SOW Bronx Ambulance.pdf

STATEMENT OF WORK

STATEMENT OF WORK – AMBULANCE SERVICES

JAMES J. PETERS VAMC

BRONX VA

130 WEST KINGSBRIDGE ROAD

BRONX, NY 10468

Furnish as needed, seven (7) days a week, twenty-four hours a day emergency, ambulance services. Contractor shall furnish Advance Life Support (ALS) and Basic Life Support (BLS) ambulance and services for eligible beneficiaries of the Department of Veterans Affairs James J.

Peters Medical Center (JJP VAMC) in the Bronx and its three Community-Based Outpatient Clinics (CBOCs) located in White Plains, Yonkers and Queens, respectively.

The ten holidays observed by the Federal Government are: New Year’s Day, Martin Luther King’s Birthday, Washington’s Birthday, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans Day, Thanksgiving Day, and Christmas, any other day specifically declared by the President of the United States to be a national holiday. The contractor will be servicing two beneficiary travel units at this facility: Business Office Veterans Transportation Service/Beneficiary Travel.

Upon the request of authorized medical center staff, the Contractor will provide Basic Life Support (BLS) and Advanced Life Support (ALS) ambulance transports of patients to designated locations, depending on the specific request and clinical needs of the patient. The Contractor may be required to transport patients to another facility for treatment or tests, wait, and transport same patient to a pre-determined destination. The Contractor may be required to transport patients from their homes to the James J. Peters VA Medical Center or one of its CBOCs. The services discussed in this solicitation are for the general vicinities of New York City and the surrounding metropolitan area including Connecticut, Pennsylvania, New Jersey, Delaware and not limited to the New York State area.

Facility Addresses

Main Hospital

James J. Peters Veterans Affairs Medical Center 130 West Kingsbridge Road Bronx, NY 10468

Outpatient Clinics

White Plains Community Based Outpatient Clinic 23 South Broadway White Plains, NY 10601

Yonkers Community Based Outpatient Clinic 124 New Main Street Yonkers, NY 10701

Queens Community Based Outpatient Clinic 47-01 Queens Boulevard, 3rd Floor, Suite 301 Sunnyside, NY 11104

The vehicles, personnel and services rendered will conform to all federal, state and local statues, laws, codes rules and regulations; including, but not limited to those required by the State of New York, Department of Health Emergency Medical Services Program. The Contractors MUST be authorized to provide services in the state of New York.

NUMBER OF PATIENTS: It is understood and agreed that only ONE patient will be transported on a trip unless specifically authorized by JJP VAMC. One attendant who is at least 18 years of age will be permitted to accompany the patient at no charge. The contractor must ensure that the pick-ups and drop-offs are scheduled so that the total distance travel will result in the most economical charge to the Government.

RATES: For all one-way trips within the city Limits, the contractor shall receive the flat rate awarded for that trip. The flat rate shall constitute full compensation for one-way trip which do not exceed the City Limits. The contractor shall receive the mileage rate awarded for any one-way trips in excess of the prescribed outside of the city limits. The mileage rate is applicable only for mileage Beyond the City Limits and under no circumstances shall the contractor receive reimbursement for the mileage rate for any mileage within the City Limits. Payment for mileage traveled beyond the city limit will be limited to “One Way Only” the distance over which the patient is transported. Trip mileage shall be determined by the latest edition of the Rand McNally Standard Mileage Guide. Access Rand McNally’s trip maker at:

http://www.randmcnally.com.

Day rates will apply to any trip between the hours 7:01am and 7:00pm. Night rates will apply to any trip between the hours 7:01pm and 7:00am. The requested pickup time will govern the determination of whether the day or night rate will apply.

Payment for mileage traveled beyond the city limits will be limited to “One 2-way only” for the distance which the patient is transported. Such mileage cost will be paid in addition to the applicable rate per trip for any trip entirely within the county limits. Trip mileage shall be determined by using the “get directions” mileage feature at www.bing.com/maps.

CITY LIMITS: are located within the 5 boroughs – Bronx, Manhattan, Brooklyn, Queens and Staten Island.

http://www.randmcnally.com/

BEYOND CITY LIMITS: The areas located outside of the five boroughs comprising of the city limits.

ORDERS: Requests for services will be made by telephone from authorized VA personnel. The Government will not be held liable for those services performed by the Contractor(s) which are ordered by people who are unauthorized. The request will specify a range of dates and times for acceptable delivery of a transported patient.

Requests for basic life support (BLS) ambulance service will be scheduled on no less than 60 minutes advanced notice. These pickups may be from any location within the Bronx, Manhattan or Westchester. A pickup may occur either at a patient’s home or a health care facility (such as a hospital, clinic or nursing home).

Pickups may be required for locations outside of the aforementioned areas, including, but not limited to, Brooklyn, Staten Island, White Plains, Yonkers, New Jersey, Connecticut, Pennsylvania, Delaware and New York Stare area.

