Attachment A - PWS Ambulance_WC Van.docx

Performance Work Statement (PWS)

GROUND AMBULANCE

VISN 4 / Station 542 NAICS 621910

Introduction:

Purpose: The Coatesville VA Medical Center (CVAMC), its associated Community-Based Outpatient Clinics (CBOCs), and affiliated healthcare clinics require contracted non-emergency ambulance transportation services. The contractor shall provide all vehicles, personnel, management, supplies, equipment, and necessary reporting for the provision of Stretcher Transports, Basic Life Support (BLS), Advanced Life Support (ALS), Wheelchair Transport, and Critical Care Transport (CCT) services. The contactor shall make these ambulance services available to the VA as needed. The vendor selected shall be ready to start on the day of award as a fully capable entity with all equipment required up and ready, with trained and certified personnel prepared to respond as directed by CVAMC what is expected. Services are to be provided to and from locations (i.e. clinics, ward locations, inpatient floors, ICU, patient homes, hospitals, pre-approved fee basis appointments) designated by the Coatesville VA Medical Center (CVAMC), CVAMC Veterans Transportation Office, in accordance with all terms, conditions, provisions and schedules set forth in this solicitation. Contractor shall assist the patient as needed to access the vehicle for transportation. This may include but is not limited to bed to stretcher or stretcher to bed transfer when necessary. Hours of Operation: 24 hours a day/ 7 days a week; including observed Federal Holiday.

Observed Federal Holidays

Christmas

Christmas Day December 25th

1. Background: The Coatesville VA Medical Center main campus is located 1400 Blackhorse Hill Road, Coatesville, PA 19320, serving over 18,000 veterans, primarily from the Chester, Montgomery, and Delaware county area and it’s two (2) Community-Based Outpatient Clinics. The hospital has 302 inpatient beds and sees approximately 1,217 -inpatient admissions and 200,000 outpatient visits a year. Veterans served within this facility lives within the following counties.

2. Contract Definitions / Acronyms Advanced Life Support (ALS) – ALS shall be provided by ambulance vehicles containing at a minimum an on-board Paramedic, cardiac monitoring, Advanced Cardiac Life Support (ALS) drugs and procedures, advanced airway management and medication monitoring and administration. Ambulances for ALS services shall be staffed in accordance with current Pennsylvania State laws and regulations governing the certification and licensure of private ambulances.

Administrative Officers of the Day (AOD) - The AOD mains the operations of all administrative activities during other than normal duty hours as described in VHA Directive 1096.

Basic Life Support (BLS) - BLS is defined as services required for non-critical patient care in which patient requires an ambulance, staffed in accordance with current Pennsylvania State laws and regulations governing the certification and licensure of private ambulances. This ambulance at a minimum will be staffed with a vehicle operator and an Emergency Medical Technician (EMT) Ambulance, and with basic airway management.

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

Critical Care Transport (CCT) Tier II - CCT is for patients needing an increased level of observation and intervention from health care professionals. These patients usually require advanced support for two or more of their organ systems or patients needing one organ system supported at a higher level of care. This also includes patients needing advanced respiratory support or intense post-operative care. This level of care is for patients needing more frequent assistance than those at ALS or CCT I.

Critical Care Paramedic (CCP) - Personnel provides necessary critical care during patient transport. They must meet the qualifications specified in this contract as well as all applicable federal, state, and local government laws, regulations, and standards.

Critical Care Emergency Medical Transport Program (CCEMTP) - Education for healthcare professionals looking to provide critical care transport for patient care purposes. The completed education program must be an approved program by the Pennsylvania Department of Health.

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

Contracting Officer’s Representative (COR) - 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 is a member of the vehicle inspection team. All administrative functions remain with the Contracting Officer.

Cardiopulmonary Resuscitation (CPR) - Life saving technique used when an individual stops breathing or their heart stops pumping.

Department of Labor (DOL) - Federal agency that oversees federal labor laws.

Dry Run - Trips made by the Contractor when the VA beneficiary is not available for pick-up.

Emergency Medical Technician (EMT) - EMTs provide basic first aid to patients.

Mileage Rate - Mileage rate for ambulance services is the rate paid for each mile traveled starting on mile 21. This rate applies to one-way transportation only. The contractor shall not receive reimbursement of the mileage rate for trips within 20-mile radius.

Ordering Officer (OO) - Person recognized as being authorized to order transport per this contract.

PA PUC - The Pennsylvania Public Utility Commission (PA PUC) is an organization which oversees public utilities throughout the state of Pennsylvania and sets forth guidelines for wheelchair vans for paratransit services.

Performance Work Statement (PWS) - The PWS describes the expectations and requirements for the Vendor.

Quality Assurance Surveillance Plan (QASP) - The QASP will lay out how CVAMC will monitor and track vendor performance.

Quality Control Plan (QCP) - QCP will describe quality standards for the vendor to follow.

