A22_Amendment 3 - W912EE22Q0026.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER (Type or print)

30-105-04EXCEPTION TO SF 30

APPROVED BY OIRM 11-84

STANDARD FORM 30 (Rev. 10-83) Prescribed by GSA

FAR (48 CFR) 53.243

Amendment W912EE22Q0026-00003 extends the offer due date to 4:00 PM CST on 11 May 2022 and adds information to the Statement of Work in section C. The changes to the Statement of Work are additional information has been added to section C.5. Medical Surveillance and section C.7.5 Training Documentation.

1. CONTRACT ID CODE PAGE OF PAGES

J 1 17

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

16C. DATE SIGNED

BY 06-May-2022

16B. UNITED STATES OF AMERICA15C. DATE SIGNED15B. CONTRACTOR/OFFEROR

(Signature of Contracting Officer)(Signature of person authorized to sign)

8. NAME AND ADDRESS OF CONTRACTOR (No., Street, County, State and Zip Code) X W912EE22Q0026

X 9B. DATED (SEE ITEM 11)

19-Apr-2022

10B. DATED (SEE ITEM 13)

9A. AMENDMENT OF SOLICITATION NO.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

X The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offer X is extended, is not extended.

Offer must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended by one of the following methods:

(a) By completing Items 8 and 15, and returning 1 copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE

CONTRACT ORDER NO. IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(B).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor is not, is required to sign this document and return copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

10A. MOD. OF CONTRACT/ORDER NO.

2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO.(If applicable)

6. ISSUED BY

3. EFFECTIVE DATE

06-May-2022

CODE

VICKSBURG CONTRACTING OFFICE

4155 CLAY ST

VICKSBURG MS 39183-3435

W912EE 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE

See Item 6

FACILITY CODECODE

EMAIL:TEL:

W912EE22Q0026

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION A - SOLICITATION/CONTRACT FORM

The required response date/time has changed from 09-May-2022 04:00 PM to 11-May-2022 04:00 PM.

SECTION C - DESCRIPTIONS AND SPECIFICATIONS

The following have been modified:

SOW

ADVANCED LIFE SUPPORT CARE (ALS) SERVICES

(2) PARAMEDICS SPECIFICATIONS

C.1. DESCRIPTION OF SERVICES

The Mat Sinking Unit is involved in erosion control work on the Mississippi and Atchafalaya Rivers. The unit employs approximately 310 men and 10 women who stay in dormitories aboard floating barges during the three-month work season. They move from one job site to another ranging from Cairo, Illinois to Venice, Louisiana, often in remote locations along the river, and have limited communications facilities. In most cases, transport of an injured employee to the closest hospital can take up to 30-90 minutes. Most of the crew works ten-hour shifts, 12 days per two-week period. There are shift personnel working 24/7 for the entire season. The contractor is required to provide services 24/7.

The purpose of this contract is to provide Advanced Life Support (ALS) and Basic Life Support (BLS) services, treatment protocols, medical direction, equipment and personnel of (2) Paramedics. This includes all supplies, equipment, drugs, treatment protocols and medical direction needed to provide BLS and ALS treatment. The contractor will be required to provide health care services for the employees of the U.S. Army Corps of Engineers, Mat Sinking Unit. The services of this contract will be for a period of performance of about 3-9 months per season, based upon the length of the work season.

The Mat Sinking Unit at this time is requiring that the paramedics be present at the Mat Sinking Unit on or about June 29, 2022. The paramedics will be required to work on the Mat Sinking Unit until about January 1, 2023. These dates are not guaranteed and may fluctuate over time dependent upon the pace of Mat Sinking Unit work. The Mat Sinking Unit reserves the right to use the paramedics for more or fewer days as needed until the Mat Sinking Unit returns to Vicksburg, MS. If the begin date moves back or forward, the end date will likely do the same. The paramedics shall provide services for every day of the season from the time required until the Mat Sinking Unit returns to Vicksburg and releases the paramedics. Time off will be given as discussed in section 3.2.

Option Seasons: This contract will consist of a base season along with four option seasons. If the Mat Sinking Unit determines that contractor’s performance is acceptable during the base season, the first option season may be executed for the next mat sinking season. And so on until all option seasons are utilized or until the contractor delivers unsatisfactory services.

Option for Paramedic: This contract will include, within each year, the option of a 3rd paramedic. This option will be executed if it is determined by the government that, due to the situation, a 3rd paramedic is needed to support operations for up to the duration of a full mat sinking season.

Option for Covid Testing: This contract will include, within each year, the option for the government to procure covid tests for use by the Mat Sinking Unit and Dredge Jadwin along with testing services at the Vicksburg Harbor.

Details of covid testing requirements are given below in section 2.

C.2. SCOPE OF WORK

The contractor shall provide full Advanced Life Support services to the Mat Sinking Unit and all associated areas including the Mooring Barge, Matboat, Quarterboats, M/V Benyaurd, M/V William James, M/V Harrison, all other Corps vessels, and any support or contract boats. The contract paramedics will participate in Mat Sinking Unit exercises, special events, and specialized training. Paramedics shall furnish all labor, supervision, supplies, online and offline treatment protocols, medical direction, equipment and reports, except as provided in Section 6, Government Furnished Property and Services. Three meals a day will be provided as well as lodging on the MSU quarter boats while the services are being provided. The contractor shall provide proof in writing of available personnel resources to replace assigned Paramedic personnel as needed as defined in paragraph 3.2. The Mat Sinking Unit requires a minimum pool of 3 paramedics available to work at the Mat Sinking Unit, therefore the contractor shall always have at least one other paramedic available to replace one of the two paramedics working on the Mat Sinking Unit as needed according to paragraph 3.2. The contract will cover up to 2000 total regular hours and 2000 total overtime hours per year, with options for additional regular and overtime hours. All hours are not guaranteed as the length of the Mat Sinking season is always subject to change.

