Ambulance_QASP_23_June_17.doc

Quality Assurance Surveillance Plan

Ambulance Service Contract 23 June 2017 Contractor Name

Contract Number

1. PURPOSE: This Quality Assurance Surveillance Plan (QASP) is a government-developed document used to determine if the contractor’s performance meets the performance standards contained in the contract. The QASP establishes procedures on how this assessment/inspection process will be conducted. It provides the details associated with a continuous oversight process, to include:

· What will be monitored

· How monitoring will take place

· Who will conduct the monitoring

· How monitoring efforts and results will be documented

The contractor is responsible for implementing and delivering performance that meets contract standards using its own quality control plan. The QASP provides the structure for the government’s surveillance of the contractor’s performance to ensure that it meet contract standards. It is the government’s responsibility to be objective, fair and consistent in evaluating contractor performance.

The QASP is not part of the contract nor is it intended to duplicate the contractor’s quality control plan. This QASP is a living document. Flexibility in the QASP is required to allow for an increase or decrease in the level of surveillance necessary based on contractor performance.

Copies of the QASP and any revisions shall be provided to the contractor and the Contracting Officer's Representative (COR) to facilitate implementation of surveillance activities. In addition, the QASP should recognize and accommodate unforeseen or uncontrollable circumstances which might occur that are outside the control of the contractor.

2. AUTHORITY: Generally, authority for issuance of this QASP is provided under Part 46 of the Federal Acquisition Regulation (FAR), Inspection of Services clauses, which provide for inspection, acceptance and documentation of the service called for in the contract or order. If commercial, quality assurance will be applied in accordance with commercial items clause.

The Inspection of Services Clause requires the contractor to establish and maintain an inspection system acceptable to the Government. And, the Government has the right to inspect at any time without unduly delaying work. The following FAR clause applies to this acquisition:

FAR 52.212-4, Commercial Items. The government may require repair or replacement of nonconforming services at no increase in price. If repair or replacement will not correct the defects or is not possible, the Government may seek an equitable price reduction or adequate consideration for acceptance of nonconforming services.

FAR 52.246-4, Fixed Price

· Contractor shall provide and maintain an inspection system acceptable to the Government.

· Contractor inspection records shall be provided to the COR upon request.

· Government has the right to inspect and test all services at any time without unduly delaying work.

· If any work does not conform to contract requirements, the Government may require the Contractor to re-perform at no additional cost

· When defects cannot be corrected through re-performance, the Government may:

· Require the contractor to take necessary action to ensure that future requirements meet contract standards and reduce contract price to reflect the reduced value of the services performed.

· If the contractor fails to promptly to act, the Government may by contract or otherwise, perform the services again and charge the contractor for any cost incurred by the Government that is directly related to the performance of service.

3. Government Roles and Responsibilities: The following personnel shall oversee and coordinate surveillance activities.

a. Contracting Officer (CO)/Buyer: 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 PCO:

Assigned CO:

Organization:

Organization:

Telephone:

Email:

b. Contracting Officer’s Representative (COR): The COR is responsible for providing continuous technical oversight of the contractor’s performance. The COR uses the QASP to conduct the oversight/surveillance processes. The COR shall keep a Quality Assurance file that accurately documents the contractor’s actual performance. The purpose is to ensure that the contractor meets the performance standards contained in the contract. The COR is responsible for early identification and reporting of performance problems to the CO. The COR is required to provide an annual performance assessment to the CO which will be used in documenting past performance. The QASP is the primary tool for documenting contractor performance. The COR is not empowered to make any contractual commitments or to authorize any contractual changes on the government’s behalf.

Assigned COR:

Chiquetta Stovall Organization:

78 MDSS/SGSM

Telephone:

(478) 327-8333 chiquetta.stovall@us.af.mil

c. Quality Assurance Program Coordinator: The QAPC is responsible to ensure pre-award documents are performance based and that the COR are adequately trained to perform surveillance. In addition, the QAPC coordinates the gathering of contractor performance data to prepare Annual Health of Services review and SDO Annual Execution Reviews.

Assigned QAPC: Beverly “Tina” Gray

Organization: AFSC/PZIOP-R Telephone: 478-468-2554 Email: Beverly.Gray@robins.af.mil

4. Contractor Representatives:

The following employees of the contractor serve as the contractor’s Program Manager and Task Manager for this contract.

