P09 - PWS D1 AMBULANCE TRANSPORTATION SERVICES Rev 2.pdf

PERFORMANCE WORK STATEMENT (PWS)

FOR THE

NORTH TEXAS MEDICAL FACILITY

SPECIAL MODE OF TRANSPORTATION

AMBULANCE (D1)

SERVICES

4/29/2021

Section I – Description of Services

1.1. SCOPE

1.1.1. The contractor shall provide all required labor, material, supplies, equipment, and supervision of contractor personnel necessary to perform Ambulance Services to/from the following locations:

• Department of Veterans Affairs Fort Worth Outpatient Clinic 2201 SE Loop 820 Fort Worth, TX 76119 United States

• Grand Prairies VA Outpatient Clinic 2737 Sherman St.

Grand Prairies, Texas, 75051

The contractor shall transact business as described herein.

1.1.2. GENERAL REQUIREMENTS:

The contractor shall provide Ambulance Services for patients (or beneficiaries) of the Department of Veterans Affairs as established herein. The contractor shall provide all services necessary to execute the full range of Ambulance services as provided in the local community. Performance shall be continuously compliant with the requirements contained within this PWS to include the standards established by the Joint and the Division of Emergency Medical Services, Texas Emergency Medical Services and all applicable Federal, State and local rules, regulations, and procedures.

•Reference: Texas Administrative Code- Title 21, Part 1, Chapter 157, Emergency Medical Care.

http://info.sos.state.tx.us/pls/pub/readtac$ext.ViewTAC?tacview=5&ti=258pt=18ch=157 &sch=A&rl=Y

1.2. GENERAL DESCRIPTION:

1.2.1. The contractor shall provide all Ambulance service, 24 hours per day, 365 days per year, as required in accordance with the terms and conditions contained herein. The contractor shall furnish vehicles sufficient to provide full and complete coverage for pick-up and delivery of all veteran patients requiring transport by Ambulance to/from the Dallas VA Medical Center, 4500 S.

http://info.sos.state.tx.us/pls/pub/readtac$ext.ViewTAC?tacview=5&ti=258pt=18ch=157&sch=A&rl=Y

Lancaster Rd., Dallas, Texas 75216, to local Medical appointments and Community Care Appointments.

1.2.2 Prior to contract performance, the COR shall provide the contractor with a list of names (or position titles) and phone numbers of authorized Government personnel who may request services. This list will be updated and submitted to the contractor as changes occur. Services rendered in response to requests from other than authorized personnel shall be at the risk of the contractor and any costs related thereto shall be borne by the contractor.

1.2.3Pick-up and deliveries will also be required from community hospitals and VA facilities within and outside the service area to include patient’s residence as requested by the COR in accordance with the procedures specified within this PWS. The trip rate provided in any category shall be all-inclusive regardless of time of day as agreed to in the price schedule of the resultant award.

1.3. VEHICLES AND EQUIPMENT

1.3.1. Ambulance services and equipment with which the contractor renders all services must meet Federal and State of Texas (or equal) requirements for insurance, licensing, registration, and equipment. All vehicles used to provide Ambulance (ALS/BLS) transportation services shall meet the following requirements:

•Texas Health & Safety Code-Chapter 773.Emergency Health Care Act.

http://www.statutes.legis.state.tx.us/Docs/HS/htm/HS.773.htm

•Texas Administrative Code- Title 21, Part 1, Chapter 157, Emergency Medical Care.

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

1.3.3. Be equipped with operational air conditioning/heating systems.

1.3.4. Meet all safety and mechanical standards established by Local, State and Federal statutes and regulations.

1.3.5. Be equipped with an operable two-way radio and/or cellular telephone communication system, which afford contact with the vehicle during all hours of operation. Beepers are not an acceptable substitute.

1.3.6. Be equipped with stretcher tie down straps and effective secure devices to secure both stretcher and Ambulance beneficiaries.

1.3.7. The lift shall incorporate an emergency method of deploying, lowering to ground level with a lift occupant, and raising and stowing the empty lift if the power to the lift fails and have a backup for all lift capacity.

1.3.8. A fixed seat position or a fixed secured floor or sidewall stretcher lock must be approved for each ambulatory, Ambulance, or stretcher restricted passenger being transported, per the passenger’s needs.

1.3.9. Driver shall ensure stretcher locks are secured and seat belts and shoulder harnesses are in place before the vehicle is driven.

1.4. STANDARD FOR MAINTENANCE

1.4.1. The objective of Standards for Maintenance is to protect veterans and to cause no harm to all parties. The contractor shall maintain all vehicles in a clean and orderly condition, free from debris and accumulations which may create an accident, injury, or fire hazard.

1.4.2. The contractor shall ensure they are in compliant with the CDC Coronavirus guidance:

https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html

1.4.3. The contractor shall maintain vehicles in accordance with manufacturer’s recommended maintenance schedule or an improved schedule based on actual vehicle operation conditions.