Contractor shall respond to emergencies caused by acute coronary syndromes, head trauma or intra-cerebral bleeds within 30 minutes or less. These pickups will only take place at the JJP VAMC and will occur approximately once a week. Contractor shall furnish ambulance service within 30 minutes after receiving a request for this particular service. If the Contractor fails to do so, the JJP VAMC reserves the right to obtain the service from another source and charge the Contractor with any excess cost that may result there from. The JJP VAMC will be the sole judge in determining when to order service from another source.

Contractor will be informed of the condition of the patient at the time of request for service. The Contractor will be required to assign appropriate personnel for the transportation of patient.

It is required that the Contractor will furnish an EMT P on all requests, however the VAMC reserves the right to request the services of an EMT I if appropriate in lieu of the EMT P.

PICKUP PROCEDURES: When an ambulance is at a pickup facility, the driver or the EMT shall announce to the Emergency Room, Clinic Nurse, Ward Nurse or designee at JJP VAMC with responsibilities for releasing or facilitating the release of patients that the ambulance is waiting for, and provide the beneficiary’s name as well as any other pertinent information as to his or her identification. The individual so informed will verify the time on the trip ticket and indicate his name. From this verified time of arrival, fifteen (15) minutes will be allowed as normal and not to lost time for the facility to release the patient to the Contractor. Such release time cannot be claimed as waiting time unless, through no fault of the Contractor, the patient is not released at all. Boarding activities are also normal to the services required and time spent at the pickup location reaching the patient and assisting him to and into the waiting ambulance is not lost time.

AUTHORIZING PERSONNEL:

The following VAMC personnel are authorized to request or authorize ambulette or ambulance services for JJP VAMC:

Chief, Business Office Mobility Manager/Travel Supervisor Travel Clerks / Backup Travel Clerk Health Administrator (HAC)

CONTACT INFORMATION:

Monday through Friday – Chief, Business Office 718-584-9000 ext. 6220

Transportation Coordinator 718-584-9000, Ext 5355 or 1290

Mobility Manager/Travel Supervisor 718-584-9000, Ext. 3781

Travel Clerks 718-584-9000, Ext. 5323/5324

When Hours, Weekends, Holidays – Hospital Nursing & Administrative Coordinators

718-584-9000 Ext. 6832 (dial 0 for operator to page)

WAITING TIME:

For time lost in waiting at either end of a trip due to causes beyond the Contractor’s control, the Contractor will be reimbursed at the rate of one-fourth the hourly rate quoted in this bid. This charge applies if the crew is delayed longer than 15 minutes at time of pickup or delivery. The proposed rate will be charged in 15-minute increments. If the pickup location is other than the JJP VAMC the Contractor will contact the JJP VAMC Travel Office (during business hours Monday – Friday 8 am – 4:30 pm) or Hospital Administrative Coordinator on duty (during all hours outside of the business hours listed) as soon as the Contractor anticipates that a delay for which Contractor expects to claim reimbursement. This call is only for the purpose of verifying the Contractors arrival time at the pick-up point (verification is made by confirming the time of pickup with the VA Staff, or the patient when the pickup is made off the VA Campus) and is not necessary if the Contractor anticipates no delay for which the Contractor will claim reimbursement.

LOADING/UNLOADING PATIENTS: Contractor(s) will be required to assist patient from point of pick-up to ambulance and from ambulance to point of destination.

REIMBURSEMENT: JJP VA Medical Center will review each invoice for transport. The VA will only reimburse those veteran patients eligible for transportation. Contractor will invoice each transportation call separately.

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

AUXILIARY SERVICE: The contractor may be required to transport medical records, medication, other items (including Stryker frames, litters, etc.) patient luggage, collapsible manual wheelchair from pickup point to destination at no additional cost to the Government.

Luggage to be transported will be restricted to luggage type. Patients are then transported to the appropriate JJP VAMC, outpatient clinics, CBOCS or service within the facility where patient has his/her appointment.

RESPONSE TIME: Response time will be calculated from the receipt of the telephonic request for service. At the time of the request, the Contractor shall acknowledge their ability to provide the service within the requested response time.

If the Contractor cannot provide the service for any reason, they must notify the VA staff person requesting the service of their inability to provide the service.

Response times for Standard Orders: Contractor shall arrive at the point of pickup no later than 1 hour from the time of request.

Response time for Long Hauls: Contractor shall arrive at the point of pickup no later than 2 hours from the time of request.

Response time for Emergency Services: Contractor shall respond to emergencies caused by acute coronary syndromes, head trauma or intra-cerebral bleeds within 30 minutes or less as detailed in the “orders” section.

If the Contractor fails to furnish service within the required response times, the VA reserves the right to obtain this service from another source. The VA will be the sole judge in determining when to order service from another source. Repeated failure to meet required response time may result in termination of the agreement, or discontinuance of further orders. Response time will be calculated from the Contractor’s receipt of the telephonic/fax request for service.

