NMTS_QA.pdf

National Medical Transport and Support HSFE70-17-R-0008 Questions & Answers

April 5, 2017

If there are any discrepancy between the attached Q&A and the revised PWS/solicitation, then the PWS governs.

1. Periods of Performance. The periods of performance for this solicitation are listed as follows:

07/28/2017 to 01/27/2018 6 months 01/28/2018 to 01/27/2019 12 months 01/28/2019 to 01/27/2020 12 months 01/28/2020 to 01/27/2021 12 months 01/28/2021 to 01/27/2022 12 months 01/28/2022 to 07/27/2022 6 months

This schedule makes it difficult to establish uniform pricing schedule year-over-year and inconsistent start-up fees since there are two each 6 month terms and 4 each 12 month terms. Would FEMA consider revising the periods of performance as follows?

07/28/2017 to 07/27/2018 12 Months 07/28/2018 to 07/27/2019 12 Months 07/28/2019 to 07/27/2020 12 Months 07/28/2020 to 07/27/2021 12 Months 07/28/2021 to 07/27/2022 12 Months

Answer: No

2. Pages 2 through 112, CLIN Listing. Some of the CLINs are confusing. Many of them contain the phrase “6/12 Hour Blocks” which we understand means FEMA is seeking pricing for 6-hour blocks as well as 12-hour blocks. We believe that 6-hour blocks are unreasonable given the potential magnitude of resources being requested. In previous RFPs and Contracts the following Unit of Measure (Quantity) for the following CLINs were 12 hour blocks:

1) Ground Ambulances

2) Paratransit Vehicles

3) Air Ambulances Fixed-Wing

4) Air Ambulance Rotary-Wing

5) Communications Team Member

6) Paramedic – Fixed Location Support

7) EMT – Fixed Location Support

8) Operations Support Team Member

Can the RFP be revised to remain consistent with previous RFPs by changing the Unit of Measure (Quantity) for these CLINS to “12 Hour Blocks”?

Answer: No, the government is requesting price for a 6 hour block and a 12 hour block

3. Pages 2 through 112, CLIN Listing. The Unit of Measure (Quantity) for the following CLINS are listed as “6/12 Hour Blocks”.

1) Advanced Practice Registered Nurse (APRN), Nurse Practitioner (NP), Clinical Nurse Specialist

(CNS), or Critical Care Registered Nurse (CCRN)

2) Registered Nurse

3) Critical Care Paramedic

4) Physician

Can the RFP be revised to change the Unit of Measure (Quantity) for these CLINS to “12 Hour Blocks”? In addition, can the CLINs for “Specialty Nurse/Advance Practice Nurse” be changed to Advanced Practice Registered Nurse (APRN), Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), or Critical Care Registered Nurse (CCRN), which more clearly defines this position?

Answer: No, the government is requesting price for a 6 hour block and a 12 hour block.

Titles can be changed as indicated.

4. Pages 2 through 112, CLIN Listing. It is our understanding that the “Quantity” (Column C) on these pages represent the estimated quantity of the individual resources that may be utilized for the specific period of performance (either 6 months for the initial base period and 12 months for all option years). Are we correct in assuming that these numbers represent estimates only and that actual quantities will be as defined in specific Task Orders for each period of performance?

Answer: The quantity listed is an estimate only, Actual quantity will be determined at Task Order Level.

5. Pages 2 through 112, CLIN Listing. We are confused by Column C “Quantity” on pages 2 through 112. It appears that this column attempts to list specific quantities of various resources listed, e.g, Ground Ambulances (ALS/BLS/Bariatric/CCT). We agree that for purposes of quantifying resources in the RFP, the ratio should be 70% ALS and 30% BLS. Are we correct in assuming that in the event of an actual deployment, the quantities of ALS ambulances, BLS ambulances, Bariatric ambulances, and Critical Care Ambulances, would be determined by the real-time actual needs as opposed to specific pre-established quantities?

Answer: Yes, at time of Task Order. Quantities can be up to stated percentages.