Scheduled Trip(s) - The term “Scheduled Trip” as used in this contract refers to those trips in which the Contractor has been given advance notice (advance notice is defined as notice given by 5:00 p.m. the prior business day) of required services and a specific pick-up time.

Tuberculosis (TB) - A bacterial infection that spreads from person to person.

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) - A national organization dedicated to improving the care, safety, and treatment of patients in a health care facility and environment.

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.

Vehicle(s) - The term “Vehicle(s)” as used in this contract refers to ambulance and Wheelchair Van Transportation provided under the requirements of this contract.

Veteran Transportation Service (VTS) - VTS program is through the VA and provides transport for Veterans to attend scheduled VA authorized medical appointments.

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 in performing contract services. Wait time is paid after the first thirty (30) minute grace period. Invoicing every 15 minutes thereafter.

Waiting Grace Period - The waiting grace period is defined as thirty (30) minutes prior to the time waiting charges commence. The base rate for ambulance services shall include a thirty (30) minute waiting grace period at origin and destination.

Wheelchair VAN (WV) - The term wheelchair is defined as manual or power chairs used by beneficiary for mode of personal transport.

3. Scope/Requirements

3.1. Types of Ambulance Service and Wheelchair Van

3.1.1. The contractor shall provide Emergent, non-emergent Stretcher Transports, Basic Life Support (BLS), Advanced Life Support (ALS), and Critical Care Transport (CCT) Tier 2 ambulance services on an as-needed basis in accordance with all federal, state, and local regulations.

3.1.2. Occasionally a veteran will need to be transported with VA staff and equipment; the contractor shall return VA Staff and equipment to the original place of pick-up.

3.1.3. The contractor shall provide handicap accessible (wheelchair van) transportation services on an as needed basis in accordance with all federal, state, and local regulations including guidelines set by the Pennsylvania Public Utility Commission. The contractor must be able to accommodate both manual and power wheelchairs.

3.1.4. Vehicles must be able to accommodate two standard wheelchairs locked down in place as well as one ambulatory seat with space for a folded wheelchair.

3.1.5. Standard wheelchair securement devices shall not be attached to van doors.

3.1.6. All standard wheelchair restraints (for occupied or unoccupied wheelchairs) shall hold the standard wheelchair stable in all manners of driving. Installation of wheelchair restraints should be installed according to the restraint manufacturer’s installation instructions. After installing the resistant system, the standard wheelchair should be properly positioned and restrained in the vehicle and tested for motion. The standard wheelchair should not be able to move more than 6 inches in any direction while driving under normal conditions. Veterans wrapped in comfort items (blankets and pillows) should be kept to a minimum to ensure the Veteran is securely restrained for safety reasons.

3.1.7. Wheelchair securement systems intended for use while the standard wheelchair is occupied shall not be attached to any part of the standard wheelchair designed for easy removal (e.g., footrest or arm rest), or to the cross member of the standard wheelchair. Patient must always be secured in the standard wheelchair when he/she is being transported to and from vehicle as well as being driven in an Ambulance.

3.1.8. Wheelchair restraints for use by driver of a motor vehicle must be operable (into and out of) the restraint solely by the driver, without the need of assistance. When the standard wheelchair is restrained in the driver’s position, there must be an audible or visual signal to the driver that assures the driver that the wheelchair is fully restrained by the restrain system.

3.1.9. Vehicles equipped with a transfer seat should have a tie-down system to secure the unoccupied wheelchair and be placed in such a position as to allow adequate client transfer. The tie-down must be operable by the client and shall be clearly labeled, “for unoccupied wheelchair only”, unless unit has been safety tested and approved for occupant use.

3.1.10. The only positions acceptable for a wheelchair occupant will be forward facing or side facing, Securement systems for passengers must conform to all other wheelchair tie-down requirements.

3.1.11. A seat belt restraint system must be provided at each driver and passenger position. Anchorages for occupied restrains shall either be directly to the vehicle or be mounted to suitable points on the standard wheelchair or wheelchair restraint, provided that such seat belts comply with the 30 MPH/20G force testing. Do not anchor to any movable or removable parts of the motor vehicle.

3.1.12. Additional chest straps, body positioners, or other equipment may be added where necessary to assist in a client’s balance and stabilization.

3.1.13. All wheelchair securement systems must be installed according to the manufacturer’s specifications and instructions.

3.1.14. Vehicle must be able to accommodate powerchairs and scooters that can be properly secured with restraints.

3.2. Transport of Miscellaneous Items with the Patient

The Contractor may also be required to transport patient luggage, medical records, medication, and comfort items from pickup points to destination at no additional cost to the Government. Luggage to be transported will be restricted to suitcase and valise types. When patients are transported to the CVAMC, destination is deemed to be the ER, Admissions, the clinic, or service within the hospital, or directly to the ward as instructed by VA Staff.

