Performance Work Statement (PWS) Ground Ambulance

1. Purpose:

The Canandaigua, New York VAMC and Rochester, New York Outpatient Clinic (ROPC) require contracted non-emergency ambulance transportation services. The contractor shall provide all vehicles, personnel, management, supplies, equipment, and necessary reporting for the provision of Basic Life Support (BLS), Advanced Life Support (ALS), or Critical Care Transport (CCT) services. The contactor shall make these ambulance services available to the VA as needed, 24 hours a day, seven days a week (24/7), including weekends and holidays.

2. Background:

The Canandaigua, New York VAMC main campus is located at 400 Fort Hill Avenue, Canandaigua, NY 14424.

Rochester, New York Outpatient Clinic (ROPC) is located at 260 Calkins Rd, Rochester, NY 14623. They serve over 23,018 Veterans, primarily from the Canandaigua and Rochester area. The hospital has 67 inpatient beds and sees approximately 55 -inpatient admissions and about 245,530 outpatient visits a year. Veterans served within this facility live within the following counties and zip codes.

County/Zip Code County/Zip Code County/Zip Code County/Zip Code County/Zip Code Monroe Wayne Livingston Ontario Seneca 14410 13143 14414 14424 13065 14420 13146 14423 14425 13148 14428 13154 14435 14432 13165 14430 14413 14437 14443 14521 14445 14433 14454 14453 14541 14450 14449 14462 14456 14588 14464 14489 14466 14461 14847 14467 14502 14480 14463 14860 14468 14505 14481 14469 14472 14513 14485 14471 14506 14516 14486 14475 14508 14519 14487 14504 14511 14520 14488 14512 14514 14522 14510 14518 14515 14538 14517 14532 14526 14542 14533 14537 14534 14551 14539 14547 14543 14555 14545 14548 14546 14563 14556 14561 14559 14568 14558 14564 14580 14589 14560 14585 14586 14590 14592 14602 14836 14603 14846 14604 14605 14606 14607 14608 14609 14610 https://www.zipcodestogo.com/Adams%20Basin/NY/14410/ https://www.zipcodestogo.com/Red%20Creek/NY/13143/ https://www.zipcodestogo.com/Avon/NY/14414/ https://www.zipcodestogo.com/Canandaigua/NY/14424/ https://www.zipcodestogo.com/Fayette/NY/13065/ https://www.zipcodestogo.com/Brockport/NY/14420/ https://www.zipcodestogo.com/Savannah/NY/13146/ https://www.zipcodestogo.com/Caledonia/NY/14423/ https://www.zipcodestogo.com/Farmington/NY/14425/ https://www.zipcodestogo.com/Seneca%20Falls/NY/13148/ https://www.zipcodestogo.com/Churchville/NY/14428/ https://www.zipcodestogo.com/South%20Butler/NY/13154/ https://www.zipcodestogo.com/Conesus/NY/14435/ https://www.zipcodestogo.com/Clifton%20Springs/NY/14432/ https://www.zipcodestogo.com/Waterloo/NY/13165/ https://www.zipcodestogo.com/Clarkson/NY/14430/ https://www.zipcodestogo.com/Alton/NY/14413/ https://www.zipcodestogo.com/Dansville/NY/14437/ https://www.zipcodestogo.com/East%20Bloomfield/NY/14443/ https://www.zipcodestogo.com/Ovid/NY/14521/ https://www.zipcodestogo.com/East%20Rochester/NY/14445/ https://www.zipcodestogo.com/Clyde/NY/14433/ https://www.zipcodestogo.com/Geneseo/NY/14454/ https://www.zipcodestogo.com/Fishers/NY/14453/ https://www.zipcodestogo.com/Romulus/NY/14541/ https://www.zipcodestogo.com/Fairport/NY/14450/ https://www.zipcodestogo.com/East%20Williamson/NY/14449/ https://www.zipcodestogo.com/Groveland/NY/14462/ https://www.zipcodestogo.com/Geneva/NY/14456/ https://www.zipcodestogo.com/Willard/NY/14588/ https://www.zipcodestogo.com/Hamlin/NY/14464/ https://www.zipcodestogo.com/Lyons/NY/14489/ https://www.zipcodestogo.com/Hemlock/NY/14466/ https://www.zipcodestogo.com/Gorham/NY/14461/ https://www.zipcodestogo.com/Interlaken/NY/14847/ https://www.zipcodestogo.com/Henrietta/NY/14467/ https://www.zipcodestogo.com/Macedon/NY/14502/ https://www.zipcodestogo.com/Lakeville/NY/14480/ https://www.zipcodestogo.com/Hall/NY/14463/ https://www.zipcodestogo.com/Lodi/NY/14860/ https://www.zipcodestogo.com/Hilton/NY/14468/ https://www.zipcodestogo.com/Marion/NY/14505/ https://www.zipcodestogo.com/Leicester/NY/14481/ https://www.zipcodestogo.com/Bloomfield/NY/14469/ https://www.zipcodestogo.com/Honeoye%20Falls/NY/14472/ https://www.zipcodestogo.com/Newark/NY/14513/ https://www.zipcodestogo.com/Lima/NY/14485/ https://www.zipcodestogo.com/Honeoye/NY/14471/ https://www.zipcodestogo.com/Mendon/NY/14506/ https://www.zipcodestogo.com/North%20Rose/NY/14516/ https://www.zipcodestogo.com/Linwood/NY/14486/ https://www.zipcodestogo.com/Ionia/NY/14475/ https://www.zipcodestogo.com/Morton/NY/14508/ https://www.zipcodestogo.com/Ontario/NY/14519/ https://www.zipcodestogo.com/Livonia/NY/14487/ https://www.zipcodestogo.com/Manchester/NY/14504/ https://www.zipcodestogo.com/Mumford/NY/14511/ https://www.zipcodestogo.com/Ontario%20Center/NY/14520/ https://www.zipcodestogo.com/Livonia%20Center/NY/14488/ https://www.zipcodestogo.com/Naples/NY/14512/ https://www.zipcodestogo.com/North%20Chili/NY/14514/ https://www.zipcodestogo.com/Palmyra/NY/14522/ https://www.zipcodestogo.com/Mount%20Morris/NY/14510/ https://www.zipcodestogo.com/Oaks%20Corners/NY/14518/ https://www.zipcodestogo.com/North%20Greece/NY/14515/ https://www.zipcodestogo.com/Pultneyville/NY/14538/ https://www.zipcodestogo.com/Nunda/NY/14517/ https://www.zipcodestogo.com/Phelps/NY/14532/ https://www.zipcodestogo.com/Penfield/NY/14526/ https://www.zipcodestogo.com/Rose/NY/14542/ https://www.zipcodestogo.com/Piffard/NY/14533/ https://www.zipcodestogo.com/Port%20Gibson/NY/14537/ https://www.zipcodestogo.com/Pittsford/NY/14534/ https://www.zipcodestogo.com/Sodus/NY/14551/ https://www.zipcodestogo.com/Retsof/NY/14539/ https://www.zipcodestogo.com/Seneca%20Castle/NY/14547/ https://www.zipcodestogo.com/Rush/NY/14543/ https://www.zipcodestogo.com/Sodus%20Point/NY/14555/ https://www.zipcodestogo.com/Scottsburg/NY/14545/ https://www.zipcodestogo.com/Shortsville/NY/14548/ https://www.zipcodestogo.com/Scottsville/NY/14546/ https://www.zipcodestogo.com/Union%20Hill/NY/14563/ https://www.zipcodestogo.com/Sonyea/NY/14556/ https://www.zipcodestogo.com/Stanley/NY/14561/ https://www.zipcodestogo.com/Spencerport/NY/14559/ https://www.zipcodestogo.com/Walworth/NY/14568/ https://www.zipcodestogo.com/South%20Lima/NY/14558/ https://www.zipcodestogo.com/Victor/NY/14564/ https://www.zipcodestogo.com/Webster/NY/14580/ https://www.zipcodestogo.com/Williamson/NY/14589/ https://www.zipcodestogo.com/Springwater/NY/14560/ https://www.zipcodestogo.com/West%20Bloomfield/NY/14585/ https://www.zipcodestogo.com/West%20Henrietta/NY/14586/ https://www.zipcodestogo.com/Wolcott/NY/14590/ https://www.zipcodestogo.com/York/NY/14592/ https://www.zipcodestogo.com/Rochester/NY/14602/ https://www.zipcodestogo.com/Dalton/NY/14836/ https://www.zipcodestogo.com/Rochester/NY/14603/ https://www.zipcodestogo.com/Hunt/NY/14846/ https://www.zipcodestogo.com/Rochester/NY/14604/ https://www.zipcodestogo.com/Rochester/NY/14605/ https://www.zipcodestogo.com/Rochester/NY/14606/ https://www.zipcodestogo.com/Rochester/NY/14607/ https://www.zipcodestogo.com/Rochester/NY/14608/ https://www.zipcodestogo.com/Rochester/NY/14609/ https://www.zipcodestogo.com/Rochester/NY/14610/

14611 14612 14613 14614 14615 14616 14617 14618 14619 14620 14621 14622 14623 14624 14625 14626 14627 14638 14639 14642 14643 14644 14646 14647 14649 14650 14651 14652 14653 14692 14694