OPTION: SCOPE OF WORK (COVID-19 TESTING)

Should the option for covid testing be exercised, the contractor shall be required to provide tests for COVID-19 (SARS-CoV-2) for the Mat Sinking Unit and Jadwin. Testing equipment supplies as needed shall be provided by the contractor with any cost therefore to be calculated within the price of the tests. The contractor shall provide a qualified employee (medic or nurse) that is trained for administering COVID-19 tests for testing at the Vicksburg harbor on weekdays. The USACE will provide ample space indoors for testing at the Vicksburg Harbor. Below are the requirements for covid testing:

- Provide testing services at the USACE Vicksburg Harbor using contractor medic/nurse and contractor testing equipment

- Mat Sinking Unit and Jadwin will generally test between 0-50 combined employees during testing days at the harbor though there are times when over 100 tests are required some days.

- There could possibly be a few days in which the Mat Sinking Unit will need to test all employees, up to 300, at the harbor. On days when multiple medics/nurses are needed to test a large group of people quickly, the government will require multiple medical personnel (to be billed as multiple harbor shifts) to provide testing.

- Provide tests and testing equipment to the Mat Sinking Unit (shipped to 2577 Haining Rd) as needed to be used weekly onboard the Mat Sinking Unit Quarterboats by contract paramedics. The contractor shall communicate with the Mat Sinking Unit on shipping status and tracking.

- Tests for COVID-19 shall be FDA approved or have emergency approval and shall be a SARS Antigen Fluorescent Immunoassay rapid test equivalent to the Quidel Sofia style test and capable of testing for SARS-CoV-2. Testing equipment/machine shall be compatible with proposed rapid test.

- Rapid tests/equipment shall give results of negative or positive in 15 minutes or less. Tests shall have sensitivity (PPA) of no less than 96% and specificity (PNA) of no less than 99%.

Quantities

- Up to 18000 tests for Mat Sinking Unit per year

- Up to 150 harbor testing days for Mat Sinking Unit per year

- Up to 2500 tests for Jadwin per year

- Up to 60 harbor testing days for Jadwin per year

C.2.1 EMERGENCY MEDICAL RESPONSE AND PATIENT TRANSPORT

The Contractor shall provide Emergency Medical Response to all emergencies and other events as requested by management. Patients will be transferred to nearest appropriate medical facility using Government furnished ambulance or other vehicles provided. These hospitals will be referred to as “local hospitals” hereafter. In areas where hospitals do not offer trauma services, landing zones will be established to get injured employee to Level 1 trauma center. Actual work involved in performance of this contract shall include:

C.2.1.1 Providing EMS services 24 hours per day every day of the season to include all applicable holidays.

C.2.1.2 Providing full Basic and Advanced Life Support paramedic care and treatment to patients and providing supplies, services and equipment necessary to maintain the patient’s medical status as directed by offline contractor medical control.

C.2.1.3 Transporting patients to local hospitals from the Mat Sinking Unit’s location; or transporting patients to landing zones (for air ambulance) and intercept locations (for ground ambulance).

C.2.1.4 Ensuring the EMT-P remains with patients until a qualified member of the receiving hospital properly accepts patients.

C.2.1.5 Notifying management and government Paramedic ASAP of acceptance to emergency room.

C.2.1.6 Document utilizing the USACE-MSU Run Report all pertinent patient and emergency facility information.

Upon completion of the run report, provide to the government Paramedic for QA/QI filing.

C.2.1.7 The contractor will respect and maintain the basic rights of patients, demonstrating concern for personal dignity and human relationships.

C.2.1.8 Providing reports to the Contracting Officer Representative (COR) concerning number of responses, transports, and summaries of care for individuals associated with Mat Sinking Unit.

C.2.2 FIRST AID OFFICE STAFFING

When not providing emergency medical care, the contractor will staff one (1) first aid office on the Mooring Barge and one (1) first aid office on the Quarter Boats. Actual work involved in performance of this contract shall include:

C.2.2.1 Providing general sick call and dispensing over the counter medications (Government provided) to employees for minor illnesses to include basic and advanced life support as needed. The OTC medications will include; analgesics, throat lozenges, anti-bacterial ointments and creams, cough suppressants, decongestants, anti-fungal ointments, antacids, diarrhea medications, etc.

C.2.2.2 Recommend to the government Paramedic employees that may need to seek a higher level of medical care.

C.3 CONTRACT PERIOD

This is a one-year contract containing a Government option to extend it in one-year increments for up to an additional four years and six months after the first year. The optional 6 months is to ensure service in case of an award delay.

C.4.0. REQUIREMENTS

- Provide health related services, first aid, and Basic and Advanced life support to a work force of approximately 320 employees engaged in work of above average hazards.