1.4.4. The contractor shall correct any deficiency that might interfere with safe operation of vehicle before vehicle is placed in service.

1.4.5. The contractor shall ensure vehicle windows are free of obstructions and lights are kept clean so that they can be easily seen when in operation.

1.4.6. The contractor shall keep the interior of vehicles clean and in good repair.

1.4.7. The contractor shall maintain (and furnish upon request) procedures that outline preventive maintenance and/or repairs on each vehicle in an individual vehicle file and in chronological order, latest service on top. A statement from the Contractor indication compliance of vehicle maintenance files is in place should be submitted at time of offer for evaluation purposes.

Requested submission and verification of these documentation requirements will be a quality assurance procedure during the contract period.

1.4.8. Maintenance procedures shall adhere to all requirements listed for the state the contractor is based out of herein Texas Medical Transportation Board Administrative Code, SECTION 380.501.

Standards for Motor Vehicles.

(1) All motor vehicles used to provide transportation services must:

https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html

(A) Meet or exceed warranty and component standards for both state and federal safety mechanical operating and maintenance standards;

(B) Be identified with the transportation provider name and vehicle number using letters that are at a minimum six inches in height; and

(C) Be equipped with:

(i) Functioning, clean, and accessible seat belts for each passenger seat position that must be stored off the floor when not in use;

(ii) An operating speedometer and odometer;

(iii) Working interior lights within the passenger compartment;

(iv) Adequate interior sidewall padding and ceiling covering;

(v) Two exterior rear-view mirrors, one on each side of the vehicle;

(vi) An interior mirror, which should be used for monitoring the passenger compartment;

(vii) A clean interior and exterior (which must be free of broken mirrors or windows, excessive grime, rust, chipped paint, and major dents);

(viii) A functional fire extinguisher (which must be secured within reach of the motor vehicle operator and visible to passengers);

(ix) A first aid kit (which must include at a minimum latex glove, hazardous waste disposal bags, scrub brush, disinfectant, and deodorizer);

(x) Working heating and cooling systems adequate for the heating, cooling, and ventilation needs of both the motor vehicle operator and the passengers; and

(xi) Signage posted within the vehicle that reads: "No Smoking, Eating or Drinking." "All passengers must wear seat belts."

"Concealed Weapons Prohibited."

(2) All motor vehicles used to provide transportation services must comply with all applicable state and federal laws, including the Americans with Disabilities Act (ADA) Accessibility Guidelines for Transportation Vehicles (36 C.F.R. 1192), Federal Motor Vehicle Safety Standards (49 C.F.R. 571), and Chapter 547 of the Texas Transportation Code.

1.5. DRIVER QUALIFICATIONS

1.5.1. The Texas Department of Veterans Affairs Medical Center (VAMC) reserves the right to restrict any contractor employee from performing services under this contract who does not meet the required qualifications for the services they are required to perform, and who violates Federal regulations or are identified as a potential threat to the security, safety, health and/or operational mission of the VA and its veteran population. The restriction of such contractor personnel shall not relieve the contractor from performing all the required services, in accordance with all terms, conditions, and schedule contained herein.

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

1.5.3. 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.

1.5.4. The company will employ personnel, who are fluent in English. They need to be able to speak and understand English in order to transport the patients successfully.

1.5.5. Staff will ensure that the patient is secured in the vehicle before the vehicle moves.

1.5.6. Each driver shall:

i) Possess a driver’s license that is valid for the class of vehicle driven and, if required under Texas Statutes (or other state equal), evidence of a special transportation service vehicle permit, or endorsement issued by the commissioner of public safety.

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

iii) For the past three years:

• Have not had a driver’s license canceled or suspended under Texas Statutes, (or other state equal);

• Have a driving record clear of convictions for operating a motor vehicle or motorcycle without insurance as required by Texas Statutes, (or other state equal);

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

• Have a driving and criminal record clear of convictions for driving under the influence of alcohol or a controlled substance under Texas Statutes (or other state equal)

• Have a record clear of criminal convictions of crimes or pending criminal indictments against persons, and crimes or anticipatory crimes reasonably related to providing special transportation services. This must be documented by a formal background check.

1.5.7. 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.

1.5.8. 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:

• https://dshs.texas.gov/emstraumasystems/Certinfor.shtm

i) 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).

ii) Shall submit evidence of equivalent training program, which has been successfully completed, to the Contracting Officer.

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

iv) Shall attend all refresher continuing education, or advanced training programs as required by the local or state government entity in which service is rendered. In no instance shall this be less frequent than every two

(2) years. Such refresher training shall be equivalent to that developed by the Department of Transportation, National Highway Safety Administration.

http://search.usa.gov/search?utf8=%E2%9C%93&affiliate=dot-nhtsa&query=refresher+training+&searchCommit=Search

1.6 PASSENGER TRANSPORTATION & SCHEDULE OF SERVICES

1.6.1 The contractor is required to provide “through the door service” for patients to and from their designated appointments. “Through the door service is defined as patients being picked up either on the ward, in their homes, in their clinic or at other stated areas and taken to their stated destination or appointment with proper transfer of patient care to an equal or higher level of care.