6. Pages 2 through 112, CLIN Listing. We are confused by Column C “Quantity” on pages 2 through 112. It appears that the quantity of specific types of aircraft are being proposed. The fact is that the types of aircraft deployed are event-specific and thus we never know what will be needed until there is an actual deployment. Are we to assume, as in the past, that Offeror will be accountable for providing the total number of aircraft per zone as specified in the Contract, but the actual mix of types of aircraft will be determined at the time the Task Order is issued?

Answer: Yes, at time of Task Order.

7. Page 2 through 112, CLIN Listing. We are confused by Column C “Quantity”. It appears that the specific quantity of various types of Paratransit Vehicles are being proposed rather than the total number of paratransit seats. The fact is that the types of Paratransit Vehicles are event-specific and thus we never know what will be needed until there is an actual deployment. Are we to assume that Offeror will be accountable for providing adequate quantities of Paratransit Vehicles to match the number of seats needed, but the actual mix of types of Paratransit Vehicles will be determined at the time the Task Order is issued?

Answer: Yes, at time of Task Order.

8. Pages 2 through 112, CLIN Listing – Shelter Package CLINs.

CLINs 0019, 0038, 0057, 0076, 1019, 1038, 1057, 1076, 2019, 2038, 2057, 2076, 3019, 3038, 3057, 3076, 4019, 1038, 4057, 4076, 5019, 5038, 5057, 5076

In all of the above listed CLIN’s, it states “Additional Shelter Packages.” What does this mean? It appears that replenishment of outdated shelter package items is covered elsewhere with “replenishment” CLINS, therefore is there a need for “Additional Shelter Packages CLINs? Also throughout the CLIN sections there is reference to “Shelter Package, Medical and Base”. Should this read “Shelter Package, Medical and General Population”?

Answer: There are four distinct shelter packages, reference to “base” and “supplemental” is considered appropriate. Sub CLINS identify medical and general. Sections refer to the purchase of new Shelter Packages if required by FEMA.

9. Page 113, Section 8.2 – Minimum and Maximum Funding Limitations. Can the following paragraph be added to the end of this section?

“Unless mutually agreed to by FEMA and the Contractor, the minimum activation (deployment) for any portion of this Contract shall be 72 hours (3 days).” The rationale for this paragraph is that it is very costly for the Contractor and Subcontractors to mobilize a deployment. The Contract requires us to commence deployment within 6 hours of “notice-to-proceed”.

Without this statement, the government could possibly activate resources in one or more zones and in hour 7, after all resources have commenced deployment, they could order a demobilization. If this were to happen, it would be cost-prohibitive for any organizations or agencies to agree to participate in this Contract.

Answer: No, deployments are to be determined at Task Order level

10. Page 115, Section C – National Medical Transportation and Support. Can this section be changed to read as follows?

NATIONAL MEDICAL TRANSPORT AND SUPPORT CONTRACT (NMTS)

ACRONYM LIST

ALS – Advanced Life Support AMC – Air Medical Crew APP – Advanced Practice Paramedic APRN – Advanced Practice Registered Nurse BLS – Basic Life Support CAD – Computer Aided Dispatch CC – Critical Care CCC – Critical Care Clinician CCP – Critical Care Paramedic CCRN – Critical Care Registered Nurse CNS – Clinical Nurse Specialist CO – Contracting Officer COR – Contracting Officer Representative CST – Communication Support Team DHS – U.S. Department of Homeland Security D.O. – Doctor of Osteopathy DOT – U.S. Department of Transportation EMAC – Emergency Management Assistance Compacts EMS – Emergency Medical Services EMT – Emergency Medical Technician ESF – Emergency Support Function FAA – Federal Aviation Administration

FEMA – Federal Emergency Management Agency FMC – Fully Mission Capable FOT – Field Operations Team GFE – Government Furnished Equipment GFP – Government Furnished Property HHS – U.S. Department of Health and Human Services ICS – Incident Command System IDIQ – Indefinite Delivery Indefinite Quantity M&IE – Meals and Incidental Expenses MD – Medical Doctor NIMS – National Incident Management System NP – Nurse Practitioner NRF – National Response Framework NMTS – National Medical Transportation and Support OHA –DHS Office of Health Affairs POC – Point of Contact RN – Registered Nurse TM – Technical Monitor TOO- Theater of Operations VSA – Vehicle Staging Area