The Contractor shall not charge the VA a cancellation fee when cancellations are made prior to the ALS/BLS vehicle embarking upon the dispatch.

PATIENT CONDITION UPON ARRIVAL:

Upon arrival at the patient pick-up point, if the Contractor determines the condition of the patient scheduled for pick-up is different than what was stated on the travel request, the Contractor shall notify the Travel Office or HAC on duty for further instruction.

TRIP REPORT:

The Contractor shall document each VA authorized transport in eCAMS with the following information:

Date Patient name Patient identification # Origin Time of pick up Destination Time of delivery Mileage; and Person calling in the travel request

Any notes regarding issues particular to the specific transport, including recording oxygen, cardiac monitoring, and other services provided (i.e. material items, supplies).

The Contractor shall include a copy of this report with all invoices and also provide the trip documentation form upon request by the VA. These reports will serve as documentation of the transport and will be a source document for reconciliation of the Contractor’s requests for payment.

ORIGIN AND DESTINATION: Contractor shall provide services to beneficiaries of the JJP VAMC to or from any designated location within the defined service area, encompassing the states of New York, New Jersey, Connecticut, Delaware and Pennsylvania but not limited to New York State area. The VA staff will specify the points of origin and the destination of every trip.

The VA reserves the right to substitute beneficiary requiring service to prevent “Unloaded Trips”, delays, and cancellations. There shall be no additional charge to the VA when such changes occur.

GLOBAL POSITIONING SYSTEM (GPS): All vehicles shall be equipped with a GPS system which has the following capabilities:

Address to address routing Voice prompts for turns & guidance Built in road maps – detailed road map displays Route capabilities show best route to take from point A to point B Waypoints capable shows locations & ability to pint to a desired destination Turn Here – unit gives signal for a next turn Maps user can upload maps for area needed

Traveling user can input series of addresses the unit displays lowest time/distance route between several destination points Large & bright screen that is easily visible to the driver Engine idle – tells you that the vehicle has stopped and is on/running Calculates speed from starting point to ending point Calculates travel mileage

EXTRAORDINARY CONDITIONS: When conditions foreseeable and/or uncontrollable by Contractor occur, such as: storms, flooding or other hazardous road and travel situations, time and distance qualifications shall be considered secondary to safety precautions. Any delays or exceptions to the required quality of services, due to such substantial difficulties, shall be reported to the Travel Supervisor at Ext. 3781, the Chief, Business Office at Ext. 6220 and/or the Travel Clerks at Ext.5323/5324. The JJP VAMC will indicate concurrence or non-concurrence re-excusing such delays for the reasons communicated to the Contracting Officer (NCO3).

ESCORT: Subject to limitations of current regulations, the VA reserves the right to have an escort, such as a relative, or care provider of beneficiary or VA staff accompany beneficiary when the VA determines that such an escort is in the best interest of the beneficiary. The VA will also be the final judge in determining when an escort is required. There shall be no additional charge to the VA when escorts are authorized to travel with beneficiary. Contractor shall only be required to transport escort with patient and shall not be required to return the escort back to point of origin.

SERVICE DISRUPTION: The contractor shall immediately report to the COR any and all vehicle breakdowns or other problems, which may cause service disruptions. When a breakdown occurs, the contractor shall provide a back-up vehicle to minimize any delay or inconvenience to the customer(s). When conditions, neither foreseeable and/or controllable by the contractor occur, such as severe storms, flooding, hazardous road and travel conditions, time and distance requirements shall be considered secondary to safety precautions. Delays or exceptions to the required quality of services shall be reported to the Travel Clerk, Travel Supervisor or HAC..

Contractor shall immediately report all incidents and accidents, including those where there is no apparent injury to the patient, which occurs while transporting VA beneficiaries. The driver shall provide a written report documenting the facts of the incident/accident to the COR within 24 hours of the occurrence. The written report shall include the names, addresses, and telephone numbers of any witnesses as well as any applicable Police Reports. Any incidents involving major damage, serious personal injury or loss of life shall be reported to the COR immediately.

Records shall be kept for three (3) years for each accident a vehicle is involved in, including the repair work required to return the vehicle to service.

PATIENT RIGHTS: The Contractor shall be courteous to VA beneficiaries under their care.

Any substantiated mistreatment of patients in the performance of this agreement may be cause for termination of the agreement, or discontinuance of further placement of orders. The VA reserves the right to request removal of any Contractor personnel from transporting VA patients if mistreatment is substantiated. Contractor personnel must be courteous and considerate of all patients they are transporting. The contractor shall notify the COR, in writing within 24 hours of any complaints made by the patients regarding service issues, providing recommendations for improvement.

INCIDENT/ACCIDENT REPORT: The contractor MUST file a report the same day if an incident/accident should occur involving the welfare of patient while transporting the patient.

The report shall be filed and reported to the COR during regular business hours (8:00 am – 4:30

pm) or to the HAC after normal business hours (4:30pm-8:00am) within 24 hours of the event.