Program Manager:

5. Performance Standards and METHOD OF SURVEILLANCE:

5.1 CONTRACT SURVEILLANCE: The goal is to ensure contractor performance is effectively monitored and documented. The COR’s contribution is a professional, non-adversarial relationships with the CO, PM and the contractor, which enable positive, open and timely communications. The foundation of this relationship is built upon objective, fair, and consistent COR evaluations of contractor performance against contract requirements. The COR uses the methods to ensure the contractor is in compliance with contract requirements. The COR function is responsible for a wide range of surveillance requirements that effectively measure and evaluate the contractor’s performance. Additionally, this QASP is based on the premise that the contractor, not the government, is responsible for management and Quality Control/Quality Assurance actions successfully meet the terms of the contract. Performance standards define desired services. The government performs surveillance to determine if the contractor exceeds, meets, or does not meet these standards.

The Services Summary listed in the Performance Work Statement includes both performance objectives and performance standards. The government shall use these standards to determine contractor performance and shall compare contractor performance to the Performance thresholds which represent the Acceptable Quality Levels (AQLs). The Services Summary outlines the performance objectives that must be performed and standards that met by the contractor and details the method of surveillance the COR will use to validate and inspect these performance elements. Inspection of each element will be documented in the COR/Quality Assurance file. Performance objectives define the desired outcomes. Performance Standards define the level of service required under the contract to successfully meet the performance objective. The inspection methodology defines how, when, and what will be assessed in measuring performance..

Ref

Transfer Patient to Higher Level of Care

5.2 MEASUREMENT:

a. Objective: Respond to emergencies Threshold: withing 7 minutes for primary and 12 minutes for secondary back up response. This standard must be met 90% of every call.

Report(s): State of GA run sheet

Documentation Frequency: Daily Process: FRED will submit to 78 MDG/Chief of Medical Staff for review

b. Objective: Prepare run sheets & DD form 2569 Threshold: delivered each Monday for prior week Report(s): run sheets & DD form 2569

Documentation Frequency: Weekly Process: FRED will submit to 78 MDG/ Chief of Medical Staff for review

c. Objective: Transfer Patient to Higher Level of Care

Threshold: within 2 hours Report(s): phone call to RAFB Command Post at 478-327-2612

Documentation Frequency: each Patient Transfer to higher level of care Process: during phone call provide the following: patient name, time of arrival, and name of the hospital that received the patient

d. Objective: Contractor Safety Program

Threshold: No more than two Class C mishaps per contract year and zero class A or B mishaps will be tolerated.

Report(s): Accident/Incident Report Documentation Frequency: Each mishap must be reported within 24 hours Process: Per instruction provide on Appendix C complete a safety mishap/incident report within 24 hours of mishap.

5.3 CONTRACTOR’S PERFORMANCE ASSESSMENT REPORT (CPAR):

(If Applicable) In evaluating the quality of contractor’s performance, the following performance ratings are used in documenting past performance. The areas rated may include: Quality of Service, Business Relations, Management, Cost Control (if applicable), and Schedule.

Performance

Rating Criteria

5.4 COR FILE DOCUMENTATION: COR must be CORT compliant. The following will be uploaded in CORT Tool

· Certificates -

· QAPC Led and CO Led Training

· DAU Training

· CLC 106, COR with a Mission Focus (Type A) or

· CLC 222 Contracting Officer Representative Course(Type B/C)

· CLC 046, Green Procurement

· CLM 003, Ethics for Acquisition Technology and Logistics (annual)

· DOD 002, Combating Human Trafficking

· Wide Area Workflow

· Nomination , Designation and Termination COR Letters

· Certificate of Supervisor Training

· Surveillance Documentation

· Performance Assessment Report (PAR)

· Corrective Action Report (CAR)

· MTF Meeting Minutes

· Any other documentation generated in performance of COR duties

· Copies of applicable modification(s)

· Invoice documentation (WAWF)

· Data submittals (CDRLs)

· EMS Training Certificates of Contractor Personnel

· Monthly Status Reports (if applicable) IAW PGI 222.1703 – The COR will ensure that the contractor is in compliance with FAR clause 52.222-50 - Combating Trafficking in Persons.

