Attachment B - Altoona Ambulance QASP.docx

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Attached to
V225--Altoona Ambulance
Solicitation number
36C24423Q0850
Issued by

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This document outlines a Quality Assurance Surveillance Plan (QASP) for ambulance services to be provided to the Altoona VA Medical Center. The contractor will be evaluated on key performance measures such as certification and training, vehicle maintenance and safety, response time, invoice procedures, and quality control. Performance will be assessed through methods like direct observation, random sampling, and periodic inspections. The QASP defines performance standards, acceptable quality levels, and incentives/deductions tied to ratings. It also establishes roles for contracting personnel and procedures for documenting performance issues. The related federal contract opportunity is solicitation number 36C24423Q0850 for ambulance services through the Veterans Health Administration VISN 4 office to support the Altoona VA Medical Center.

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Contract Description: Contractor shall provide Ambulance Services to eligible beneficiaries of the Altoona VA Medical Center, Altoona, PA.

Contractor’s Name: To Be Determined

The contractor will be evaluated in accordance with the following:

1. PURPOSE

This Quality Assurance Surveillance Plan (QASP) provides a systematic method to evaluate performance for the stated contract. This QASP explains the following:

· What will be monitored?

· How monitoring will take place.

· Who will conduct the monitoring?

· How monitoring efforts and results will be documented.

This QASP does not detail how the contractor accomplishes the work. Rather, the QASP is created with the premise that the contractor is responsible for management and quality control actions to meet the terms of the contract. It is the Government’s responsibility to be objective, fair, and consistent in evaluating performance.

This QASP is a “living document” and the Government may review and revise it on a regular basis. However, the Government shall coordinate changes with the contractor through contract modification. Copies of the original QASP and revisions shall be provided to the contractor and Government officials implementing surveillance activities.

2. GOVERNMENT ROLES AND RESPONSIBILITIES

The following personnel shall oversee and coordinate surveillance activities.

a. Contracting Officer (CO) – The CO shall ensure performance of all necessary actions for effective contracting, ensure compliance with the contract terms, and shall safeguard the interests of the United States in the contractual relationship. The CO shall also assure that the contractor receives impartial, fair, and equitable treatment under this contract. The CO is ultimately responsible for the final determination of the adequacy of the contractor’s performance.

Assigned CO: To Be Determined (Administrative Contract Specialist) Organization or Agency: Network Contracting Office (NCO) 4, U.S. Department of Veterans Affairs

b. Program Point of Contact (POC) – The POC is responsible for technical administration of the contract and shall assure proper Government surveillance of the contractor’s performance. The POC shall keep a quality assurance file. The POC is not empowered to make any contractual commitments or to authorize any contractual changes on the Government’s behalf.

Assigned POC: To Be Determined Organization or Agency: Altoona VA Medical Center

3. CONTRACTOR REPRESENTATIVES

The following employee(s) of the contractor serve as the contractor’s program manager(s) for this contract.

Primary: To Be Determined Alternate: To Be Determined

4. PERFORMANCE STANDARDS

The contractor is responsible for performance of ALL terms and conditions of the contract. POCs will provide contract progress reports quarterly to the CO reflecting performance on this plan and all other aspects of the resultant contract. The performance standards outlined in this QASP shall be used to determine the level of contractor performance in the elements defined. Performance standards define desired services. The Government performs surveillance to determine the level of Contractor performance to these standards.

The Performance Requirements are listed below in Section 6. The Government shall use these standards to determine contractor performance and shall compare contractor performance to the standard and assign a rating. At the end of the performance period, these ratings will be used, in part, to establish the past performance of the contractor on the contract.

5. INCENTIVES/DEDUCTS

The Government shall use past performance as incentives. Incentives shall be based on ratings received on the performance standards.

6. METHODS OF QA SURVEILLANCE

Various methods exist to monitor performance. The POC shall use the surveillance methods listed below in the administration of this QASP.

a. DIRECT OBSERVATION. This observation will need to be accomplished via the Chief of the Service Line as this requires clinical expertise regarding the patient safety measure.

b. RANDOM SAMPLING. For example, ten (10) randomly selected patient files will be reviewed per quarter. All reviews and reports will be conducted in compliance with VA Privacy and Information security standards.

Quality Assurance Surveillance Plan (QASP)

PERFORMANCE MEASURES

Measures
PWS

Reference Performance Requirement

Standard
Acceptable Quality Level
Surveillance

Method

Incentive
Disincentive/Deduct
Certification & Training
5.2 Contractor Personnel Qualifications
Contractor/employee to maintain current proper licenses and ensure all attendants are properly trained and competent to provide service.
All (100%) contractor/employee are properly certified.
100%, no deviations
Random Sampling
Favorable contactor performance evaluation.
Contractor employee shall be removed from providing services until proof of proper certificates/licensing requirements are met.

Unfavorable contractor performance evaluation.

Vehicle Maintenance & Safety
5.6 Contractor Equipment, Vehicles and Inspection
All vehicles shall be in proper condition and fit for patient and public safety.
All (100%) vehicles must be current on all maintenance and safety aspects.
100%, no deviations.
Random Surveillance and Periodic Inspection
Favorable contactor performance evaluation.
Unfavorable contractor performance evaluation.
Response Time
5.9 Response Time
Ground ambulance transport services performed in accordance with PWS requirements.
All (100%) services performed as required.
95% accepted.
Random Inspection of qualification documents. Review trip tickets with medical center requests.
Favorable contactor performance evaluation.
Unfavorable contractor performance evaluation.

