Vendor QA _1_01-18-2024.pdf

VENDOR QUESTIONS and GOVERNMENT RESPONSES

GROUND AMBULANCE SERVICES

SOLICITATION

W81K00-24-R-0004

1. Can you please confirm that this procurement is for staffing only and does not require the company to provide the actual ambulances?

Response: Reference PWS paragraph 1.1 Description of Services/Introductions (more than just a staffing) and Reference PART 3 and all the sub paragraphs to include paragraph 3.3 Equipment to include Attachment 8 Government Furnished Property*that spells out what the Government will provide.

2. As qualifying SBA 8(a), AND a Teaming Agreement is established prior to Bid/Proposal, WITH an already established Ground Ambulance Provider with full Current Certifications by Texas SOS, satisfy their requirements?

AND this Solicitation (since they would be the performing sub-contracted Provider)?

Response: A qualifying 8(a) vendor or established 8(a) joint venture participant must hold the State of Texas EMS license.

3. Mainly I was hoping to learn if this effort has an incumbent.

Response: United Medevac Solutions

4. Does 100% SB 8(a) set-aside mean that all work bid and performed under this contract has to be performed by a SB or can 49% of the work be performed by a large business?

Response: Refer to Clause 52.219-14 LIMITATIONS ON SUBCONTRACTING (DEVIATION 2021-

O0008) (FEB 2023).

5. Why does our company need a copy of the Company’s State of Texas EMS License? This is a medical staffing contract and find this license to be restricting and also unnecessary.

Response: This is not simply a staffing contract and the vendor is required to hold a State of Texas EMS License. Please refer to the PWS for what is required.

6. Will the Government please clarify if an Alaska Native Corporation’s use of prior experience and/or past performance from an affiliate company will or will not be allowed? PLEASE NOTE: The Government Accountability Office (GAO) permits Alaska Native Corporations to claim all the experience and work history of its affiliated corporations for the purposes of establishing performance capability in the context of a competitive acquisition. Reference: Ecompex, Inc., B-292865.4, B-292865.5, B-292865.6, June 18, 2004 (see page 5). Serco, Inc., B 406683, B-406683.2, Aug. 3, 2012. AMI-ACEPEX, Joint Venture, B- 401560, Sept. 30, 2009. Specifically, GAO has ruled that an ANC bidding on a government contract may rely on the past performance of an affiliated company when the proposal makes it clear that the resources associated with the affiliated company will have meaningful involvement in the execution of the present contract.

Response: Reference Attachment 1_Instructions to Offerors_Evaluation (ITO) VOLUME III- FACTOR 2- PAST PERFORMANCE states: “The Offeror shall submit with its proposal evidence of recent and relevant past performance under which YOUR company (the Offeror) provided the same or similar services with similar magnitude and scope in the public and/or private sector. Performance must have been by the Offeror (not by a subsidiary or sister company) either as the prime contractor or subcontractor…….”

7. Will the Government consider lifting the requirement in 5.2 (d) that all crew members must be awake and dressed at all times while on-duty? This requirement effectively limits shift lengths to 12 hours and creates, in our opinion, an unreasonable demand for staffing that cannot be met effectively based on the local workforce in El Paso and southern New Mexico. If the Government will reevaluate this requirement and lengthen the required “out-of-chute” time (5.2 (e)) to two minutes, it could effectively reduce the required number of FTEs by 35 – 40%.

Response: Yes, the requirement in 5.2(d) will be removed. 5.2(e) has been adjusted to two minutes.

a. If the Government is willing to relax the “awake and dressed” requirement, is there a limit to the number of continuous hours a crewmember can be on-duty?

Response: This is a non-personal services contract, therefore, the scheduling of the crew to provide 24/7 coverage is at the responsibility of the contractor. 5.2(d) will be removed.

b. Do the established base locations (aside from the rental facility at WSMR) have space for bunks, kitchens, and showers?

Response: Aside from the crew stationed at the MTF, the crews are stationed at the Fire Station which does have bunks, kitchens, and showers.

8. What are the historic shift fill rates for the 41 EMTs and 41 paramedics by month over the last 12 months?

Response: 100% fill-rate. All stations were covered 24/7.

9. Were these shifts filled with 100% local workers, or did it include travelers?

Response: 100% local workers

10. What percentage of shifts were filled with personnel working overtime?

Response: The contract doesn’t have overtime hours. It is the responsibility of the contractor to meet the standard IAW PWS.