The Contractor shall make initial contact immediately after the event via telephone, fax, or email notifying the VA of any incident, accidents, or medication or transfusion errors involving injury to VA patients during transport. The VA will provide POC’s and phone numbers after execution of agreement and prior to service start.

The Contractor must prepare and submit a detailed incident report with all information necessary to conduct a full review (date, time, patient, place of pick, place of incident, names of parties involved, a detailed summary of events, police report if available, etc.) with recommended/implemented corrective action within 24 hours of such incident to the Contracting Officer with a copy to the Patient Safety Program Manager of the James J. Peters VAMC.

The Contractor shall notify the COR, in writing within 24 hours of any complaints made by the patients regarding service issues, providing recommendations for improvement.

INVOICE PROCEDURES:

The Contractor shall use an itemized billing format, with the resources furnished when submitting ambulance service invoices.

Invoices shall be submitted no later than fifteen (15) calendar days following the end of the month of services and are to include all services provided under the agreement for the preceding month. Invoices shall specify the agreement number, patient name and identification number, date of service, and pick-up and delivery points, person calling in the travel request, mileage, wait times (if applicable) and total number of trips for the month.

A copy of all applicable trip reports shall be attached to the invoice. The date of payment will be computed from the date a proper invoice is received by the VA. When non-authorized service runs are referenced on an invoice, the VA Travel Clerk, after discussion with the Contractor, may delete and initial the service. This will assist the Contractor in expediting the invoices.

Invoices are to be submitted to the following address:

Department of Veterans Affairs Financial Services Center PO Box 149971 Austin, TX 78714-8971

Attn: Business Office James J. Peters VAMC 130 W. Kingsbridge Rd Room 9A-30 Bronx, NY 10468

NOTE: This is the payment office.

Ensure that original invoices are sent Here for payment.

NOTE: Copies sent here for verification

The VA will review and reconcile invoices with travel forms and VA logs. Unauthorized charges will be suspended pending investigation. Unauthorized charges are those that are being disputed or have not been pre-approved by authorized VA personnel, and that are not allowable under the agreement. A final determination will be made, within 30-days, after notifying the Contractor of charges being suspended.

QUALIFICATIONS: The Contractor must be licensed as both an advanced and basic life support ambulance service by the State of New York and outside the limits to provide Emergency Medical Services. The Contractor must maintain licensure/certification with the State of New York, throughout the life of the agreement. License/certification lapses or expiration is grounds for termination of the agreement or discontinuance of further ordering from the Contractor.

The Contractor must maintain documentation demonstrating they meet all requirements of Federal, State, and County or City codes regarding operation of this type of service.

Documentation shall be made available to the VA immediately upon request for the duration of this agreement.

COMMISSION ON ACCREDITATION OF AMBULANCE STANDARDS:

The Contractor shall perform required services in accordance with the standards of the Commission on Accreditation of Ambulance Services, established principles and ethics of the medical profession established by the American Medical Association (AMA) and American College of Emergency Physicians (ACEP).

The Contractor, upon request, shall provide quality data and information related to services provided and participate in VA Medical Center Performance Improvement Programs when requested to do so. Upon request the Contractor shall also provide documentation of the competency of staff that will be providing services under the agreement.

The Contractor will be responsible for ensuring Contractor employees providing work under this agreement are fully trained and completely competent to perform the required work; they will also be required to maintain records that document competence/performance level of employees working under this agreement. Upon request the Contractor shall provide a current copy of the competence assessment checklist and annual performance evaluation to the Contracting Officer’s Representative (COR) for each Contractor employee working under this agreement.

CONTRACTOR PERSONNEL:

The Contractor shall ensure that the following personnel (Emergency Medical Technicians (EMT), Paramedic, and Non-Emergency Attendant/ Drivers) requirements are met:

Ensure and certify that personnel performing the services required under this agreement are properly licensed and fully trained in the use of the vehicle and equipment that will be used in the carrying out services performed under this agreement.

The Contractor shall ensure minimum staffing requirements as mandated by the State of New York on are met. Each vehicle shall be operated with sufficient personnel for adequate patient care, at least one of whom shall be an Emergency Medical Technician (EMT).

Contractor must maintain records of each employee as to character and physical capabilities of performing the services of a driver and/or attendant. A record of each employee as to character, physical capabilities, and qualifications performing the duties of an ambulance driver or attendant must be maintained at the Contractor's establishment and made available for inspection upon request of the Contracting Officer or COR.

A roster of Paramedics, Registered Nurses (RN), Emergency Medical Technicians (EMT), and Non-emergency Attendant Drivers (EMTs and LPNs if used to provide these services) shall be furnished to the Contracting Officer or COTR upon request, and shall contain the following information:

Name Paramedic or EMT license number Driver's license number Date of initial training Date of refresher training

EMERGENCY MEDICAL TECHNICIAN (EMT): Emergency Medical Technicians providing emergency services on ambulances servicing JJP VAMC and clinics must have the following qualifications:

Have completed training in accordance with standards published by the New York State Department of Health and Human Services with a minimum curriculum of 81 hours or “equivalent: including an in-hospital training period. Such training period must also be acceptable under the regulating requirements for local EMS systems supported by DHHS and PL 93-154.39 Fed. Reg. 24.304 (1974).

