S02 Wheelchair Transport Mpls VAMC 36C26325R0001.docx

PAGE 1 OF

1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

UEI:

EFT:

PHONE:

FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Only) 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) 30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

(REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

618-25-2-155-0047

36C26325R0001 03-13-2025 Jeffrey Brown 651-293-3009 04-03-2025 17:00

CDT

36C263 Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

316 Robert Street N. STE. 506 St. Paul MN 55101

X

Y 485991 $19 Million

N/A

Department of Veterans Affairs Minneapolis VA Medical Center One Veterans Drive, Building 70

Minneapolis MN 55417

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

316 Robert Street N. STE. 506 St. Paul MN 55101

Y

Financial Services Center PO Box 149971

Austin TX 78714-9971

See CONTINUATION Page Provide wheelchair bound patient transportation services for the VHA Minneapolis Health Care System in accordance with the Performance Work Statement, QASP and Schedule below.

Prior to submitting a quote, please review all documentation within.

Review and follow INSTRUCTIONS TO OFFERORS In Clause 52.212-1 Addendum.

This solicitation is set aside-for small businesses.

See CONTINUATION Page 618-3650160-155-829800 Patient Care Tra-2119 Beneficiary tvl other th-010041088

Jeffrey Brown

VA-VHA-RPOC-2024-0033

Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C263 Jeffrey Brown

NETWORK 23 CONTRACTING OFFICE

316 Robert Street N. STE. 506 St. Paul MN 55101

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

3. INVOICES: Invoices shall be submitted in arrears:

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

Base Rate/Loads (includes firs 15 minutes of wait time) Contract Period: Base POP Begin: 05-02-2025 POP End: 05-01-2026 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation PRODUCT/SERVICE CODE: V226 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Taxicab

Rate per Mile (loaded only). Unit is subject to economic price adjustment

POP Begin: 05-02-2025 POP End: 05-01-2026

Additional Driver/Attendant Required to Transfer Patient

POP Begin: 05-02-2025 POP End: 05-01-2026

Wait Time per Quarter Hour (beyond initial quarter hour)

POP Begin: 05-02-2025 POP End: 05-01-2026

Unloaded miles for one-way transports that are equal to or greater than 50 miles driving distance from/to MVAMC and pick-up/drop-off point

POP Begin: 05-02-2025 POP End: 05-01-2026

Base Rate/Loads (includes firs 15 minutes of wait time) Contract Period: Option 1 POP Begin: 05-02-2026 POP End: 05-01-2027

Rate per Mile (loaded only). Unit is subject to economic price adjustment

POP Begin: 05-02-2026 POP End: 05-01-2027

Additional Driver/Attendant Required to Transfer Patient

POP Begin: 05-02-2026 POP End: 05-01-2027

Wait Time per Quarter Hour (beyond initial quarter hour)

POP Begin: 05-02-2026 POP End: 05-01-2027

Unloaded miles for one-way transports that are equal to or greater than 50 miles driving distance from/to MVAMC and pick-up/drop-off point

POP Begin: 05-02-2026 POP End: 05-01-2027

Base Rate/Loads (includes firs 15 minutes of wait time) Contract Period: Option 2 POP Begin: 05-02-2027 POP End: 04-30-2028

Rate per Mile (loaded only). Unit is subject to economic price adjustment

POP Begin: 05-02-2027 POP End: 04-30-2028

Additional Driver/Attendant Required to Transfer Patient

POP Begin: 05-02-2027 POP End: 04-30-2028

Wait Time per Quarter Hour (beyond initial quarter hour)

POP Begin: 05-02-2027 POP End: 04-30-2028

Unloaded miles for one-way transports that are equal to or greater than 50 miles driving distance from/to MVAMC and pick-up/drop-off point

POP Begin: 05-02-2027 POP End: 04-30-2028

Base Rate/Loads (includes firs 15 minutes of wait time) Contract Period: Option 3 POP Begin: 05-02-2028 POP End: 05-01-2029

Rate per Mile (loaded only). Unit is subject to economic price adjustment

POP Begin: 05-02-2028 POP End: 05-01-2029

Additional Driver/Attendant Required to Transfer Patient

POP Begin: 05-02-2028 POP End: 05-01-2029

Wait Time per Quarter Hour (beyond initial quarter hour)