- Upon completion of administering all Tuberculosis (TB) tests, the contract Paramedics will read the TB screenings administered and document as required.

- The Paramedics will assist in identifying all who test positive for the PPD and report the results to the Government Paramedic on board. Appropriate actions will be taken.

- The Paramedics will assist with testing employees for viruses as needed.

- Required to treat injuries on the Mat Sinking Unit to include; lacerations, contusions, sprains, strains, abrasions, fractures, amputations, heat injuries, eye injuries, contact dermatitis, chemical poisonings, etc.

- Will assist the Government Paramedic in proper disposition of injured employee(s), and will assist in transporting the injured employee to an appropriate medical care facility by ground or air transport as deemed appropriate by the government Paramedic.

- Paramedics will provide BLS and ALS treatment to injured employee when necessary under contractor treatment protocols.

- Paramedics will monitor and document employee’s blood pressure and /or blood sugar, as directed by the employee’s physician or Mat Sinking Unit management.

C.4.1. OTHER DUTIES

- Will advise employees of the need to see a physician, and where necessary, drive a government vehicle to transport the employee to an appropriate medical care facility if needed.

- Will notify the Government Paramedic, or in his absence, Safety Specialist of physician’s diagnosis and opinion, and supply own opinion as to recommend action.

- The contract Paramedics will assist with moving ambulance and locating the nearest Hospital, with an Emergency Room, from each new job site, and complete a Hospital Route from the Quarterboats to the Hospital if needed.

- Contract Paramedics will set-up pre-determined landing zones for air transports and relaying those G.P.S.

coordinates to proper officials.

- Paramedics will assist with administering Annual Flu shots to employees that wish to receive one.

- Paramedics will be responsible for doing safety checks on various equipment, supplies and activities.

- Paramedics will be responsible for daily checks of the ambulance and first aid stations. Documentation will be maintained by the Government Paramedic.

C.4.2 WORKING HOURS

Normal work schedule will be approximately 10 hours per day (0700-1730). However, due to safety and operational concerns, additional use of the Contract Paramedic may be required before or after normal working hours as set by Contract Office Representative (COR). Paramedics will be required to provide services each day (including holidays during the season) for the entire season. Contract personnel must be relieved by another licensed Paramedic in order to leave, though exceptions can be made in emergencies if agreed to by the COR or Mat Sinking Unit Chief.

Additional hours will be required when deemed necessary for safety. The Paramedics will rotate being on call for overnight work while aboard the MSU. The contract Paramedics will coordinate with the COR, Mat Sinking Unit Chief, or Government Paramedic onboard the MSU anytime he/she has a need to leave the MSU for any reason.

When a contract Paramedic leaves the MSU due to personal emergency, the contractor will provide a qualified replacement within 24 hours of departure. For scheduled Paramedic replacement, the replacement Paramedic must be on site one day prior to the departing Paramedic’s departure to allow for appropriate orientation.

The paramedics will alternate being off work every other go-home weekend with the crew. Go-home weekends occur every other weekend. This will result in each paramedic receiving 2 days off every 4 weeks. The paramedic that is not off work will be required to provide services for the small portion of the crew that is working. The government is not obligated to provide the paramedics transportation to and from the Mat Sinking Unit on their off weekends. The government will only pay for hours that the paramedics are physically onboard the Mat Sinking Unit working.

Contract Paramedics will staff (1) First Aid Office on working plant and (1) First Aid Office on Quarter Boats. This will be assigned based on a rotating plan.

In accordance with Federal Labor Laws, any time worked over 40 hours in a given week will result in the contractor being paid overtime hours. The contract shall not include special rates for holiday. All hours shall be paid at the same rate unless it is for overtime.

Transportation to local airports will be provided for the purpose of swapping contract personnel and must be coordinated with the COR to ensure availability of driver and transport. It is requested that contractors stay on the unit a minimum of two-week intervals between swaps for logistical purposes, though exceptions can be made for special circumstances.

C.5. MEDICAL SURVEILLANCE

All Medical Records and information contained therein are considered Protected Health Information (PHI) and covered under the H.I.P.A.A. Privacy Rule. All medical records will be kept secured and stored in accordance with applicable laws. All other information is covered under the Privacy of Information Act and shall be kept confidential.

Added by Amendment W912EE22Q0026-00003

The contract shall abide by the following guidelines:

Obligations and Activities of Contractor:

(a) Not use or disclose protected health information other than as permitted or required by the Agreement or as required by law;

(b) Use appropriate safeguards, and comply with Subpart C of 45 CFR Part 164 with respect to electronic protected health information, to prevent use or disclosure of protected health information other than as provided for by the Agreement;

(c) Report to the Mat Sinking Unit any use or disclosure of protected health information not provided for by the Agreement of which it becomes aware, including breaches of unsecured protected health information as required at 45 CFR 164.410, and any security incident of which it becomes aware;

(d) In accordance with 45 CFR 164.502(e)(1)(ii) and 164.308(b)(2), if applicable, ensure that any subcontractors that create, receive, maintain, or transmit protected health information on behalf of the contractor agree to the same restrictions, conditions, and requirements that apply to the contractor with respect to such information;

(e) Make available protected health information in a designated record set to the government/Mat Sinking Unit as necessary to satisfy government’s/Mat Sinking Unit’s obligations under 45 CFR 164.524;

(f) Make any amendment(s) to protected health information in a designated record set as directed or agreed to by the Mat Sinking Unit pursuant to 45 CFR 164.526, or take other measures as necessary to satisfy covered entity’s obligations under 45 CFR 164.526;

(g) Maintain and make available the information required to provide an accounting of disclosures to the Mat Sinking Unit as necessary to satisfy covered entity’s obligations under 45 CFR 164.528;

(h) To the extent the contractor is to carry out one or more of covered entity's obligation(s) under Subpart E of 45 CFR Part 164, comply with the requirements of Subpart E that apply to the Mat Sinking Unit in the performance of such obligation(s); and

(i) Make its internal practices, books, and records available to the Secretary for purposes of determining compliance with the HIPAA Rules.