Evidence of the “equivalent training program successfully completed by the EMT, for inspection purposes, must be submitted to the Contracting Officer with the Offerors proposal.

The EMT must be certified, licensed or otherwise officially recognized by the local, state, or regional government or public entity where the emergency ambulance service is operated or by which it is governed. Certificates shall be submitted with proposal.

The EMT must be enrolled periodically in “refresher” continuing education or advances training programs as required by the local, state or government entity in which the service is rendered to veterans but no instance shall this be less frequently than every two (2) years.

Such “refresher” training must be equivalent to that developed by the Department of Transportation National Highway Safety Administration. Evidence of successful completion for “refresher” training must be submitted to the Contracting Officer when updated periodically as required by the governmental entity.

NON-EMERGENCY ATTENDANT/DRIVERS: Prices include non-emergency medical technicians and/or drivers as appropriate. They shall be an Emergency Medical Technician and Driver on board each time a patient is transported. The contractor shall maintain a record of each employee as to the character, current driving records and physical capabilities or each employee performing the duties of an ambulance driver or attendant and be made available for inspection upon request by the COR. Technicians and drivers must be capable to administer oxygen and have successfully completed the Standard and Advances First Aid Courses of the American Red Cross or U.S. Bureau of Mines, or equivalent. Proof in the form of the current certificate that such first aid training has been successfully completed shall be submitted to the CO with the Offerors proposal. An additional record of each employee showing that the employee performance transportation service for or coming in contact with patients of the JJP VAMC is screened and found to be free of any infectious or communicable diseases on an annual basis.

Qualifications of the attendants shall be submitted to the CO prior to award. The COR reserves the right to obtain copies of all qualification records for JJP VAMC local files. New drivers shall be made available to the CO and/or COR prior to commencement of the individual transporting VA patients.

PARAMEDICS: Paramedics providing emergency services on ambulances servicing the JJP VAMC shall have the following qualifications:

Complete training in accordance with the standard published by the New York Department of Public Health to be licensed in the state of New York.

The paramedic must be certified, licensed or otherwise officially recognized by the local, state, or regional government or public entity where the emergency ambulance service is operated, or by which it is governed. Proof of such certification must be certification must be submitted to the CO with the Offerors proposal.

The paramedic must be enrolled periodically in “refresher” continuing education, or advanced training programs as required by the local or state government entity in which the service is rendered to veterans, but in no instance shall this be less frequently than every three (3) years.

Such “refresher” training must be equivalent to that developed by the Department of Transportation, National Highway Safety Administration. Proof of such refresher training must be submitted to the CO for appropriate action/review as required by government entity.

Must possess EMT-P Card.

Drivers providing service under this agreement shall have a valid ambulance personnel license with a driver designation as required by Federal, State, and local law.

Contractor shall ensure each ALS and BLS driver who operates a permitted vehicle meets qualifications as required by the State of New York and shall be responsible for assuring that its drivers are knowledgeable and competent in emergency vehicle operations and thoroughly familiar with the vehicles assigned.

Ambulance drivers must complete all State of New York licensing requirements.

Attendant/driver must have successfully completed standard and advanced first aid courses including use of cardiopulmonary resuscitation techniques (CPR) of the American Red Cross, U.S. Bureau of Mines, or equivalent; be able to safely use all associated equipment, such as wheelchair lifts, and fire extinguishers; and been fully briefed and trained in passenger assistance techniques. Proof in the form of a current certificate that first aid training has been successfully completed must be available upon request.

All Contractor employees must be enrolled periodically in “refresher” continuing education or advanced training programs as approved and required by the State of New York, Department of Health Bureau of Emergency Medical Services. Such refresher training shall be submitted to the Contracting Officer upon request for verification of compliance. In no instance may this continuing education training be less frequent than every two years.

Background Criminal Checks and Investigations. Contractor must provide a copy of the State of New York background criminal check. Copies of all background criminal checks and investigations must be provided to the Contracting Officer within 30 days after award of the Contract. Performance of the contract cannot begin until these documents have been received by the Contracting Officer

NOTE: The offeror must screen all employees to ensure that they meet core competencies on an annual basis; that they have performed a criminal background check on any staff member who will be treating or transporting patients etc. The CO or designated COR will inspect Contractor records to determine if training is current and training standards are up to date.

VEHICLES: The ambulances used under the terms of this agreement shall be licensed and meet the minimum requirements governing emergency vehicles that is mandated by the Department of Transportation of the State of New York under Chapter VI of the Transportation Regulations and mandated by the State of New York Public Health Law for Emergency Medical Services, such compliance shall be maintained in current state throughout the term of the contract.

