Attachment A - Ambulance Contract Questions and Answers v6_29 Oct 25.pdf

1. Does the Government require the contractor to possess an established Emergency Medical Services (EMS) license with the State of Colorado specifically as a ground ambulance service provider in accordance with Colorado Department of Health and Environment EMS licensing under the authority of SB22-225 for this upcoming contract, in addition to the individual EMT and Paramedic licenses? (Ref:

https://cdphe.colorado.gov/emergency-care/ground-and-air-ambulance/ground-ambulance-licensing & https://leg.colorado.gov/bills/sb22-225).

a. Yes.

2. We define a dedicated ambulance as a unit stationed specifically for a required contract's use, meaning it cannot respond to any calls that do not fall under that specific contract. Could the Government confirm if this definition aligns with their intent for the dedicated ambulance mentioned in the PWS, or provide their specific definition of a "dedicated ambulance" or "dedicated unit" in the context of this contract?

a. Concur with definition.

3. Is it the Government's intent to have two dedicated ambulances, one at Peterson

SFB and one at Schriever SFB, operating on a 24/7 schedule specifically for this contract, with at least one additional unit available for backfill support to cover both installations in the event of simultaneous responses, equipment failures, or other unforeseen circumstances?

a. Yes.

4. Section 1 of the PWS states that “The contractor shall furnish all labor, management, supervision, vehicle, supplies, equipment, transportation, and reports, except as provided in paragraph 1.9, Government- Furnished Property.” However, section 1.9 of the PWS refers to Contractor Manhour Reporting. Could the government please clarify which items or resources are considered "Government- Furnished Property"?

a. Paragraph 1.10 is government-furnished property. An administrative change made in section 1 of PWS. [PWS updated 23 Oct 25]

5. For the response time goal of 90% within eight (8) minutes and 10% within twelve

(12) minutes, is this metric calculated on a per-incident basis, or is there an aggregate monthly target for all emergent responses? Is it the intent for response time goals to align with DoDI 6055.06 conformance metrics which are similar to NFPA standards?

a. This metric will be calculated monthly, with the percentage of aggregated response times falling within expected parameters used to measure success. Response times will be averaged at each base (Peterson and Schriever), not as a total average between bases.

b. Response time performance goals have been deemed appropriate by Chief of Aerospace Medicine.

6. For the "additional backfill ambulance vehicle" required at both Peterson Space

Force Base (PSFB) and Schriever Space Force Base (SSFB), what is the expected response time for deployment, and under what specific conditions, beyond mechanical issues, would it be required? Does the government anticipate extra-unit hours for certain scheduled large gathering events? (may also apply to Q18 below, see infra.)

a. When an of-base transfer occurs, the expectation is that another ambulance is provided to backfill this capability. Contact with dispatch should be documented upon determination that an of-base transfer is required and backfill support should be in place no more than 30 minutes post-departure of primary ambulance.

7. What are the anticipated frequency, typical duration, and specific personnel/ambulance requirements for participation in PSFB and SSFB exercises, special events, sports/athletic events, specialized training, and in-flight emergencies?

a. See chart below:

Response types - annual Schriever Peterson Notes

Fire Department-only exercises

Duration 30-45 minutes (typical)

Specialized training - live fire firefighter training

Duration 1-3 hours (typical)

In-flight & ground emergency responses

6-12 IFEs per year

Duration 15-45 minutes (typical)

Medical calls received

Varies

Base-wide major accident exercises

Duration 3-5 hours (typical)

8. Regarding the development and approval of "protocols developed by the contractor’s physician advisor in cooperation with representatives from local Fire Departments and the closest hospital with capability," could the Government elaborate on the process for identifying the "closest hospital with capability" and the approval workflow for these protocols?

a. EMS personnel will collaborate with Chief of Aerospace medicine, 21 MDG, or designee to determine closest hospital with capability, as required.

9. We hold contracts where the government provides the training for "Special Flight Line Driving Certification," and contracts where we (as contractor) provide the training for "Special Flight Line Driving Certification." Who will be providing the training for this certification and what is the certification expectation for the contractor and expected time commitment (in training hours) for individual employees?

a. EMS is not required to complete flightline/airfield driver’s training because the fire department will escort non-badged/trained personnel & vehicles.

Ambulance will always be escorted by a fire vehicle when responding on the airfield.

b. Paragraph 1.5.3.3 removed. [PWS updated 23 Oct 25]

10. Could the Government provide specific examples or detailed requirements for the format and electronic submission method for Patient Care Documentation, Run Reports, and TRICARE billing to ensure 100% monthly compliance? Are there specific systems or platforms preferred for these submissions?

a. Example of run sheet provided. See Attachment A.1 – Medical PCR (SF and ES).

b. Billing for TRICARE, and for all other insurances, is accomplished between contractor and TriWest and/or the relevant insurer. Government is not party to that transaction.