Answer: List as shown in PWS adequately indicates contract program elements. Additions suggested are mostly shown in 5.3 with acronyms in parenthesis

11. Page 116, Section 1 – Background, second paragraph. The term listed is “entire continental United States

(CONUS).” In past Contracts, the term used was “Contiguous States” which implies that the Contract covers only the 48 contiguous states. Some definitions of “Continental U.S.” include 49 states, inclusive of Alaska, which has never been part of this Contract. Can the language be clarified to specify that only the 48 contiguous states are covered?

Answer: Yes, see revised section in PWS.

12. Page 116, Section 3 – Scope. This RFP has added Critical Care Ground Transport; therefore should the section read as follows?

1) Medical Transportation

a) Basic Life Support (BLS) Ground Ambulances

b) Advanced Life Support (ALS) Ground Ambulances

c) Bariatric Ground Ambulances

d) Critical Care Ground Ambulances

e) Paratransit support

f) Medical Airlift

Answer: Yes for Bariatric. Critical Care Ground Ambulance infers a specialized ambulance other than

ALS.

13. Page 117, Section 4.1 – Full Zone - Optional. Can this section be modified to read as follows?

Optional – The following resource would be part of a full zone only if there was a Critical Care component needed with the deployment:

• 5-10 ALS modified Critical Care Transport Ambulances with a minimum of 2 attendants one of which shall be a Critical Care Clinician as listed in Section 5.3 Critical Care Ground Transport Personnel.

Answer: Yes, see revised section in the PWS

14. Page 119, Section 5.3 – Medical Personnel. There are more current nationally accepted EMS standards than those listed in the RFP. Can section 5.3 be completely re-written as follows?

5.3 Medical Personnel.

The Contractor shall provide qualified personnel to perform all requirements specified in Task Orders awarded under this IDIQ contract. All sub-Contractors shall be with licensed and credentialed (in their State of origin) ambulance provider organizations. FEMA will assist in getting the affected state(s) to allow reciprocity for Contractor and subcontractors responding pursuant to this contract.

EMS personnel functioning under this contract shall use as a guideline the National Highway Transportation and Safety Administration (NHTSA) National EMS Education Standards (DOT HS 911 077A – January 2009). The National EMS Education Standards outline the minimal terminal objectives for entry-level EMS personnel to achieve within the parameters outlined in the National EMS Scope of Practice Model. Although educational programs must adhere to the Standards, its format will allow diverse implementation methods to meet local needs and evolving educational practices. The less prescriptive format of the Standards will also allow for ongoing revision of content consistent with scientific evidence and community standards of care. If additional or more current EMS standards are developed during the term of the Contract, they must be agreed upon by FEMA and the Contractor prior to implementation.

Resource can be found at https://www.ems.gov/pdf/education/EMS-Education-for-the-Future-A-Systems- Approach/National_EMS_Education_Standards.pdf Critical Care Ground Transport (CCGT) Personnel

Critical Care Ground Transport ambulances are staffed by a minimum of one driver and two medical attendants, one of which must be a Critical Care Clinician as listed below.

https://www.ems.gov/pdf/education/EMS-Education-for-the-Future-A-

• Advanced Practice Paramedic (APP)

• Critical Care Paramedic (CCP)

• Registered Nurse (RN)

• Critical Care Registered Nurse (CCRN)

• Advanced Practice Registered Nurse (APRN)

• Nurse Practitioner (NP)

• Clinical Nurse Specialist (CNS)

• Medical Doctor (M.D.)

• Doctor of Osteopathy (D.O.)

The level of medical care required to transport a critical care patient includes:

• Expert level of provider knowledge and skills appropriate to the medical needs of the patient;

• Patient care environment commensurate with the critical care provided, including the necessary equipment and supplies;

• Ability to address the added challenges of transport and initiate and/or maintain the continuity of tertiary or quaternary hospital care during transport; and

• Vehicle (ground, fixed-wing or rotor-wing) equipped to support the delivery of medical to critical care patients during transport. The critical care transport teams actually delivering the care to patients must have sufficient capability to meet the medical needs of critical care patients

Answer: “Registered Nurse” added to list of clinicians that may accompany CC ground ambulances, no other changes made.