3.2.1 Contractor shall take every reasonable measure to assure that the patient has all their personal belongings. In the event personal items are left in the vehicle in error, contractor shall bring them to the patient immediately when found aboard the vehicle or requested by CVAMC at no cost to the VA.

3.2.2 Contractor shall resolve patient complaints of damage to personal material. Contractor shall be responsible for repair replacement of patient personal property damaged while in the custody of the contractor until delivery and turnover of patient.

3.2.3 Transportation of significant others/caregivers will be arranged in advance with approval from the COR or an ordering official.

3.3. Contractor Personnel: Contractor personnel shall be courteous and always conduct themselves in a businesslike manner while providing services under this contract.

3.3.1. Emergency Medical Technicians (EMTs), Critical Care Transport Paramedics (CCTPs) & Other Personnel

3.3.1.1. EMTs, CCTPs and other medical personnel (as applicable) shall at all times meet the qualifications specified in this contract as well as all applicable federal, state, and local government laws, regulations, and standards. EMTs, CCTPs and other medical personnel (as applicable) shall be certified, licensed, or otherwise officially recognized by the local, state, or regional government or public entity where the emergency service is operated or by which it is governed.

3.3.1.2. If the contractor wishes to add or replace personnel throughout the life of the contract, it shall provide evidence of required training, certifications, licensing, and any other qualifications to the Contracting Officer’s Representative (COR) for review within 15 days.

3.3.1.3. All ambulance drivers shall have a valid driver’s license in accordance with state requirements for their place of operation and the services they perform. If the contractor wishes to add or replace drivers throughout the life of the contract, it shall provide a valid driver’s license to the COR. The Contractor shall ensure that all drivers providing services under this contract shall have less than five (5) current points on their driver’s license, none of which were assessed for “Reckless Driving” or “Driving Under the Influence (DUI).” Contractor shall provide copies of driver licenses to the verify these conditions are met. They should be submitted within 7 days of award and annually. If this contractor wishes to add or replace drivers throughout the life of the contract then a valid driver’s license should be submitted to the COR within 15 days of the personnel starting. CVAMC reserves the right to order the removal of personnel from service under this contract, any driver who violates the provisions of this section.

3.3.1.4. Contractor will ensure that drivers shall:

· Perform their duties with due regard for the safety, comfort and convenience of customers and their property.

· Comply with all applicable Federal and State laws, regulations, and licensing requirements, including drug testing.

· Have and maintain a current Driver's License, valid in the State in which Contractor's facility is located, with less than five current points, none of which were assessed for "Reckless Driving” or “DUI."

· Contact the Contractor's dispatcher before leaving the designated location without picking up the customer(s) and when encountering problems such as customer(s) not being ready, incorrect addresses, or medical emergencies.

· Drivers shall be required to always dress in a professional manner when transporting VA patients and display approved name tag stating the driver's name and Contractor's company name.

· No passengers other than the patient and/or their attendant shall be allowed in the vehicle during transport without approval by an authorized official of the CVAMC.

· Ensure smoking, eating and/or drinking in vehicles is not permitted by passengers or drivers.

· Ensure that no playing / recording of audio/visual equipment in vehicles shall be allowed without the approval of all customers aboard.

· Ensure its personnel comply with 49 CFR (Code of Federal Regulations) Parts 40, 653 and 654 on Substance Abuse Prevention, which are respectively incorporated herein by reference and thus made part of this contract.

3.3.1.5. CCTPs shall have met all state requirements for the tier in which they are performing services in CCT Tier II. Proof in the form of a current certificate for the successful completion of such must be provided to the COR upon request.

3.3.1.6. When conditions, not foreseeable and/or controllable by the Contractor occur, such as but not limited to severe storms, flooding, hazardous road and travel conditions, time and distance requirements shall be considered secondary to safety precautions. Delays or exceptions to the required quality of services shall be reported to the Travel Clerk or AOD after hours. The COR will make a determination as to whether such delays in service will be excused.

3.3.1.7. EMTs, CCTPs, and other contractor personnel as applicable must pass the Contractor’s background check and must not have been convicted of (or have any pending charges for) a felony for the past five years. Personnel (and Contractor) must report any new or additional charges or convictions if they arise during the course of performance under this contract so VA can review them and determine whether the employee in question needs to be discharged of his or her duties until the matter is adjudicated.

3.3.2. Tuberculosis Exposure Control Policy

3.3.2.1. The contractor shall provide the VA with a policy on tuberculosis (TB) exposure and control, to include TB decontamination.

3.3.2.2. The contractor shall have its personnel tested for TB in accordance with state guidelines and provide written confirmation to the COR that all personnel (current employees and any new hires) performing services under this contract are current in their TB test by at the start of each Ordering Period.

3.4. Contractor Equipment, Vehicles, and Inspection

3.4.1. Ambulances shall meet all applicable federal, state, and local regulations and specifications, including but not limited to licensing, registration, and safety standards (KKK-A-1822DD).