11. Could the Government clarify any specific local protocols or standing orders from El

Paso County that may significantly difer from general Colorado State regulations and protocols, particularly regarding stafing minimums or patient care procedures?

a. 21 MDG is not tracking any significant deviations from El Paso Protocols last reviewed Feb 24.

12. In relation to Subfactor 1.2 on Key Personnel Certifications, are there specific government systems, formats, or reporting requirements for tracking certification expiration dates and ensuring timely renewals?

a. Contractor will provide confirmation of key certifications IAW contract requirements upon Government’s request. When personnel begin employment within the contract, contractor will provide key certifications IAW contract requirements to Government (21 MDG Chief of Aerospace Medicine) prior to the new individual’s start of employment. Reference para 1.5.3.1, 1.5.3.2, and 1.8.1 of the PWS. The government will maintain records management of these certifications and will monitor their expiration dates. No specific government format is required. Industry standard is acceptable.

13. Section 1.1.4 – Licensing and Permits. "The contractor shall hold a valid license and permit issued by the Board of County Commissioners (BoCC) for ambulances operating on and supporting PSFB and SSFB before starting performance of the contract and throughout the duration of the contract." It is our understanding that the State of Colorado is now responsible for ambulance certifications and that the BoCC no longer issues these permits. Can you please confirm whether BoCC approval is still a requirement, or if state certification alone will suffice?

a. State certification will suffice. All ground ambulance agencies must hold a state-issued license to operate.

b. INFO: Per SB22-225, on and after July 1, 2024, ambulance services must obtain a state license from the department of public health and environment.

c. Links to confirm:

• https://cdphe.colorado.gov/press-release/cdphe-announces-new-state-licensing-for-ground-ambulance-agencies

• https://leg.colorado.gov/bills/sb22-225

14. Section 1.3.1 – TRICARE Billing. "The contractor shall provide copies of all

TRICARE submitted insurance billing for reimbursement." This solicitation appears to be a Firm-Fixed Price (FFP) contract, as indicated by the CLIN structure. Can you confirm whether this is indeed an FFP contract or if billing is based on a per-call or per-run basis? If FFP, would this not preclude the need for insurance reimbursement documentation?

a. The intent of the government is to award a Firm Fixed Price (FFP) contract as stated in the solicitation. The reason for the TRICARE verbiage in the PWS is to clearly draw the boundaries between what is and what is not billed for. This contract pays for the contractor to comply with the PWS. The CLIN structure will include a base plus 4 options years and the Unit of Issue will be in Months. Therefore, the contractor will invoice each month for the agreed FFP amount for the month. This monthly payment pays for the contractor to provide services IAW the PWS.

15. Section 1.7.1 – TRICARE Reimbursement and Balance Billing. "If the contractor does not obtain full reimbursement or collects less than the billed amount from WPS, the contractor shall not balance bill any TRICARE eligible member..." This seems to support the notion that the contract is not FFP, as reimbursement variances are addressed. Can you clarify whether these provisions are precautionary or if they imply that the contract is not FFP?

a. Same as the answer to question 14, this is a FFP contract and the monthly FFP amount will be paid to the contractor upon appropriate services being received per the PWS. The intent in this statement is to clearly state that the care provided will be billed to TRICARE, not the member. We as the government are paying the contractor to be available 24/7 and to respond in accordance with the PWS. The patient care will be billed to the patient’s insurance, not the government.

16. In-Flight and Flight Line Emergencies – Emergency Decompression Treatment.

"Provide in-field care including decompression sickness and in-flight emergency capabilities..." Would the government consider Emergency Mobile Decompression Treatment during transport to a higher level of care as an acceptable or even favorable element of our proposal?

a. Emergency Decompression Treatment is not an evaluation factor for award and will not be considered favorable in award consideration. Cost for any training/equipment associated with this elevated capability would be borne by contractor, not the government.

17. Dedicated Ambulance Requirements. "One (1) dedicated ambulance per installation, plus a backfill ambulance." Would the government be open to a proposal that includes two (2) ambulances and one (1) backup per site, for a total of three (3) per installation?

a. The requirement is one (1) dedicated ambulance per installation, plus a backfill ambulance per the PWS. Any proposal above this minimum requirement would be meet the minimum, but the baseline requirement remains the same. Providing above and beyond what is asked for in the PWS is not an evaluation factor for award and will not be considered favorable in award consideration