11. If all eight ambulances are staffed with at least one paramedic 24/7, it appears that the list of Government Furnished Equipment (Attachment 8) is missing several items. For example, there appear to only be four Lifepak 15 monitor-defibrillators. Are the other four ambulances operating as BLS units even though they are staffed with a paramedic?

Response: The ambulances are equipped with the necessary GFP to be operational for patient care.

12. Are all ambulances intended to be staffed with one (1) paramedic and one (1) EMT or would the Government consider allowing some units to be staffed at the BLS (two EMT) level? (Note: The PRS in Technical Exhibit A states that the Contractor must meet 98% compliance of providers complying with basic life support requirements, which would imply that these units could be 100% staffed with EMTs instead of paramedics. Also, it references section 5.3.1 and 5.3.2 which do not exist.)

Response: All ambulances should be staffed with a paramedic and EMT at all times. ALS care level is expected at all times. Removed references to 5.3.1 and 5.3.2.

13. Do all eight ambulances require 24/7 staffing, or would it be reasonable to operate some ambulances only 12 hours per day (such as one of the Medical Center ambulances) or only during periods of high-risk training (for the range ambulances)?

Response: Yes; 24/7 coverage of all 8 stations.

14. Please provide the historic call volumes by ambulance for the last three years, broken out as follows:

Ambulance unit number / station location Number of responses

Response: There is no historical data. The BLS/ALS (EMT/Paramedic) intervene at the same time.

Dispatch calls.

Number of transports requiring BLS intervention Number of transports requiring ALS intervention Number of cancellations / refusals (note: c + d + e should = b

15. What are the common MTF destinations for the ambulances stationed at WSMR or the outer ranges? What are the typical transport times for these units?

Response: Closest appropriate medical facility depending on the acuity level and patient preference, if allowed.

16. While it is not explicitly stated in the PWS, the implied context of a Contractor providing EMS personnel and medical direction is that the Contractor will also be responsible for providing clinical quality assurance, clinical education (including continuing education and refreshers), narcotics management, and other related functions. Can the Government please answer / confirm the following:

a. Will the Contractor need to provide an electronic Patient Care Report (ePCR) platform for charting purposes? If the Contractor is not providing an ePCR platform, how should the contractor conduct clinical quality reviews?

Response: There is not standardized PCR in use within the EMS system at this time. Records are expected to be kept on a standardized PCR platform and the medical direction and ED staff will be provided access to that platform as well for uploading of PCRs to the medical record and for risk management purposes.

b. Will the Government allow access to the internet for ePCR charting and online clinical education, or does the Contractor need to provide their own internet access?

Response: The MTF and stations have internet.

c. Does the Government’s EMS Coordinator / COR and/or the Medical Center require any base-specific EMS education (such as Response to Heat Emergencies, Snake/Animal Bites and Stings / Antivenom Administration, etc.)? If so, please provide a list.

Response: The EMS Coordinator and COR is a Government Civilian position.

d. Since the Contractor will be providing the Medical Director, will the narcotics and pharmaceuticals be ordered on that individual’s license? If so, should the Contractor provide their own narcotics control policy and process, or is there a specific policy already in place from the Government? If so, please share a copy.

Response: No, the MTF will provide the Narcotics and Pharmaceuticals.

e. Will the Government be interested in the Contractor providing new innovations which are rapidly being adopted by civilian EMS programs nationwide, such as the use of Virtual Care (telemedicine) in lieu of transport?

Response: No.

17. How are ambulances currently dispatched? Does the Contractor have any responsibilities related to dispatch services? Is the process the same for “911” calls and for calls from the Medical Center? If not, how do Medical Center calls originate and get assigned?

Response: Ambulances will be directly dispatched by DES under the current plan. Medical center calls will also route through 911 as EMS will be providing a nearly exclusive prehospital service.

Very limited exceptions for interfacility transports will exist but will be the minority.

18. How many ambulances are stationed at WSMR? Is there an established location at WSMR for the Contractor to rental facility space? If so, can the Government provide current / historic rental fees and a point of contact? If not, can the Government provide a location and geographic range that the rental facility must be located within?

Response: One ambulance is assigned to WSMR. The current contractor has leased housing at WSMR through Balfour Beatty. White Sands Missile Range, NM 88002. 575-674-2463.

19. Medical Director's Role and Compensation: We've noted an inclusion of a Medical Director in the PWS (5.2.1 Task), but there’s no mention of this role in the Compensation Plan (Volume II-Factor 1). We need clarification on this discrepancy to ensure proper budgeting and compliance.