POP Begin: 05-02-2028 POP End: 05-01-2029

Unloaded miles for one-way transports that are equal to or greater than 50 miles driving distance from/to MVAMC and pick-up/drop-off point

POP Begin: 05-02-2028 POP End: 05-01-2029

Base Rate/Loads (includes firs 15 minutes of wait time) Contract Period: Option 4 POP Begin: 05-02-2029 POP End: 05-01-2030

Rate per Mile (loaded only). Unit is subject to economic price adjustment

POP Begin: 05-02-2029 POP End: 05-01-2030

Additional Driver/Attendant Required to Transfer Patient

POP Begin: 05-02-2029 POP End: 05-01-2030

Wait Time per Quarter Hour (beyond initial quarter hour)

POP Begin: 05-02-2029 POP End: 05-01-2030

Unloaded miles for one-way transports that are equal to or greater than 50 miles driving distance from/to MVAMC and pick-up/drop-off point

POP Begin: 05-02-2029 POP End: 05-01-2030

B.3 PERFORMANCE WORK STATEMENT

WHEELCHAIR VAN TRANSPORT – MINNEAPOLIS VA HEALTH CARE SYSTEM (MVAHCS)

1. REQUIREMENTS

a. Contractor to provide sufficient vehicles, drivers, and attendants when required, to transport wheelchair patients of the Minneapolis Veteran Affairs medical Center (MVAHCS) to and from the MVAHCS, within the VISN 23 area, Wisconsin and upper Michigan peninsula.

b. Contract period of performance shall be for a base ordering period of twelve (12) months, with the option of four (4) additional twelve (12) month ordering periods.

2. RATES

a. Rates are to include vehicle and the services of a qualified driver. If the Contractor is required to provide an attendant (in addition to the driver), the Contractor will be notified at the time service is requested. Contractor shall only be reimbursed for the services of an attendant which are authorized in advance by COR.

b. Payment for trips shall be computed as follows:

i. The base rate plus mileage.

ii. Mileage shall be charged from patient pick up point to destination.

iii. Payments for trips are limited to one way only “loaded” miles.

iv. No Loads - A no load is defined as a request for service by authorized Medical Center personnel (COR or authorized representative from the call list), whereby the Contractor arrives at the destination pick-up point and no Veteran is transported due to a chance in the Medical Center’s needs, Veteran refuses pick-up, Veteran not home or Veteran not medically/mentally suitable for transport. The Contractor will be entitled to the applicable base rate only (no mileage) when no loads are encountered due to no fault or negligence of the Contractor.

v. When more than one patient is transported: Contractor may invoice mileage for the total distance traveled plus the base rate for each transported patient. Contractor must ensure that the pick-ups and drop-offs are scheduled so that the total distance traveled will result in the most economical charge to the Government.

vi. Contractor’s odometer will be used to measure actual miles.

c. Waiting Time: Rates to include one quarter hour of waiting time at either end or both ends of a trip. Waiting time shall begin at the actual point of pick-up (i.e., on the ward, at the clinic, or the patient’s residence). The Contractor shall be reimbursed at the rate indicated per quarter hour, in excess of the initial one quarter hour allowed. Anytime that the Contractor anticipates a delay for which the Contractor expects to claim reimbursement (Under the no loads line item), the Contractor shall call the Beneficiary Travel office and advise that a delay is anticipated and the approximate time of such delay for which the Contractor expects to claim reimbursement. Contractor’s failure to notify the Beneficiary Travel office when waiting beyond the initial one quarter hour shall result in non-payment for waiting time. This call is only for the purpose of verifying the Contractor’s arrival time at the pick-up or drop-off point and is not necessary if the Contractor anticipates no delay for which the Contractor will be claiming a reimbursement. However, if prior notification has been given to the Contractor that waiting time in excess of the initial 15 minutes will be required, the Contractor is not obligated to call for verification. The Contractor shall be responsible for all costs incurred in verifying waiting time.

d. If the Contractor’s place of business is located beyond the local telephone call zone of locations listed in the Schedule of Items, the Contractor agrees to accept telephone orders for service on a collect basis.

e. Approximately 50% of all runs picked up will be within 30 miles of the medical center. Approximately 95% of all runs picked up will occur Monday through Friday.

f. An estimated five (5) trips per week are outside the state of Minnesota.

