P09 PWS MEM SMT FINAL 01.26.2022.docx

Special Mode Transportation Performance Work Statement

The Memphis Veterans Administration Healthcare System (VA HCS) provides Special Mode Transportation Services to Veterans based upon medical necessity. The Contractor shall provide non-emergent wheelchair and stretcher ground transportation services, as identified within this Performance Work Statement (PWS). This shall include all vehicles, personnel, management, supplies, transportation, insurance, equipment and reports necessary to provide ground transportation services for beneficiaries of the Memphis VA HCS in a 53-county tri-state (Tennessee, Arkansas, and Mississippi) area catchment area (see Attachment 1 – Memphis VA HCS Catchment Area Map). The catchment area includes:

1. North Community Based Outpatient Clinic (CBOC), 3461 Austin Peay Hwy, Memphis TN, 38127.

2. South CBOC 1689 Nonconnah Blvd, Memphis TN, 38132.

3. Dyersburg, TN CBOC, 1065 Vendall Rd, Dyersburg TN, 38024.

4. Jackson, TN CBOC, 180 Old Hickory Blvd, Jackson TN, 38305.

5. Savannah, TN CBOC, 70 Harbert Drive North, Savannah TN, 38372.

6. Tupelo, MS CBOC, 1114 Commonwealth Blvd, Tupelo MS, 38804.

7. Holly Springs, MS CBOC, .

8. Helena, AR CBOC, 131 Quarles Lane, West Helena AR, 72342.

9. Jonesboro, AR CBOC, 2908 S. Caraway Road, Jonesboro AR, 72401.

1. SERVICES: The contractor agrees to furnish 24-hour, seven days per week, non-emergent wheelchair and stretcher transportation services for the beneficiaries of the Memphis VA HCS to include all federal holidays.

2. FEDERAL HOLIDAYS

(And any other Federal Holidays determined by the President.)

3. ORDERS FOR SERVICES: NON – EMERGENT TRANSPORT (NET): During normal working hours, Monday thru Friday from 7:30 am – 4:30 pm (0730 - 1630 hrs.), the Contractor shall provide wheelchair and stretcher transportation services to Memphis VA HCS beneficiaries who requires a non-emergent transportation but need special assistance, which means providing help and support to the veteran, if necessary, getting to essential medical appointments. The Contractor shall furnish two (2) personnel per vehicle for stretcher transportation and one (1) personnel per vehicle for wheelchair transportation to ensure patients are escorted to and from clinic locations. Contractors’ vehicles shall be specially equipped to transport riders in wheelchairs (to include bariatric wheelers), stretchers, and an attendant for special needs such as a Health Tech/Nursing Assistant (NA) / Certified Nursing Assistant (CNA) attendant/ caregiver to provide sitter duties. NET services may be used for medical appointments, imaging, discharge from hospitals or transferring facilities.

4. NUMBER OF PATIENTS: It is understood and agreed that only one patient and possibly an attendant and /or caregiver shall be transported on a trip unless specifically authorized by VA. When, pursuant to the Department of Veterans Affairs, verbal authorization by the Contracting Officer (CO) to the contractor direction to transport more than one patient on the trip, reimbursement shall be made at the rate for transporting a single patient.

5. COMPANIONS & LUGGAGE: The following items may accompany the patient at no extra expense: one (1) companion to include a Service Dog, three (3) pieces of luggage, one (1) wheelchair (manual or electric), one (1) egg crate mattress and any necessary medical supplies, durable and/or needed medical equipment.

6. WAITING TIMES: Waiting times shall not begin until 15 minutes after the designated pick-up time. However, if the contractor’s driver arrives earlier than the specified time, it is not considered wait time for the purposes of payment. For lost time, at either end or both ends of the trip due to causes beyond their control, the Contractor shall be reimbursed. If the pickup is other than the Memphis VA HCS, the Contractor shall call the Supervisor, Travel unit or Medical Administrative Assistant (MAA) on duty as soon as they anticipate that a delay may develop for which reimbursement is expected. This call is only for the purposes of verifying their arrival time at the pick-up point and is not necessary if the Contractor anticipates no delay for which they shall claim reimbursement.

NOTE: In cases of patients that are being transported to the Airport for the purpose of boarding a Military and/or Commercial Aircraft, the vehicle must remain on the flight line until the aircraft lifts off the runway.

7. SERVICE REQUEST: Request for services will be made in writing and/or by telephone, by the Chief, Business Office or their designee authorized to request transportation service. A list of all authorized requesters will be forwarded upon award of the contract. If the contractor fails to furnish transportation service within a reasonable time (45 minutes under usual circumstances) after receiving the request for service, the Memphis VA HCS reserves the right to obtain service from another source and to charge the contractor with any excess cost that results. Failure to respond to service requests within the specified time may be grounds for default. The contractor shall utilize Veteran Transportation Service (VTS) to set up VET-Ride scheduling and shall be responsible for accepting and completing trips. https://www.vetride.va.gov/app/home EXCEPTIONS: The Contractor shall not be held liable for non-performance caused by an occurrence beyond the reasonable control of the Contractor and without its fault or negligence, such as…