Each vehicle shall be equipped in accordance with the Federal Specification for Ambulances, KKK-A-1822F and which such safety items as required by Federal State and Local authorities in the area in which the vehicles are operated. In the future, if any items are required by Federal, State and Local authorities in the area in which the vehicles are operated, they shall be added to each vehicle. Proof of compliance with Federal, State and Local authorities shall be provided upon request by the COR. Each ambulance shall be equipped with not less than the following equipment a t no additional charge to the Government:

First aid kit with Band-Aids, gauze, elastic bandages, sterile gauze pads, triangular bandages, cleansing wipes, tape scissors, eye pads, ammonia inhalants, sterile gloves etc.

Two-way radio or portable phone Face masks/nasal cannula Splints Blood tubes Oxygen and oxygen breathing apparatus in good operating condition. Oxygen masks must be of the disposable type.

Shall have one ambulance cot and collapsible stretcher.

IV supplies, including pumps – when required

Monitors, defibrillators, mounting brackets

(10) Shall have adequate straps to secure the patient safely to stretcher or ambulance cot and adequate means of securing the stretcher or ambulance cot within the vehicle.

(11) Shall have adequate supply of sanitary sheets, pillows, pillowcases, blankets, urinals and emesis basins.

The Department of Veterans Affairs will not be responsible for providing items that normally would be used or required for comfort, safety, or necessity of the patients being transported.

These items include but are not limited to wrist restraints, disposable gloves, large pampers, linens, blankets, bedpans, urinals, emesis basins, pillows, and all other items normally stocked in ambulances.

The Contractor must have an adequate number of vehicles to meet the requirements of this agreement, along with the evidence of satisfactory vehicle inspection prior to use under this agreement.

Staffing of ALS and BLS vehicles must maintain the appropriate number and type of staffing as required by the aforementioned State of New York laws and regulations.

Vehicles and equipment used in the performance of this agreement must be clean, orderly, and in excellent operating condition at all times, and records of maintenance/preventive maintenance must be made available for inspection upon request.

All vehicles shall be smoke free and have “No Smoking” signage posted.

The Contractor shall notify the Contracting Officer of all changes/additions/deletions of vehicles and equipment after execution of this agreement.

The Department of Veteran Affairs reserves the right to thoroughly inspect Contractor vehicles prior to execution of the agreement and at any time while the agreement is in effect. Mechanical defects noted at the time of inspection must be corrected and the ambulance (s) re-inspected prior to use under this agreement.

AMBULANCE MEDICAL EQUIPMENT:

Every ambulance in service under this agreement shall be equipped as required by the State of New York and carry at least the minimal equipment necessary for the type of service to be provided, as determined by standards adopted by the State of New York.

Each emergency care vehicle shall have patient compartment facilities, oxygen and suction systems and equipment, environmental climatic equipment communications and additional systems equipment accessories and supplies as required by the applicable codes, rules and regulations established by Federal, State and Local regulating authorities.

TRAINING:

Emergency Medical Technicians (EMT) providing emergency services on this agreement must meet the following training requirements:

Have completed training in accordance with the standard published by the US Department of Health and Human Services and follow State of New York requirements. EMT’s must have a minimum curriculum of 81 hours or equivalent including an in-hospital training period. Such training program must also be acceptable under the regulating requirements for local EMS systems supported by DHHS and PL 93-154, 39 Fed. Reg. 24,304 (1974). EMTs must also meet ongoing re-certification requirement standards determined by the State of New York.

Evidence of the "equivalent" training program successfully completed by the EMT must be submitted to the Contracting Officer before execution of the agreement. Failure to provide the requested evidence of training will result in an offeror being determined non-responsive and that offer will not be considered for establishment of an agreement.

The EMT must be certified, licensed or otherwise officially recognized by the local, state, or regional government or public entity where the emergency ambulance service is operated or by which it is governed. Current and updated certifications of EMTs providing service under this agreement must be submitted to the Contracting Officer.

Have completed the required all emergency medical technician and paramedic re-certification training. The rules shall provide that all re-certification training equals at least 700 hours of training that provide didactic and skills practice components, including a field internship experience aboard an advanced life support permitted ambulance. The Paramedic must be certified, licensed or otherwise officially recognized by the local, state, or regional government or public entity where the emergency ambulance service is operated or by which it is governed.

INSURANCE COVERAGE:

Throughout the effective period of this agreement, the Contractor shall possess insurance coverage in the minimum amounts to satisfy VAAR clause 852.237-71, Indemnification and Insurance, or New York State requirements, whichever are higher. Any lapse in required coverage could result in discontinuance of further ordering. Prior to the start of performance, the Contractor must submit to the Contracting Officer their certificate of insurance coverage evidencing required levels.

INSPECTIONS:

Before execution or during the effective period of the agreement, the VA reserves the right to thoroughly inspect and investigate the establishment, facilities, business reputation, and other licensure and qualifications of the Contractor.