Response: The Medical Director is a position within the Contract Company, this position does not provide services at WBAMC. A Medical Director is required for the license renewals of EMS personnel. We are not asking for the compensation plan to be provided for this position.

20. Is the current contract fully staffed? If not, how many positions, by labor category, are vacant?

Response: Yes; all eight stations are staffed to ensure 24/7 coverage.

21. Due to the current staffing shortage in the area for Paramedics, is the Govt open to receiving proposals priced using travelers?

Response: All personnel must be fully vetted prior to providing services so that would be the biggest limitation to this approach.

22. Understanding the 98% Fill Rate Requirement:

a. Are there flexibility provisions for unforeseen staffing challenges, like sudden illness or emergencies?

Response: No, the contractor is responsible in providing 24/7 coverage to all 8 stations. Field events are coordinated with ample time to ensure proper staffing.

b. How is compensation structured for additional hours or overtime to meet this fill rate?

Response: There is no additional hours or set aside overtime hours. The overtime is determined by the contractor as they are responsible for the shifts/scheduling of the personnel.

c. Do historical data or benchmarks from previous contracts exist to guide us in achieving this standard?

Response: There is no historical data.

23. Impact of 98% Fill Rate on Field Hours (Special Events):

a. Is there staffing flexibility for additional Field Hours (Special Events) under the 98% fill rate requirement?

Response: The Field Hours are additional set-aside hours to cover the events. The coverage for these events should not impact the fill rate as the contractor will receive ample notice to ensure proper staffing is available and scheduled for these events.

b. How will compensation be managed for overtime required during both regular and Field Hours?

Response: That is determined and managed by the contractor.

c. What support, if any, is available from the government in maintaining the high fill rate, especially considering Field Hours?

Response: It is the responsibility of the contractor to ensure all eight stations are properly staffed 24/7 as well as coordinate staffing to support scheduled field events. No additional support will be provided by the government.

24. Is the Government anticipating that all positions will be filled with local hires (including, as appropriate, the incumbent workforce) or will the Government accept a staffing plan that relies heavily on recruitment and utilization of temporary “travel” workers brought onsite for limited duration assignments?

Response: Incumbents are all local personnel. It is the responsibility of the contractor to ensure there is proper staffing at each station to ensure the mission is met. All personnel, whether local or non-local must be fully vetted prior to onboarding.

Note: Using 100% local hires may not be possible. Our understanding is that there are only approximately 400 – 500 licensed or certified paramedics in the entire El Paso market, the vast majority of whom are already gainfully employed (primarily by El Paso Fire Department and other regional 911 providers).

If the Government will allow travel workers, is the Government willing to allow the use of multiday temporary visitor passes for base access for these workers in 30-day increments, understanding that the process to obtain approval for a Common Access Card can take 6 to 12 months?

Response: All personnel, whether local or non-local must be fully vetted prior to onboarding.

Background Investigation can take 4-6 weeks once a complete security packet is received.

Credentialing: less than 1 week once a complete credentialing packet is received.

Once the personnel are fully vetted, the individual will receive their Hospital Badge and Common Access Card during their on-boarding.

If an Offeror intends on utilizing travel staffing from other areas, is the Government prepared to accept pricing proposals that are significantly higher than the dollar values associated with the three legacy contracts shared in Technical Exhibit E?

Response: The contractor may utilize local or non-local to be fully vetted to provide services. The solicitation will be evaluated in accordance with the criteria stated so provide the pricing you believe will be needed to satisfy the requirement.

25. How many trips per month does the government estimate will need to be completed? and at what service level BLS/ALS/CCT?

Response: There is no historical data. Every station has different trips. BLS/ALS

26. Will provider be reimbursed for dry runs?

Response: It is the contractor responsibility meet requirements in accordance with the PWS. The PWS does not specify or reference runs and the CLINS are not broken out in that manner for pricing purposes.

27. Will the government reimburse for mileage plus trip?

Response: No. Mileage is not tracked. In accordance with the PWS. Reference paragraph 3.3 Equipment: “The Government will provide ambulance and other GSA leased vehicles and fuel, maintenance, insurance, storage, and parking space for these vehicles. The Government will provide equipment and supplies to be used in the ambulance vehicles…….”. Also, CLINS are not broken out in that manner for pricing purposes.

28. Could you please provide information on how to procure pricing details on housing/crew office at White Sands Missile Range? (Part 3 of PWS)

Response: https://www.whitesandshomes.com/ and also reference response to questions 19.

29. The government states that it will supply all non-controlled medications (PWS 3.3). Will the contractor be expected to supply controlled medications (i.e. Morphine, Valium, etc.)?