15. Page 120, Section 5.5 – Communication Support Team Members. FEMA no longer offers ICS course IS- 704, therefore can the first paragraph be revised as follows?

A Communication Support Team (CST) member shall have no less than five years’ experience in a police, fire, EMS, or rescue emergency management experience emergency communications role. and meet the minimum requirements of the Incident Command System (ICS) course, IS-704. Information on the ICS courses is found at https://training.fema.gov/nims/.

Answer: Yes, see revised section in the PWS.

16. Page 120, section 6.1.1 – Contractor Infrastructure. Can the last sentence of this paragraph be re-written as

“The General and Command Staff Section Leaders and Branch Directors at the coordination center shall have intermediate and advanced ICS training using NIMS guidelines (not to be provided by FEMA).”

Answer: Yes

17. Page 121, Section 6.1.3 – Medical Personnel Repository. Can this paragraph be revised as follows?

The Contractor shall maintain a repository of all potential medical responders to substantiate insurance, certifications, licenses, and training as required by State and local authorities in their State of origin. The Contractor shall also maintain records of participation by its employees in continuing education programs and reports showing frequency and type of medical incidents. The Contractor is responsible for providing a validation report containing personnel names and any data required to verify credentials, given their respective disciplines at the centralized check-in area within 24 hours of activation. At the request of the COR and as a readiness and activation monitoring tool, the Contractor shall immediately validate the credentials of all prospective responders.

https://training.fema.gov/nims/

The rationale for this is that it may be impossible to transmit credentials to the FOB, especially if there are austere conditions. The Offeror Office of Emergency Management keeps the credentials electronically and they can be transmitted as requested by FEMA.

Answer: See revision in section of the PWS

18. Page 121, Section 6.1.5 – Ambulance Tracking/One-on-One Communication Resources. Can item #4 be re-written as follows?

“The communications devices shall be geospatially tracked from the time of activation until demobilization. It is preferred positioning of the devices be such that the asset can be tracked from time of check-in until demobilization.”

Answer: Yes

19. Page 121, Section 6.2 – Shelter Packages. Can the following statement be added to this section?

It is understood there may be factors beyond the control of the Contractor in providing medications and/or medical supplies. Such factors include national shortages due to disruption in manufacturing or limited production. Many drugs and supplies are produced by a single manufacturer, which often produces multiple products on an ultra-lean, just-in-time production schedule. The lack of redundancy in manufacturing, combined with the length of time required for remediating a production facility quality issue or bringing a new manufacturing facility on line all exacerbate the problem. In these situations the Contractor shall make a “best-effort” to provide the medications specified in the Contract.

Answer: No

FEMA assumes that the list of medications and supplies in the shelter packages were developed by subject matter experts and determined to be the supplies necessary for shelter care.

20. Page 122, Section 6.3.3 – Reserve Ambulance Caches. Can this section be revised to read as follows?

The Contractor may stockpile caches of reserve ambulances. These ambulances are owned by the Contractor and are not considered GFP. If they are used only for NMTS response, they will not be required to be permitted/licensed as an ambulance by the EMS Office in the state and/or local jurisdiction in which they are stored. If they are deployed as part of the NMTS, all reserve ambulances shall be properly equipped and Fully Mission Capable (FMC) prior to being checked-in during the deployment.

Answer: FEMA has no objection as long as all federal and state laws are complied with, and response time per contract is met.

21. Page 122, Section 6.3.3 – Fully Mission Capable (FMC). Can the last sentence of the first paragraph be re-

“All reserve ambulances shall be properly equipped and Fully Mission Capable (FMC) prior to being checked-in during a deployment.”