Invoice Procedure

5.14. Invoice Procedure

Contractor must provide monthly reports and trip tickets in accordance with PWS requirements.
All (100%) monthly reports submitted within 10 calendar days following the end of the month of service.
Contractor must submit the required documents of performed services on time 95% of the time
Periodic Sampling and Inspection
Favorable contactor performance evaluation.

Unfavorable contractor performance evaluation.

Quality Control
8.0 Contractor’s Quality Control Program
Maintain and complete QCP, to include an inspection plan to ensure that the requirements of the contract are provided as specified in the PWS.
All (100%) of all aspects of the contract are performed as required and the QCP is maintained to ensure satisfactory performance.
Contractor must ensure that use of QCP is maintained 95% of the time.
Periodic Sampling and Random Sampling
Favorable contactor performance evaluation.
Unfavorable contractor performance evaluation.

7. RATINGS

Metrics and methods are designed to determine rating for a given standard and acceptable quality level. The following ratings shall be used:

EXCEPTIONAL:
Performance meets contractual requirements and exceeds many to the

Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Note: To justify an Exceptional rating, you should identify multiple significant events in each category and state how it was a benefit to the GOVERNMENT. However a singular event could be of such magnitude that it alone constitutes an Exceptional rating. Also there should have been NO significant weaknesses identified.

VERY GOOD:
Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Note: To justify a Very Good rating, you should identify a significant event in each category and state how it was a benefit to the GOVERNMENT. Also there should have been NO significant weaknesses identified.

SATISFACTORY:
Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

Note: To justify a Satisfactory rating, there should have been only minor problems, or major problems the contractor recovered from without impact to the contract. Also there should have been NO significant weaknesses identified.

MARGINAL:
Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.
Note: To justify Marginal performance, you should identify a significant event in each category that the contractor had trouble overcoming and state how it impacted the GOVERNMENT. A Marginal rating should be supported by referencing the management tool that notified the contractor of thecontractual deficiency (e.g. Management, Quality, Safety or Environmental Deficiency Report or letter).
UNSATISFACTORY:
Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.
Note: To justify an Unsatisfactory rating, you should identify multiple significant events in each category that the contractor had trouble overcoming and state how it impacted the GOVERNMENT. However, a singular problem could be of such serious magnitude that it alone constitutes an unsatisfactory rating. An Unsatisfactory rating should be supported by referencing the management tools used to notify the contractor of the contractual deficiencies (e.g. Management, Quality, Safety orEnvironmental Deficiency Reports, or letters).

8. DOCUMENTING PERFORMANCE

a. The Government shall document positive and/or negative performance. Any report may become a part of the supporting documentation for any contractual action and preparing annual past performance using CONTRACTOR PERFORMANCE ASSESSMENT REPORT (CPAR).

b. If contractor performance does not meet the Acceptable Quality level, the CO shall inform the contractor. This will normally be in writing unless circumstances necessitate verbal communication. In any case the CO shall document the discussion and place it in the contract file. When the POC and the CO determines formal written communication is required, the POC shall prepare a Contract Discrepancy Report (CDR), and present it to CO. The CO will in turn review and will present to the contractor's program manager for corrective action.

The contractor shall acknowledge receipt of the CDR in writing. The CDR will specify if the contractor is required to prepare a corrective action plan to document how the contractor shall correct the unacceptable performance and avoid a recurrence. The CDR will also state how long after receipt the contractor has to present this corrective action plan to the CO. The Government shall review the contractor's corrective action plan to determine acceptability. The CO shall also assure that the contractor receives impartial, fair, and equitable treatment. The CO is ultimately responsible for the final determination of the adequacy of the contractor’s performance and the acceptability of the Contractor’s corrective action plan.

Any CDRs may become a part of the supporting documentation for any contractual action deemed necessary by the CO. See Sample CDR below.

CONTRACT DISCREPANCY REPORT

1. CONTRACT NUMBER
2. REPORT NUMBER FOR THIS DISCREPANCY
3. TO: (Contracting Officer)
4. FROM: (Name of POC)

5. DATES

a. CDR PREPARED

b. RETURNED BY CONTRACTOR:
c. ACTION COMPLETE

6. DISCREPANCY OR PROBLEM (Describe in detail. Include reference to PWS Directive; attach continuation sheet if necessary.)

7. SIGNATURE OF POC
Date:
8. SIGNATURE OF CONTRACTING OFFICER
Date:
9a. TO (Contracting Officer)
9a. FROM (Contractor)

10. CONTRACTOR RESPONSE AS TO CAUSE, CORRECTIVE ACTION AND ACTIONS TO PREVENT RECURRENCE. (Cite applicable quality control program procedures or new procedures. Attach continuation sheet(s) if necessary.)

11. SIGNATURE OF CONTRACTOR REPRESENTATIVE
Date:

12. GOVERNMENT EVALUATION. (Acceptance, partial acceptance, reflection. Attach continuation sheet(s) if necessary.)

13. GOVERNMENT ACTIONS (Acceptance, partial acceptance, reflection. Attach continuation sheet(s) if necessary.)

14. CLOSE OUT

NAME
TITLE
SIGNATURE
DATE

CONTRACTOR NOTIFIED

POC

CONT. OFFICER

9. FREQUENCY OF MEASUREMENT

a.Frequency of Measurement. The frequency of measurement is defined in the contract or otherwise in this document. The government (POC or CO) will periodically analyze whether the frequency of surveillance is appropriate for the work being performed.
b.Frequency of Performance Reporting. The POC shall communicate with the Contractor and will provide written reports to the Contracting Officer quarterly (or as outlined in the contract or POC delegation) to review Contractor performance.

10. POC AND CONTRACTOR ACKNOWLEDGEMENT OF QASP

SIGNED:

Contracting Officer Representative

SIGNED:

Contractor Representative

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