3. VEHICLES AND EQUIPMENT

a. Regulations contractor shall meet: Minnesota State Statutes, Chapter 8840, Department of Special Transportation Services, Operating Standards, subpart 8840.5100 through 8840.6300 (revised) and Code of Federal Regulations (CFR) Title 49, Section 38. (The Contracting Officer shall provide a copy of referenced materials upon written request.)

i. The vehicles and equipment with which the Contractor renders the above services shall meet all State of Minnesota (or Equal) requirements for insurance, registration, and equipment and are to include, but not be limited to the following:

1. Approved system for wheelchair securement devices and a tool designed for cutting securement straps in case of emergency.

2. Safety requirements for seat belts and handling of motorized or electric wheelchair.

3. Contractor must furnish shoulder/chest harness for double amputee patients when applicable.

b. Provide vehicles with interior of sufficient height to ensure that an individual of 6' has adequate head clearance.

c. Vehicles shall be handicapped accessible and meet all applicable Federal and State Motor Vehicle Safety Standards.

d. The ramp or lift shall have a slip-proof surface.

e. All additional items such as first aid kits, flashlights, warning triangles, ice scrapers, blankets, etc. shall be secured and stored below the level of seat backs.

f. Dry chemical fire extinguishers shall be securely mounted in a bracket and readily accessible to the driver in an emergency. Extinguishers shall be serviced annually and display a tag indicating date of service.

g. Heater(s) shall be of sufficient capacity to maintain patient’s warmth during winter months.

h. All vehicles shall be air conditioned to maintain patient’s comfort during warm periods.

i. MVAHCS reserves the right to inspect contractor's equipment and vehicles or require documentation of compliance with contract specifications, and State laws, rules, regulations and guidelines governing transport vehicles. MVAHCS is not required to obtain a warrant to inspect contractor’s vehicles and equipment to ensure contract compliance. All issues found during inspection shall be reported to contractor, and any illegal issues shall be reported to MVAHCS police. MVAHCS reserves the right to restrict the Contractor’s use of equipment and vehicles which need repair, unclean, unsafe, damaged on the interior or exterior body, and are not in compliance with contract requirements. The restriction of such equipment and vehicles shall not relieve the contractor from performing in accordance with the strict intent and meaning of the contract.

4. STANDARDS FOR MAINTENANCE

a. All vehicles shall be maintained in a clean and orderly condition, free from debris and any accumulations which may constitute an accident, injury, or fire hazard.

b. Vehicles shall be maintained in accordance with manufacturer’s recommended maintenance schedule, or an improved schedule based on actual vehicle operating conditions. Maintenance log shall be provided to CO or COR upon request.

c. Contractor shall correct a deficiency that might interfere with safe operation of vehicle before vehicle is placed in service.

d. Windows and lights shall be kept clean and operational.

e. The interior of vehicles shall be clean and in good repair.

f. Wheelchair lifts shall be maintained in conformance with operation/maintenance manual instructions provided by lift manufacturer. When a vehicle is serviced, the mechanic or service facility shall inspect, repair, or service the lift in accordance with the manufacturer’s instructions.

g. Contractor shall maintain (and furnish upon request) procedures that outline preventive maintenance and/or repairs on each vehicle in an individual vehicle file and in chronological order, latest service on top. Submission and verification of these documents shall be provided upon request in order to comply with quality assurance procedures.

5. DRIVER QUALIFICATIONS

a. Drivers shall have the following qualifications to perform work on this contract:

i. Has visual acuity of 20/20 in each eye corrected, and a field of vision of at least 70 degrees in the horizontal meridian of each eye; The ability to recognize the colors of traffic signals and devices showing standard red, green, and amber.

ii. Does not have a hearing loss greater than 30 dB in the better ear with or without a hearing aid; and

iii. Has no current medical condition which interferes with the ability to drive safely.