· acts of God or the public enemy

· acts of the Government in its sovereign or contractual capacity

· fires

· floods

· epidemics/pandemics

· strikes

· delays of common carriers

· quarantine restrictions

· unusually severe weather

8. PICK UP AND DROP OFF REPORTING PROCEDURES FOR AFTER HOURS SUPPORT: After hour proceedings shall commence Monday-Friday from 4:30 p.m. – 7:30 a.m.(1630 – 0730 hrs.); all weekends, and federal holidays (24 hours). When responding to a transportation order, the contractor shall report to the Emergency Department Admission’s representative or the MAA or Administrator of the Day (AOD) to:

A. Announce his/her arrival to pick-up and transfer the patient and

B. Obtain report of pertinent information regarding the patient’s condition from the primary provider.

C. When delivering a patient, the contractor shall give report to appropriate medical personnel and provide a copy of the run sheet which will be retained by the facility for the patient’s medical record.

D. In cases where the contractor must divert to a local emergency room while performing a Memphis VA HCS-authorized transport, the Contractor’s dispatcher shall notify the Memphis VA HCS Beneficiary Travel section or MAA, of the patient’s location and status as soon as this information becomes available.

9. CANCELLATIONS / NO-SHOWS: For trips in which the Contractor is notified of a cancellation before the vehicle is dispatched, there will be no charge to the Government.

A. NO-SHOWS: A “no-show” is defined as an order that is canceled after the Contractor has dispatched a vehicle and the vehicle is enroute or has arrived at the pick-up location, and there is no longer a need for this patient transport. The Contractor may request one-way reimbursement for no-shows, which are based on the base rate for the service and one-way mileage accrued enroute to the pick-up location at time of cancellation. Mileage for no-show cancellations shall be confirmed by the Contractor and reported to the Contracting Officer’s Representative (COR) or designee as soon as possible from the time of cancellation.

B. ADDITIONAL CHARGES: There will be no additional charge for wait time spent on site for Contractor drivers awaiting the arrival of additional Contractor staff and/or delivery of parts and/or supplies.

10. LOCAL MILEAGE LIMITS (LML): The Local Mileage Limits, for the purpose of this requirement, is defined as travel within a 30-mile radius of the Memphis VA HCS, located at 1030 Jefferson Ave, Memphis, TN. Mileage will be paid only when 30 miles of the Medical Center is exceeded. Trips within 30 Miles of the Memphis VA HCS will be paid at the applicable per trip rate. Trips exceeding the 30-mile radius will be paid the applicable per trip rate plus the mileage rate, which exceeds the 30-mile radius, to the destination.

11. RATES: Daily rates will apply to any trip between the hours of 6:01 a.m.-6:00 p.m. (0601-1800 hrs.). Nightly rates will apply to any trip between the hours of 6:01 p.m.- 6:00 a.m. (1801-0600 hrs.) The time the patient is picked up determines whether day or night rates apply. Payment for the mileage traveled beyond the LML will be limited to “one way only” the distance over which the patient is transported. Such mileage costs will be paid in addition to the applicable rate per trip for any trip exceeding the LML. Trip mileage shall be determined at www.bing.com/maps online driving directions from Memphis VA HCS to the patient’s home address. The Rand McNally online Driving Directions (fastest route) shall be used to calculate the mileage. If the online directions do not go all the way to the patients address, Memphis VA HCS will consider the actual mileage within a 5-10-mile difference. The Contractor shall ensure that the pickups and drop-offs are scheduled so that the total distance traveled shall result in the most economical cost to the government.

12. TOLL CHARGES: It is agreed and understood that the prices quoted in the schedule does not include any ferry, bridge, tunnel, or road toll charges. Any such legitimate charges incurred shall be limited to ONE WAY ONLY and shall be listed separately on the Contractor’s invoice.

13. VEHICLES: To meet the requirements of this contract, vehicles must be available to furnish all services required. All vehicles used to transport patients in wheelchairs and stretchers shall follow Americans with Disabilities Act (ADA) Compliance (49 CFR § 38). Lifts must have a minimum design load of 600 pounds and lift platforms must accommodate a wheelchair measuring 30 inches by 48 inches. All vehicles shall have a wheelchair and/or stretcher lockdown system, 70 inch doorway clearance, and 15 inch raised roof (minimum clearance). The VA HCS will be the sole judge of determining when to order service from another source. The Contractor is required to furnish a minimum of five (5) vehicles at any given time to meet the terms and condition of transport. This requirement is not to be construed as a limitation upon the number of vehicles, which may be needed, nor as restriction on the number of additional vehicles the Contractor may wish to employ in the performance of this contract. There must be enough clearance inside the vehicle to accommodate high-backed wheelchairs. All passenger locations in vehicles transporting VA HCS patients and companions shall have both lap and shoulder restraint systems. If transporting veterans in electric mobility carts, the cart should be secured the same as a wheelchair and the patient should transfer to a vehicle seat and properly secured. All vehicles shall be a smoke-free environment. Stretchers shall have enough sheets and blankets that are clean and in good condition.

