Quality Assurance Surveillance Plan.pdf

PDF 341 KB Posted

Attached to
V119--Special Mode Transportation for VANCHCS Federal contract opportunity
Solicitation number
36C26126Q0457
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 21

About this file

This is a Quality Assurance Surveillance Plan (QASP) for Special Mode Transportation Services provided to the VA Northern California Health Care System. The document establishes systematic methods for evaluating contractor performance throughout the contract period.

The QASP is administered by the Contracting Officer (Emily Trinh, Network Contracting Office 21) and the Contracting Officer's Representative (Merico Zanotti, VA Northern California Health Care System, Benefits & Data Management). The contractor's primary program manager is also identified as Merico Zanotti, Assistant Chief of BDMS. Performance monitoring employs three surveillance methods: direct observation of contractor personnel for professionalism and courteous behavior upon arrival at VA facilities; periodic quarterly inspections of vehicles, equipment, records, and certifications; and review of validated user/customer complaint surveys and survey cards. Seven key performance metrics are established with specific acceptable quality levels: treatment on gurney (30% of time), VetRide Vendor Portal utilization (100% of time), patient pick-up time adherence within 15-minute windows (94% of time), incident reporting within one hour (100% of time), handling patients with extreme caution and care (100% of time), proper loading/unloading techniques (100% of time), and contractor employee identification badges (100% of time). Contractor performance is rated using five CPARS categories: Exceptional, Very Good, Satisfactory, Marginal, and Unsatisfactory. When performance falls below acceptable quality levels, the CO issues a Contract Discrepancy Report (CDR), which may require the contractor to submit a corrective action plan. The document serves as a living document subject to modification through contract changes coordinated with the contractor.

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36C26126Q0457 0001.docx DOCX document
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36C26126Q0457.pdf PDF
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VHA 1605.05 BUSINESS ASSOCIATE AGREEMENT.docx DOCX document
Wage Determination 2015-5627.pdf PDF
Wage Determination 2015-5655.pdf PDF
Wage Determination 2015-5623.pdf PDF

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Text version

Quality Assurance Surveillance Plan (QASP)

Special Mode Transportation Services for VA Northern California Health Care System

The contractor will be evaluated in accordance with the following:

1. PURPOSE

This Quality Assurance Surveillance Plan (QASP) provides a systematic method to evaluate performance for the stated contract. This QASP explains the following:

• What will be monitored?

• How will monitoring take place?

• Who will conduct the monitoring?

• How will monitoring efforts and results be documented?

This QASP does not detail how the contractor accomplishes the work. Rather, the QASP is created with the premise that the contractor is responsible for management and quality control actions to meet the terms of the contract. It is the Government’s responsibility to be objective, fair, and consistent in evaluating performance.

This QASP is a “living document” and the Government may review and revise it on a regular basis. However, the Government shall coordinate changes with the contractor through contract modification. Copies of the original QASP and revisions shall be provided to the contractor and Government officials implementing surveillance activities.

2. GOVERNMENT ROLES AND RESPONSIBILITIES

The following personnel shall oversee and coordinate surveillance activities.

a. Contracting Officer (CO) – The CO shall ensure performance of all necessary actions for effective contracting, ensure compliance with the contract terms, and shall safeguard the interests of the United States in the contractual relationship. The CO shall also assure that the contractor receives impartial, fair, and equitable treatment under this contract. The CO is ultimately responsible for the final determination of the adequacy of the contractor’s performance.

Assigned CO: Emily Trinh | Emily.Trinh@va.gov

Organization or Agency: Network Contracting Office 21

b. Contracting Officer’s Representative (COR) – The COR is responsible for technical administration of the contract and shall assure proper Government surveillance of the contractor’s performance. The COR shall keep a quality assurance file. The COR is not empowered to make any contractual commitments or to authorize any contractual changes on the Government’s behalf.

Assigned COR: Merico Zanotti | Merico.Zanotti@va.gov

Organization or Agency: VA Northern California Health Care System, Benefits & Data Management mailto:Emily.Trinh@va.gov mailto:Merico.Zanotti@va.gov

3. CONTRACTOR REPRESENTATIVES

The following employee(s) of the contractor serve as the contractor’s program manager(s) for this contract.