3. Acronyms

ALS – Advanced Life Support AOD – Administrative Officers of the Day BLS – Basic Life Support CCT – Critical Care Transport CCTP – Critical Care Transport Paramedic CCEMTP – Critical Care Emergency Medical Transport CO – Contracting Officer COR – Contracting Officer’s Representative CPR – Cardiopulmonary Resuscitation DOL – Department of Labor EMT – Emergency Medical Technician IAW – In Accordance With OO – Ordering Officer PWS – Performance Work Statement QASP – Quality Assurance Surveillance Plan QC – Quality Control Plan TB – Tuberculosis TJC – The Joint Commission VTS – Veteran Transportation Service https://www.zipcodestogo.com/Rochester/NY/14611/ https://www.zipcodestogo.com/Rochester/NY/14612/ https://www.zipcodestogo.com/Rochester/NY/14613/ https://www.zipcodestogo.com/Rochester/NY/14614/ https://www.zipcodestogo.com/Rochester/NY/14615/ https://www.zipcodestogo.com/Rochester/NY/14616/ https://www.zipcodestogo.com/Rochester/NY/14617/ https://www.zipcodestogo.com/Rochester/NY/14618/ https://www.zipcodestogo.com/Rochester/NY/14619/ https://www.zipcodestogo.com/Rochester/NY/14620/ https://www.zipcodestogo.com/Rochester/NY/14621/ https://www.zipcodestogo.com/Rochester/NY/14622/ https://www.zipcodestogo.com/Rochester/NY/14623/ https://www.zipcodestogo.com/Rochester/NY/14624/ https://www.zipcodestogo.com/Rochester/NY/14625/ https://www.zipcodestogo.com/Rochester/NY/14626/ https://www.zipcodestogo.com/Rochester/NY/14627/ https://www.zipcodestogo.com/Rochester/NY/14638/ https://www.zipcodestogo.com/Rochester/NY/14639/ https://www.zipcodestogo.com/Rochester/NY/14642/ https://www.zipcodestogo.com/Rochester/NY/14643/ https://www.zipcodestogo.com/Rochester/NY/14644/ https://www.zipcodestogo.com/Rochester/NY/14646/ https://www.zipcodestogo.com/Rochester/NY/14647/ https://www.zipcodestogo.com/Rochester/NY/14649/ https://www.zipcodestogo.com/Rochester/NY/14650/ https://www.zipcodestogo.com/Rochester/NY/14651/ https://www.zipcodestogo.com/Rochester/NY/14652/ https://www.zipcodestogo.com/Rochester/NY/14653/ https://www.zipcodestogo.com/Rochester/NY/14692/ https://www.zipcodestogo.com/Rochester/NY/14694/

4. Scope/Requirements

4.1. Types of Ambulance Service

4.1.1. The contractor shall provide non-emergent Stretcher Transports, Basic Life Support (BLS), Advanced Life Support (ALS), and Critical Care Transport (CCT) Tier 1, 2, and 3 ambulance services on an as-needed basis in accordance with all federal, state, and local regulations.

4.1.2. Occasionally a Veteran will need to be transported with VA staff and equipment; the contractor shall return VA Staff and equipment to the original place of pick-up.

4.2. Transport of Miscellaneous Items with the Patient

The Contractor may also be required to transport patient luggage, medical records, medication, and comfort items from pickup points to destination at no additional cost to the Government. Luggage to be transported will be restricted to suitcase and valise types. When patients are transported to Canandaigua, New York VAMC or Rochester, New York Outpatient Clinic (ROPC) destination is deemed to be the ER, Admissions, the clinic, or service within the hospital, or directly to the ward as instructed by VA Staff.

4.3. Contractor Personnel: Contractor personnel shall be courteous and always conduct themselves in a businesslike manner while providing services under this contract.

4.3.1. Emergency Medical Technicians (EMTs), Critical Care Transport Paramedics (CCTPs) & Other Personnel

4.3.1.1. EMTs, CCTPs and other medical personnel (as applicable) shall at all times meet the qualifications specified in this contract as well as all applicable federal, state, and local government laws, regulations, and standards. EMTs, CCTPs and other medical personnel (as applicable) shall be certified, licensed, or otherwise officially recognized by the local, state, or regional government or public entity where the emergency service is operated or by which it is governed.

4.3.1.2. If the contractor wishes to add or replace personnel throughout the life of the contract, it shall provide evidence of required training, certifications, licensing, and any other qualifications to the Contracting Officer’s Representative (COR) for review.

4.3.1.3. All ambulance drivers shall have a valid driver’s license in accordance with state requirements for their place of operation and the services they perform. If the contractor wishes to add or replace drivers throughout the life of the contract, it shall provide a valid driver’s license to the COR.

4.3.1.4. CCTPs shall have met all state requirements for the tier in which they are performing services in (I, II, III). Proof in the form of a current certificate for the successful completion of such must be provided to the COR upon request.

4.3.1.5. Investigative Requirements for Contract Personnel: Contract personnel will be subject to the same investigative requirements as those for regular VA appointees and employees. The level of investigation commensurate with the level of access to perform the performance work statement is:

Special Agreement Checks (SAC). Fingerprinting for contract personnel will be conducted at The Canandaigua, New York VAMC. Thereafter the contracted employees will be subject annually to the same requirement, with a 90-day window to complete such requirements as provided by The Canandaigua, New York VAMC. The Workforce Management and Consulting, Human Resource Operation Office, Personnel Security Contracting Team (WMC HROO PerSec Contracting Team) is responsible for adjudicating all background investigations for contract employees.

