SOW Transportation Lockport Service Unit.docx

Lockport IHS Health Center Statement of Work For the Transportation for Lockport Service Unit

11/22/2024

1.0 General

1.1 Background

Lockport Service Unit is in need of non-emergent transportation for patients to and from Lockport Service Unit, and for our PRC eligible patient to take them to and from appointments.

1.2 Objective

To provide non-emergency medical transportation for eligible patients who have appointments with Lockport IHS Health Center for non-emergency medical appoints at Lockport or PRC approved appointments.

1.3 Scope of Work

The contractor will provide non-emergency medical support for eligible patients who have appointments with Lockport IHS Health Center Dental department, Behavioral Health, Community Health Services, PRC or Medical Non-emergency medical transport shall be provided for eligible patients who live in:

Services shall include ambulette or livery transportation, but may not include transportation for patients requiring monitoring or delivery of health care services while in transport (i.e. ambulance services).

Contractor drivers must be appropriately licensed in the State of New York. Licensing includes driver certification, driver training and continuing education where appropriate. Driver’s license and driving records must be verified annually and upon the occasion of any incident involving a Lockport IHS Health Center passenger. Contractor must provide an annual statement affirming that drivers are screened, trained and competent to safely transport patients. The annual statement of driver competency must include any driver advanced certifications, such as Advanced Cardiac Life Support or specialized training to assist and secure patients by stretcher or wheelchair.

The Contractor must report vehicle accidents and incidents to the Contracting Officer with a formal accident report.

Accident and incident reports are also to be forwarded to the Lockport IHS Health Center Administrative Officer. This includes patient adverse events occurring during transport.

Contractor vehicles must be appropriately licensed in the State of New York. An annual statement of NYSDOT vehicle inspection, certification and licensing must be provided to the Lockport IHS Health Center. Vehicles must be compliant with all relevant provisions of the Americans with Disabilities Act.

The Contractor shall be fully insured for transportation liability and umbrella coverages as required by the State of New York. Proof of liability coverage shall be provided to Lockport IHS Health Center annually.

Contractor will make available to the service unit, contractor policies and procedures which at minimum will address the following:

The Contractor will provide service during the following hours:

The Contractor will be provided with the date, time and physical location for passenger pick-up by Lockport IHS Health Center. Transportation arrangements will include the destination address and time for the patient's appointment, as well as the telephone number for the health provider's office.

The Contractor's driver will be expected to wait for the patient at the destination. A secondary destination may be pre-authorized, such as to a local pharmacy to obtain prescribed medication treatment. In such cases the driver will wait for the patient while prescriptions are filled. At the completion of the patient's pharmacy transaction, the driver will return the patient to the final authorized destination or residence.

The Contractor will bill for transportation services on a monthly basis, and within 30 (thirty) days of the date of service. Invoices shall include the Contractor's company name of record, remittance address, telephone number, fax number, the name and email address of the business office point of contact, and date. The invoice shall identify each trip by a unique identifier to be established by the service unit, which will be provided to the Contractor at the time the trip is arranged. Included with the identifier on the invoice will be the associated fee for each trip. A summary total for the invoice should be included. The Contractor may provide an invoice identification number or reference.

Invoices may not include any patient identification information, such as patient's name, address, destination or health information. Patient identification information and associated information retained by the Contractor for the purposes of service delivery and billing shall be maintained in strict confidence and safeguarded against disclosure. Paper and electronic files containing patient information that are maintained by the Contractor shall be protected against loss, theft, misuse and unnecessary exposure. This information is to be used for its intended purposes only, and distribution, dissemination or other uses is strictly prohibited.

1.4 Period of Performance

The period of performance of this contract is Base Period: 04/01/2025 to 09/30/2025 Option I: 01 October 2025 through 30 September 2026 Option II: 01 October 2026 through 30 September 2027 Option III: 01 October 2027 through 30 September 2028 Option IV: 01 October 2028 through 30 September 2029

1.5 Place of Performance

Lockport IHS Health Center 150 Professional Parkway Lockport, NY 14094 716-280-3850 Attn: Jennifer Tonemah, Administrative Officer

2.0 Specific Requirements/Tasks

3.0 Delivery or Deliverables