CONTRACTOR PRIVACY/SECURITY TRAINING: All Contractor employees shall complete the VA’s on-line Security Awareness Training Course and Privacy Awareness Training Course annually within 15 days of the contract period of performance. Contractors shall provide signed certifications of completion to the COR during each year of the contract in addition to providing a signed Statement of Commitment and Understanding within the first 30 days of the period of performance for each employee. This requirement is in addition to any other training that may be required of the contractor.

HEALTH INFORMATION PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) AND

CONFIDENTIALITY OF PATIENT RECORDS:

The VAMC and the Contractor are required to comply with all of the provisions of the Privacy Act of 1974, the Health Insurance Portability and Accountability Act (HIPAA) of 1996, as well as all applicable VHA regulations, which are obtainable at http://www.hipaa.org/ and http://www1.va.gov/vhapublications/. The Contractor shall not maintain and/or share sensitive or patient identifiable information in any form or for any purpose, other than what is needed to perform its obligation under the established business agreement.

CONFIDENTIALITY OF PATIENT RECORDS: The Contractor, as a VA provider, will assist in the provision of health care to patients seeking such care from or through VA. As such, the Contractor is considered as being part of the Department health care activity. Contractor is considered to be a VA provider for purposes of the Privacy Act, Title 5 USC 552a. Further, for the purpose of VA records access and patient confidentiality, Contractor is considered to be a VA contractor may have access, as would other appropriate components of VA, 7362.

Therefore, Contractor may have access, as would other appropriate components of VA, to patient medical records including patient treatment records pertaining to drug and alcohol abuse, HIV, and sickle cell anemia, to the extent necessary to perform its contractual responsibilities. The Contractor is restricted from making disclosures of VA records, or information contained in such records, to which it may have access, except to the extent that explicit disclosure authority from VA has been received. The Contractor is subject to the same penalties and liabilities for unauthorized disclosures of such records as VA.

The records referred to above shall be and remain in property of VA and shall not be removed or transferred from VA except in accordance with U.S.C. 551a (Privacy Act), 38 U.S.C.5701 (Confidentiality of Claimant Records) 38 U.S.C. 552 (FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332 (Confidentiality of certain medical records) and federal laws, rules and regulations. Subject to applicable federal confidentiality or privacy laws, the Contractor, or their designated representatives, and designated representatives of federal regulatory agencies having jurisdiction over Contractor, may have access to VA’s record, at VA’s place of business on requesting during normal business hours, to inspect and review and make copies of such records.

DISPOSITION OF RECORDS: The Contractor must notify the COR prior to the destruction of any records. The Contractor shall dispose of archived records in accordance with the following The Joint Commission regulations:

Records Control Schedule (RCS) 10-1, Section XXVI.

M1, Part I, Chapter 5, Patient Records.

The Joint Commission, Standards IM.2 and IM.3.

52.224-2 PRIVACY ACT (APR 1984)

(a) The Contractor agrees to--http://www.hipaa.org/ http://www1.va.gov/vhapublications/

(1) Comply with the Privacy Act of 1974 (the Act) and the agency rules and regulations issued under the Act in the design, development, or operation of any system of records on individuals to accomplish an agency function when the contract specifically identifies--

(i) The systems of records; and

(ii) The design, development, or operation work that the contractor is to perform.

(2) Include the Privacy Act notification contained in this contract in every solicitation and resulting subcontract and in every subcontract awarded without a solicitation, when the work statement in the proposed subcontract requires the design, development, or operation of a system of records on individuals that is subject to the Act; and

(3) Include this clause, including this subparagraph (3), in all subcontracts awarded under this contract which requires the design, development, or operation of such a system of records.

(b) In the event of violations of the Act, a civil action may be brought against the agency involved when the violation concerns the design, development, or operation of a system of records on individuals to accomplish an agency function, and criminal penalties may be imposed upon the officers or employees of the agency when the violation concerns the operation of a system of records on individuals to accomplish an agency function. For purposes of the Act, when the contract is for the operation of a system of records on individuals to accomplish an agency function, the Contractor and any employee of the Contractor is considered to be an employee of the agency.

(c) (1) "Operation of a system of records," as used in this clause, means performance of any of the activities associated with maintaining the system of records, including the collection, use, and dissemination of records.

(2) "Record," as used in this clause, means any item, collection, or grouping of information about an individual that is maintained by an agency, including, but not limited to, education, financial transactions, medical history, and criminal or employment history and that contains the person's name, or the identifying number, symbol, or other identifying particular assigned to the individual, such as a fingerprint or voiceprint or a photograph.

(3) "System of records on individuals," as used in this clause, means a group of any records under the control of any agency from which information is retrieved by the name of the individual or by some identifying number, symbol, or other identifying particular assigned to the individual.