On the return trip, the contractor will return the patient to either designated ward, inside his/her home, or to the other stated areas.

http://search.usa.gov/search?utf8=%E2%9C%93&affiliate=dot-nhtsa&query=refresher+training+&searchCommit=Search http://search.usa.gov/search?utf8=%E2%9C%93&affiliate=dot-nhtsa&query=refresher+training+&searchCommit=Search

1.6.2 It is understood that the patient plus one (1) additional passenger, family member or care giver at the discretion of the transport crew to be transported on a trip will be based on the size of the vehicle and authorization by VAMC.

1.6.3 Drivers and passenger shall always use seat belts/securement devices.

1.6.4 There shall be no smoking by the driver, attendants, or passengers, while in the vehicle or on the Medical Center Campus unless in a designated smoking area.

1.6.5 No unauthorized stops shall be permitted. An authorized stop is any stop not necessary for patient care.

1.6.6 In the event an emergency arises while in transit, the contractor shall transport the patient to the closest facility that can mitigate the emergency.

1.6.7 The contractor shall be required to transport non-ambulatory veterans on gurneys and litters who are not in need of emergency transportation or medical attention.

1.6.8 Upon delivery or pick-up of a patient, the contractor shall log in the patient on a log sheet at the location designated at the facility. The contractor shall provide the following information on the log sheet:

1. Patient name,

2. Last four of the patient's Social Security Number,

3. Time of delivery or pick-up,

4. Point of origin or destination, and

5. Name of Contractor personnel picking or delivering patient.

1.6.9 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) 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. If the beneficiary refuses to be properly secured, they shall be returned back into the building which they came from.

1.6.10 An authorized official of the VA Medical Center, the COR or the Mobility Manager may, in the best interest of the patient, allow one (1) relative of concerned other to accompany the patient at no additional cost to the Government. The relative or concerned other only is to be transported home with the beneficiary if approved by an official of the VA Medical Center. The beneficiary will also be allowed to carry with her or him one (1) bag of luggage during his or her transport.

1.6.11 The contractor is required to notify the COR of any unusual events, including but not limited to accidents, safety problems and deviations in transportation that occur and involve any VA beneficiary being transported under this contract. This notification will be made within 15 minutes by telephone to the COR and AOD during normal working hours. A written report using email or company letterhead of the event will be delivered to the COR within 24 hours. Failure to comply with this provision may be grounds for default.

1.6.12 The patient pick-up/drop-off location at the North Texas VA Medical Center will be at the South Entrance of the medical center for scheduled appointments. If waiting time is necessary, the vehicle must park in the appropriately designated general parking lot areas.

1.6.13 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.

1.6.14 If or when patient’s medical records are transported, the contractor shall ensure that Health Insurance Portability and Accounting Act (HIPAA) guidelines are followed.

1.6.15 Patients will be entitled to transport one certified trained service animal. No pets are to be transported at any time. A. VHA Directive 1188, Animals on Veterans Health Administration (VHA) Property, dated August 26, 2015.

1.6.16 Passengers should be transported in compliance to CDC standards:

https://www.cdc.gov/coronavirus/2019-ncov/infection-control/infection-prevention-control-faq.html

1.6.17 All trips will be charged an agreed upon base rate from point of pick-up to point of drop-off, as well as a mileage rate.

1.6.18 The base rate will be applied at the point of pick-up and will only be paid if the awarded contractor has arrived at the initial point of pick up.

1.16.19 Mileage will only be paid when a patient is being transported. There will be no payment for mileage accrued without a VA approved passenger onboard. Trip mileage shall be determined by the latest edition of Bing Maps.

1.16.20 Rates are still inclusive of all cost associated with the performance of the contract.

1.16.21 Other Charges: It is understood that the prices quoted in the SCHEDULE OF SERVICES, shall be inclusive of all ferry, bridge, tunnel or road toll charges. The contractor shall not bill the VA separately for any such charges.

1.16.22 Round trips shall be considered two separate trips in terms of wait time, mileage and base rate.

1.16.23 The offeror shall quote maximum dollar amounts for all price schedule data elements listed herein in order to be considered technically acceptable. Please note that the only minimum amounts that the Government shall be contractually obligated to provide are all https://www.cdc.gov/coronavirus/2019-ncov/infection-control/infection-prevention-control-faq.html https://www.cdc.gov/coronavirus/2019-ncov/infection-control/infection-prevention-control-faq.html covered within the base period. In other words, there shall be no mandatory minimum amounts during any option year of the effort.