6. Performance Reporting 6.1PERFORMANCE ASSESSMENT REPORT (PAR): Routine surveillance will be documented on a Performance Assessment Report. All performance will be measured and noted on the PAR. The contractor will initial the PAR to document acknowledgement of the inspection conducted. A report template is attached. Any report may become a part of the supporting documentation for fixed fee payments, award fee payments, or other actions.

6.1 CORRECTIVE ACTION REPORT (CAR): For repeated instances of non-performance or for any issue involving safety or security, a CAR will be initiated by the COR. The contracting officer formally issues the CAR to the contractor for corrective and preventive action. The contractor shall acknowledge receipt of the CAR in writing. The contractor shall prepare a corrective action plan to document how to correct the unacceptable performance and avoid recurrence. The government shall review the contractor's corrective action plan to determine acceptability. A CAR becomes a part of the official contract file and will be used as a record of negative past performance.

6.2 INITIAL CONTRACT PERFORMANCE REVIEW: Within 30 days of award or when performance begins, the COR shall notify the Services Designated Official with information on contractor performance. The initial review shall answer the following questions:

· Is the contract fully operation and successful?

· Is the contract within estimated cost, schedule and performance baselines?

· Any potential risk or performance issues?

Additionally, the Government will, on a quarterly basis will present performance data to the Services Designated Official (SDO) responsible for the acquisition of services.

6.4 PERFORMANCE ASSESSMENT MEETINGS. The contractor and the government shall meet to discuss performance progress and issues. The frequency of performance assessment meetings are monthly and an email to all pertinate MTF members is suffient to be in compliance with AFI 63-138.

________________________COR _______________________QAPC

_________________________CO ____________________Contractor

PERFORMANCE ASSESSMENT REPORT (PAR)

(If more space is needed, use reverse and identify by number)

4. CONTRACTING OFFICER'S REP (COR) SIGNATURE AND DATE

I. PERFORMANCE

7. FORMCHECKBOX

DEFICIENCY (CHECK ALL BOXES THAT APPLY)

FORMCHECKBOX

NEW

FORMCHECKBOX

REPEAT

FORMCHECKBOX

NO DEFICIENCY NOTED

8. SERVICES SUMMARY or PWS PARAGRAPH ITEM REVIEWED

II. CONTRACTOR VALIDATION

11. CONTRACTOR REPRESENTATIVE FORMCHECKBOX

CONCUR FORMCHECKBOX

NON-CONCUR

12. CORRECTIVE ACTION ESTIMATED COMPLETION DATE

13. CONTRACTOR REPRESENTATIVE CORRECTIVE ACTION AND PREVENTION OF RECURRENCE OR REASON FOR NON-CONCURRENCE OF COR CITED DEFICIENCY

III. ACTION CORRECTED

14. FORMCHECKBOX

CONCUR FORMCHECKBOX

NON-CONCUR COR SIGNATURE AND DATE

15. COR REMARKS (REQUIRED)

6. CONTRACTOR REPRESENTATIVE REMARKS

CORRECTIVE ACTION REPORT (CAR)

(If more space is needed, use reverse and identify by number)

1. CONTRACTOR

2. CONTRACT NUMBER

3. TYPE OF SERVICES

4. FUNCTIONAL AREA

5. SUSPENSE DATE

6. CONTROL NUMBER

7. DEFICIENCY FORMCHECKBOX

MAJOR FORMCHECKBOX

MINOR

FINDING:

FINDING IMPACT:

Please respond with a written corrective action plan that details the corrective action of the cited deficiency, the cause of the deficiency, and actions taken to prevent recurrence by Suspense Date in Block 5. If date was not entered in Block 5, the contractor is not required to provide a response.

8. CONTRACTING OFFICER REPRESENTATIVE (COR)

TYPED NAME AND GRADE

SIGNATURE AND DATE

9. ISSUING AUTHORITY

TYPED NAME AND GRADE

SIGNATURE AND DATE

10. COR RESPONSE TO CONTRACTOR CORRECTIVE ACTION AND ACTION TAKEN TO PREVENT RECURRENCE

11. COR DETERMINATION

FORMCHECKBOX

ACCEPTED FORMCHECKBOX

REJECTED

12. CLOSE DATE