Primary Program Manager:

Name: Merico Zanotti

Title: Assistant Chief, BDMS

Email: merico.zanotti@va.gov

Phone:916-716-5977

Alternate Program Manager:

Name: ____________________________

Title: _____________________________

Email: _____________________________

Phone: ____________________________

4. PERFORMANCE STANDARDS

The contractor is responsible for performance of ALL terms and conditions of the contract. CORs will provide contract progress reports quarterly to the CO reflecting performance on this plan and all other aspects of the resultant contract.

The performance standards outlined in this QASP shall be used to determine the level of contractor performance in the elements defined. Performance standards define desired services. The Government performs surveillance to determine the level of Contractor performance to these standards.

The Performance Requirements are listed below in Section 6. The Government shall use these standards to determine contractor performance and shall compare contractor performance to the standard and assign a rating.

At the end of the performance period, these ratings will be used, in part, to establish the past performance of the contractor on the contract.

5. METHODS OF QA SURVEILLANCE

Various methods exist to monitor performance. The COR shall use the surveillance methods listed below in the administration of this QASP.

a. DIRECT OBSERVATION. 100% surveillance: Upon arrival at VA facilities, the VA staff may directly observe contractor personnel for professionalism and courteous/considerate behavior.

b. PERIODIC INSPECTION. Inspections will be completed quarterly or as needed. The Government may inspect vehicles, equipment, records and certifications. All inspections and reports will be conducted in compliance with VA Privacy and Information security standards.

c. VALIDATED USER/CUSTOMER COMPLAINTS. The Government will review on-site surveys and survey cards provided by Contractor in accordance with performance work statement section 6(h).

6. SAMPLE QASP PERFORMANCE REPORT DATE:__________________

Measures

PWS

Reference Performance Requirement

Acceptable Quality Level

Surveillance Method

Met AQL/DID NOT MEET AQL-

CPARS RATING/ADD

COMMENTS

Treatment on Gurney 4(b) The Contractor, when requested and scheduled, shall allow treatment by VA providers to be performed on the Contractor’s gurney.

30% of the time Direct Observation

VetRide Vendor Portal 5(a) The contractor agrees to utilize the VetRide Vendor Portal or VA-Approved Transportation Software with every patient transported under this contract.

100% of the time Periodic Inspection

Patient Pick Up Time 5(q)

5.4(e)

5.4(f)

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.

Patient pickups shall be completed within one hour after notification for unscheduled trips and 30 minutes for scheduled trips.

The contractor shall miss no more than three patient pickups per 50.

94% of the time Validated User/Customer Compliant

Incident Reporting 5.2(a) 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.

100% of the time Direct Observation / Validated

Handling Patient with Extreme Caution and Care

6(d) The VA requires the contractor to exercise extreme caution and care in the handling of patients.

100% of the time Validated

Proper Loading/Unloading Techniques

10(d) Contractor employee shall ensure proper loading/unloading techniques are followed always.

100% of the time Direct Observation / Validated

Identification Badges 11 Contractor employees shall be clearly identified by a company uniform and badge with name, function, and name of the Contractor and a photograph of the employee.

100% of the time Direct Observation

7. CPARS RATINGS ASSIGNED TO QASP ITEMS:

Metrics and methods are designed to determine rating for a given standard and acceptable quality level. The following ratings shall be used (Reference: CPARS User Manual:

https://www.cpars.gov/cparsweb/assets/documents/CPARS_User_Manual.pdf

EXCEPTIONAL: Performance meets contractual requirements and exceeds many to the Government’s benefit.

The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Note: To justify an Exceptional rating, you should identify multiple significant events in each category and state how it was a benefit to the GOVERNMENT. However, a singular event could be of such magnitude that it alone constitutes an Exceptional rating. Also, there should have been NO significant weaknesses identified.

VERY GOOD:

Performance meets contractual requirements and exceeds some to the Government’s benefit.

The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Note: To justify a Very Good rating, you should identify a significant event in each category and state how it was a benefit to the GOVERNMENT. Also, there should have been NO significant weaknesses identified.