1.7 CALLS

1.7.1 All patient pick-up(s) and drop-off(s) shall be authorized via “calls” which shall only be issued by the designated primary or alternate Contracting Officers Representative (COR). When placing calls for services, the COR shall contact the designated contractor point of contact(s) to provide the following information:

1. Mode of transportation required,

2. Required time of arrival and/or within 20-minute timeframe.

3. Name of beneficiary,

4. Pick-up and delivery point,

5. Type and number of additional medical care specialists required,

6. Type of equipment required,

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

8. Any other special instructions.

1.7.2 All vendors must call patients the night and morning before proceeding to the patient’s house to ensure that they are going to their scheduled appointment.

1.8 HOURS OF PERFORMANCE

1.8.1 This is a full-service contract, 24 hours per day, 365 days per year. The contractor shall provide all wheel chair services as stated in the performance work statement for veteran beneficiaries, when requested by the VA.

1.8.2 The contractor shall furnish and maintain vehicles so as to ensure timely pick-up and delivery service to all veterans serviced by the VA.

1.9 RESPONSE TIME

1.9.1. The contractor shall respond to all calls for Ambulance transport service by being on-site at the designated VA facility within 1 hour after notification. STAT notifications require a 15-minute response time. Should the time period for pick-up, stated herein, be physically impossible due to location of veteran beneficiary, the Contractor shall contact the appropriate individual at the VA and proceed to inform him/her of the anticipated time required for pick-up and delivery of said patient.

1.9.2. The contractor shall provide and respond to each call, in accordance with all Federal, State, and Local regulations governing dispatch of emergency medical vehicles and medical care of on-board patients, to include the use of sirens and other measures to ensure timely arrival at the designated location.

1.10 ELECTRONIC TRANSMISSIONS

1.10.1 The contractor shall, at all times during the contract period, have on his/her premises both the ability to receive, read, and transmit emails to and from the VA and a functioning fax machine to communicate with the VA. If PII or PHI is to be transmitted, an approved encrypted email must be used.

1.11 CONFORMITY TO REGULATIONS

1.11.1 The contractor and his/her operators shall conform to all Federal, State and local regulations governing the performance of contracted services.

1.11.2 VAMC facilities have been designated NO SMOKING areas in their entirety. Individuals found in violation of this no smoking policy may be subject to a $50.00 federal citation for disregarding posted safety rules and regulations. Furthermore, the contractor may be directed to stop work. The contractor is to notify all of his/her employees and/or sub-contractors of this strict enforcement policy.

1.11.3 The contractor must have the appropriate permits/licenses to perform the required services.

1.11.4 All services provided by the contractor shall comply with applicable current laws, regulations and standards of the appropriate regulatory body.

1.12. EVIDENCE OF COVERAGE

1.12.1 Before commencing work under the contract, the contractor shall furnish the Contracting Officer with a certification from his/her insurance company indication that the coverage outlined in this contract has been obtained and that it may not be changed of canceled during the term of the contract.

1.13 WAGE RATES

1.13.1 Wage Determination(s) as listed in Texas State Labor Wage Determination.

https://beta.sam.gov/help/wage-determination-resources

1.13.2 The contractor certifies by signature on this offer that the salaries to be paid workers involved in the performance of the contract are equal to or greater than those specified in the attached Wage Determination(s).

1.14 INSPECTIONS

https://beta.sam.gov/help/wage-determination-resources

1.14.1 The VA reserves the right to inspect the contractor's equipment and vehicles and/or require documentation of compliance with contract specifications, and State laws, rules, regulations and guidelines governing emergency medical transport vehicles.

1.14.2 VA inspections of Contractor facilities shall in no way constitute a warranty by the VA that the Contractor's vehicles and equipment are properly maintained.

1.14.3 Inspections shall take place at the outset of the contract and on an as needed basis thereafter. To be in and remain in compliance, the contractor shall adhere to the Texas Department of State and Human Service and the Texas Department of Motor Vehicles.

1.14.4 The VA reserves the right to restrict the contractor’s use of equipment and vehicles which are in need of repair, unclean, unsafe, damaged on the interior or exterior body, and are not in compliance with contract specifications.

1.14.5 The restriction of such equipment and vehicles shall not relieve the Contractor from performing in accordance with the strict intent and meaning of the contract without additional cost to the VA.

1.14.6 The VA reserves the right to have VA personnel, such as Contracting Officer and Contracting Officer's Technical Representative, or their designee, observe and inspect contractor operations at any time during the term of this contract.

1.14.7 The VA shall conduct scheduled or unscheduled site visits to observe and inspect contractor operations. A scheduled site visit is defined as a visit that the contractor is made aware of in advance. An unscheduled site visit is defined as a visit without advance notice.

1.15. PATENT RIGHTS

1.15.1 The contractor shall be courteous to VA beneficiaries and shall not smoke/play loud music while transporting patients. Patients may bring a reasonable amount of equipment, such as folding Ambulance, consumable medical supplies and personal suitcase.