14. VEHICLE INSPECTION: Initial inspection of all vehicles to be utilized in the performance of this contract shall be inspected prior to contract award and at the beginning of the contract period for each option year. All vehicles must be inspected by VA HCS personnel. Any vehicle that does not meet the requirements of this contract cannot be utilized in the performance of this contract. Any vehicle that has not been inspected at the beginning of the contract period and is anticipated to be utilized shall be inspected by VA HCS personnel prior to utilization. The contractor shall notify the COR of any new vehicle utilization and a date and time for inspection must be determined.

15. SERVICING OF VEHICLES: Servicing of vehicles should not be an excuse for not performing contracted services. Vehicles should be maintained by regular maintenance, the vehicle should be clean both interior and exterior, the cooling and heating system shall be working properly, worn tires should be replaced and noticeable noises should be checked, and repairs performed as necessary. Maintenance and quality control records should be available upon request by the COR. Manufacturer’s instructions are followed regarding use of vehicle and all installed adaptive equipment, wheelchair locks, etc.

16. INFECTION CONTROL POLICY

A. Prior to performance any services under this agreement, the Contractor shall provide the Memphis VA HCS their policy on Tuberculosis (TB) exposure and control, to include TB decontamination.

B. The Contractor shall have its personnel tested for TB and provide each of these test results to the COR.

C. Prior to performance any services under this agreement, the Contractor shall provide the Memphis VA HCS their policy on Coronavirus (COVID-19) exposure and control, to include COVID-19 decontamination.

Note: Based on the guidance from the Centers for Disease Control and Prevention for COVID-19, contractors shall adhere to standards and infection control measures that focus on source control, limiting airborne dissemination, contamination containment, the use of personal protective equipment (PPE), and disinfectants while serving our veterans. Furthermore, the Memphis VA HCS will not incur any additional expense associated with contractor’s obligation regarding safety precautions, worker protections, patient and/or caregiver support.

17. NON-EMERGENT ATTENDANTS / DRIVERS & TRAINING: All attendant/drivers shall have a valid driver’s license in accordance with state requirements for their place of operation and the services they perform. Contractor’s personnel are required to always wear Identification (ID) badges. Drivers shall be trained in the following areas:

A. Defensive driving/proper vehicle operation ensuring safety.

B. First Aid and CPR/recognition of patient exhibiting medical distress. Have successfully completed the Standards and Advanced First Aid Courses of the American Red Cross or US Bureau of Mines or equivalent. Proof in the form of a current certificate for the successful completion of such training must be provided upon request.

C. Universal Precautions training (location and availability of protective gear, availability of hepatitis injections, etc.).

D. Driver responsibilities (ex. keeping logs of patient transported & Confidentiality of patients, in accordance with the Privacy Act of 1974 and HIPAA mandates).

E. Customer Service Training.

F. Proper use of seat belt and all adaptive equipment in vehicles in accordance with manufacturer's instructions.

G. Non-use of drugs and alcohol; maintaining a non-smoking environment in the vehicle.

H. Proper lifting techniques.

18. DRIVER CONDUCT: The following acts are not permissible by drivers which provide services under this agreement or while on Memphis VA HCS premises:

A. Use of intoxicating liquors, narcotics, or controlled substances of any kind (excluding Dr.’s prescriptions which do not impair driving ability), while on duty or reporting for duty.

B. Gambling in any form.

C. Smoking and other uses of tobacco while on duty.

D. Carrying of pistols, firearms, or concealed weapons.

E. Resorting to physical violence to settle a dispute with a fellow employee(s), customer(s), or the general public while on duty.

F. Spitting, or any other unsanitary, or offensive practice or behavior while on premises’ use of loud, indecent, or profane language and/or making threatening or obscene gestures towards customers or other employees.

G. Stopping for personal business, including use of a restroom, while a patient is in the vehicle.

H. Leaving the vehicle with the key in the ignition at any time.

I. Engaging in political or religious beliefs.

J. Engaging a customer in a verbal confrontation to settle a disagreement. Should a disagreement arise, the driver is to contact their dispatcher/supervisor.

K. Soliciting or accepting tips from customers, companions, or caregivers at any time.

19. VETERANS ADMINISTRATION (VA) COMPLIANCE TRAINING: All contractor employees and subcontractor employees requiring access to VA information and VA information systems shall complete the following before being granted access to VA information and its systems:

A. Sign and acknowledge (either manually or electronically) understanding of and responsibilities for compliance with the Contractor Rules of Behavior, Appendix E relating to access to VA information and information systems.

B. Successfully complete the VA Cyber Security Awareness and Rules of Behavior training and annually complete required security training; Privacy and HIPAA Training (VA course number 10203) and VA Privacy and Information Security Awareness and Rules of Behavior (VA course number 10176).

C. Successfully complete the appropriate VA privacy training and annually complete required privacy training; Privacy and HIPAA Training (VA course number 10203) and VA Privacy and Information Security Awareness and Rules of Behavior (VA course number 10176).

D. Successfully complete any additional cyber security or privacy training, as required for VA personnel with equivalent information system access [to be defined by the VA program official and provided to the CO for inclusion in the solicitation document – e.g., any role-based information security training required in accordance with NIST Special Publication 800-16, Information Technology Security Training Requirements].