4.3.1.6. EMTs, CCTPs, and other contractor personnel as applicable must pass the Contractor’s background check and must not have been convicted of (or have any pending charges for) a felony for the past five years. Personnel (and Contractor) must report any new or additional charges or convictions if they arise during the course of performance under this contract so VA can review them and determine whether the employee in question needs to be discharged of his or her duties until the matter is adjudicated. 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 or cause.

4.3.2. Tuberculosis Exposure Control Policy

4.3.2.1. The contractor shall provide the VA with a policy on tuberculosis (TB) exposure and control, to include TB decontamination.

4.3.2.2. The contractor shall have its personnel tested for TB in accordance with state guidelines and provide written confirmation to the COR that all personnel (current employees and any new hires) performing services under this contract are current in their TB test at the start of each 0rdering Period.

4.4. Contractor Equipment, Vehicles, and Inspection

4.4.1. Ambulances shall meet all applicable federal, state, and local regulations and specifications, including but not limited to licensing, registration, and safety standards.

4.4.2. The VA reserves the right to inspect the contractor’s equipment and vehicles or require documentation of compliance with state laws, rules, regulations, and guidelines governing emergency medical transport vehicles (ambulances). VA inspections of contractor equipment do not constitute a warranty or guarantee that the contractor’s vehicles and equipment are properly maintained. The VA reserves the right to restrict the contractor’s use of equipment and vehicles in the performance of this contract which are not in compliance with contract requirements. The restriction of such equipment and vehicles shall not relieve the contractor from performance in accordance with the contract nor necessitate additional cost to the VA.

4.4.3. Vehicles shall be clean and maintained in good repair in accordance with manufacturer’s instructions.

4.4.4. The contractor shall not borrow or exchange supplies, equipment, and/or medications with the VA.

Equipment attached to or in use by the patient at time of pick-up may remain with the patient during transport to ensure continuity of care. Medical Control Authorities are responsible for maintaining and supplying medication during patient transport. All VA equipment and unused medications must be returned to VA during patient drop-off or as promptly as feasible within 24 hours.

4.4.5. The contractor shall furnish all linen required for patient transport at no additional cost. Linen shall not be exchanged with linen belonging to The Canandaigua, New York VAMC and Rochester, New York Outpatient Clinic (ROPC).

4.4.6. The contractor must be capable of transporting the drugs and/or equipment as required by the patient as listed in Attachment A Specialty Care Transport (SCT) or Critical Care Transport (CCT) Capabilities Confirmation. The contractor shall have the appropriate medications, including Specialty Care and Critical Care Transport, if necessary, based on the EMS region the ambulance provider is functioning in.

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

4.4.7.1. 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.

4.4.7.2. Each driver shall possess a driver’s license that is valid for the class of vehicle driven. Evidence of a special transportation service vehicle permit, or endorsement issued by the commissioner of public safety.

• Be at least 18 years of age and have not less than one year of experience as a licensed driver; and o For the past three years:

Have not had a driver’s license canceled or suspended.

Have a driving record clear of convictions for operating a motor vehicle or motorcycle without insurance.

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

Have a driving and criminal record clear of convictions for driving under the influence of alcohol or a controlled substance.

4.4.7.3. The contractor personnel will ensure that the patient is secured to the stretcher/cot and that the stretcher /cot is secure in the back of the ambulance before the vehicle moves.

4.4.7.4. 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.

4.4.7.5. 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:

• 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).

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

4.5. Transportation Request

4.5.1 VetRide or VA-approved Transportation Software Utilization:

The contractor agrees to utilize the VetRide Vendor Portal or VA-Approved Transportation Software with every patient transported under this contract.

Department of Veteran Affairs will provide the software and access to the VetRide Vendor Portal or VA-Approved Transportation Software for the vendor/contractor in this contract. The Contractor will utilize the VetRide Vendor Portal or VA-Approved Transportation Software fully as instructed:

a) Receive and respond to electronic trip requests

b) Receive, use, and ensure the use of the Vendor pass by the driver.

c) Submit claims via the electronic HCFA 1500 in the VetRide Vendor Portal or VA-Approved Transportation

Software system.

d) All invoices must be submitted within 30 calendar days of date of service in accordance with 38 CFR 70 to be considered timely submission.

i. The contractor’s invoice must be on the HCFA 1500 to include:

ii. Contract Number

iii. Date of Service (to include Box 24 A-J)

iv. Authorization number(s)

v. Pick-up and drop-off location of the patient

vi. Base Rate

vii. Name (Last, First and Middle Initial (if any)) and Full Social Security number (Box 1a) of patient transported

viii. Date of Birth and Sex

ix. Diagnosis Codes or Nature of Illness or Injury

x. Documentation of circumstances when billing for waiting time

xi. Any miscellaneous charges for which the contractor is expecting reimbursement i.e., Tool charges, waiting time, etc.

xii. VA authorizing official’s name

xiii. Healthcare Procedure Coding System/National Level II (HCPCS)

e) Unauthorized charges will be reviewed by the Contracting Officer Representative (COR) as to the validity of the charges and as to whether the payment will be made. A final determination will be made within 30 days after notifying the Contractor of the charges which are being suspended.