Permitted Uses and Disclosures by Business Associate:

(a) Contractor may only use or disclose protected health information as approved by the MVK Safety Office.

Contact information for Safety Office POC will be given as the need arises.

(b) Contractor may use or disclose protected health information as required by law.

(c) Contractor agrees to make uses and disclosures and requests for protected health information consistent with the government’s necessary policies and procedures.

(d) Contractor may not use or disclose protected health information in a manner that would violate Subpart E of 45 CFR Part 164.

Permissible Requests by Covered Entity

The government shall not request the contractor to use or disclose protected health information in any manner that would not be permissible under Subpart E of 45 CFR Part 164 if done by covered entity.

Term and Termination

(a) Term. The Term of this Agreement shall be effective as of the contract award date, and shall terminate on contract end date or on the date the government terminates for cause as authorized in paragraph (b) of this Section, whichever is sooner.

(b) Termination for Cause. The contractor authorizes termination of this Agreement by the government, if the government determines the contractor has violated a material term of the Agreement [and the contractor has not cured the breach or ended the violation within the time specified by the government].

(c) Obligations of Contractor Upon Termination.

Upon termination of this Agreement for any reason, the contractor shall return to the government [or, if agreed to by the government, destroy] all protected health information received from the government, or created, maintained, or received by the contractor on behalf of the government, that the contractor still maintains in any form. The contractor shall retain no copies of the protected health information.

(d) Survival. The obligations of the contractor under this Section shall survive the termination of this Agreement.

Miscellaneous

(a) Regulatory References. A reference in this Agreement to a section in the HIPAA Rules means the section as in effect or as amended.

(b) Amendment. The Parties agree to take such action as is necessary to amend this Agreement from time to time as is necessary for compliance with the requirements of the HIPAA Rules and any other applicable law.

(c) Interpretation. Any ambiguity in this Agreement shall be interpreted to permit compliance with the HIPAA Rules.

End of Additional Information Added by W912EE22Q0026-00003

C.6. CONTRACTOR RESOURCES

Documentation must demonstrate the contractor has adequate medical license, medical direction and insurance to perform the work or the ability to secure them.

C.6.1 MEDICAL REQUIREMENTS

Documentation must show that the contractor has a current unrestricted Advanced Life Support Provider license Service Emergency Medical Services Advanced Life Support Provider license and the ability to provide medical direction requirements.

1. Provide verifiable license/certificate, in any US State, as an EMS Advanced Life Support Provider

2. Provide verifiable medical and federal DEA license of Medical Doctor (MD or DO) working as Medical Director (Nurse Practitioners and Physician Assistants will not meet the requirements of this contract). If contractor uses an EMS system, a letter stating that the contractor is in good standing with the system and covered by their primary Medical Director, is required from the system, along with aforementioned medical and federal DEA licensure.

3. Provide copies of Online/Offline Basic and Advanced Life Support Treatment protocols

4. Provide copies of Advanced Practice procedures and protocols for remote/extended care treatment of patients. (Required if contractor’s primary ALS protocols do not include all of the required procedures).

C.6.2 INSURABILITY

Documentation must demonstrate the contractor’s insurability for medical malpractice.

1. Provide verifiable insurance certificates or statement from insurance institution, or equivalent.

2. Provide representations and certifications statement identifying any and all malpractice assertions and lawsuits within the past 10 years including a statement of facts and outcome. Negative statement is required, if none.

C.7. PERSONNEL REQUIREMENTS

Documentation must demonstrate the contractor has adequate human resources with satisfactory performance records to perform the work or the ability to secure them.

C.7.1 EMPLOYEE CRIMINAL BACKGROUND CHECK. The contractor assumes responsibility for conducting criminal background investigations on employees who will likely have access to DEA regulated controlled substances. The contractor shall produce the results of these checks upon request by the Vicksburg District Security Office or the Mat Sinking Unit.

C.7.2 FORMAL EDUCATION / CERTIFICATION. Paramedics performing services under this contract must be high school graduates or have a General Education equivalency certificate and be United States State certified/licensed as a paramedic.

C.7.3 DRIVING RECORD. Paramedics must not have any reckless or dangerous driving citations within the previous 24-month period and have no Driving While Intoxicated (DWI) or Driving Under the Influence (DUI) convictions in the previous five years.

C.7.4 EXPERIENCE. Paramedics performing services under this contract must have at least one year experience as a paramedic.

C.7.5 TRAINING DOCUMENTATION. The contractor shall maintain files to assure that all paramedics performing work under this contract shall have current certifications and/or documents listed below. Before award of contract, contractor shall provide copies of all requested documents. Upon request the contractor shall provide copies of these documents for all paramedic to the designated government representative or Vicksburg District Contracting Office.