b. Every two years each driver shall obtain a physician’s statement, or the statement of a nurse practitioner certified by the American Nurses’ Association (or other professional nursing certifying organization having authority to certify registered nurses in advanced nursing practice) that the driver has no current medical condition that interferes with the driver’s ability to drive safely. It must be obtained before driving a special transportation service vehicle. Drivers for facilities that are licensed by the Department of Health or the Department of Human Services and required by either of those departments to provide a physician’s or nurse practitioner’s statement of health on a regular basis may substitute that form or statement for the form required in this part. A driver who has a driver’s license containing a valid school bus endorsement issued under Minnesota Statutes, section 171.321, (or other state Equal) or the rules of the commissioner of public safety, or a current United States Department of Transportation health card, may furnish a copy of that endorsement or card instead of furnishing the physician’s statement of health.

c. Each driver shall be able to perform a vehicle safety inspection daily to ensure their vehicle is in proper working condition. This includes checking Service Brakes, Parking Brakes, Steering System, Lights and reflectors, Tires, Wheels, Rims, Horn(s), Windshield Wipers, Rearview Mirrors, Oil/Coolant Levels, Emergency Equipment.

d. Each driver and attendant, when a vehicle is staffed by both a driver and an attendant, shall be able to assist a passenger into and out of the vehicle and operate a wheelchair lift or ramp.

e. Each driver shall:

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

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

iii. For the past three years:

1. Have not had a driver’s license canceled under Minnesota Statutes, section 171.14, revoked under Minnesota Statutes, section 171.17, or suspended under Minnesota Statutes, section 171.18, clause (2), (3), (4), (5), (7), or (11) (or other state equal).

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

3. Have a driving and criminal record clear of convictions for driving under the influence of alcohol or a controlled substance under Minnesota Statutes, section 169A.20, or an ordinance in conformity with that section, of alcohol-related driving by commercial vehicle drivers under Minnesota Statutes, section 169A.20, and of driver's license revocations under Minnesota Statutes, sections 169A.51 to 169A.53 (or other state Equal).

4. Each driver shall also have a record clear of criminal convictions of crimes or anticipatory crimes against persons, and crimes or anticipatory crimes reasonably related to providing special transportation services. Background checks are to be completed by Contractor. MVAHCS may requests records at any time.

f. Contractor personal must follow Federal Motor Carrier Safety Administration (FMCSA) Regulations.

6. DRIVER AND ATTENDANT TRAINING REQUIREMENTS

a. Contractor employees performing services to VA beneficiaries under this contract shall meet all requirements of Minnesota Department of Transportation Chapter 8840.5900/5910 (or other state Equal) for drivers and attendants of special transportation service vehicles, including a basic First Aid Class.

b. Driver and attendant shall have successfully completed a minimum of eight (8) hours training in the techniques of transporting and assisting elderly and physically handicapped passengers which shall include instruction in the following elements:

i. Discussion of characteristics of the aging process and major disabling conditions.

ii. Discussion of common assistance devices used by elderly and handicapped persons.

iii. Discussion of attitudes toward elderly and handicapped persons which includes the participation of handicapped and elderly persons.

iv. Instruction in methods of handling wheelchairs.

v. Instruction in moving, lifting, and transferring passengers.

vi. Guidelines for transporting handicapped persons; and

vii. Instruction in the operation of lifts, ramps, and wheelchair securement devices.

c. Each contractor employee shall be instructed in fire extinguisher, radio dispatch, and vehicle ramp operations, wheelchair lift and securement devices; and will know what to do and whom to call in a medical emergency or accident.

d. Each contractor employee shall complete four (4) hours of training in first aid (or show evidence of possessing American Red Cross First Aid Certificate).

e. Each contractor employee shall complete four (4) hours of classroom instruction in defensive driving and abuse-prevention training.

f. Each contractor employee shall successfully complete a refresher first aid course every three (3) years.

g. The Contractor shall have on file satisfactory evidence of above training, evidence that the instructor is qualified to teach the above, and the certificates for instructor and trainee/driver for training available for review and inspection by the VA Contracting Officer or COR.

h. A record of each contractor employee capability of performing the duties of a driver or attendant must be maintained and made available upon request by COR.

i. VA reserves the right to restrict any contractor employee from performing services under this contract who do not meet the required qualifications for the services they are required to perform and who violates Federal regulations or are identified as a potential threat to the security, safety, health and/or operational mission of the VA and its’ veteran population. The restriction of such contractor personnel shall not relieve the contractor from performing all the required services, in accordance with all terms, conditions, and schedules contained herein.