4.5.1.1. A transportation request is defined as one incidence of a request for one-way service (Stretcher Transports, BLS, ALS, CCT). No more than one patient will be transported per order unless approved by an authorized VA staff. Transportation requests will be made through VetRide or VA-Approved Transportation Software Utilization. Contractors must have the capability to receive orders, update ride status, and input trip costs and other required data through this portal. Contractors must have dedicated staff available to monitor this portal 24/7. The Canandaigua, New York VAMC and Rochester, New York Outpatient Clinic (ROPC) Travel Program Staff will be available to assist with account setup and training for the Contractor’s Staff. In the event VetRide or other VA-Approved Transportation Software Utilization is down, other methods of communication (i.e., telephone, facsimile) will be used to place Transportation requests.

4.5.1.1.1. The Canandaigua, New York VAMC and Rochester, New York Outpatient Clinic (ROPC)

Travel Program Staff/or authorized VA employees will work with the Contractor the following business day to reconcile any transportation requests that were placed outside of VetRide or VA-Approved Transportation Software Utilization.

4.5.1.1.2. The Contractor must update VetRide or VA-Approved Transportation Software Utilization with any data and/or notes in real time that deviate from the original order such as invoicing for additional mileage due to a road closure, wait time, reason for no load, etc.

The Canandaigua, New York VAMC and Rochester, New York Outpatient Clinic (ROPC)

Travel Program Staff/or authorized VA employees may place a “hold” on payment of this order until it has been reconciled.

4.5.1.2. Only the following VA staff are authorized to place, cancel, or make changes to transportation requests:

Contracting Officer (CO) Ordering Officers (OO) Administrative Officer of the Day (AOD) Beneficiary Travel Office Staff Contracting Officer’s Representative (COR)

The Contracting Officer will furnish the Contractor with the names of individuals above, who are authorized as Ordering Officers, by separate memorandum upon issuance of the contract. The Contracting Officer will update this list throughout the life of the contract as Ordering Officers change.

Ordering Officers are responsible for issuing and administering orders placed under this contract.

Ordering Officers have no authority to modify any term of this basic contract. Any deviation from the terms of the basic contract must be approved in writing by the Contracting Officer responsible for this contract. The Contractor shall accept orders against this contract only from the Contracting Officer and/or authorized ordering officers. Fulfilling orders from persons other than the Contracting Officer or ordering officer may result in loss or delay in payment for supplies/services provided under such orders.

Non-authorized VA employees and private agencies (e.g., nursing homes) are not considered authorized to place transportation requests.

4.5.1.2.1. All patient pick-up(s) and drop-off(s) shall be authorized via “orders” which shall only be issued by the designated Ordering Officers. When placing orders for services, the Ordering Officer shall contact the designated contractor point of contact(s) to provide the following information:

Mode of transportation required, Required time of arrival Name of the beneficiary, Pick-up and delivery point, Type and number of additional medical care specialists required, Type of equipment required, Last four of the patient's Social Security Number, and Any other special instructions

4.5.1.3. For ALL Transports – an Audit system will be put in place by the VA to include the COR or designee, Beneficiary Travel Department staff, and clinical staff to ensure appropriateness of the order and timeliness of the response.

4.5.1.4. The type of transportation service (Stretcher Transports, BLS, ALS, CCT) required will be discussed and determined by VA clinical personnel and the contractor. The contractor shall transport the patient per its policies and standard industry practice. If the type of transportation service differs from what was agreed upon by the VA and contractor, the contractor shall submit documentation to the VA explaining its rationale.

4.5.1.5. The VA may authorize an escort (e.g., spouse, relative, guardian, etc.) to accompany the patient during medical transport if it is practicable and, in the patient’s, best interest. The contractor shall allow the escort to accompany the patient at no additional cost.

4.5.1.6. The contractor shall have sufficient vehicles and personnel to provide services for up to four (4) simultaneous transportation requests. Transport required may be for any mix of Stretcher Transports, BLS, ALS transports. One of these four simultaneous forms of transport may require CCT capability up to Tier III. If Canandaigua, New York VAMC or Rochester, New York Outpatient Clinic (ROPC) requires ambulance services exceeding four (4) simultaneous transportation requests, the vendor will be offered to provide the services if they have sufficient vehicles/personnel available; but may decline these additional orders if sufficient vehicles/personnel are unavailable.

4.5.1.7. The number of transports under normal operating conditions will typically range from 2 to 3 transports each weekday and significantly less on weekends and holidays. The number of actual transports may vary throughout the life of the contract.

4.5.1.8. 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.