1.15.2 The contractor shall immediately notify the VA of any incidents involving injury to a VA patient during transport. The contractor shall complete and submit to the COR, the form entitled, Report of Accident within 24 hours. http://vaww.va.gov/vaforms/va/pdf/VA2162.pdf

1.15.3 The contractor shall notify the COR, in writing, within 24 hours of any complaints made by the patients with regards to service.

1.15.4 The contractor may provide recommendations for improved services along with the patient complaints for the VA’s review. No recommendation shall be construed as being effective until a written modification to the contract is executed by the Contracting Officer.

http://vaww.va.gov/vaforms/va/pdf/VA2162.pdf

1.15.5 Upon delivery or pick-up of a patient, the contractor shall log in the patient on a log sheet at the location designated at the facility. The contractor shall provide the following information on the log sheet:

1. Patient name,

2. Last four of the patient's Social Security Number,

3. Time of delivery or pick-up,

4. Point of origin or destination, and

5. Name of Contractor personnel picking or delivering patient.

1.16 REQUIRED REPORTS AND DOCUMENTS

1.16.1 Within fifteen (15) days after contract award, the contractor shall provide the following:

a) Contractor Personnel Roster: In this document, contractor shall identify the employee

1. Name,

2. Position,

3. Title, and

4. Work assignment area.

Thereafter, all changes shall be submitted to the COR within two (2) business days after the change(s) occur.

1.16.2 At the time of delivery, the contractor shall provide a patient care report as part of the patient's permanent record. This patient care report shall include a record of the patient’s vital signs, medications used, oxygen use, and any changes in the patient’s condition. The list stated here shall not be construed as all inclusive, and the contractor shall provide all pertinent information.

1.17 SAFETY REQUIREMENTS

1.17.1 In the performance of this contract, the contractor shall take additional safety precautions as determined necessary by the CO or COR. If the contractor is advised of noncompliance issues, the Contractor shall take immediate corrective action. Such notice shall be administered in writing to the Contractor. If the contractor fails or refuses to comply promptly, the CO may issue an order stopping all or any part of the work and hold the contractor in default.

1.17.1 Safety practices shall adhere to all requirements listed herein as well as those set forth by the

• Texas Health & Safety Code-Chapter 773.Emergency Health Care Act.

http://www.statutes.legis.state.tx.us/Docs/HS/htm/HS.773.htm

• Texas Administrative Code- Title 21, Part 1, Chapter 157, Emergency Medical Care.

1.17.2 Each licensed Medical Transportation Organization (MTO) shall comply with all Occupational Safety and Health Administration OSHA) blood borne pathogens regulations as defined by 29 C.F.R. 1910.1030.

1.17.3 A licensed MTO shall ensure that sanitation procedures are provided to all personnel in a written document that conforms with current standards as set forth in occupational safety and health administration-blood borne pathogens protocol.

1.17.4 A licensed MTO shall maintain and follow a written sanitation plan that conforms with the latest blood borne pathogen standards as written by the occupational safety and health administration. The following documentation shall be maintained for each vehicle:

(1) Sanitation schedule;

(2) Date the sanitation was completed;

(3) Documentation of who performed sanitation.

1.18 PERFORMANCE REQUIREMENT SUMMARY

1.18.1 Response time is within one hour of notification of need. The contractor would be responsible for providing a vehicle to transport the patient another Higher Level of Care facility home within one hour of the trip notification. STAT response time is within 20 minutes of notification of need.

1.18.2 When unforeseeable or uncontrollable conditions occur, such as, but not limited to severe storms, flooding, or other hazardous road and travel situations, time and distance qualifications shall be considered secondary to safety precautions.

1.18.3 Any delays or exceptions to the required quality of services, due to such substantial difficulties, shall be reported to the Travel Office during normal business hours. Outside normal business hours, the Administrative Officer of the Day (AOD) for the medical center is to be contacted.

1.18.4 The Contracting Officer will make a determination as to whether any such delays in service will be excused. VA will not be charged for trips canceled due to conditions listed within 1.17.1.

1.18.5 The Contracting Officer's Representative (COR) and/or Alternate COR shall be responsible for verifying contract compliance.

1.18.6 Any incidents of contractor noncompliance, as evidenced by the monitoring procedures in the Performance Requirement Summary, shall be forwarded to the Contracting Officer within one business day.

1.18.7 Documentation of services performed shall be reviewed prior to certifying payment. The COR and/or Alternate COR shall perform routine audits in conjunction with the contracting service in order to ensure proper documentation of services. Contract monitoring and recordkeeping procedures shall be sufficient to ensure proper payment and to allow auditors to verify that services were provided.

1.19 CONTRACTOR’S QUALITY CONTROL PROGRAM (QCP)

1.19.1 The contractor shall establish and maintain a complete QCP to ensure the requirements of this contract are provided as specified. An original and one (1) copy of this QCP will be forwarded to the CO along with the requested initial proposal.