j. The Contractor shall furnish qualified personnel as required by contract specifications to accomplish all services under this contract. During the contract period of performance, if the Contractor proposes to add-on or replace personnel to perform contract services, the Contractor shall submit the required evidence of training, certifications, licensing, and any other qualifications to the designated COR. At no time shall the Contractor utilize add-on or replacement personnel to perform contract services who do not meet the qualifications under the terms and conditions of this contract.

k. Contractor personnel performing services for the VA shall always conduct themselves in a professional manner, maintain personal hygiene, wear clean, neat uniforms and be identified by having the company name and employee name affixed to the uniform. The COR has authority to report to the Contractor any perceived violations of dress standards and ask the contractor to dismiss personnel until compliant. The Contractor shall be responsible for furnishing all vehicles, personnel, equipment and supplies, vehicle fuel, uniforms, name tags and/or badges for performance of services under this contract. Employee identifications shall be worn in clear view above the waist.

l. The Government reserves the right to restrict any contractor employee from performing services under this contract who do not meet the required qualifications, or who violate Federal regulations or are identified as a potential threat to the security, safety, health and/or operational mission of VA and its veteran population. The restriction of such contractor personnel shall not relieve the contractor from performing all the required services in accordance with all terms, conditions, and schedules contained herein.

m. Contractor shall comply with U.S. Interstate Commerce Commission required insurance liability coverage for out-of-state trips (Wisconsin, Iowa, Dakotas, etc.). “Wheelchair Van Transportation” is defined as transport of non-ambulatory patients (and equipment) who are usually wheelchair bound and therefore require wheelchair van transport.

n. Contractor personnel shall not smoke in vehicles or engage in unlawful cellphone use while transporting VA patients.

7. PASSENGER TRANSPORTATION

a. It is understood that only one passenger will be transported on a trip unless specifically authorized by the COR or authorized representative from the Delegation of Authority List. VA personnel will not provide assistance with loading or unloading passengers.

b. Drivers and passengers shall use seat belts/securement devices at all times. All VA patients will be transported in a wheelchair secured properly and seated facing forward.

c. If patient is ambulatory, they may be seated in vehicle without a wheelchair. Patient must be secured using appropriate safety restraints.

d. There shall be no smoking by the driver, attendants, or passenger(s).

e. Contractor shall provide “through the door service” for patients to and from their designated appointments. Patients are to be picked up on the ward, in their homes, in their clinic, or at other stated areas and taken to their stated destination or appointment. At the conclusion of their appointments the patient shall be returned to the ward, inside their home, or to other stated areas. All patients shall be attended by a responsible party at all times. Assistance in maneuvering stairs and other barriers shall be provided by the driver and/or attendant as necessary. When a patient is delivered to or departing from a destination (such as a clinic or other appointment), a responsible party at the destination shall be informed of the patient’s arrival by the driver or attendant. “Responsible party” is defined as any driver, professional staff at medical center, nursing home or clinic, or patients concerned other.

i. Patients denoted to be enrolled in Client Assistive Services (CAS) must be dropped off in the MVAHCS CAS office during normal business hours, 7:30am through 4:00pm. Drop offs occurring outside of normal business hours will be dropped off at the patient’s clinic or ward and handed off to a responsible party. At the conclusion of the patient’s treatment, the Contractor shall pick up the patient from the area designated by the COR or authorized representative on the manifest. Upon drop off at the patient’s residence, the Contractor will hand off the patient to a responsible party or verify the patient is able to enter their residence if a responsible party is not present.

1. Normal business hours for the CAS office may be subject to change. The COR will notify the Contractor if any changes occur.

2. If the patient does not comply with the above, the Contractor shall contact the Beneficiary Travel office immediately.

ii. Patients denoted to be enrolled in a Contract Nursing Home (CNH) must be dropped off at the patient’s clinic or ward and handed off to a responsible party. At the conclusion of the patient’s treatment, the Contractor shall pick up the patient from the area designated by the COR or authorized representative on the call list. Upon drop off at the patient’s CNH, the contractor will hand off the patient to a responsible party.