4.5.1.9. Response Times*

4.5.1.9.1. Orders that are scheduled by 7pm local time the day before the required services are defined as scheduled in advance. With the exceptions found below, the contractor shall arrive on time for all orders scheduled in advance.

4.5.1.9.2. Emergent Transport (Originating from VA (Only): The contractor shall be required to provide Ground Ambulance transportation within thirty (30) minutes of order/patient pick up call.

4.5.1.9.3. For all add-ons (not scheduled in advance) transportation requests, with pick up at Canandaigua, New York VAMC or Rochester, New York Outpatient Clinic (ROPC): The contractor will be allotted up to a sixty (60) minute response time from time of order placement for transportation requests that are not previously scheduled in advance.

a. For an urgent transport request for a critical patient (as deemed by the physician) with pick up Canandaigua, New York VAMC or Rochester, New York Outpatient Clinic (ROPC), the contractor will be allotted up to a thirty (30) minute response time.

4.5.1.9.4. For transportation requests which do not have a pick-up at Canandaigua, New York VAMC or Rochester, New York Outpatient Clinic (ROPC)

a. The contractor may be required, if requested by the VA, to dispatch ambulances on short notice for transportation requests not scheduled in advance; for these transportation requests the contractor shall dispatch ambulances within thirty (30) minutes of receiving the order.

b. Pick-up appointment times shall be agreed upon by the VA and contractor at time of order placement and be reasonable based upon travel distance, speed limits, and weather conditions.

c. The contractor’s patient pick-up time cannot be more than 15 minutes prior to the schedule pickup time nor 15 minutes later than the scheduled pickup time for transportation requests scheduled in advance.

* The contractor shall not be held liable for nonperformance 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, quarantine restrictions, strikes, and unusually severe weather. The contractor MUST notify the VA with as much advance notice as possible should any of these occur.

4.5.2. Cancellations

4.5.2.1. For trips in which the contractor is notified of cancellation before the vehicle is dispatched, there shall be no charge to the Government.

4.5.2.2. A Cancellation Without Prior Notice is defined as a transportation request which is cancelled after the contractor has dispatched a vehicle for a scheduled wait-and-return trip, the vehicle is enroute, or has arrived at the pick-up location, and there is no longer a requirement for patient transportation.

The contractor may request one-way reimbursement. Reimbursement shall a $225.00 Flat Fee per occurrence. Mileage for such cancellations shall be confirmed by the contractor and reported to the VA as soon as possible from time of cancellation.

4.5.2.3. A “no show” is defined as a transportation request which is cancelled after the contractor has dispatched a vehicle, the vehicle is enroute, or has arrived at the pick-up location, and there is no longer a requirement for patient transportation. The contractor may request one-way reimbursement for no-shows. No-show reimbursement shall be based upon the base rate for the type of service requested.

4.5.2.4. For transportation requests OUT of at Canandaigua, New York VAMC or Rochester, New York Outpatient

Clinic (ROPC) ONLY – The contractor will immediately dispatch a vehicle upon receipt of the order (including transportation requests in which the final destination may change prior to pick up due to the critical condition of the patient). When the contractor is notified of a cancellation prior to arrival at the at Canandaigua, New York VAMC or Rochester, New York Outpatient Clinic (ROPC) campus, there shall be no charge to the Government.

4.6. Pick-Up/Drop-Off/Reporting Procedures

4.6.1. Ambulance personnel shall pick-up and deliver patients at specified locations (e.g., front door of

Outpatient Clinic Entrance). These locations will be specified by VA staff when an order is placed and communicated to the transporting personnel.

4.6.2. When applicable, ambulance personnel shall report to the Veteran Transportation Service (VTS)

Dispatcher or Administrative Officer of the Day (AOD) to (1) announce his/her arrival to pick-up and transfer the patient and (2) obtain report of pertinent information regarding the patient’s condition from the primary nurse/physician.

4.6.3. When delivering a patient, ambulance personnel shall give report to the appropriate VA healthcare staff and provide a copy of the run sheet which will be retained by the facility for inclusion to the patient’s medical record.

4.6.4. In cases where ambulance personnel must divert to a local emergency department while performing a VA authorized transport, the contractor’s dispatcher shall notify the VA Beneficiary Travel Department or Administrative Officer of the Day of the patient’s location and status as soon as this information becomes available.

4.7. Patient Welfare

4.7.1. The contractor shall be responsible for the patient’s welfare during transport. The contractor shall be held responsible for patient and/or VA property during transport. Any damaged or lost wheelchairs, walkers, crutches, or personal belongings shall be replaced at the contractor’s expense.

4.7.2. The VA requires the contractor to exercise extreme caution and care in the handling of patients.

4.7.3. 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. In the event that the beneficiary refuses to be properly secured, they shall be returned back into the building which they came from.

4.8. Incident Reporting

4.8.1. The contractor shall notify the COR, Requestor, Program Manager, Beneficiary Travel Department, of any accidents and/or safety problems that occur while the patient is being transported. This notification shall occur within one (1) hour by telephone. A written report of the incident shall be delivered to the COR, Program Manager, or Beneficiary Travel Department, by the close of business of the next working day.