Provide the following information for credential review on each proposed assigned and contingency personnel:

1. Proof of successful completion of a Paramedic Program;

2. A valid, current, unrestricted Paramedic license/certificate;

3. A current certification in Basic Life Support (BLS);

4. A current certification in Advanced Cardiac Life Support (ACLS);

5. A current certification in Pre Hospital Trauma Life Support (PHTLS or ITLS);

6. A current certification to give and read Tuberculosis skin tests in any U.S. state;

7. Evidence of immunity to Hepatitis "A" and "B" and evidence of freedom from chronic communicable disease(s) i.e., HIV, and TB;

8. Valid State Driver’s License;

9. Have completed a CEVO 3 (or equivalent) emergency vehicle driver training program

Added by W912EE22Q0026-00003

10. Proof of successful completion of annual HIPAA employee training. Certificate of completion shall be provided to the Contracting Officer and Contracting Officer Representative.

End of Additional Information Added by W912EE22Q0026-00003

C.8. REQUIRED ALS PROCEDURES

The contractor and contract personnel shall be licensed and have supporting protocols/equipment to provide the following ALS procedures:

Diagnostic Procedures

- Blood Pressure

- Pulse

- Blood glucose measurement

- Measurement of O2 saturation by pulse oximetry

- Measurement of Carbon Monoxide by CO-oximetry

- Measurement of Partial Pressure CO2 by Capnography

Cardiac Procedures

- ECG monitoring/interpretation

- 12 Lead Cardiac interpretation

- Defibrillation

- Synchronized cardioversion

- Transcutaneous pacing

- Drug Assisted Rapid Sequence Intubation

- Direction of patient in Valsalva maneuver

Airway Procedures

- Endotracheal intubation

- EOA or ETC (Combitube or King Airway) insertion

- Cricothyrotomy

- Needle thoracostomy for tension pneumothorax

- Drug Assisted Rapid Sequence Intubation

- Measurement of O2 saturation by pulse oximetry

- Measurement of Partial Pressure CO2 by Capnography

IV Procedures

- Peripheral IV insertion (including external jugular)

- IV Saline lock

- IV fluids and lines

- Intraosseous insertion devices (IO)

- Blood drawing

Drug Administration

- Administration of specified drugs by:

- IV push technique

- IM and SC injection

- Oral and sublingual administration

- Inhalation (includes nebulization)

- Administration of specified drugs via endotracheal tube

C.9. REQUIRED EQUIPMENT

The contractor shall maintain at a minimum the required equipment for each of the specified locations:

C.9.1 Quarterboat First Aid Office

Equipment shall be kept in a jump bag or bags (contractor provided) for easy deployment to scene.

Diagnostic Equipment

(1) Stethoscope

(1) Large Adult Blood Pressure Cuff

(1) Oxygen Pulse Ox monitor

(1) Blood glucose testing meter

(60) Blood glucose test strips

(60) Blood glucose testing lancets

(100) Alcohol prep pads

Cardiac Equipment

(1) Portable 12 lead ECG monitor/defibrillator/pacer with strip writer, synchronization capabilities, patient cable / Capnography capable (or handheld monitor)

(10) Packs of Disposable electrodes

(2) Sets of hands-free defibrillation pads

(3) Rolls of printing paper

(2) Spare charged batteries (not required if unit has built-in charger)

Airway Equipment

(1) Set of Endotracheal blades (MAC and Miller) with handles

(2) Of each size Endotracheal tubes – sizes 5.0 to 8.5

(1) End-tidal Co2 detector

(1) Combi-tube or King airway kit

(1) Capnography monitor (if not included in cardiac monitor)

(3) Packs of water soluble lubricant

(1) Pair of Magill forceps

(2) Roll of tape to secure tube (or tube securing device)

(1) Cricothyrotomy device and ventilation equipment

(1) Carbon Monoxide monitor (CO-oximetry)

(1) Adult size Ambu ventilation bag

(2) Adult Nasal Canula oxygen delivery device

(3) Adult Non-Rebreather oxygen mask

(8) Adult Nebulization device (mask or tube style)

IV Equipment

(5) Each size, IV needles, safety needle 16-24 ga

(6) IV lock devices

(10) Saline flushes

(2) IV fluid- Normal Saline 500 ml bags

(2) IV fluid- Lactated Ringers 500 ml bags

(2) IV fluid- D5W 500 ml bags

(2) 10 or 15 drop IV fluid administration sets

(2) 60 drop IV fluid administration sets

(1) IV infusion pump

(2) Sets of IV infusion pump tubing

(10) Alcohol prep pads

(4) Tourniquets

(4) IV securing device

(2) Sets of Blood draw tubes and adapter

Drug Box Drugs will be kept in a drug box or drug bag that can be sealed for easy evidence of tampering.