Answer: See revision in PWS

22. Page 123, Section 6.4 – Utilization of in-State and Contiguous State Resources. Can this paragraph be re-

The Contractor is precluded from utilizing ground ambulance resources from affected state(s) with disaster declarations unless authorized by state EMS authorities. The Contractor is precluded from utilizing ground ambulances from state(s) contiguous to affected state(s) with disaster declarations if the ambulances are part of an Emergency Management Compact (EMAC) agreement between affected state(s) and contiguous state(s). Furthermore, the Contractor shall assure that subcontractor personnel, vehicles or other resources provided are not committed to state and local emergency response plans. For purposes of this section, the term “affected state(s)” shall mean states with a Federal disaster declaration, which includes an EMS component.

Answer: See revisions in section of the PWS

23. Page 123, Section 6.4.1 – Critical Care Ground Ambulance.

The last sentence states that this capability is made available to the states for no longer than 72 hours. We recommend striking this last sentence from the solicitation as this is an operational decision between the Federal and Local Governments. If FEMA wants the CCT Ground Ambulances deployed for only 72 hours, shouldn’t it simply be stated as such in the task order? Does the contractor bear any responsibility or are there any penalties should this availability exceed 72 hours?

Answer: Section will be left as is, with the addition after the last sentence. “This limit may be waived by FEMA based on operational considerations”.

24. Page 224, Section 3 – Past Performance Instructions, paragraph 2. This paragraph states that the “past performance questionnaire is contained in Attachment 4 of this solicitation”. It should read “Attachment 11”.

Answer: See revised Attachment RFP

25. Page 125, 6.5.1 – Ground Resources. Suggest changing the ambulance to: “Type IV – Critical Care Transport” and striking any reference to personnel since they are defined in several other sections of the

RFP.

Answer: Yes, see revised section of the PWS

26. Page 125, Section 6.5.1 – Type IV – ALS/Critical Care Transport. Can this bullet point be changed to read “Critical Care Transport, Non-Hazmat”?

Answer: See revised Section in the PWS

27. Page 126, Section 7 – Delivery Requirements, second paragraph. Can this section be revised as follows?

The Contractor shall maintain an adequate Response Network of resources to meet the requirements of this Contract. The Contractor shall be intimately familiar with the deployment and management of medical services over a large geographical area. The Contractor shall have available infrastructure and systems capable of allowing the Contractor to simultaneously deploy requirements in two zones.

The Contractor is precluded from utilizing ground ambulance resources from affected state(s) with disaster declarations unless authorized by state EMS authorities. The Contractor is precluded from utilizing ground ambulances from state(s) contiguous to affected state(s) with disaster declarations if the ambulances are part of an Emergency Management Compact (EMAC) agreement between affected state(s) and contiguous state(s). Furthermore, the Contractor shall assure that subcontractor personnel, vehicles or other resources provided are not committed to state and local emergency response plans. For purposes of this section, the term “affected state(s)” shall mean states with a Federal disaster declaration, which includes an EMS component.

Answer: See revised section in PWS

28. Page 126, Section 7.2 – Response Time. Can this section be revised as follows?

The Contractor must be able to commence deployment of a full zone as defined in this Section within 6 hours and arrive to the check-in location(s) within 24 hours of receiving a verbal or written authorization to proceed by the Contracting Officer. Any task order issued for less than a full zone deployment must also commence deployment within 6 hours and arrive at the designated check-in location(s) within 24 hours of receiving a task order.

If the Government requires more than 300 ground ambulances, there may be two waves of response resources for Zone 1. Up to 300 ground ambulances shall still commence deployment within 6 hours and arrive at the check-in location(s) within 24 hours of receiving a task order. All other resources, up to 200 ground ambulances, shall be commence deployment within 12 hours and arrive within 48 hours.

If the Contractor is providing these services to more than one zone, resources from another zone may be used, provided they are not responding to another event either under another task order issued under this contract or otherwise committed under EMAC or state or local emergency response plans. If the Government requires an additional full zone, the contractor shall commence deployment resources within 12 hours and arrive within 48 hours.

If the Contractor is providing these services to more than one zone, resources from another zone may be used, provided they are not responding to another event either under another task order issued under this contract or under EMAC.