3.4.2. The VA reserves the right to inspect the contractor’s equipment and vehicles or require documentation of compliance with state laws, rules, regulations, and guidelines governing emergency medical transport vehicles (ambulances). VA inspections of contractor equipment do not constitute a warranty or guarantee that the contractor’s vehicles and equipment are properly maintained. The VA reserves the right to restrict the contractor’s use of equipment and vehicles in the performance of this contract which are not in compliance with contract requirements. The restriction of such equipment and vehicles shall not relieve the contractor from performance in accordance with the contract nor necessitate additional cost to the VA.

3.4.3. Vehicles shall be clean and maintained in good repair in accordance with manufacturer’s instructions.

3.4.4. All vehicles used in this contract shall:

3.4.5. Have functioning mechanisms, which ensure that all access doors are capable of being opened from the inside and remain closed and secure during travel.

3.4.6. Have a functioning speedometer indicating speed in miles per hour and a functioning odometer correctly indicating distance in tenths of a mile.

3.4.7. Be equipped with operational air conditioning/heating systems. If the air conditioning system becomes inoperable or is unable to maintain temperatures between 68-79 degrees Fahrenheit in the patient compartment, the vehicle must be immediately pulled from service at the termination of the current trip and shall not be used again for service under this contract until the air conditioning/heating system has been repaired.

3.4.8. Have exterior free of grime, oil, or other substances and free from cracks, breaks, dents, and damaged paint that noticeably detracts from the overall appearance of the vehicle.

3.4.9. Be equipped with hubcaps or wheel covers and have all vehicle body molding in place, or if removed, holes must be filled and painted.

3.4.10. Have passenger compartment that shall be clean of dirt and free from torn upholstery or floor coverings, damaged or broken seats, protruding sharp edges and vermin or insects.

3.4.11. Have unobstructed vision on all sides.

3.4.12. Be equipped with an operable two-way mobile radio and/or cellular telephone communication system, which affords contact with the vehicle during all hours of operation.

3.4.13. Beepers are not an acceptable substitute.

3.4.14. Meet all safety and mechanical standards established by State and Federal statutes and regulations.

3.4.15. Not have leaks of any kind.

3.4.16. Have fully charged, certified and non-expired fire extinguisher.

3.4.17. The contractor shall not borrow or exchange supplies, equipment, and/or medications with the VA. Equipment attached to or in use by the patient at time of pick-up may remain with the patient during transport to ensure continuity of care. Medical Control Authorities are responsible for maintaining and supplying medication during patient transport. All VA equipment and unused medications must be returned to VA during patient drop-off or as promptly as feasible within 24 hours.

3.4.18. The contractor shall furnish all linen required for patient transport at no additional cost. Linen shall not be exchanged with linen belonging to CVAMC or its CBOCs.

3.4.19. The contractor must be capable of transporting the drugs and/or equipment as required by the patient as listed in Attachment A Critical Care Transport Capabilities Confirmation. The contractor shall have the appropriate medications, up to and including CCT Tier II if necessary, based on the EMS region the ambulance provider is functioning in.

3.4.20. The contractor shall furnish qualified personnel as required by contract specifications to accomplish all services under this contract.

3.4.20.1. The contractor personnel performing services for the VA, shall, at all times, conduct themselves in a professional manner, and be identified by having the company name, and employee name affixed to the uniform. The Contractor shall be responsible for furnishing all vehicles, uniforms, nametags and/or badges for performance of services under this contract. Employee identifications shall be worn in clear view above the waist. The contractor personnel shall not smoke/play loud music originating from any device in vehicles while transporting VA patients.

3.4.20.2. Each driver shall possess a driver’s license that is valid for the class of vehicle driven. Evidence of a special transportation service vehicle permit, or endorsement issued by the commissioner of public safety.

· Be at least 18 years of age and have not less than one year of experience as a licensed driver; and

· For the past three years:

· Have not had a driver’s license canceled or suspended.

· Have a driving record clear of convictions for operating a motor vehicle or motorcycle without insurance.

· Have a driving record clear of convictions for driving a motor vehicle without a valid current license for the class of vehicle driven

· Have a driving and criminal record clear of convictions for driving under the influence of alcohol or a controlled substance.

3.4.20.3. The contractor personnel will ensure that the patient is secured to the stretcher/cot and that the stretcher /cot is secure in the back of the ambulance before the vehicle moves.

3.4.20.4. Ambulance drivers shall have a valid driver’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 shall have successfully completed the standard and advanced first aid course of the American Red Cross of U.S. Bureaus of Mines of equivalent and be capable of providing necessary medical assistance to the attending emergency medical technician or paramedic.

3.4.20.5. Emergency Medical Technician (EMT) and Paramedic Qualifications: EMT’s and Paramedic’s providing services under this contract shall have the following qualifications, in additions to those required by Federal, State, and Local Government:

· Have completed training in accordance with the standards published by the Department of Health and Human Services with a minimum curriculum of 150 hours 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).