(2) Adenosine (Adenocard) 12mg

(7) Albuterol - premixed for nebulization - 2.5 mg

(1) Amiodarone (Cordarone)

(10) Aspirin, children’s chewable – 81 mg tablets

(2) Atropine Sulfate *Pre-filled syringe*

(1) Calcium chloride 10 percent

(1) Cardizem (Dilitiazem)

(4) Dextrose 50 percent * Pre-filled syringe*

(4) Diphenhydramine HCL (Benadryl)

(2) Dopamine

(3) Epinephrine 1:1000

(3) Epinephrine 1:10,000 * Pre-filled syringe*

(4) Furosemide (Lasix)

(1) Glucagon

(3) Ipratropium bromide (Atrovent)

(2) Lidocaine *Pre-filled syringe*

(1) 4 mg/ML, 250 ML Pre-filled bag

(2) Magnesium sulfate

(3) Naloxone (Narcan)

(10) Nitroglycerin tablets or spray - 0.4 mg (grains 1/150)

(2) Ondansetron (Zofran)

(2) Promethazine (Phenergan)

(1) Sodium bicarbonate

(1) Terbutaline sulfate (Brethine)

(1) Thiamine

(1) Verapamil

DEA Regulated Medications (Controlled Substances) DEA Regulated Medications will be kept in hard mounted drug cabinet provided in the facility. Daily inventory and tracking procedures must be put into place and documented by contract personnel. If found to be missing, contract Paramedic(s) will contact the COR.

(4) 100 Mg, Morphine Sulfate **Must be kept double locked*

(4) 100 Mg, Valium (Diazepam) **Must be kept double locked**

(4) 100 Mg, Versed (Midazolam) ** Must be kept double locked**

(2) Sets, RSI medications (Sedation, Paralytics) based on protocols

C.9.2 Mooring Barge First Aid Office

Equipment shall be kept in a jump bag or bags for easy deployment to scene. Cardiac monitor shall be self-contained.

Diagnostic Equipment

(1) Stethoscope

(1) Large Adult Blood Pressure Cuff

(1) Oxygen Pulse Ox monitor

(1) Blood glucose testing meter

(60) Blood glucose test strips

(60) Blood glucose testing lancets

(15) Alcohol prep pads

Cardiac Equipment

(1) Portable 12 Lead cardiac ECG monitor/defibrillator/pacer with strip writer, synchronization capabilities, patient cable, fully charged batteries.

(10) Packs of Disposable electrodes

(2) Sets of Hands free defibrillation pads

(2) Rolls of printing paper

(2) Spare charged batteries (not required if unit has built-in charger)

Airway Equipment

(1) Set of Endotracheal blades with handles

(2) Of each size Endotracheal tubes – sizes 5.0 to 8.5

(1) End-tidal Co2 detector

(1) Combi-tube or King airway kit

(4) Packs of water soluble lubricant

(3) Pair of Magill forceps

(4) Roll of tape to secure tube (or tube securing device)

(2) Cricothyrotomy device and ventilation equipment

(2) Carbon Monoxide monitor (CO-oximetry)

(4) Adult size Ambu ventilation bag

(5) Adult Nasal Canula oxygen delivery device

(2) Adult Non-Rebreather oxygen mask

(7) Adult Nebulization device (mask or tube style)

IV Equipment

(3) Each size, IV needles, safety needle 16-24 ga

(4) IV lock devices

(4) Saline flushes

(2) IV fluid- Normal Saline 1000 ml bags (or 4- 500ml bags)

(2) IV fluid- Lactated Ringers 1000 ml bags (or 4- 500ml bags)

(2) IV fluid- D5W 500 ml bags

(2) 10 or 15 drop IV fluid administration sets

(2) 60 drop IV fluid administration sets

(10) Alcohol prep pads

(4) Tourniquets

(4) IV securing device

(2) Sets of Blood draw tubes and adapters

Drug Box Drugs will be kept in a drug box or drug bag that can be sealed for easy evidence of tampering.

(1) Adenosine (Adenocard) 6mg

(2) Adenosine (Adenocard) 12mg

(4) Albuterol - premixed for nebulization - 2.5 mg

(1) Amiodarone (Cordarone)

(10) Aspirin, children’s chewable – 81 mg tablets

(1) Atropine Sulfate *Pre-filled syringe*

(1) Calcium chloride 10 percent

(1) Cardizem (Dilitiazem)

(2) Dextrose 50% * Pre-filled syringe*

(4) Diphenhydramine HCL (Benadryl)

(1) Dopamine

(3) Epinephrine 1:1000

(3) Epinephrine 1:10,000 * Pre-filled syringe*

(4) Furosemide (Lasix)

(1) Glucagon

(3) Ipratropium bromide (Atrovent)

(2) Lidocaine *Pre-filled syringe*

(1) 4 mg/ML, 250 ML Pre-filled bag

(2) Magnesium sulfate

(3) Naloxone (Narcan)

(10) Nitroglycerin tablets or spray - 0.4 mg (grains 1/150)

(2) Ondansetron (Zofran)

(2) Promethazine (Phenergan)

(1) Sodium bicarbonate

(1) Terbutaline sulfate (Brethine)

(1) Thiamine

(1) Verapamil

DEA Regulated Medications DEA Regulated Medications will be kept on the person of Paramedic working on the Mooring Barge (Physical Custody). Daily inventory and tracking procedures must be put into place by contract personnel. At the end of shift, DEA Regulated Medications will be returned to safe in Quarterboat First Aid Office.

(2) Morphine Sulfate **Must be kept double locked**

(2) Valium (Diazepam) **Must be kept double locked**

(2) Versed (Midazolam) ** Must be kept double locked**

C.9.3 US Army Corps of Engineers Ambulance

Equipment shall be limited to 1 jump bag due to limited space in the van type ambulance. Cardiac monitor, drug bag and IV infusion pump will be placed separately in the ambulance.