4.8.2. The COR will monitor the service provided. The contractor shall cooperate with the COR in providing information and answering questions in a timely manner. The contractor shall promptly inform the COR of any complaints received directly from patients. If warranted, the VA may conduct incident investigations and require written response from the contractor within 48 hours of request.

4.9. Invoicing

4.9.1. Each transport shall include thirty (30) minutes of wait time; the contractor may invoice for wait times in excess of this initial thirty (30) minutes. Wait time shall begin only once the contractor has both reached the pick-up address location and the appointment time has elapsed. All wait times shall be itemized and invoiced in fifteen (15) minute intervals. For partial fifteen (15) minute intervals, zero (0) to seven (7) minutes shall be rounded down to zero (0) minutes and eight (8) to fifteen (15) minutes rounded up to fifteen (15) minutes.

4.9.2. When invoicing for mileage, the contractor shall round to the nearest mile. Mileage ending in .5 or higher shall be rounded up to the nearest mile. Mileage ending in .4 or lower shall be rounded down to the nearest mile. Payment for mileage to or from the point of care shall be limited to the VA’s calculation according to the VA’s Bing Maps API determination. Bing Maps API is optimized to determine mileage based on the shortest time of travel.

4.9.3. Long Distance Mileage — Payment for mileage outside the contract miles covered in the base rate, shall be at the mileage rate stated in the price schedule, and shall be based upon the miles from the pick-up point and the specified destination. Any mileage from the place of business and/or location of vehicle and the pick-up point, or from the delivery destination back to the place of business and/or location of next trip are not considered as a separate item of this reimbursement but would be expected to be incorporated into the mileage rate as part of the administrative costs (or costs of doing business).

4.9.4. Upon notification of the contracting officer, the vendor must receive training and begin implementation of invoices via Vet Ride within 30 days versus VA Tungsten Network e-Invoicing network. Invoices must be submitted via the electronic HCFA 1500 in the VetRide Vendor Portal or other VA approved software.

These invoices shall not include patient information, but shall include the following:

Contractor Name Contract Number Current Purchase Order Number Date of service Total amount invoiced including a summary of the total number of charges that align with the line items of this contract (i.e., total number of BLS Base Rate, total BLS Mileage incurred, etc.)

An itemized list of charges or services rendered that align with the line items of this contract (i.e., BLS

Base Rate, BLS Mileage incurred, etc.)

Payment by VA under this contract to a provider of ground ambulance transportation services authorized under this contract extinguishes any and all liability on the part of the VA BENEFICIARY for that transportation service. UNDER NO CIRCUMSTANCES ARE VA BENEFICIARIES, THIRD PARTY INSURANCES, MEDICARE, OR

MEDICAID TO BE BILLED FOR THE SERVICES PERFORMED UNDER THIS CONTRACT.

5. Period & Place of Performance

5.1. This contract’s ordering period shall be effective from Date of Award through March 31, 2027.

5.2. The Place of Performance is variable and may occur within the state of __New York_; ambulance services may be required to or from locations including, but not limited to the following:

5.2.1. Canandaigua VA Medical Center to include specific Atrium Clinics, Emergency Department, pavilions, or out-buildings on the VAMC campus. The Canandaigua VAMC address is: 400 Fort Hill Avenue, Canandaigua, NY 14424.

5.2.2. Rochester VA Outpatient Clinic Community-Based Outpatient Clinics (CBOCs):

CBOC Name Address Rochester Calkins VA Clinic 260 Calkins Rd

5.2.3. Other VA Medical Centers, Hospitals, or CBOCs within Veterans Integrated Service Network (VISN 02) including, but not limited to:

Medical Center Name: Address:

Buffalo, NY VAMC 3495 Bailey Ave, Buffalo, NY

14215 Batavia, NY VAMC 222 Richmond Ave, Batavia, NY

14020 Canandaigua, NY VAMC 400 Fort Hill Ave, Canandaigua, NY 14424

Syracuse, NY VAMC 800 Irving Ave, Buffalo, NY 13210 Albany, NY VAMC 113 Holland Ave, Albany, NY

12208 VA Hudson Valley Health Care System, Castle Point Campus

41 Castle Point Rd, Wappingers Falls, NY 12590

VA Hudson Valley Healthcare System, Montrose Campus

2094 Albany Post Rd, Montrose, NY 10548

James J. Peters VA Medical Center 130 W Kingsbridge Rd, Bronx, NY 10468

NJ Health Care System, East Orange Campus

385 Tremont Ave, East Orange, NJ 07018

NJ Health Care System, Lyons Campus

151 Knollcroft Rd, Lyons, NJ 07939

NY Harbor Healthcare System, Brooklyn Campus

800 Poly Place, Brooklyn, NY 11209

Margaret Cochran Corbin VA Campus 423 E 23rd St, New York, NY 10010

St. Albans VA Medical Center 179-00 Linden Blvd, Queens, NY 11424

Northport VA Medical Center 79 Middleville Rd, Northport, NY 11768

5.2.4. Other Non-VA Medical facilities and Community Care facilities as authorized by the VA.

5.2.5. Veteran’s residence.

5.2.6. Local airports including: Elmira Corning Regional Airport, Ithaca Tompkins Regional Airport, Greater

Rochester International Airport.