Answer: See revised section in PWS

29. Page 128, Section 8.2.2, third paragraph – Air Resources. Can this paragraph be revised as follows?

Determination of suitable flying conditions shall be made by the local Federal Aviation Administration (FAA) representative responsible for the subject geographical area or the contractor’s Safety Officer.

Answer: See revised section in the PWS

30. Page 129, section 9.2 – Controlled Substances. Can the following statement be added to this section?

Supply and resupply of controlled substances are subject to national availability.

Answer See PWS as written.

31. Page 131, Need new section – National EMS Education Standards. Can this new section be added?

Section 12.7. National EMS Education Standards (DOT HS 811 077A, January 2009).

The National EMS Education Standards outline the minimal terminal objectives for entry-level EMS personnel to achieve within the parameters outlined in the National EMS Scope of Practice Model.

Although educational programs should adhere to the Standards, its format will allow diverse implementation methods to meet local needs and evolving educational practices. The less prescriptive format of the Standards will also allow for ongoing revision of content consistent with scientific evidence and community standards of care. In implementing the Standards, EMS instructors and educational programs will have the freedom to develop their own curricula or use any of the wide variety of publishers’ lesson plans and instructional resources that are available at each licensure level.

Resource can be found at https://www.ems.gov/pdf/education/EMS-Education-for-the-Future-A-Systems- Approach/National_EMS_Education_Standards.pdf

Answer: See revised section in the PWS

32. Page 143, section H.3 - Accessibility of meetings, conferences, and seminars to persons with disabilities.

This section goes into great detail in listing requirements the contractor should meet in accordance with the Americans with Disabilities Act. It would be impossible to comply with these ADA requirements during a disaster deployment. Can you provide clarification and confirmation that these standards do not apply to the contractor within the Theater of Operations (TOO) during activation of the contract?

https://www.ems.gov/pdf/education/EMS-Education-for-the-Future-A-Systems-Approach/National_EMS_Education_Standards.pdf https://www.ems.gov/pdf/education/EMS-Education-for-the-Future-A-Systems-Approach/National_EMS_Education_Standards.pdf

Answer: Section H.3 refers to meetings, conferences and seminars and apply to meetings held during a deployment

33. Attachment 4, Federal EMS, Ambulance & Paratransit Disaster Request. The form “Federal EMS, Ambulance & Paratransit Disaster Request” should be revised to include Critical Care Ground Ambulance and Critical Care Non-Ambulance Support Personnel. Offeror can provide this revision in its Proposal to the RFP.

Answer: Yes.

34. Attachment 8 Shelter Kit Equipment. There are numerous revisions needed to the Shelter Packages

(Attachment 8). Some of the items and quantities are unnecessary. As you know, the lists are quite extensive. Some of the changes include:

• Nitro Spray and/or Nitro Tablets should be added

• Brand names should be changed to generic names

Can we submit our recommended Shelter Package revisions with the RFP Proposal which is due May 12, 2017?

35. Attachment 9, section 3 – EMS Medical Personnel. Can Section 3 be re-written as follows?

EMS Medical Personnel

The Contractor shall provide qualified personnel to perform all requirements specified in Task Orders awarded under this IDIQ contract. All sub-Contractors shall be with licensed and credentialed (in their State of origin) ambulance provider organizations. FEMA will assist in getting the affected state(s) to allow reciprocity for Contractor and subcontractors responding pursuant to this contract.

The NTMS scope of practice for EMS personnel functioning under this contract shall use as a guideline, the National Highway Transportation and Safety Administration (NHTSA) National EMS Education Standards (DOT HS 911 077A – January 2009). The National EMS Education Standards outline the minimal terminal objectives for entry-level EMS personnel to achieve within the parameters outlined in the National EMS Scope of Practice Model. Although educational programs must adhere to the Standards, its format will allow diverse implementation methods to meet local needs and evolving educational practices.

The less prescriptive format of the Standards will also allow for ongoing revision of content consistent with scientific evidence and community standards of care. If additional, different, or more current EMS standards are developed during the term of the Contract, they must be agreed upon by FEMA and the Contractor prior to implementation.