Diagnostic Equipment

(1) Stethoscope

(1) Large Adult Blood Pressure Cuff

(1) Oxygen Pulse Ox monitor

(1) Blood glucose testing meter

(15) Blood glucose test strips

(15) Blood glucose testing lancets

(15) Alcohol prep pads

Cardiac Equipment

(1) Portable 12 lead ECG monitor/defibrillator/pacer with strip writer, synchronization capabilities, patient cable / Capnography capable (or handheld monitor)

(6) Packs of Disposable chest electrodes

(2) Sets of Hands free defibrillation pads

(2) Rolls of printing paper

(2) Spare charged batteries (Inverter is installed in the ambulance, however is not powered by a shoreline)

Airway Equipment

(1) Set of Endotracheal blades with handles

(1) Of each size Endotracheal tubes – sizes 5.0 to 8.5

(1) End-tidal Co2 detector

(1) Combi-tube or King airway kit

(1) Capnography monitor (if not included in cardiac monitor)

(3) Packs of water soluble lubricant

(1) Pair of Magill forceps

(1) Roll of tape to secure tube (or tube securing device)

(1) Cricothyrotomy device and ventilation equipment

(1) Adult size Ambu ventilation bag

(3) Adult Nasal Canula oxygen delivery device

(3) Adult Non-Rebreather oxygen mask

(2) Adult Nebulization device (mask or tube style)

IV Equipment

(3) Each size, IV needles, safety needle 16-24 ga

(4) IV lock devices

(4) Saline flushes

(2) IV fluid- Normal Saline 500 ml bags

(2) IV fluid- Lactated Ringers 500 ml bags

(2) IV fluid- D5W 500 ml bags

(3) 10 or 15 drop IV fluid administration sets

(3) 60 drop IV fluid administration sets

(1) Sets of IV infusion pump tubing

(10) Alcohol prep pads

(4) Tourniquets

(4) IV securing device

(2) Sets of Blood draw tubes and adapters

Drug Box Drugs will be kept in a drug box or drug bag that can be sealed for easy evidence of tampering.

(1) Adenosine (Adenocard) 6mg

(2) Adenosine (Adenocard) 12mg

(4) Albuterol - premixed for nebulization - 2.5 mg

(1) Amiodarone (Cordarone)

(10) Aspirin, children’s chewable – 81 mg tablets

(1) Atropine Sulfate *Pre-filled syringe*

(1) Calcium chloride 10 percent

(1) Cardizem (Dilitiazem)

(4) Dextrose 50 percent * Pre-filled syringe*

(2) Diphenhydramine HCL (Benadryl)

(1) Dopamine

(3) Epinephrine 1:1000

(3) Epinephrine 1:10,000 * Pre-filled syringe*

(4) Furosemide (Lasix)

(1) Glucagon

(3) Ipratropium bromide (Atrovent)

(1) Lidocaine *Pre-filled syringe*

(1) 4 mg/ML, 250 ML Pre-filled bag

(2) Magnesium sulfate

(3) Naloxone (Narcan)

(10) Nitroglycerin tablets or spray - 0.4 mg (grains 1/150)

(2) Ondansetron (Zofran)

(2) Promethazine (Phenergan)

(1) Sodium bicarbonate

(1) Terbutaline sulfate (Brethine)

(1) Thiamine

(1) Verapamil

DEA Regulated Medications

DEA Regulated Medications will be kept in small lockable container in narcotics safe. When ambulance transportation is needed, narcotics will be transported with paramedic. Daily inventory and tracking procedures must be put into place by contract personnel.

(2) Morphine Sulfate **Must be kept double locked**

(2) Valium (Diazepam) **Must be kept double locked**

(2) Versed (Midazolam) ** Must be kept double locked**

C.9.4 Communication Equipment

(2) Cellular telephones for communication between treatment facilities, MSU management and Government Paramedic. Internet “Hot Spot” provided to allow for email correspondence with contact supervisor and government officials as needed.

C.10. Sustainability Requirements All items supplied must meet applicable sustainability requirements when applicable. All requirements can be searched using the SFTool.gov website. According the website, all blood bags and infusion tubing are required to be Phthalate free and PVC free. The COR shall be referred to for any questions.

C.11. Payments Payments will be made semi-monthly after receipts of a proper invoice. See Section G for invoicing instructions.

Payment will be made for the number of hours of actual duty worked during the time the Contract Paramedics are retained in the custody of the government. Payment will be made at the applicable hourly rate in the contract, calculated to the nearest half-hour.

C.12. PARAMEDIC/CONTRACTOR PERFORMANCE THRESHOLDS

Performance Objectives SOW Paragraph Performance Threshold

Requirements 3.0 No more than 2 valid customer complaints* Other Duties 3.1 No more than 2 valid customer complaints* Medical Surveillance 4 No deficiencies allowed

*All complaints will be evaluated by the contract COR and Mat Sinking Unit management. If any one complaint is deemed worthy to have the paramedic removed, the contractor shall replace with another paramedic immediately, no matter how many valid complaints have accrued against that paramedic. For any third valid complaint throughout the season, the paramedic shall also be replaced.

C.13. Quality Control The contractor shall utilize their own internal quality control processes to ensure services are performed in accordance with commonly accepted commercial practices and this Scope of Work.