1.19.2 The contractor’s QCP shall include, at a minimum, the following:

a) An inspection plan covering all services required by this contract. The inspection plan must specify the areas to be inspected on either a scheduled or unscheduled basis, how often inspections will be accomplished and documented, or the title of the individual(s) who will perform the inspections.

b) On-site records of all inspections conducted by the contractor noting necessary corrective action taken. The Government reserves the right to request copies of any or all inspections which occur.

c) Incorporation of either active or established internal policy or procedures for updating medical service protocols that may affect performance of the contract.

d) The methods for identifying and preventing deficiencies in the quality of service performed, before the level of performance becomes unacceptable and organizational functions noting intermediate supervisory responsibilities and overall management responsibilities for ensuring total acceptable performance.

e) On-site records of all vehicle maintenance and repairs performed, on vehicles used in the performance of this contract. The methods of identifying and preventing vehicle breakdowns, and detailed procedure for alternative transportation of patients in the event of mechanical breakdown of the Ambulance vehicle.

f) On-site records identifying the character, physical capabilities, certifications and ongoing training of each employee performing services under this contract.

g) The methods of identifying and preventing radio communication breakdowns. A detailed procedure for alternative communications in the event of electronic and mechanical breakdown of vehicle two-way radios.

h) A log to account for all requests for service. The log shall indicate the date and time of service call, name of beneficiary requiring services, type of transportation requested, designated pick-up and delivery points, actual time of arrival at pick-up and delivery points and actual waiting time at pick-up and delivery points, if waiting charges are claimed.

i) On-site records of any complaints or problems, with procedures taken to allow for corrections and/or elimination before effects caused interruption of performance of contract.

j) The contractor shall establish and maintain quality control to ensure all contract requirements and applicable Joint Commission requirements are met. The Contractor shall identify how he/she shall measure and provide customer satisfaction, the method of identifying deficiencies, the quality of service to be performed and methods for identifying and implementing necessary corrective actions.

k) The contractor shall participate in quarterly scheduled and with the VA representatives to provide a report of on-going operational issues.

1.20 INVOICING PROCEDURE

1.20.1 The awarded contractor will invoice the North Texas VA Medical Center by utilizing a secured means of Electronic Data Interchange (EDI). When invoicing, the VA requires that each trip is disclosed with the individual cost, mileage utilized, point of pick-up, and point of drop-off, along with the date of transport and associated patient identification.

1.20.2 The contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include the following information:

(i) Nam e and address of the contractor;

(ii) Invoice date and number;

(iii) Contract number, contract line item number and, if applicable, the order number;

(iv) Description, quantity, unit of measure, unit price and extended price of the items delivered;

(v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on an ordering activity bill of lading;

(vi) Terms of any discount for prompt payment offered;

(vii) Name and address of official to whom payment is to be sent;

(viii) Name, title, and phone number of people to notify in event of defective invoice; and

(ix) Taxpayer Identification Number (TIN). The contractor shall include its TIN on the invoice only if required elsewhere in this contract.

(x) Electronic funds transfer (EFT) banking information.

1.20.3 At the time of delivery of the patient to their destination, the contractor shall provide a “Run Sheet” as part of the patient's permanent record. This Run Sheet shall include a record of the patient’s vital signs, medications used, oxygen use, and any changes in the patient’s condition.

The Run Sheet shall provide the following information either in this format or in the contractors established format. www.dps.texas.gov http://www.dps.texas.gov/

1.21 CONTRACTOR PERFORMANCE ASSESSMENT RATING SYSTEM (CPARS)

Required Registration with Contractor Performance Assessment Rating System (CPARS)

1.21.1 As prescribed in Federal Acquisition Regulation (FAR) Part 42.15, the Department of Veterans Affairs (VA) evaluates contractor past performance on all contracts that exceed $1,000,000 and shares those evaluations with other Federal Government contract specialists and procurement officials. The FAR requires that the contractor be provided an opportunity to comment on past performance evaluations prior to each report closing. To fulfill this requirement VA uses an online database. The CPARS database information is shared with the Past Performance Information Retrieval System (PPIRS) database, which is available to all Federal Agencies.

1.21.2 Each contractor whose contract award is estimated to exceed $1,000,000 is required to register with the Contractor Performance Assessment Rating System (CPARS) database at the following https://www.cpars.gov/ or by calling (207) 438-1690. Registration should occur no later than thirty days after contract award and must be kept current should there be any change to the contractor’s registered representative.

1.21.3 For contracts with a period of one year or less, the contracting officer will perform a single evaluation when the contract is complete. For contracts exceeding one year, the contracting officer will evaluate the contractor’s performance annually. Interim reports will be filed each year until the last year of the contract when the final report will be completed. The report shall be assigned in CPARS to the contractor’s designated representative for comment. The contractor representative will have thirty days to submit any comments and re-assign the report to the VA contracting officer.

1.21.4 Failure to have a current registration in the CPARS database, or to re-assign the report to the VA contracting officer within those thirty days, will result in the Government’s evaluation being placed on file in the database with a statement that the contractor failed to respond.