E. The contractor shall provide to the CO and/or the COR a copy of the training certificates and certification of signing the Contractor Rules of Behavior for each Applicable employee within 1 week of the initiation of the contract and annually thereafter, as required.

F. Failure to complete the mandatory annual training and sign the Rules of Behavior Annually, within the timeframe required, are grounds for suspension or termination of all physical or electronic access privileges and removal from work on the contract until such time as the training and documents are complete.

20. CERTIFICATION / LICENSING REQUIREMENTS: Prior to performing any services under this agreement, the Contractor shall provide evidence of required training, certifications, licensing, and any other qualifications of any personnel performing services under this agreement. If the Contractor wishes to add or replace personnel, it shall provide the above requirements to the COR for approval.

21. PROBLEM RESOLUTION: Contractor shall specify key personnel that shall be contacted for problem resolution regarding this contract. Please include name and telephone number of this person. Patient complaints will be investigated by the VA and the contractor. Contractor shall provide written documentation to the VA resolving the complaint within 48 hours. Any substantial complaint of patient abuse or neglect will be grounds for corrective action.

22. ACCIDENTS/EMERGENCIES: In the event of an obvious or suspected injury to the patient or their companion, the driver shall call 911, if available, or contact emergency medical services. Care and transport shall be in accordance with area Emergency Response policy. The Contractor shall provide the drivers with either a cellular phone or a two-way radio for communication in emergency situations. Drivers shall not drive more than 8 consecutive hours in a 24-hour period. In any event of accident, the VA should be contacted as soon as possible, giving the name of the patient(s) and/or companion, patient SSN, and an account of what happened and to what hospital, if any, VA beneficiaries are being transported to. It is requested that a copy of the accident report be forwarded to the Chief, Business Office (136) Department of Veterans Affairs, 1030 Jefferson Ave, Memphis, TN 38104. Any traffic fines are the responsibility of the Contractor.

23. TRIP LOG: Trip logs are to be maintained listing the following: patient name, last four of SSN, date of transport, pick-up point, destination point, mode of transport, number of out-of-town miles, waiting time (if applicable) cost of transportation and total cost. Trip logs are to be submitted with each invoice.

**UNDER NO CIRCUMSTANCES ARE VA BENEFICIARIES, THIRD PARTY INSURANCES, MEDICARE OR MEDICAID TO BE BILLED FOR SERVICES PERFORMED UNDER THIS AGREEMENT WHICH ARE AUTHORIZED BY MEMPHIS VA HCS.

24. CONTRACTOR’S QUALITY CONTROL PROGRAM: Contractor shall establish and maintain a complete Quality Control Program (QCP) to ensure the requirements of this agreement are provided as specified. The QCP shall address processes and procedures to ensure services are performed in accordance with all state and local standards and codes. Contractor’s QCP shall include the following at a minimum:

A. Incorporation of either active or established internal policy or procedures for updating service protocols that may affect the performance of the agreement.

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

C. On-site records identifying the character (background checks), certifications, applicable tests (e.g., TB Test), and documentation of ongoing training of all staff performing services under this agreement.

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

E. The Contractor shall record a log to account for all requests for service. The log shall indicate date and time of service calls, actual time of pick-up vs. scheduled time, patient's name, designated pick-up and delivery points, mileage, and actual waiting time at pick-up/delivery points, if waiting charges are claimed. The Contractor shall provide this report monthly to the COR.

F. On-site records of complaints or problems, with procedures taken to allow for corrections and/or elimination before the effects cause interruption of performance of the agreement. Contractor shall report any complaints to the COR within 48 hours along with any planned corrective action.

G. Contractor may be requested to take part in training in conjunction with Memphis VA HCS staff to ensure emergency response quality.

25. SECURITY REQUIREMENTS: Access to work areas and performance monitoring will be accomplished by the COR/designee. Smoking is prohibited on Memphis VA HCS property to include inside and outside all Memphis VA HCS buildings. Possession of weapons is prohibited. Enclosed containers shall be subject to search. Violations of VA regulations may result in citation answerable in the U.S. (Federal) District Court, not a local, state, or municipal court. The Authorization requirements do not apply, and that a Security Accreditation Package is not required.

26. VA INFORMATION CUSTODIAL LANGUAGE:

A. Information made available to the contractor or subcontractor by VA for the performance or administration of this contract or information developed by the contractor/subcontractor in performance or administration of the contract shall be used only for those purposes and shall not be used in any other way without the prior written agreement of the VA. This clause expressly limits the contractor/subcontractor's rights to use data as described in Rights in Data - General, FAR 52.227-14(d) (1).

B. VA information should not be co-mingled, if possible, with any other data on the contractors/subcontractor’s information systems or media storage systems in order to ensure VA requirements related to data protection and media sanitization can be met. If co-mingling must be allowed to meet the requirements of the business need, the contractor must ensure that VA’s information is returned to the VA or destroyed in accordance with VA’s sanitization requirements. VA reserves the right to conduct onsite inspections of contractor and subcontractor IT resources to ensure data security controls, separation of data and job duties, and destruction/media sanitization procedures compliant with VA directive requirements.