· Shall be certified, licensed, or otherwise officially recognized by the local, state of regional government or public entity where the emergency ambulance service is operated or by which it is governed.

3.5. Transportation Request

3.5.1 VetRide or VA-Approved Transportation Software Utilization:

The contractor agrees to utilize the VetRide Vendor Portal or VA-Approved Transportation Software with every patient transported under this contract.

Department of Veteran Affairs will provide the software and access to the VetRide Vendor Portal or VA-Approved Transportation Software for the vendor/contractor in this contract. The Contractor will utilize the VetRide Vendor Portal or VA-Approved Transportation Software fully as instructed:

a) Receive and respond to electronic trip requests

b) Receive, use, and ensure the use of the Vendor pass by the driver.

c) Submit claims via the electronic HCFA 1500 in the VetRide Vendor Portal or VA-Approved Transportation Software system.

d) All invoices must be submitted within 30 calendar days of date of service in accordance with 38 CFR 70 to be considered timely submission.

i. The contractor’s invoice must be on the HCFA 1500 to include:

ii. Contract Number

iii. Date of Service (to include Box 24 A-J)

iv. Authorization number(s)

v. Pick-up and drop-off location of the patient

vi. Base Rate

vii. Name (Last, First and Middle Initial (if any)) and Full Social Security number (Box 1a) of patient transported

viii. Date of Birth and Sex

ix. Diagnosis Codes or Nature of Illness or Injury

x. Documentation of circumstances when billing for waiting time

xi. Any miscellaneous charges for which the contractor is expecting reimbursement i.e., Tool charges, waiting time, etc.

xii. VA authorizing official’s name

xiii. Healthcare Procedure Coding System/National Level II (HCPCS)

e) Unauthorized charges will be reviewed by the Contracting Officer Representative (COR) as to the validity of the charges and as to whether the payment will be made. A final determination will be made within 30 days after notifying the Contractor of the charges, which are being suspended.

3.5.2 A transportation request is defined as one incidence of a request for one-way service (Stretcher Transports, BLS, ALS, CCT). No more than one patient will be transported per order unless approved by an authorized VA staff. Transportation requests will be made through VetRide or VA-Approved Transportation Software Utilization. Contractors must have the capability to receive orders, update ride status, and input trip costs and other required data through this portal. Contractors must have dedicated staff available to monitor this portal 24/7. CVAMC Travel Program Staff will be available to assist with account setup and training for the Contractor’s Staff. In the event VetRide or other VA-Approved Transportation Software Utilization is down, other methods of communication (i.e., telephone, facsimile) will be used to place Transportation requests.

3.5.2.1 CVAMC Travel Program Staff/or authorized VA employees will work with the Contractor the following business day to reconcile any transportation requests that were placed outside of VetRide or VA-Approved Transportation Software Utilization.

3.5.2.2. The Contractor must update VetRide or VA-Approved Transportation Software Utilization with any data and/or notes in real time that deviate from the original order such as invoicing for additional mileage due to a road closure, wait time, reason for no load, etc. CVAMC Travel Program Staff/or authorized VA employees may place a “hold” on payment of this order until it has been reconciled.

3.5.3. Only the following VA staff are authorized to place, cancel, or make changes to transportation requests:

Contracting Officer’s Representative (COR)

The Contracting Officer will furnish the Contractor with the names of individuals above, who are authorized as Ordering Officers, by separate memorandum upon issuance of the contract. The Contracting Officer will update this list throughout the life of the contract as Ordering Officers change.

Ordering Officers are responsible for issuing and administering orders placed under this contract. Ordering Officers have no authority to modify any term of this basic contract. Any deviation from the terms of the basic contract must be approved in writing by the Contracting Officer responsible for this contract. The Contractor shall accept orders against this contract only from the Contracting Officer and/or authorized ordering officers. Fulfilling orders from persons other than the Contracting Officer or ordering officer may result in loss or delay in payment for supplies/services provided under such orders.

Non-authorized VA employees and private agencies (e.g., nursing homes) are not considered authorized to place transportation requests.

3.5.3.1. All patient pick-up(s) and drop-off(s) shall be authorized via “orders” which shall only be issued by the designated Ordering Officers. When placing orders for services, the Ordering Officer shall contact the designated contractor point of contact(s) to provide the following information:

· Mode of transportation required,

· Required time of arrival

· Name of the beneficiary,

· Pick-up and delivery point,

· Type and number of additional medical care specialists required,

· Type of equipment required,

· Last four of the patient's Social Security Number, and

· Any other special instructions

3.5.3.2. For ALL Transports – an Audit system will be put in place by the VA to include the COR or designee, Beneficiary Travel Department staff, and clinical staff to ensure appropriateness of the order and timeliness of the response.

