplies, and personal suitcase.

5.19.3. The Contractor shall notify the POC or Travel Office (during normal operating hours) in writing within 24 hours of any complaints made by the beneficiaries with regards to the ambulance service. The Contractor may provide recommendations for improved services along with the beneficiary complaints for the Altoona VAMC's review. No recommendation shall be construed as being effective until and unless it is provided as a written modification to the contract from the Contracting Officer.

6.0. DELIVERABLES.

6.1. Reports/Deliverables: The Contractor shall be responsible for complying with all reporting requirements established by the Contract. Contractor shall be responsible for assuring the accuracy and completeness of all reports and other documents as well as the timely submission of each. Contractor shall comply with contract requirements regarding the appropriate reporting formats, instructions, submissions timetables and technical assistance as required.

6.2. The following are brief descriptions of…