1. If the patient does not comply with the above, the Contractor shall contact the Beneficiary Travel office immediately.

f. The Contractor shall have sufficient vehicles and personnel to meet the requirements of this contract. If MVAHCS has a need for additional transport services beyond eighty-five (85) trips per day, the initial call for service shall be placed with the Contractor. If the Contractor agrees to provide service beyond eight-five (85) trips per day, the billing shall be at the prices indicated in the schedule of items. The Contractor may decline service beyond eighty-five (85) trips per day without penalty and VAHCS may then order additional service from another vendor source.

i. Contractor will need to provide sufficient evidence to the COR to show VAHCS has requested beyond eighty-five (85) trips or justify to why a ride would be denied when under the designated number of trips.

g. Contractor shall supply wheelchairs for transporting patients. VA-owned wheelchairs may not be removed from the medical center unless specifically authorized by the COR. VA- owned wheelchairs will be immediately returned upon completion of authorized trip., at no additional cost to the VA.

i. Contractor will not store contractor-owned wheelchairs on VA property when not in use.

h. If a VA beneficiary being transported declines to be properly belted or removes the securement devices himself/herself, the driver shall notify the Contracting Officer’s Representative (COR) of this fact prior to departure, or upon arrival at destination if incident occurred during transit. The Contractor is not required to transport any VA beneficiary who refuses to be properly secured while being transported.

i. An authorized official of the VA Health Care System (usually the COR) may, in the best interest of the patient, allow one (1) relative or concerned other to accompany the patient at no additional cost to the Government. Prior to contract performance, the Contracting Officer shall provide the Contractor with a list of names (or position titles) and phone numbers of authorized Government personnel who may request services and receive calls from Contractor regarding contract performance. This list will be updated and submitted to the Contractor as changes occur. The Contractor shall ensure that requests for services are received from authorized medical center personnel. Services rendered in response to requests from other than authorized personnel shall be at the risk of the Contractor and any cost related thereto shall be borne by the Contractor.

j. Contractor shall notify the COR of any unusual events, such as accidents, safety problems and patients unbelting themselves, that occur and involve any VA beneficiary being transported under this contract. This notification will be made within one (1) hour by telephone and an email of the event will be delivered to the COR and the Contracting Officer by close of business the next working day. Failure to comply with this provision may be grounds for default.

k. Patients using motorized wheelchairs or electric carts shall be secured in accordance with Federal and State regulations for transport or transferred to a manually operated wheelchair before being loaded in the vehicle. The motorized cart or wheelchair shall be loaded separately and must be secured to the vehicle during transport. Patients using motorized scooters not approved for occupied transport will be required to transfer to a manual wheelchair or into the vehicle’s seat. Contractor will contact COR if questions arise about suitability for occupied transport of motorized scooter.

l. For VAHCS transports, unload and load patients at proper entrance as designated in the daily manifest or as indicated by VA staff. At no time shall Contractor’s vehicle use the MVAHCS ambulance entrance unless drop-off or pick-up constitutes a medical emergency. If waiting time is necessary, vehicle shall park in appropriate designated general parking lot areas.

m. If or when patient’s medical records are transported, Contractor shall ensure that Privacy Act guidelines are followed.

8. HOURS OF SERVICE

a. Contractor shall provide service seven (7) days a week including holidays, 24 hours per day for the term of this contract. The Contractor shall provide VA with a method of contacting them, 24-hours per day.

9. REQUEST FOR SERVICES

a. Request for services shall be made by telephone (followed up in writing) or in writing by facsimile machine or secure email by the COR and/or designated VAHCS personnel. The contractor shall, always during the contract period, have on their premises a functioning fax machine to communicate requirements with the MVAHCS (i.e., requests for service, patient incidents, special correspondence, etc.). When ordering services, the MVAHCS shall provide the Contractor with the following type of information:

i. Required date and time of arrival.

ii. Name of beneficiary and last 4 digits of the Social Security number.

iii. Pick-up and delivery point.

iv. Any other special instructions (i.e., extra attendant required, CAS designation, etc.)