Response: No, the contractor will not supply controlled medications.

30. Are offerors limited to including only three (3) PPQ's for past performance? (Instructions to Offeror - Past Performance)

Response: Offeror should FOLLOW the Attachment 1_ Instructions to Offerors_Evaluations and submit what is requested only. The Offeror shall submit with its proposal evidence of recent and relevant past performance under which YOUR company (the Offeror) provided the same or similar services with similar magnitude and scope in the public and/or private sector…… The PPQ shall reference the exact same projects detailed in the PPI.

31. Are government dispatchers Emergency Medical Dispatch (EMD) trained/certified? If not, how will EMS self-help emergency medical aid and instruction be relayed to bystanders who are near or attending patients calling 911 before the EMS unit's arrival? If qualified, how will pre-arrival instructions be relayed to responding EMS personnel before ambulance arrival on the scene?

https://www.whitesandshomes.com/

Response: Fort Bliss Emergency Communications Center (EDC) is a component of the U.S. Army Garrison - Fort Bliss Directorate of Emergency Services. That entity is responsible for all emergency telecommunications. Standards are set by AR 420-1 and AR 525-27. EMS is not involved in directing bystander care. Medical Direction and QA of EMD is provided by USA MEDCEN-FT Bliss Medical Director, not by the Contractor.

32. Do government dispatchers possess the experience and medical knowledge of critical care for taking in/outbound ambulance transfer requests, to include the critical care requirements for specialty equipment such as ventilators, ventilator management settings, vasoactive and other medications, and intravenous pump settings?

Response: This contract does not reference Interfacility Transport. That is a mission of the Defense Health Agency, and not supported by Army EMS.

33. What are the dispatch notification procedures and expectations for dispatch interface with EMS as it relates to STEMI, stroke, and trauma alerts for activating in-hospital medical teams before EMS arrival at receiving facilities?

Response: As in most EMS Systems - the transporting EMS crew contacts the receiving hospital for pre-notification of arrival A standardized format for radio/telephone reports is provided in the Joint Prehospital Emergency Care Protocols (JPECP).

34. Are government dispatchers experienced with outbound and in-transit hospital notification and relay procedures to provide essential pre-arrival patient reporting to receiving facilities?

Response: As in most EMS Systems - the transporting EMS crew contacts the receiving hospital for pre-notification of arrival. A standardized format for radio/telephone reports is provided in the

JPECP.

35. Will online medical control consults be recorded and facilitated by government dispatch for in-field medical orders against receiving facility and physician preference?

Response: Online medical consults are rarely required under the JPECP. If required, the EMS crew will contact the William Beaumont Army Medical Center ER or the receiving hospital for orders.

*****Request USA MEDCEN-FT Bliss confirm whether installation LMR or calls into the WBAMC ER are recorded.*****

36. Are government dispatchers in charge of scheduling and arranging patient appointments and patient pickup and delivery times for floor and unit transfer requests to internal and external facilities for scheduled hospital transfers?

37. Will government dispatch be responsible for coordinating EMS resource response, and staging for unscheduled real-world mass casualty situations, including multi-unit level EMS AMBUS (ambulance bus) response (for a minimum of 8-stretcher patients & 12-walking wounded)?

Response: The Directorate of Emergency Services will coordinate any MASCAL responses on the installation. No AMBUS requirement exists for the Department of the Army.

38. Will government dispatch be responsible for coordinating and scheduling EMS participation in scheduled mass-casualty drills/exercises and/or for surge demand?

Response: The Directorate of Emergency Services will coordinate any requirement for EMS participation in installation MASCAL drills.

39. Given the limited carrying capacity of standard government ambulances, will government dispatchers schedule and coordinate specialty care transport teams and equipment for Neonatal, Pediatric, and ECMO transport teams, including the appropriate size of transportation (AMBUS) to accommodate multiple healthcare providers and extra equipment for complicated patients?

40. The PWS outlines that this is a non-personal services contract as defined in FAR 37.101 to provide 24/7 Ground Ambulance services that "shall include all functions, tasks and responsibilities normally performed by a ground ambulance emergency response and transport organization." Given the medical complexity of this upcoming requirement, would the government want offerors to submit a management plan, quality control plan, key personnel resumes (i.e., Medical Director, On-Site Program Manager), and other documentation to effectively demonstrate both the offeror’s understanding and the capability to perform the tasks outlined in the PWS?

Response: Refer to Attachment 1_Instructions to Offerors_Evaluation for what is required to be submitted.