3.5.3.3. The type of transportation service (Stretcher Transports, BLS, ALS, WV and CCT) required will be discussed and determined by VA clinical personnel and the contractor. The contractor shall transport the patient per its policies and standard industry practice. If the type of transportation service differs from what was agreed upon by the VA and contractor, the contractor shall submit documentation to the VA explaining its rationale.

3.5.3.4. The VA may authorize an escort (e.g., spouse, relative, guardian, etc.) to accompany the patient during medical transport if it is practicable and, in the patient’s, best interest. The contractor shall allow the escort to accompany the patient at no additional cost.

3.5.3.5. The contractor shall have sufficient vehicles and personnel to provide services for up to four (4) simultaneous transportation requests. Transports required may be for any mix of Stretcher Transports, BLS, ALS, and Wheelchair Van transports. One of these four simultaneous transports may require CCT capability up to Tier II. If CVAMC requires transportation services exceeding four (4) simultaneous transportation requests, the vendor will be offered to provide the services if they have sufficient vehicles/personnel available; but may decline these additional orders if sufficient vehicles/personnel are unavailable.

3.5.3.6. The number of transports under normal operating conditions will typically range from 1-4 transports each weekday and significantly less on weekends and holidays. The number of actual transports may vary throughout the life of the contract.

3.5.3.7. The patient may bring with her or him up to three (3) liters of oxygen. The contractor shall be responsible for providing adequate and safe storage of the oxygen tanks during transport.

3.5.3.8. Response Times*- Orders may be placed 24/7/365

3.5.3.8.1. Orders that are scheduled by 5:00 pm local time the day before the required services are defined as scheduled in advance. With the exceptions found below, the contractor shall arrive on time for all orders scheduled in advance.

3.5.3.8.2. Verification and acknowledgment of the upcoming day’s scheduled orders shall be made by Contractor between the hours of 2:00 pm and 3:00 pm, Monday through Friday, excluding holidays, the day prior to the service to be performed. Verification is to be made with the Travel Clerk. Travel Office shall be notified of any delays or cancellations.

3.5.4. Vehicles will be requested on a by-needed basis. CVAMC authorized personnel will call a dedicated vendor dispatch point of contact and request pick-up location, drop-off location and pick-up time. Four (4) vehicles shall be required for services within the CVAMC service area between the hours of 6:00 am and 8:00 pm, Monday through Friday to include all Federal Holidays. Two (2) vehicles shall be required for services within the CVAMC service area between the hours of 8:00 pm and 6:00 am, Monday through Friday to include all Federal Holidays and twenty-four (24) hours per day on weekends, to include all holidays. This vehicle requirement is defined as vehicles in use or in route exclusively for CVAMC patients.

3.5.4.1. Emergent Transport (Originating from VA (Only)): The contractor shall be required to provide Ground Ambulance arrangements within sixty (60) minutes of order/patient pick up call.

3.5.4.2. For all unscheduled (not scheduled in advance) transportation requests, with pick up at CVAMC: The contractor will be allotted up to a sixty (60) minute response time from time of order placement for transportation requests that are not previously scheduled in advance.

a. For an urgent transport request for a critical patient (as deemed by the physician) with pick up at CVAMC, the contractor will be allotted up to a sixty (60) minute response time.

3.5.4.3. For transportation requests which do not have a pick-up at CVAMC:

a. The contractor may be required, if requested by the VA, to dispatch ambulances on short notice for transportation request not scheduled in advance; for these transportation requests the contractor shall dispatch ambulances within sixty (60) minutes of receiving the order.

b. Pick-up appointment times shall be agreed upon by the VA and contractor at time of order placement and be reasonable based upon travel distance, speed limits, and weather conditions.

c. The contractor’s patient pick-up time cannot be more than 15 minutes prior to the schedule pickup time nor 15 minutes later than the scheduled pickup time for transportation requests scheduled in advance.

* The contractor shall not be held liable for nonperformance caused by an occurrence beyond the reasonable control of the contractor and without its fault or negligence such as, acts of God or the public enemy, acts of the Government in its sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions, strikes, and unusually severe weather. The contractor MUST notify the VA with as much advance notice as possible should any of these occur.

3.5.5. Cancellations

3.5.5.1. For trips in which the contractor is notified of cancellation before the vehicle is dispatched, there shall be no charge to the Government.

3.5.5.1.1. A “dry run” is defined as a transportation request which is cancelled after the contractor has dispatched a vehicle, the vehicle is enroute, or has arrived at the pick-up location, and there is no longer a requirement for patient transportation. The contractor may request one-way reimbursement for no-shows. No-show reimbursement shall be based upon the base rate for the type of service requested (Stretcher Transports, BLS, ALS, Wheelchair Van, and CCT) and the one-way mileage (Stretcher Transports, BLS, ALS, Wheelchair Van, and CCT) accrued enroute to the pick-up location at time of cancellation. Mileage for no- show cancellations shall be confirmed by the contractor and reported to the VA as soon as possible from time of cancellation.