Fixed Location Medical Support The Contractor shall supply EMS and Critical Care personnel with the required certification to be stationed within shelters, airheads, triage centers, or other fixed locations.

Answer: Please see revised section of the PWS, National EMS Scope of Practice Model 2007 seems sufficient for FEMA contract purposes to define EMT personnel requirements. If additional, different, or more current EMS standards are developed during the term of the Contract, they must be agreed upon by FEMA and the Contractor prior to implementation. Also reference #32.

36. Attachment 9, section 4 – Field Operations Team Member (CLIN 0011). Can this section be re-written as

FOT members who function as Section Chiefs or Branch Directors as part of the IMT Command and General Staff must be certified at the Incident Command System (ICS) level 400 (Advanced).

Answer: See revised Section in PWS.

37. Attachment 9, section 7 – Critical Care Ground Transport (CCGT) Personnel. Can this section be re-written as follows?

Critical Care Ground Transport (CCGT) Personnel (Critical Care Paramedic, CLIN 0014) Critical Care ground ambulances are staffed by a minimum of one driver and two medical attendants, one of which must be a certified Critical Care Paramedic (CCP), Registered Nurse (RN), Critical Care Registered Nurse (CCRN), Advanced Practice Registered Nurse (APRN), Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), or Physician (M.D. or D.O.).

Answer: See revised section in the PWS.

38. Attachment 10. Quality Assurance Surveillance Plan. Can this new section be added?

5. Force Majeure Events. The Contractor may be relieved from meeting the performance requirements of this Contract when certain circumstances beyond their reasonable control arise, making performance inadvisable, illegal or impossible.

Answer: Contractor will not be asked to complete any Task that are unsafe, unlawful or impossible.

However, if there are any concerns during contract performance, they will be discussed between contractor and Government to resolve.

39. Attachment 10 – Service Performance Summary Matrices. We are requesting that some of the “Acceptable Level of Performance” be changed from 100% to 95%. While we will always strive to achieve 100% compliance, we feel that to expect 100% compliance for all of these categories is unreasonable. If for some unforeseen reason we were to miss the target by one (1) for some of these items, which require thousands of resources, we would be non-compliant. When this Federal EMS Contract was first developed, the compliance standard was 90%. We believe that 95% is fair in 2017.

Readiness Performance Standards Can item numbers 3, 4, 5, 6, 12, Acceptable Level of Performance, be changed from 100% to 95%?

40. Deployment Performance Standards Can item numbers 16, 17, 18, 19, 20, 21, 22, 25, 26, 27, 28, 30, 31, 32 be changed from 100% to 95%?

Administrative & Reporting Performance Standards Can item numbers 38, 39, 40, 41, 42 be changed from 100% to 95%?

Answer: See revised Attachment 10

41. Attachment 10, Item #26. Can the Performance Standard be changed as follows so that it is consistent with Section 4.1, which calls for 5-10 CCT ambulances? In addition, we believe the reference to Section 8.3.1 of the PWS is incorrect and it should be 6.4.1.

5-10 of ALS ambulances outfitted with additional equipment as stated in section 6.4.1 of the PWS.

42. Attachment 10, Item #32. We believe the reference to Section 6.1.1 in the Performance Standard is incorrect. It should be Section 4.1.1.

43. Attachment 10, Item #34. We believe the reference to Section 8.3.5 is incorrect. It should be Section 6.4.3.

44. All throughout the document – Project Manager/Director. The position is called “Project Manager”. Page 149 of the RFP calls this position “Project Director” yet both narratives use the term “Project Manager”.

We do not have a preference on which term to use as long as they are consistent.

Answer: See revision in RFP

45. Attachment 12 – Past Contractual Performance/Experience. We believe there is a typographical error on the second page of this document. Although this is Attachment #12, the header of the second page states “Attachment 11”. Can this be changed to read “Attachment 12”?

Answer: See revised Attachment 12

46. All attachments and forms. If there are more current forms available than what is contained in this solicitation, can they be used instead?

Answer: Only attachments 1 through 10 may be sent with updated forms