b. Generally, services provided under this agreement shall be scheduled in advance with the Contractor for handicapped transportation services, schedule requirements are defined as follows:

i. Scheduled Trips refers to those trips for which the Contractor has been given advance notice, which is defined as notice given by 4:30 p.m. the previous day of pick up for required services and a specific pick-up time. These transports shall always be on time for patient pick-up. On-time is defined as no more than 10 minutes after scheduled pick-up time. Contractor must notify the Contracting Officer’s Representative (COR), or authorized designee, at least eight (8) hours in advance of need when Contractor believes they may be unable to meet the number of scheduled trips required.

ii. Unscheduled Trips are those trips required on an as needed basis. Response time for vehicle arrival at prescribed destination is within one (1) hour of notification of need. If the Contractor’s vehicle fails to arrive at the prescribed destination within one (1) hour after receiving a request on an order MVAHCS reserves the right to obtain the service from another source and to charge the Contractor with any excess cost which may result therefrom. If no other vendor is available, a deduction in the amount of ten percent (10%) of the base rate charge may be assessed per every quarter hour (15 minutes) more than the allowable response time (1 hour). The CO and COR will determine when to order service from another source.

iii. Delays

1. In the case of inclement weather, the decision as to whether a VA beneficiary will be transported shall be made mutually by the COR and the Contractor.

2. When safety of patient and driver may be in question the decision as to whether a VA beneficiary will be transported shall be made mutually by the COR and the Contractor.

10. MNDOT (or equivalent) REQUIREMENTS

a. Contractor shall comply with all requirements of the Minnesota Department of Transportation (MNDOT) “Operating Standards for Special Transportation Service” – (latest edition). Evidence of this compliance shall be in the form of an annually current “Certificate of Compliance” issued by the State of Minnesota Commissioner of Transportation (State of Minnesota Department of Transportation, Office of Motor Carrier Safety and Compliance).

b. For the purposes of this contract, any waivers granted by the State Commissioner of Transportation in issuing the “Certificate of Compliance” shall be approved by the COR or Contracting Officer.

c. Contractor shall submit “Equal” evidence of compliance from out-state governing agencies if their main base of operations is in a state other than Minnesota.

11. SAFETY REQUIREMENTS

a. In the performance of this contract, the Contractor shall take such safety precautions determined to be reasonably necessary to protect the lives and health of all persons affected by this contract. The Contracting Officer or COR shall notify the Contractor of any noncompliance with the foregoing provisions and the action to be taken. The Contractor shall, after receipt of such notice, immediately correct the conditions to which attention has been directed. Such notice, when served on the Contractor or their representative at the site of the work, shall be deemed sufficient for the purposes aforesaid. If the Contractor fails or refuses to comply promptly, the Contracting Officer may issue an order stopping all or any part of the work and hold the Contractor in default.

12. CONFORMITY TO REGULATIONS

a. The Contractor and their operators shall conform to all regulations, Federal, State, and local, governing the performance of contracted services.

b. All MVAHCS facilities have been designated as no smoking in their entirety. Individuals found in violation of this no smoking policy shall be subject to a $50 federal citation for disregarding posted safety rules and regulations. Contractor may be directed to stop work. Contractor is to notify all employees and/or sub-contractors of this strict enforcement policy.

13. INSPECTIONS

a. The Government shall accept vehicle inspection documentation from MNDOT or other inspection department who performs such inspections on a routine basis. However, the Government shall inspect Contractor’s establishment, vehicles or maintenance records at least annually, and may inspect any element any time, and especially upon receipt of a complaint about the condition of the vehicle or its equipment, the driver or attendant, or service provided.

14. REQUIRED REPORTS AND DOCUMENTS

a. Within seven (7) days after contract award the contractor shall provide the following for all contracted and sub-contracted personnel and vehicles:

i. Contractor/Sub-Contractor Personnel Roster - In this document, contractor shall identify all employees name and position and provide training documentation with date and location of such training for employees that will work on this contract along with signed a Contractor Rules of Behavior form (listed in section D). Include contractor’s project manager with telephone and fax numbers; include telephone and fax numbers through which scheduling transport requests will be made.

ii. Listing of all vehicles with VINs and documentation of insurance coverage; MNDOT or equivalent vehicle inspection documentation and statement indicating that all have been fully maintained and are currently safe to operate.

b. Any personnel or vehicle changes shall be submitted within two (2) business days after changes occur.