C. Prior to termination or completion of this contract, contractor/subcontractor must not destroy information received from VA, or gathered/created by the contractor in the course of performing this contract without prior written approval by the VA. Any data destruction done on behalf of VA by a contractor/subcontractor must be done in accordance with National Archives and Records Administration (NARA) requirements as outlined in VA Directive 6300, Records and Information Management and its Handbook 6300.1 Records Management Procedures, applicable VA Records Control Schedules, and VA Handbook 6500.1, Electronic Media Sanitization. Self-certification by the contractor that the data destruction requirements above have been met must be sent to the VA CO within 30 days of termination of the contract.

D. The contractor/subcontractor must receive, gather, store, back up, maintain, use, disclose and dispose of VA information only in compliance with the terms of the contract and applicable Federal and VA information confidentiality and security laws, regulations and policies. If Federal or VA information confidentiality and security laws, regulations and policies become applicable to the VA information or information systems after execution of the contract, or if NIST issues or updates applicable FIPS or Special Publications (SP) after execution of this contract, the parties agree to negotiate in good faith to implement the information confidentiality and security laws, regulations, and policies in this contract.

E. The contractor/subcontractor shall not make copies of VA information except as authorized and necessary to perform the terms of the agreement or to preserve electronic information stored on contractor/subcontractor electronic storage media for restoration in case any electronic equipment or data used by the contractor/subcontractor needs to be restored to an operating state. If copies are made for restoration purposes, after the restoration is complete, the copies must be appropriately destroyed.

F. If VA determines that the contractor has violated any of the information confidentiality, privacy, and security provisions of the contract, it shall be sufficient grounds for VA to withhold payment to the contractor or third party or terminate the contract for default or terminate for cause under Federal Acquisition Regulation (FAR) part 12.

G. If a VHA contract is terminated for cause, the associated BAA must also be terminated and appropriate actions taken in accordance with VHA Handbook 1600.01, Business Associate Agreements. Absent an agreement to use or disclose protected health information, there is no business associate relationship.

H. The contractor/subcontractor must store, transport, or transmit VA sensitive information in an encrypted form, using VA-approved encryption tools that are, at a minimum, FIPS 140-2 validated.

I. The contractor/subcontractor’s firewall and Web services security controls, if applicable, shall meet or exceed VA’s minimum requirements. VA Configuration Guidelines are available upon request.

(i) Except for uses and disclosures of VA information authorized by this contract for performance of the contract, the contractor/subcontractor may use and disclose VA information only in two other situations: (i) in response to a qualifying order of a court of competent jurisdiction, or (ii) with VA’s prior written approval. The contractor/subcontractor must refer all requests for, demands for production of, or inquiries about, VA information and information systems to the VA CO for response.

J. Notwithstanding the provision above, the contractor/subcontractor shall not release VA records protected by Title 38 U.S.C. 5705, confidentiality of medical quality assurance records and/or Title 38 U.S.C. 7332, confidentiality of certain health records pertaining to drug addiction, sickle cell anemia, alcoholism or alcohol abuse, or infection with human immunodeficiency virus. If the contractor/subcontractor is in receipt of a court order or other requests for the above- mentioned information, that contractor/subcontractor shall immediately refer such court orders or other requests to the VA CO for response.

K. For service that involves the storage, generating, transmitting, or exchanging of VA sensitive information but does not require C&A or an MOU-ISA for system interconnection, the contractor/subcontractor must complete a COR VA INFORMATION CUSTODIAL LANGUAGE request.

27. THE FOLLOWING STANDARD ITEMS RELATE TO RECORDS GENERATED IN EXECUTING THIS CONTRACT:

A. Citations to pertinent laws, codes, and regulations such as 44 U.S.C. Chapter 21, 29, 31 and 33; Freedom of Information Act (5 U.S.C. 552); Privacy Act (5 U.S.C. 552a); 36 CFR Part 1222 and Part 1228.

B. Contractor shall treat all deliverables under the contract as the property of the U.S. Government for which the Government Agency shall have unlimited rights to use, dispose of, or disclose such data contained therein as it determines to be in the public interest.

C. Contractor shall not create or maintain any records that are not specifically tied to or authorized by the contract using Government ‘IT’ equipment and/or Government records.

D. Contractor shall not retain, use, sell, or disseminate copies of any deliverable that contains information covered by the Privacy Act of 1974 or that which is generally protected by the Freedom of Information Act.

E. Contractor shall not create or maintain any records containing any Government Agency records that are not specifically tied to or authorized by the contract.

F. The Government Agency owns the rights to all data/records produced as part of this contract.

G. The Government Agency owns the rights to all electronic information (electronic data, electronic information systems, electronic databases, etc.) and all supporting documentation created as part of this contract. Contractor must deliver sufficient technical documentation with all data deliverables to permit the agency to use the data.

H. Contractor agrees to comply with Federal and Agency records management policies, including those policies associated with the safeguarding of records covered by the Privacy Act of 1974. These policies include the preservation of all records created or received regardless of format [paper, electronic, etc.] or mode of transmission [e-mail, fax, etc.] or state of completion [draft, final, etc.].