C.14. Quality Assurance The Government will monitor the Contractor’s performance to ascertain Contractor compliance with this contract.

Changes to surveillance methods and/or procedures are solely within the Contracting Officer’s discretion and control. COR will provide report of any deficiencies to the KO (contracting officer) for resolution (if applicable).

C.15. Security Requirements

(1) AT Level I Training. All contractor employees, to include subcontractor employees, requiring access to Army installations, facilities, controlled access areas, or require network access, shall complete AT Level I awareness training within 30 calendar days after contract start date or effective date of incorporation of this requirement into the contract, whichever is applicable. Upon request, the contractor shall submit certificates of completion for each affected contractor employee and subcontractor employee, to the COR or to the contracting officer (if a COR is not assigned), within 5 calendar days after completion of training by all employees and subcontractor personnel. AT Level I awareness training is available at the following website: http://jko.jten.mil/courses/atl1/launch.html; or it can be provided by the RA ATO in presentation form which will be documented via memorandum.

(2) Access and General Protection/Security Policy and Procedures. All contractor and all associated sub-contractor employees shall comply with applicable installation, facility and area commander installation/facility access and local security policies and procedures (provided by government representative). The contractor shall also provide all information required for background checks to meet installation/facility access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency Services or Security Office. Contractor workforce must comply with all personal identity verification requirements (FAR clause 52.204-9, Personal Identity Verification of Contractor Personnel) as directed by DOD, HQDA and/or local policy. In addition to the changes otherwise authorized by the changes clause of this contract, should the Force Protection Condition (FPCON) at any installation or facility change, the Government may require changes in contractor security matters or processes.

(3) For contractors who do not require CAC, but require access to a DoD facility or installation. Contractor and all associated sub-contractors employees shall comply with adjudication standards and procedures using the National Crime Information Center Interstate Identification Index (NCIC-III) and Terrorist Screening Database (TSDB) (Army Directive 2014-05 / AR 190-13), applicable installation, facility and area commander installation/facility access and local security policies and procedures (provided by government representative, as NCIC and TSDB are available), or, at OCONUS locations, in accordance with status of forces agreements and other theater regulations.

(4) Suspicious Activity Reporting Training (e.g. iWATCH, CorpsWatch, or See Something Say Something). The contractor and all associated sub-contractors shall receive a brief/training (provided by the RA) on the local suspicious activity reporting program. This locally developed training will be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to the project manager, security representative or law enforcement entity. This training shall be completed within 30 calendar days of contract award and within 30 calendar days of new employees commencing performance with the results reported to the COR NLT 5 calendar days after the completion of the training.

(5) For Contacts that Required OPSEC Training. All new contractor employees will complete Level I OPSEC Training within 30 calendar days of their reporting for duty. Additionally, all contractor employees must complete annual OPSEC awareness training. The contractor shall submit certificates of completion for each affected contractor and subcontractor employee, to the COR or to the contracting officer (if a COR is not assigned), within 5 calendar days after completion of training. OPSEC awareness training is available at the following websites:

https://www.iad.gov/ioss/ or http://www.cdse.edu/catalog/operations-security.html; or it can be provided by the RA OPSEC Officer in presentation form which will be documented via memorandum.

(6) Will be escorted in areas where they may be exposed to classified and/or sensitive materials and/or sensitive or restricted areas. All contract employees, including subcontractor employees who are not in possession of the appropriate security clearance or access privileges, will be escorted in areas where they may be exposed to classified and/or sensitive materials and/or sensitive or restricted areas.

(7) Pre-screen candidates using E-Verify Program, The Contractor must pre-screen Candidates using the E-Verify Program (http://www.uscis.gov/e-verify) website to meet the established employment eligibility requirements. The Vendor must ensure that the Candidate has two valid forms of Government issued identification prior to enrollment to ensure the correct information is entered into the E-Verify system. An initial list of verified/eligible Candidates must be provided to the COR no later than 3 business days after the initial contract award. When contacts are with individuals, the individuals will be required to complete a Form I-9, Employment Eligibility Verification, with the designated Government representative. This Form will be provided to the Contracting Officer and shall become part of the official contact file.

C.16. Veterans Employment Emphasis for U.S. Army Corps of Engineers Contracts

In addition to complying with the requirements outlined in FAR Part 22.13, FAR Provision 52.222-38, FAR Clause 52.222-35, FAR Clause 52.222-37, DFARS 222.13 and Department of Labor regulations, U.S. Army Corps of Engineers (USACE) contractors and subcontractors at all tiers are encouraged to promote the training and employment of U.S. veterans while performing under a USACE contract. While no set-aside, evaluation preference, or incentive applies to the solicitation or performance under the resultant contract, USACE contractors are encouraged to seek out highly qualified veterans to perform services under this contract. The following resources are available to assist USACE contractors in their outreach efforts:

- U.S. Department of Labor Veterans’ Employment and Training Service (VETS):

https://www.dol.gov/vets/

- Federal Veteran Employment Information: https://www.fedshirevets.gov/

- Veterans Opportunity to Work (VOW) Program: https://www.benefits.va.gov/vow/

- U.S. Army Warrior Transition Command Employment Index:

https://wct.army.mil/modules/employers/index.html

- Hiring Our Heroes: https://www.uschamberfoundation.org/hiring-our-heroes

(End of Summary of Changes)