6. Quality Control Plan

6.1. Quality Control

6.1.1. The contractor shall maintain a Quality Control Plan (QCP) that contains, at a minimum, the following:

6.1.1.1. A description of the company’s organizational structure including a description of the roles and responsibilities of management and supervisors.

6.1.1.2. A description of the methods to be used by the contractor for identifying and preventing deficiencies or problems in the quality of service.

6.1.1.3. A description of the specific steps the contractor will take for corrective action if needed if a deficiency or problem in the quality of service occurs.

6.1.1.4. A description of the company’s records and tracking system used to identify up-to- date background checks, applicable certifications and tests, and training of each employee performing services under this contract.

6.1.1.5. A description of the method used to provide on-time ambulance services to meet the requirements of this contract (24/7 availability and up to 4 simultaneous transports in accordance with PWS 4.5.1.7).

6.1.1.6. A description of the methods used to identify and prevent radio communication breakdowns and a detailed procedure for alternative communications in the event of electronic and mechanical breakdown of vehicle two-way radios.

6.1.1.7. CONTENGENCY PLAN: (In case VetRide Vendor Portal is down) A description of the method/system used to log all requests for service. The contractor shall confirm that the log indicates the date and time of service call, actual time of pick-up versus the scheduled time, name of patient requiring services, designated pick-up and delivery points, mileage, and actual waiting time at pick-up and delivery points if waiting charges are claimed. The contractor shall confirm the log will be sent to the COR monthly.

6.1.2. The Government will evaluate the contractor’s performance under this contract to ensure that the contractor’s QCP is adequate, and that quality is achieved through a Quality Assurance Surveillance Plan

(QASP).

6.1.3. The Government shall prepare a QASP after contract award derived from the PWS and contractor’s submitted quality control plan. The QASP is a “living document” and the Government may review and revise it at any time. However, the Government shall coordinate changes to the QASP with the contractor.

6.1.4. The QASP will specify the work requiring surveillance and the Government’s method of surveillance.

6.2. Minimum Performance Standards

6.2.1. The contractor shall maintain performance standards in accordance with the standards outlined in the table below. Failure to meet the Acceptable Quality Levels (AQL) may result in termination of the contract.

6.2.2. The QASP will include the standards below as well as others derived from the successful offeror’s quality control plan.

Task PWS Reference

Standard Acceptable Quality Level

Method of Surveillance

Provide on-time ambulance services

Section 4.5.1.8.3

Scheduled patient pick-ups shall not deviate more than 15 minutes past scheduled pick-up time for scheduled orders

97% Customer Feedback

Incident Reporting

Section 4.8 The contractor shall notify the Program Manager, Beneficiary Travel Department, of any accidents and/or safety problems that occur while the patient is being transported. This notification shall occur within one (1) hour by telephone. A written report of the incident shall be delivered to the Program Manager, Benefits Management, by the close of business of the next working day.

97% Customer Feedback

Invoice Reports

Section 4.9 Provide a monthly invoice including secondary documentation in accordance with Section 4.10 of the PWS

95% 100% inspection of monthly invoices/reports

7. COVID-19 Or Other Similar Infectious Diseases

7.1. Contractor shall not refuse transports of COVID-19 positive or other similarly infected patients.

7.2. Contractor shall abide by all additional procedures and precautions that may be implemented by the VA based on

VA-issued guidance and/or CDC recommendations. These procedures are subject to change throughout the life of the contract and will be incorporated via attachment (See S03 VTS Patient Transport PPE and Vehicle Cleaning/Disinfection SOP).

7.3. Contractor shall have written policy of steps they will take to prevent the spread of COVID-19 or other similarly infectious diseases by their employees and/or vehicles. This policy shall, at a minimum, include procedures of screening drivers before each shift, deliberate decontamination of their vehicles and all other preventative precautions taken by Contractor employees.

7.4. Contractor shall furnish all required PPE throughout the life of the contract.

8. Conformity To Regulations

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

8.2 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.

9. Wage Rates

9.1. Wage Determination(s) as listed in Section D in this solicitation are applicable to any resulting contract.

9.2. 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).

9.3 The Department of Labor has held that contractors must pay their employees the Service Contract Act waged while they are driving both to and from destinations for the VA. The Wage Determination is attached in Section D.

10. Evidence of Coverage

10.1 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.

11. Worker’s Compensation

11.1 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.

12. Contractor Personnel Security Requirements

12.1 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.

12.1.1 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.

12.1.2 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.

13. Medical Liabilities Insurance

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

14. Annual VHA Training

14.1 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…