I. No disposition of documents shall be allowed without the prior written consent of the CO. The Agency and its contractors are responsible for preventing the alienation or unauthorized destruction of records, including all forms of mutilation. Willful and unlawful destruction, damage or alienation of Federal records is subject to the fines and penalties imposed by 18 U.S.C. 2701. Records may not be removed from the legal custody of the Agency or destroyed without regard to the provisions of the agency records schedules. Contractor is required to obtain the CO's approval prior to engaging in any contractual relationship (sub-contractor) in support of this contract requiring the disclosure of information, documentary material and/or records generated under or relating to this contract. The Contractor (and any sub-contractor) is required to abide by Government and Agency guidance for protecting sensitive and proprietary information.

28. REQUIRED LANGUAGE:

The solicitation and subsequent contact include FAR 52.222-41, Service Contract Labor Standards (SCLS). The Offeror and resultant contract awardee, by signing the offer and contract, is acknowledging they have reviewed the clause and will fully comply throughout the contract period. It is the responsibility of the Contractor to determine and pay the appropriate prevailing wage rate and fringe benefits for the location. The Government will not be held responsible for any mistakes in applying the SCLS. VA reminds contractors of the Department of Labor Regulations which implement the SCLS, and which read at 29 CFR § 4.115:

Employee coverage does not depend on form of employment contract. The Act, in section 8(b), makes it plain that the coverage of service employees depends on whether their work for the contractor or subcontractor on a covered contract is that of a service employee as defined in section 8(b) and not on any contractual relationship that may be alleged to exist between the contractor or subcontractor and such persons. In other words, any person, except those discussed in §4.156 below, who performs work called for by a contract or that portion of a contract subject to the Act is, per se, a service employee. Thus, for example, a person's status as an “owner-operator” or an “independent contractor” is immaterial in determining coverage under the Act and all such persons performing the work of service employees must be compensated in accordance with the Act's requirements.

29. SECURITY INCIDENT INVESTIGATION:

A. The term “security incident” means an event that has, or could have, resulted in unauthorized access to, loss or damage to VA assets, or sensitive information, or an action that breaches VA security procedures. The contractor/subcontractor shall immediately notify the COR and simultaneously, the designated VA Information Security Officer and Privacy Officer for the contract of any known or suspected security/privacy incidents, or any unauthorized disclosure of sensitive information, including that contained in system(s) to which the contractor/subcontractor has access.

B. To the extent known by the contractor/subcontractor, the contractor/subcontractor’s notice to VA shall identify the information involved, the circumstances surrounding the incident (including to whom, how, when, and where the VA information or assets were placed at risk or compromised), and any other information that the contractor/subcontractor considers relevant.

C. With respect to unsecured protected health information, the business associate is deemed to have discovered a data breach when the business associate knew or should have known of a breach of such information. Upon discovery, the business associate must notify the covered entity of the breach. Notifications need to be made in accordance with the executed business associate agreement.

D. In instances of theft or break-in or other criminal activity, the contractor/subcontractor must concurrently report the incident to the appropriate law enforcement entity (or entities) of jurisdiction, including the VA Office of Inspector General (VA OIG)and Security and Law Enforcement. The contractor, its employees, and its subcontractors and their employees shall cooperate with VA and any law enforcement authority responsible for the investigation and prosecution of any possible criminal law violation(s) associated with any incident. The contractor/subcontractor shall cooperate with VA in any civil litigation to recover VA information, obtain monetary or other compensation from a third party for damages arising from any incident, or obtain injunctive relief against any third party arising from, or related to, the incident.

30. LIQUIDATED DAMAGES FOR DATA BREACH:

A. Consistent with the requirements of 38 U.S.C. §5725, a contract may require access to sensitive personal information. If so, the contractor is liable to VA for liquidated damages in the event of a data breach or privacy incident involving any security/privacy incidents the contractor/subcontractor processes or maintains under this contract.

B. The contractor/subcontractor shall provide notice to VA of a “security incident” as set forth in the Security Incident Investigation section above. Upon such notification, VA must secure from a non-Department entity or the VA OIG an independent risk analysis of the data breach to determine the level of risk associated with the data breach for the potential misuse of any sensitive personal information involved in the data breach. The term 'data breach' means the loss, theft, or other unauthorized access, or any access other than that incidental to the scope of employment, to data containing sensitive personal information, in electronic or printed form, that results in the potential compromise of the confidentiality or integrity of the data. Contractor shall fully cooperate with the entity performing the risk analysis. Failure to cooperate may be deemed a material breach and grounds for contract termination.

C. Each risk analysis shall address all relevant information concerning the data breach, including the following:

I. Nature of the event (loss, theft, unauthorized access).

II. Description of the event, including:

a. Date of occurrence

b. Data elements involved, including any PII, such as full name, social security number, date of birth, home address, account number, disability code.

III. Number of individuals affected or potentially affected.

IV. Names of individuals or groups affected or potentially affected.

V. Ease of logical data access to the lost, stolen or improperly accessed data considering the degree of protection for the data, e.g., unencrypted, plain text.

VI. Amount of time the data has been out of VA control.

VII. The likelihood that the sensitive personal information will or has been compromised (Made accessible to and usable by unauthorized persons).