1.22 CONTRACTOR PERSONNEL SECURITY REQUIREMENTS

1.22.1 All contractor employees who require access to the Department of Veterans Affair's computer systems or who come into contact with veteran/beneficiaries shall be the subject of a background investigation and must receive a favorable adjudication from the VA Office of Security and Law Enforcement prior to contract performance. This requirement is applicable to all subcontractor personnel requiring the same access. If the investigation is not completed prior to the start date of the contract, the contractor will be responsible for the actions of those individuals they provide to perform work for the VA.

Position Sensitivity - The position sensitivity for this contract has been designated as LOW RISK.

Background Investigation - The level of background investigation commensurate with the required level of access for this contract is National Agency Check with Written Inquiries.

Contractor Responsibilities:

• The contractor shall pre-screen all personnel requiring VA access to ensure they maintain a U.S. citizenship and are able to read, write, speak and understand the English language.

• The contractor shall submit or have their employees submit the following required forms requested by Department of Veterans Affairs, Office of Security and Law Enforcement, Security and Investigations Center, 2200 Fort Roots Drive Bldg. 104, North Little Rock, AR 72114 within 30 days of receipt:

• All documents completed and submitted at the following website:

http://www.va.gov/SECURITYINVESTIGATIONSCENTER/

• Fingerprints submitted at the North Texas (Dallas) VAMC Security Office

• The contractor, when notified of an unfavorable determination by the Government, shall withdraw the employee from consideration from working under the contract. Failure to comply with the contractor personnel security requirements may result in termination of the contract for cause.

1.22.2 The contractor shall agree that all deliverables, associated working papers, and other material deemed relevant by the contractor in the performance of this task order are the property of the United States Government. The contractor shall agree that all individually identifiable health information shall be treated with the strictest confidentiality. Access to records shall be limited to essential personnel only. Records shall be secured when not in use. At the conclusion of the contract, all copies of individually identifiable health records shall be destroyed or returned to the VA. Any individually identifiable health records shall be deleted from computers not belonging to the VA. The contractor shall comply with the Privacy Act, 38 U.S.C. 5701, 38 U.S.C. 7332, and 5 U.S.C. 552(a) et. Seq. Contractor staff shall sign confidentiality statements before the start date of the contract. The contractor shall comply with all provisions of the Health Information Portability and Accountability Act (HIPAA), including but not limited to privacy, security of electronic health data, and adherence to standards and code sets as required by HIPAA. The contractor shall ensure the confidentiality of all patient and employee information and shall be held liable in the event of breach of confidentiality. Any person, who knowingly or willingly discloses confidential information obtained from the VA with non-essential persons, may be subject to fines.

1.22.3 HIPAA COMPLIANCE. HIPAA compliance is required. The contractor must adhere to the provisions of Public Law 104-191, Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the National Standards to Protect the Privacy and Security of Protected Health Information (PHI). As required by HIPAA, the Department of Health and Human Services (HHS) has promulgated rules governing the security and use and disclosure of protected health information by covered entities, including the Department of Veterans Affairs (VA). In accordance with HIPAA, the contractor may be required to enter into a Business Associate Agreement (BAA) with VA.

1.22.4 BLOOD BORNE PATHOGENS: The contractor and the employees provided, pursuant to this contract, shall comply with the effective VAMC Policy (and Occupational Health requirements in accordance with OSHA Blood Borne Pathogens (BBP) Law and the OSHA Tuberculosis Compliance Directive, enforceable under OSHA’s General Duty Clause) governing health care workers infected with a blood borne pathogen. If the contractor obtains information that a health care worker providing care pursuant to this agreement may be infected with a blood borne pathogen, the contractor will advise the Contracting Officer immediately.

1.23 WORKER’S COMPENSATION

1.23.1 The Act of June 25, 1936, 42 Stat. 1938 (40 USC 290), authorized the constituted authority of the several states to apply their workmen’s compensation laws to all lands and premises owned or held by the United States. The contractor agrees to procure and maintain while the contract is in effect, Worker’s Compensation and Employers Public Liability insurance. The policy shall provide coverage for Public Liability Limits of not less than the statutory limitations for any one accident, and at least meet the statutory limitations if more than one person is involved. , Upon award of the contract, the contractor shall furnish to the Contracting Officer a certificate from its insurance company indicating that this coverage has been obtained and that such coverage may not be changed or canceled unless 30 day advance written notice is provided to the Contracting Officer.

1.24 MEDICAL LIABILITIES INSURANCE

1.24.1 The contractor shall carry required insurance (See VAAR Clause 852.237-7 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE) and vehicle insurance in accordance with the Texas Department of State Health Services

1.25 ANNUAL VHA TRAINING

1.25.1 In accordance with VHA Directive 2003-028 "Compliance and Business Integrity Program", its updates or replacement directives, IG Guidance at 8994, Section II(C); Guidance at 4875, Section III (B)(4) Sentencing Guidelines, Section 8B2.1 (b) (4) (B) annual compliance training is to be provided to all contractors within the scope of their work. The medical center COTR’s are to coordinate the annual training with their respective Contracting Officer and Compliance and Business Integrity Officers. A copy of the documentation of the completed annual training is to be provided to the Compliance and Business Integrity Officers for their files.