SATISFACTORY:

Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

Note: To justify a Satisfactory rating, there should have been only minor problems, or major problems the contractor recovered from without impact to the contract. Also, there should have been NO significant weaknesses identified.

MARGINAL:

Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

Note: To justify Marginal performance, you should identify a significant event in each category that the contractor had trouble overcoming and state how it impacted the GOVERNMENT. A Marginal rating should be supported by referencing the management tool that notified the contractor of the contractual deficiency (e.g. Management, Quality, Safety or Environmental Deficiency Report or letter).

UNSATISFACTORY:

Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

Note: To justify an Unsatisfactory rating, you should identify multiple significant events in each category that the contractor had trouble overcoming and state how it impacted the https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cpars.gov%2Fcparsweb%2Fassets%2Fdocuments%2FCPARS_User_Manual.pdf&data=05%7C02%7C%7C1299a8a1556647c9c9b208dd897915ec%7Ce95f1b23abaf45ee821db7ab251ab3bf%7C0%7C0%7C638817875334440754%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=6A9MQEEm9YUvO1cWqDUn1sC8wYUJvuCVqG%2F2AhW8s1E%3D&reserved=0

GOVERNMENT. However, a singular problem could be of such serious magnitude that it alone constitutes an unsatisfactory rating. An Unsatisfactory rating should be supported by referencing the management tools used to notify the contractor of the contractual deficiencies (e.g. Management, Quality, Safety or Environmental Deficiency Reports, or letters).

8. DOCUMENTING PERFORMANCE

a. The VA shall document positive and/or negative performance. Any report may become a part of the supporting documentation for any contractual action and preparing annual past performance using CONTRACTOR

PERFORMANCE ASSESSMENT REPORTING SYSTEM (CPARS).

b. If contractor performance does not meet the Acceptable Quality level, the CO shall inform the contractor. This shall normally be in writing unless circumstances necessitate verbal communication. In any case the CO shall document the discussion and place it in the contract file. When the COR and the CO determines formal written communication is required, the COR shall prepare a Contract Discrepancy Report (CDR), and present it to CO.

The CO shall in turn review and shall present to the contractor's program manager for corrective action.

The contractor shall acknowledge receipt of the CDR in writing. The CDR shall specify if the contractor is required to prepare a corrective action plan to document how the contractor shall correct the unacceptable performance and avoid a recurrence. The CDR shall also state how long after receipt the contractor has to present this corrective action plan to the CO. The VA shall review the contractor's corrective action plan to determine acceptability. The CO shall also assure that the contractor receives impartial, fair, and equitable treatment. The CO is ultimately responsible for the final determination of the adequacy of the contractor’s performance and the acceptability of the Contractor’s corrective action plan.

Any CDRs may become a part of the supporting documentation for any contractual action deemed necessary by the CO.

See Sample on following page.

9. COR AND CONTRACTOR ACKNOWLEDGEMENT OF QASP

SIGNED:

COR NAME/TITLE DATE

SIGNED:

CONTRACTOR NAME/TITLE DATE

CONTRACT DISCREPANCY REPORT

1. CONTRACT NUMBER 2. REPORT NUMBER FOR THIS DISCREPANCY

3. TO: (Contracting Officer) 4. FROM: (Name of COR)

5. DATES

a. CDR PREPARED

b. RETURNED BY

CONTRACTOR:

c. ACTION COMPLETE

6. DISCREPANCY OR PROBLEM (Describe in detail. Include reference to PWS Directive; attach continuation sheet if necessary.)

7. SIGNATURE OF COR Date:

8. SIGNATURE OF CONTRACTING OFFICER Date:

9a. TO (Contracting Officer) 9a. FROM (Contractor)

10. CONTRACTOR RESPONSE AS TO CAUSE, CORRECTIVE ACTION AND ACTIONS TO PREVENT

RECURRENCE. (Cite applicable quality control program procedures or new procedures. Attach continuation sheet(s) if necessary.)

11. SIGNATURE OF CONTRACTOR REPRESENTATIVE Date:

12. GOVERNMENT EVALUATION. (Acceptance, partial acceptance, reflection. Attach continuation sheet(s) if necessary.)

13. GOVERNMENT ACTIONS (Acceptance, partial acceptance, reflection. Attach continuation sheet(s) if necessary.)

14. CLOSE OUT

NAME TITLE SIGNATURE DATE

a. CONTRACTOR

NOTIFIED

b. COR c.