VIII. Known misuses of data containing sensitive personal information, if any.

IX. Assessment of the potential harm to the affected individuals.

X. Data breach analysis as outlined in 6500.2 Handbook, Management of Security and Privacy Incidents, as appropriate: and

XI. Whether credit protection services may assist record subjects in avoiding or mitigating the results of identity theft based on the sensitive personal information that may have been compromised. Based on the determinations of the independent risk analysis, the contractor shall be responsible for paying to the VA liquidated damages per affected individual to cover the cost of providing credit protection services to affected individuals consisting of the following:

a. Notification.

b. One year of credit monitoring services consisting of automatic daily monitoring of at least 3 relevant credit bureau reports. Data breach analysis.

c. Fraud resolution services, including writing dispute letters, initiating fraud alerts and credit freezes, to assist affected individuals to bring matters to resolution.

d. One year of identity theft insurance with $20,000.00 coverage at $0 deductible; and

e. Necessary legal expenses the subjects may incur to repair falsified or damaged credit records, histories, or financial affairs.

31. CONFIDENTIALITY TRAINING: All Contractor employees assigned to this requirement who create, work with, or otherwise handle records are required to take VHA-provided records management training. The Contractor is responsible for confirming training has been completed according to agency policies, including initial training and any annual or refresher training.

Note: To the extent an agency requires contractors to complete records management training, the agency must provide the training to the contractor.

VA will provide the contractor with access to pertinent patient medical information, with the existing privacy rules and regulations, for the purpose of providing coordinated comprehensive primary care. Contractor shall ensure the confidentiality of all patient information and shall be held liable in the event of the breach of confidentiality.

32. POLICIES, GUIDELINES, STANDARDS AND REGULATIONS:

A. NFPA 99 and 55

B. CGA p-1, 1991. Safe Handling of Compressed Gases in Containers

C. 49 CFR -Transportation

D. 21 CFK- Food and Drugs

E. CDC Guidelines.

33. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 (HIPAA): HIPAA Compliance: Contractor shall adhere to the provision of Public Law 104-191, Health Insurance Portability and Accountability Act (I11PAA) 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 (HIIS) 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 is required to enter into a Business Associate Agreement (BAA) with VA.

A. Contractor shall comply with all applicable records management laws and regulations, as well as National Archives and Records Administration (NARA) records policies, including but not limited to the Federal Records Act (44).

B. U.S.C. (Chapters. 21, 29, 31, 33), NARA regulations at 36 CFR Chapter XII Subchapter B, and those policies associated with the safeguarding of records covered by the Privacy Act of 1974 (5 U.S.C. 552a). These policies include the preservation of all records, regardless of form or characteristics, mode of transmission, or state of completion.

C. In accordance with 36 CFR 1222.32, all data created for Government use and delivered to, or falling under the legal control of, the Government are Federal records subject to the provisions of 44 U.S.C. Chapters 21, 29, 31, and 33, the Freedom of Information Act (FOIA) (5 U.S.C. 552), as amended, and the Privacy Act of 1974 (5 U.S.C. 552a), as amended and must be managed and scheduled for disposition only as permitted by statute or regulation. In accordance with 36 CFR 1222.32, Contractor shall maintain all records created for Government use or created during performing the contract and/or delivered to, or under the legal control of the Government and must be managed in accordance with Federal law. Electronic records and associated metadata must be accompanied by enough technical documentation to permit understanding and use of the records and data.

D. Memphis VA HCS and its contractors are responsible for preventing the alienation or unauthorized destruction of records, including all forms of mutilation. Records may not be removed from the legal custody of Memphis VA HCS or destroyed except for in accordance with the provisions of the agency records schedules and with the written concurrence of the Head of the Contracting Activity. Willful and unlawful destruction, damage or alienation of Federal records is subject to the fines and penalties imposed by 18 U.S.C. 2701.

E. In the event of any unlawful or accidental removal, defacing, alteration, or destruction of records, Contractor must report to Memphis VA HCS. The agency must report promptly to NARA in accordance with 36 CFR 1230.

F. The Contractor shall immediately notify the appropriate CO upon discovery of any inadvertent or unauthorized disclosures of information, data, documentary materials, records, or equipment. Disclosure of non-public information is limited to authorized personnel with a need-to-know as described in the [contract vehicle]. The Contractor shall ensure that the appropriate personnel, administrative, technical, and physical safeguards are established to ensure the security and confidentiality of this information, data, documentary material, records and/or equipment is properly protected. The Contractor shall not remove material from Government facilities or systems, or facilities or systems operated or maintained on the Government’s behalf, without the express written permission of the Head of the Contracting Activity. When information, data, documentary material, records and/or equipment is no longer required, it shall be returned to Memphis VA HCS control or the Contractor must hold it until otherwise directed. Items returned to the Government shall be hand carried, mailed, emailed, or securely electronically transmitted to the CO or address prescribed in the [contract vehicle]. Destruction of records is EXPRESSLY PROHIBITED unless in accordance with Paragraph (4).

G. The Contractor is required to obtain the CO's approval prior to engaging in any contractual relationship (sub-contractor) in support of this contract requiring the disclosure of information, documentary material and/or records generated under, or relating to, contracts. The Contractor (and any sub- contractor) is required to abide by Government and Memphis VA HCS guidance for protecting sensitive, proprietary information, classified, and controlled unclassified information.