In accordance with VHA Directive 1605.1 “Privacy and Release of Information”, updates or replacement directives annual VHA Privacy Policy Training is to be provide to all contractors within the scope of their work. A copy of the documentation of the completed annual training is to be provided to the Contracting Officer and the facility Privacy Officer for their files.

In accordance with VA Directive 6500, “Information Security Program”, updates or replacement directives annual VHA Cyber and Security Information Training is to be provided to all contractors within the scope of their work. A copy of the documentation of the completed annual training is to be provided to the Contracting Officer and the facility Information Security Officer for their files.

1.26 CONFORMANCE WITH ENVIRONMENTAL MANAGEMENT SYSTEMS

The contractor shall perform work under this contract consistent with the relevant policy and objectives identified in the agency, organizational, or facility environmental management system (EMS) applicable for your contract. The contractor shall perform work in a manner that conforms to all appropriate Environmental Management Programs and Operational Controls identified by the agency, organizational, or facility EMS, and provide monitoring and measurement information as necessary for the organization to address environmental performance relative to the environmental, energy, and transportation management goals. In the event an environmental nonconformance or noncompliance associated with the contracted services is identified, the contractor shall take corrective and/or preventative actions. In the case of a noncompliance, the contractor shall respond and take corrective action immediately. In the case of a nonconformance, the contractor shall respond and take corrective action based on the time schedule established by the EMS Site Coordinator. In addition, the Contractor shall ensure that their employees are aware of the roles and responsibilities identified by the environmental management system and how these requirements affect their work performed under this contract.

All on-site contractor personnel shall complete yearly EPA sponsored environmental training specified for the type of work conducted on-site. Upon contract award, the Contracting Officer's Representative will notify the facility-level Environmental Management Systems Coordinator to arrange EMS training for appropriate staff.

DEFINITIONS/ACRONYMS:

ACO – Administrative Contracting Officer – An individual designated by the Contracting Officer who is authorized to commit and obligate the government through the life of the contract, with consent from the Contracting Officer.

MAA – Medical Administrative Assistant – VA official that works in the admissions area during evenings and nights, and monitors hospital activities during other than normal working hours. This person acts as hospital administrator during off-hours.

ALS – Advanced Life Support - Advanced Life Support shall be provided by ambulance vehicles containing at a minimum an on-board Paramedic, Cardiac monitoring, Advanced Life Support drugs and procedures, Advanced airway management and Medication monitoring and administration, and provide restraint and seclusion management when needed.

• Reference: Texas Administrative Code- Title 21, Part 1, Chapter 157, Emergency Medical Care.

http://info.sos.state.tx.us/pls/pub/readtac$ext.ViewTAC?tacview=5&ti=258pt=18ch=157&sch=A &rl=Y

Base Rate – Base Rate is defined as the rate paid for one-way transportation and handling of a patient, from a designated pick-up point to a designated delivery point. This rate will be paid for all authorized one-way trips ordered under this contract action up to 20 miles.

Beneficiary – Veterans and others determined to be eligible for benefits by the VA.

BLS – Basic Life Support- Basic Life Support shall be provided by ambulance vehicles containing at a minimum, an on-board Emergency Medical Technician (EMT), Basic airway management and IV keeping vein open (KVO) without additives. The contractor shall also provide restraint and seclusion management when needed.

• Reference: Texas Administrative Code- Title 21, Part 1, Chapter 157, Emergency Medical Care.

http://info.sos.state.tx.us/pls/pub/readtac$ext.ViewTAC?tacview=5&ti=258pt=18ch=157&sch=A &rl=Y

Class D Operators License – Defined by the Texas Department of Motor Vehicles as a driver’s license issued to a person to operate a motor vehicle, or motor driven cycle, other than a commercial motor vehicle and includes probationary license, restricted license, and any operators or chauffeurs license issued before January 1, 1990.

CO - Contracting Officer, VA official with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings, and is a member of the vehicle inspection team.

CBOC - Community Based Outpatient Clinic

Contractor - The term “contractor” as used herein refers to both the prime contractor and his employees, and any subcontractors and their employees. The contractor shall be responsible for assuring that his subcontractors comply with the provisions of this contract.

COR – Contracting Officer’s Representative – VA official responsible for providing technical guidance to the contractor and Contracting Officer. Responsibilities include certification of invoices, providing technical guidance, overseeing technical aspects of the contract and are a member of the vehicle inspection team.

Emergency Medical Technician - a person who is specially trained and certified to administer basic emergency services to victims of trauma or acute illness before and during transportation to a hospital or other healthcare facility.

Excusable delays – The contractor shall respond to all calls for…