15. CONTRACTOR’S QUALITY CONTROL PROGRAM (QCP)

a. The Contractor shall establish and maintain a complete QCP to ensure the requirements of this contract are provided as specified. An original and one (1) copy of this QCP is due with the initial proposal. The Contractor’s QCP shall include the following at a minimum:

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

ii. On-site records of all inspections conducted by the Contractor noting necessary corrective action taken. The Government reserves the right to request copies of any and/or each inspection.

iii. Incorporation of either active or established internal policy and procedures for updating service protocols that may affect performance of contract.

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

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

vi. On-site records identifying the character (background checks) and certifications of ongoing training of each employee performing services under this contract.

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

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

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

16. PATIENT RIGHTS

a. The Contractor shall be courteous to VA beneficiaries and shall not smoke while transporting patients. Patients may bring a reasonable amount of equipment, such as any wheelchair, electric cart or prosthetic devices, and consumable medical supplies and personal suitcase during their transport.

b. The contractor shall immediately notify the VA of any incidents involving injury to VA patients during transport. The contractor shall complete and submit to the COR, a detailed “Incident Report” with all information necessary to conduct a full review. Written report is required to be submitted within twenty-four (24) hours of incident with a list of involved Contractor names, Veteran’s names, witness names and pertinent information to be filed with the COR.

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

17. INVOICING

a. Contractor is required to submit invoices electronically to the VA Financial Services Center (FSC). The FSC uses a third-party contractor, Tungsten Network (http://www.tungsten-network.com/), to assist vendors in submitting invoices electronically, free of charge.

b. Invoices shall include the following information in addition to the times specified:

i. Date of service

ii. Name of Veteran

iii. Pick-up location

iv. Destination/drop-off location

v. Additional charges

vi. Number of miles traveled

vii. Purchase order number

c. If an item is under the threshold amount VA may use a purchase card for services.

18. MISCELLANEOUS

a. At no time will the Contractor leave vehicles on VA premises unless a pick-up or delivery is in progress.

b. Contractor employees shall conduct themselves in a businesslike manner at all times while on VA premises.

c. When transporting patients to or from medical facilities, the driver, acting for the Contractor, shall ensure that patient’s luggage, medical records, medications, and prosthetic devices are properly accounted for and delivered with the patient as required.

d. Contractor shall always have available a wheelchair for transport of Veterans from pick-up point to delivery point. When the Veteran is delivered to a destination other than the Department of Veterans Affairs and return trip is ordered for the same day, the Veteran will transfer from the contractor's wheelchair to a facility owned wheelchair. Veterans will be transported utilizing standard 4-wheel chairs. No Veteran shall be transported while sitting in a 3-wheel scooter. Veterans requiring transport in a 3-wheeled scooter will transfer to a seat in the vehicle with the scooter being transported with the Veteran at no additional cost to the VA.

e. The driver will observe the Veteran during transport. Any indication of significant change in condition (i.e., sudden onset of rapid or labored respirations, complaints of chest pains) will be immediately communicated to the Medical Center Admitting office phone number shall be provided after award. Depending on the condition of the Veteran, the Veteran will be returned to the Admitting Office, transported to the nearest emergency room, or advanced life support called.

f. The Contractor shall notify the Contracting Officer in writing immediately upon entering an agreement (either oral or written) to sale or transfer all or part of its stock or other ownership interest to any other party.

g. The Manifest will consist of the daily schedule provided by MVAHCS to the Contractor 2x per day. Once in the morning and once in the afternoon. The manifest will go over all appointments scheduled or cancelled for the current or next day.

B.4 QUALITY ASSURANCE SURVEILLANCE PLAN

For: Minneapolis VAHCS WHEELCHAIR SERVICES Contract Number: TBD (Upon award, Government will enter contract number) Contract Description: Wheelchair Van Service Contractor’s name: TBD (Upon award, Government will enter Contractor identification)

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 monitoring will take place.

· Who will conduct the monitoring.

· How monitoring efforts and results will 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. 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: TBD Organization or Agency: Department of Veterans Affairs, VHA

b. Contracting Officer’s Representative (COR) - The COR is responsible for administration of the contract and shall assure proper Government surveillance of the contractor’s performance.