3.5.5.2. For transportation requests OUT of CVAMC ONLY – The contractor will immediately dispatch a vehicle upon receipt of the order (including transportation requests in which the final destination may change prior to pick up due to the critical condition of the patient). When the contractor is notified of a cancellation prior to arrival at the CVAMC campus, there shall be no charge to the Government.

3.6. Pick-Up/Drop-Off/Reporting Procedures

3.6.1. Ambulance personnel shall pick-up and deliver patients at specified locations. These locations will be specified by VA staff when an order is placed and communicated to the transporting personnel.

3.6.2. When applicable, Wheelchair Van / ambulance personnel shall report to the VA POC provided at the time of scheduling or Administrative Officer of the Day (AOD) after hours to (1) announce his/her arrival to pick-up and transfer the patient and (2) obtain report of pertinent information regarding the patient’s condition from the primary nurse/physician.

3.6.3. When delivering a patient, ambulance personnel shall give report to the appropriate VA healthcare staff and provide a copy of the run sheet which will be retained by the facility for inclusion to the patient’s medical record.

3.6.4. In cases where ambulance personnel must divert to a local emergency department while performing a VA authorized transport, the contractor’s dispatcher shall notify the VA Beneficiary Travel Department or Administrative Officer of the Day of the patient’s location and status as soon as this information becomes available.

3.7. Patient Welfare

3.7.1. The contractor shall be responsible for the patient’s welfare during transport. The contractor shall be held responsible for patient and/or VA property during transport. Any damaged or lost wheelchairs, walkers, crutches, or personal belongings shall be replaced at the contractor’s expense.

3.7.2. The VA requires the contractor to exercise extreme caution and care in the handling of patients.

3.7.3. If a VA beneficiary being transported declines to be properly secured or removed the securement devices himself/herself, the driver will notify the Contracting Officer’s Representative (COR) / Ordering Official of this fact prior to departure. The contractor is not required to transport any VA beneficiary who refuses to be properly secured while being transported. In the event that the beneficiary refuses to be properly secured, they shall be returned back into the building which they came from.

3.8. Incident Reporting

3.8.1. The contractor shall notify the COR, Requestor, Program Manager, Beneficiary Travel Department, of any accidents and/or safety problems that occur while the patient is being transported. If incident occurs after hours (after 4:30), contractor shall notify campus police. This notification shall occur within one (1) hour by telephone. A written report of the incident shall be delivered to the COR, Program Manager, or Beneficiary Travel Department, within 24 hours of incident.

3.8.2. The COR will monitor the service provided. The contractor shall cooperate with the COR in providing information and answering questions in a timely manner. The contractor shall promptly inform the COR of any complaints received directly from patients. If warranted, the VA may conduct incident investigations and require written response from the contractor within 48 hours of request.

3.8.3. Complaints against driver’s behavior or courtesy will be taken by CVAMC and may result in requiring Contractor to remove offending driver(s) from the provisions of contracted services. Drivers who accumulate five (5) unrelated, substantiated complaints in a 12-month period shall be prohibited from providing any further services under this contract. If a complaint is of a severe nature, the COR has the right to prohibit driver from performing service under the contract.

3.9. Invoicing

3.9.1. Each transport shall include thirty (30) minutes of wait time; the contractor may invoice for wait times in excess of this initial thirty (30) minutes. Wait time shall begin only once the contractor has both reached the pick-up address location and the appointment time has elapsed. All wait times shall be itemized and invoiced in fifteen (15) minute intervals. For partial fifteen (15) minute intervals, zero (0) to seven (7) minutes shall be rounded down to zero (0) minutes and eight (8) to fifteen (15) minutes rounded up to fifteen (15) minutes.

3.9.2. When invoicing for mileage, the contractor shall round to the nearest mile. Mileage ending in .5 or higher shall be rounded up to the nearest mile. Mileage ending in .4 or lower shall be rounded down to the nearest mile. Payment for mileage to or from the point of care shall be limited to the VA’s calculation according to the VA’s Bing Maps API determination. Bing Maps API is optimized to determine mileage based on the shortest time of travel.

3.9.3. Except for dry runs and trips when, the contractor shall invoice for loaded (patient onboard) services and mileage only.

3.9.4. Upon notification of the contracting officer, the vendor must receive training and begin implementation of invoices via Vet Ride within 30 days versus VA Tungsten Network e-Invoicing network. Invoices must be submitted via the electronic HCFA 1500 in the VetRide Vendor Portal or other VA approved software. These invoices shall not include patient information, but shall include the following:

· Contractor Name

· Contract Number

· Current Purchase Order Number

· Date of service

· Total amount invoiced including a summary of the total number of charges that align with the line items of this contract (i.e., total number of BLS Base Rate, total BLS Mileage incurred, etc.)