CONTRACTING

OFFICER

Primary Program Manager Name Merico Zanotti Title Assistant Chief BDMS Email mericozanottivagov Phone9167165977:
Name:
Title:
Email:
Phone:
DATE:
Treatment on Gurney:
4b:
30 of the time:
Met AQLDID NOT MEET AQL CPARS RATINGADD COMMENTSDirect Observation:
VetRide Vendor Portal:
5a:
100 of the time:
Met AQLDID NOT MEET AQL CPARS RATINGADD COMMENTSPeriodic Inspection:
Patient Pick Up Time:
5q 54e 54f:
94 of the time:
Met AQLDID NOT MEET AQL CPARS RATINGADD COMMENTSValidated UserCustomer Compliant:
Incident Reporting:
52a:
100 of the time_2:
Met AQLDID NOT MEET AQL CPARS RATINGADD COMMENTSDirect Observation Validated UserCustomer Compliant:
6d:
100 of the time_3:
Validated UserCustomer Compliant:
Proper LoadingUnloading Techniques:
10d:
Contractor employee shall ensure proper loadingunloading techniques are followed always:
100 of the time_4:
Direct Observation Validated UserCustomer Compliant:
Direct Observation:
Identification BadgesRow1:
11Row1:
Contractor employees shall be clearly identified by a company uniform and badge with name function and name of the Contractor and a photograph of the employeeRow1:
100 of the timeRow1:
Direct ObservationRow1:
Identification BadgesRow2:
11Row2:
Contractor employees shall be clearly identified by a company uniform and badge with name function and name of the Contractor and a photograph of the employeeRow2:
100 of the timeRow2:
Direct ObservationRow2:
EXCEPTIONAL:
Performance meets contractual requirements and exceeds many to the Governments benefit The contractual performance of the element or subelement being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective Note To justify an Exceptional rating you should identify multiple significant events in each category and state how it was a benefit to the GOVERNMENT However a singular event could be of such magnitude that it alone constitutes an Exceptional rating Also there should have been NO significant weaknesses identifiedVERY GOOD:
SATISFACTORY:
MARGINAL:
UNSATISFACTORY:
GOVERNMENT However a singular problem could be of such serious magnitude that it alone:
1 CONTRACT NUMBER:
2 REPORT NUMBER FOR THIS DISCREPANCY:
3 TO Contracting Officer:
4 FROM Name of COR:
5 DATES:
a CDR PREPARED:
b RETURNED BY CONTRACTOR:
c ACTION COMPLETE:
6 DISCREPANCY OR PROBLEM Describe in detail Include reference to PWS Directive attach continuation sheet if necessary:
7 SIGNATURE OF COR:
Date:
8 SIGNATURE OF CONTRACTING OFFICER:
Date_2:
9a TO Contracting Officer:
9a FROM Contractor:
10 CONTRACTOR RESPONSE AS TO CAUSE CORRECTIVE ACTION AND ACTIONS TO PREVENT RECURRENCE Cite applicable quality control program procedures or new procedures Attach continuation sheets if necessary:
11 SIGNATURE OF CONTRACTOR REPRESENTATIVE Date:
12 GOVERNMENT EVALUATION Acceptance partial acceptance reflection Attach continuation sheets if necessary:
13 GOVERNMENT ACTIONS Acceptance partial acceptance reflection Attach continuation sheets if necessary:
14 CLOSE OUTRow1:
NAMEa CONTRACTOR NOTIFIED:
TITLEa CONTRACTOR NOTIFIED:
SIGNATUREa CONTRACTOR NOTIFIED:
DATEa CONTRACTOR NOTIFIED:
NAMEb COR:
TITLEb COR:
SIGNATUREb COR:
DATEb COR:
NAMEc CONTRACTING OFFICER:
TITLEc CONTRACTING OFFICER:
SIGNATUREc CONTRACTING OFFICER:
DATEc CONTRACTING OFFICER:
2026-03-16T15:37:21-0700
MERICO ZANOTTI

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