SAFETY REQUIREMENTS:

In order to protect the lives and health of patients, the Contractor shall take such safety precautions as the Contracting Officer, or COTR may determine to be reasonably necessary. The Contracting Officer or COTR will notify the Contractor of any safety non-compliance and the action to be taken. The Contractor shall, after receipt of such notice, immediately correct the conditions to which attention has been directed. 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 discontinuance of further order placement.

The Contractor is responsible for compliance with all federal, state and local fire safety codes, regulations and standards. In the event of a finding of non-compliance, the situation will be corrected prior to dispatch of that particular vehicle and/or equipment.

INFECTION CONTROL:

Contractor employees shall receive ongoing training on universal precautions and infection control as appropriate to their duties. Contractor personnel shall use universal precautionary measures at all times for the prevention and control of the spread of infectious agents to all persons.

The Contractor shall delay using personnel who have the cold, flu, chickenpox, measles, or any other contagious disease or have been in the presence of a contagiously ill person until personnel are well or no longer symptomatic.

BLOOD-BORNE PATHOGENS:

Contractor employees shall be trained in and shall follow all OSHA, state and local laws, regulation and guidance when working with patients and in situations with a risk of exposure to blood-borne pathogens.

DISPOSAL OF HAZARDOUS WASTE:

Contractor employees shall be trained on how to handle bio-hazardous waste during transport and how to properly dispose of bio-hazardous waste in designated containers, including how to dispose in designated containers when on VA grounds. The Contractor shall not dispose of any bio-hazardous materials at any location on the premises except as specified by the Contracting Officer.

CONTRACTOR’S QUALITY CONTROL PROGRAM (QCP):

The Contractor shall establish and maintain a complete QCP to assure the requirements of this agreement are provided as specified, during the life of the agreement. The Contractor’s QCP shall include the following:

An inspection plan covering all services required by this agreement: The inspection plan must specify the type of inspections (i.e. scheduled, unscheduled), areas for inspection, frequency of inspections and documentation of inspections, and who will conduct the inspections, with his or her title specified.

On-site records of all inspections conducted by the Contractor: The inspection records must note findings and necessary corrective action taken, the timeframe, and follow-up responsibility/issues. The VA reserves the right to request copies of any and/or each inspection.

Internal procedures for updating medical service protocols: The Contractor must have established internal procedures for updating medical service protocols, which have been revised, requires changes and/or incorporation of new protocols since licensing. The changes to processes, equipment, and/or protocol that may affect performance of services must be communicated in writing to the Contracting Officer.

Methods for identifying and preventing deficiencies: The Contractor must have quality improvement mechanisms in place that allows the business to evaluate the quality of services performed by using established methods for identifying and preventing deficiencies before the level of performance becomes unacceptable. Specific organizational monitoring functions and areas must be identified with levels of responsibility associated, noting intermediate supervisory responsibility and overall management responsibility for ensuring total acceptable performance.

On-site competency records of each employee: The Contractor must have employee records available on-site that identifies the character, physical capabilities, certifications, and ongoing training records of each employee performing services under this agreement.

A log of all requests for service: The Contractor must use a log to account for all requests for services. The log shall contain the same information recorded on the trip report. The log shall also contain a patient trip evaluation section, which should be completed for ongoing monitoring of customer comments.

On site records for tracking of customer complaints and actions taken: The Contractor shall keep onsite records for tracking customer complaints or problems with the procedures or initiatives implemented for correction and/or elimination of the problem before negative effects caused interruption of performance.

Drug Testing Policy: The Contractor shall have internal policies and procedures for addressing drug and alcohol abuse.

MISCELLANEOUS:

Contractor employees shall conduct themselves in a professional manner at all times while performing services under this agreement.

Vehicles transporting VA beneficiaries may not transport non-VA patients on the same transport under this agreement.

All employees shall be dressed in uniform with a name badge displayed.

PERFORMANCE STANDARDS:

The Contractor is expected to meet all of the requirements of this contract at all times. Due to the nature of this requirement, if the services are not performed in a timely and professional manner patient health and safety may be compromised, the following performance standards are included.

The last month of each contract year the Contracting Officer will review contract compliance reports submitted by the COR. When total compliance falls to 98% or below, an amount equaling 1% of the expenditures for the contract year will be deducted from that month’s payment.

Amounts deducted from billing may be reduced by the Contracting Officer upon submission of mitigating evidence by the Contractor.

PERFORMANCE SURVEILLANCE PLAN / MONITORING PROCEDURES:

Please provide a Quality Assurance Surveillance Plan (QASP), specifying the Offerors plan of action to manage all management and technical requirements of this contract. The Quality Assurance Surveillance Plan is to be designed to monitor contract compliance. The COR will implement the plan to provide effective and systematic surveillance of all aspects of this contract. The surveillance plan will employ various monitoring methods.

Periodic Inspection: The contractor's facility, methodologies, and quality control procedures may be examined by the COR at any time during the life of the contract. Examinations may be either scheduled or random findings documented by the COR, or authorized designee, on the Surveillance Activity Checklist.

Random Basic Inspection: Contract requirements are to be…