H. The Contractor shall only use Government IT equipment for purposes specifically tied to or authorized by the contract and in accordance with Memphis VA HCS policy.

I. The Contractor shall not create or maintain any records containing any non- public Memphis VA HCS information that are not specifically tied to or authorized by the contract.

J. The Contractor shall not retain, use, sell, or disseminate copies of any deliverable that contains information covered by the Privacy Act of 1974 or that which is generally protected from public disclosure by an exemption to the Freedom of Information Act.

K. The Memphis VA HCS owns the rights to all data and records produced as part of this contract. All deliverables under the contract are the property of the U.S. Government for which Memphis VA HCS shall have unlimited rights to use, dispose of, or disclose such data contained therein as it determines to be in the public interest. Any Contractor rights in the data or deliverables must be identified as required by FAR 52.227-11 through FAR 52.227-20.

34. REQUIRED DOCUMENTATION: Contractor is responsible for the documentation listed below. Failure to provide the documentation when requested, or at the times called for in the PWS may result in unfavorable performance evaluations.

A. QUALITY CONTROL PLAN – as outlined under Quality Assurance Surveillance Plan (QASP) section.

B. SERVICE LOG SHEETS

C. GENERAL LIABILITY COVERAGE

D. SAFETY AND HEALTH PLAN

E. TRAINING AND CERTIFICATION – evidence of required training, certifications, licensing, and any other qualifications of any personnel performing services under this agreement.

35. QUALITY ASSURANCE: Contractor shall ensure services are performed in accordance with accepted commercial practices. Memphis VA HCS will evaluate the Contractor’s performance and approve all services per the COR/designee in accordance with the Quality Assurance Surveillance Plan (QASP).

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P10 VHA Local BAA MEM VAMC SMT.doc BUSINESS ASSOCIATE AGREEMENT BETWEEN THE DEPARTMENT OF VETERANS AFFAIRS VETERANS HEALTH ADMINISTRATION, MEMPHIS VETERANS ADMINISTRATION MEDICAL CENTER, AND <TBD CONTRACTOR>

Purpose. The purpose of this Business Associate Agreement (Agreement) is to establish requirements for the Department of Veterans Affairs (VA), Veterans Health Administration (VHA), Memphis Veterans Administration Medical Center and <TBD CONTRACTOR> in accordance with the Health Insurance Portability and Accountability Act (HIPAA), the Health Information Technology for Economic and Clinical Health Act (HITECH) Act, and the HIPAA Privacy, Security, Breach Notification, and Enforcement Rules (“HIPAA Rules”), 45 C.F.R. Parts 160 and 164, for the Use and Disclosure of Protected Health Information (PHI) under the terms and conditions specified below.

Scope. As described this Agreement and other applicable contracts or agreements, Veteran Affairs will provide Wheelchair transportation services to, for, or on behalf of Memphis Veterans Administration Medical Center.

In order for <TBD CONTRACTOR> to provide such services, Memphis Veterans Administration Medical Center will disclose PHI to <TBD CONTRACTOR>, and <TBD CONTRACTOR> will use or disclose PHI in accordance with this Agreement.

Definitions. Unless otherwise provided, the following terms used in this Agreement have the same meaning as defined by the HIPAA Rules: Breach, Data Aggregation, Designated Record Set, Disclosure, Health Care Operations, Individual, Minimum Necessary, Notice of Privacy Practices, PHI, Required by Law, Secretary, Security Incident, Subcontractor, Unsecured PHI, and Use.

“Breach” shall have the same meaning as described at 45 C.F.R. § 164.402. For the purposes of this Agreement, Breach shall refer to an acquisition, access, use, or disclosure of PHI in a manner not permitted by the HIPAA Rules or by this Agreement.

“Business Associate” shall have the same meaning as described at 45 C.F.R. § 160.103. For the purposes of this Agreement, Business Associate shall refer to <TBD CONTRACTOR>, including its employees, officers, or any other agents that create, receive, maintain, or transmit PHI as described below.

“Covered Entity” shall have the same meaning as the term is defined at 45 C.F.R. § 160.103. For the purposes of this Agreement, Covered Entity shall refer to Memphis Veterans Administration Medical Center.

“Incident” shall have the same meaning as described in VA Handbook 6500.2, Management of Breaches Involving Sensitive Personal Information, which is an event that has resulted in, or had the potential to result in, unauthorized access to or disclosure of VA sensitive personal information in a manner not permitted under the applicable confidentiality provisions. An incident that involves access or disclosure of PHI in a manner not permitted under the HIPAA Privacy Rule is presumed to be a breach unless Business Associate demonstrates that there is a low probability that the PHI has been compromised based on a risk assessment using at least the listed factors in the Breach Notification Rule.

“Protected Health Information” or “PHI” shall have the same meaning as described at 45 C.F.R. § 160.103. “Protected Health Information” and “PHI” as used in this Agreement include “Electronic Protected Health Information” and “EPHI.” For the purposes of this Agreement and unless otherwise…