· An itemized list of charges or services rendered that align with the line items of this contract (i.e., BLS Base Rate, BLS Mileage incurred, etc.)

3.9.5 For the purposes of this contract, dry runs are defined as trips made by the Contractor when the VA beneficiary is not available for pick-up.

3.9.7 The Contractor will be reimbursed one way at the full contract amount for dry runs. This charge will not be allowed if the trip is canceled by authorized VA personnel within two (2) hours before the scheduled pick-up time.

3.9.8 Other Charges-It is understood that the prices listed in the accepted Schedule of Supplies or Services and Prices/Costs shall be inclusive of all ferry, bridge, tunnel, or road toll charges. Contractor shall not bill the CVAMC for any such separate charges.

Payment by VA under this contract to a provider of wheelchair van and ground ambulance transportation services authorized under this contract extinguishes all liability on the part of the VA BENEFICIARY for that transportation service. UNDER NO CIRCUMSTANCES ARE VA BENEFICIARIES, THIRD PARTY INSURANCES, MEDICARE, OR MEDICAID TO BE BILLED FOR THE SERVICES PERFORMED UNDER THIS CONTRACT.

4. Place of Performance

4.6. The Place of Performance is variable and may occur within the states of Pennsylvania, Delaware, and New Jersey ambulance services may be required to or from locations including, but not limited to the following:

4.6.1. Coatesville VA Medical Center to include specific Atrium Clinics, Emergency Department, pavilions, or out-buildings on the CVAMC campus. The CVAMC address is: 1400 Blackhorse Hill Road, Coatesville, PA 19320.

4.6.2. CVAMC Community-Based Outpatient Clinics (CBOCs):

4.6.3. Other VA Medical Centers, Hospitals, or CBOCs within Veterans Integrated Service Network (VISN) 4 including, but not limited to:

4.6.4. Other Non-VA Medical facilities and Community Care facilities as authorized by the VA.

4.6.5. Veteran’s residence.

4.6.6. Local airports including Philadelphia International Airport.

5. Quality Control Plan

5.1. Quality Control

5.1.1. The contractor shall maintain a Quality Control Plan (QCP) that contains, at a minimum, the following:

5.1.1.1. A description of the company’s organizational structure including a description of the roles and responsibilities of management and supervisors.

5.1.1.2. A description of the methods to be used by the contractor for identifying and preventing deficiencies or problems in the quality of service.

5.1.1.3. A description of the specific steps the contractor will take for corrective action if needed if a deficiency or problem in the quality of service occurs.

5.1.1.4. A description of the company’s records and tracking system used to identify up-to- date background checks, applicable certifications and tests, and training of each employee performing services under this contract.

5.1.1.5. A description of the method used to provide on-time ambulance services to meet the requirements of this contract (24/7 availability and up to 4 simultaneous transports in accordance with PWS 3.5.1.6).

5.1.1.6. A description of the methods used to identify and prevent radio communication breakdowns and a detailed procedure for alternative communications in the event of electronic and mechanical breakdown of vehicle two-way radios.

5.1.1.7. CONTENGENCY PLAN: (In case VetRide Vendor Portal is down) A description of the method/system used to log all requests for service. The contractor shall confirm that the log indicates the date and time of service call, actual time of pick-up versus the scheduled time, name of patient requiring services, designated pick-up and delivery points, mileage, and actual waiting time at pick-up and delivery points if waiting charges are claimed. The contractor shall confirm the log will be sent to the COR monthly.

5.1.2. The Government will evaluate the contractor’s performance under this contract to ensure that the contractor’s QCP is adequate, and that quality is achieved through a Quality Assurance Surveillance Plan (QASP).

5.1.3. The Government shall prepare a QASP after contract award derived from the PWS and contractor’s submitted quality control plan. The QASP is a “living document” and the Government may review and revise it at any time. However, the Government shall coordinate changes to the QASP with the contractor.

5.1.4. The QASP will specify the work requiring surveillance and the Government’s method of surveillance.

6.2 Deliverable

6.2.1 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.

6.2.2 The following are brief descriptions of required documents that must be submitted by Contractor: weekly; monthly; quarterly; annually, etc. Identified throughout the PWS and is provided here as a guide for Contractor convenience. If an item is within the PWS and not listed here, the Contractor remains responsible for delivery of the item.

Task 3.3.1.1 and 3.3.1.2- Emergency Medical Technician (EMT) and Paramedic Qualifications

7 days after award, Annually, Upon request, and /or within 15 days of changes

POC/Designee

Task 5.0 Contractor’s Quality Control Plan

Task 11 Certification of Minimum Liability Insurance Coverage

5.2. Minimum Performance Standards

5.2.1. The contractor shall maintain performance standards in accordance with the standards outlined in the table below. Failure to meet the Acceptable Quality Levels (AQL) may result in termination of the contract.

5.2.2. The QASP will include the standards below as well as others derived from the successful offeror’s quality control plan.

Reference

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