V225--Air Ambulance (VA-22-00056117)

Minneapolis VA Health Care System

Air Ambulance Services

Statement of Work

Scope:

Provide fixed wing Air Ambulance transportation services under an indefinite delivery/indefinite quality firm fixed price contract for the Minneapolis VA Health Care System (VA HCS) beneficiaries.

Requirements:

Transport will usually originate at the Minneapolis-St. Paul International Airport, Holmen Field St. Paul, or Flying Cloud-Eden Prairie transporting beneficiaries to locations outside Minnesota. However, this does not preclude the transport of beneficiaries from and to other locations within the VISN 23 coverage area, including: Iowa, Minnesota, North and South Dakota.

a) Start and destination points will be computed from those airfields. Payment per statute mile will be based upon direct air mileage as compute on the appropriate sectional Aeronautical Chart prepared by the National Ocean Survey and will be based on round trip mileage from airport where patient is picked up to destination airport where patient is landing.

Minneapolis VA HCS will authorize payment only for layovers necessitated by the patient, authorized by the Government, or Federal Air Regulations pilot duty requirement.

The service quantities are estimated based on past need. Orders from the above pick up and destination areas or from other pickup and destination locations will be honored by the Contractor at contract prices.

The Air Ambulance Contractor will not release the patient until the appropriate ground

transportation is available. In order to provide continuity of transportation, the air ambulance contractor will coordinate aircraft departures and arrivals with the Minneapolis VA HCS and require surface transportation contractor to avoid any delays at the points of origin and destination. If VA has awarded a ground ambulance contract for that area, the air ambulance contractor must use that contract and cannot diver to other transport unless approved by the VA. VA will not pay for non-approved diverted ambulances. When proper estimated time of arrival notification has been made to the ground ambulance contractor, the VA reserves the right to bill the Air ambulance Contractor the established ground ambulance wait time per quarter hour, in excess of the initial one quarter hour allowed as a result of contractor delays. If delay is unavoidable, the patient must be protected from inclement weather, including temperatures that could adversely affect their condition.

In addition, the requirement set forth in this solicitation, the Air Ambulance contractor must be in full compliance with the requirements of the Minnesota Department of Health, Life Support Transportation Services as contained in Chapter 4690.0100 through 4690.8300 or equal. Contractor must have a current Minnesota Emergency Medical Services Regulatory Board (EMSRB) ambulance license or current license from another site that supports the intention of the Minnesota Life Support Transportation Services and requirements of this solicitation. Information regarding the above may be found by contacting:

Minnesota Emergency Medical Services Regulatory Board

2829 University Ave SE, Suite 310

Minneapolis MN, 55414

(612) 627-5424

http://www.emsrb.state.mn.us/

The Air Ambulance Contract operator shall possess a current Federal Aviation Administration (FAA) Part 135 Air Taxi Certificate, (a copy of which must be submitted with proposal) and shall comply with the regulations of the FAA and the rules of the Minnesota Department of Transportation, Aeronautics Division.

The Contractor shall abide by all applicable FAA regulations, Each Pilot who performs under this contract shall hold a commercial airman s certificate with appropriate ratings for the conditions of the flight being undertaken, and operate under the air taxi rules for the certificate.

FAA flight plan shall be filed and used or any aircraft used for the air ambulance under this contract. Where ever practical and possible the pilot shall take advantage of all existing ground and air communication facilities. Before each flight, the pilot shall obtain the latest information relative to weather, airport communications, and navigational facilities, and further, shall be satisfied that all conditions are such that they do not constitute a hazard.

In the event a flight is interrupted short of destination, contractor shall immediately notify the Travel Department at the Minneapolis VA medical center.

No more than three (3) aircraft need be available at any one time. If more than three (3) simultaneous trips are required, the Minneapolis VA may acquire the services elsewhere, however, the Contractor will not be liable for any additional costs in these instances, The specified number of trips/miles in the Schedule of Items are based on the Minneapolis VA s best estimate of its historical and projected 12 month history to various locations at any one time and are not to be construed as (1) either a commitment to order such a number or (2) as limiting the number of aircraft which may be required or (3) limiting the geographical areas that may be requested for patient trips.

Government-Furnished Materials. The Minneapolis VA will provide the necessary medial materials to include but not limited to medications/intravenous solutions, dressings and catheterization kits for the specific patient needs. For patients transported with arterial lines, the Minneapolis VA will provide the necessary transducer monitoring cables for patients transported with arterial lines. The contractor will be required to sign for all necessary equipment and maintain control throughout the contract period. The contractor will be required to return all monitoring cables at the end of the term of the contract.

Personnel:

The prices quoted in the schedule of items and include the services of qualified pilots and medical personnel as dictated by standard industry practices. FAA and EMSRB to provide medical/nursing care that is required. If the condition of the patient necessitates more than one qualified medical attendant, the contractor shall be notified at the time the service is requested. The contractor will be reimbursed for the services of any additional attendant which are authorized by the VA in advance. The contractor will notify the travel section of the Minneapolis VA medical center if any attendant or second attended request has come from the medical personnel during the receiving of the patient s medical status report.

The contractor will have a medical director qualified for ambulance services, the Minnesota EMS to be Multi state certified will be a physician who accepts responsibility for the quality of care provided during transport by pilots and attendance; provide standards of upgrading and purchasing equipment; describes any standing orders for the provision of life-support care; provides triage, treatments and transporting protocols to assure that the patients requiring care transported appropriately; assist with the development and operation of an internal quality assurance mechanisms that include a review of services provided; provides written procedure for the storage and administration of drugs; and provides written standards for medical equipment and supplies to provide air ambulance service.

Medical Flight Attendants personnel serving the capacity of this contract are any licensed physician nurse physician assistants or emergency medical technician who has had additional training in various aspects of Aaron nautical transportation as specified in paragraph (D) below. A medical flight attendant may not serve simultaneously as required pilot or crewmember of the flight. Medical flight attendant personnel will have sufficient training when Karen necessitates administration of medication and intravenous solutions tracheostomy care cardiac monitoring ventilator dependent patients procedures requiring sterile technique evaluating medical conditions predisposing to in-flight hypoxic conditions and to interpret basic and complex EKG rhythms administers monitors and titrates IV fluids and vasoactive intropic, antiarrhythmic and narcotic agents under the direction of physicians recognizes indications for defibrillation and performs procedures maintains patency of arterial lines and interprets arterial waveforms maintains patency of CVP s and pulmonary artery and catheters and interprets we ve the forms obtained from them. Assumes responsibility for the care of the patient with pacemaker (transvenous and/or cutaneous) insuring proper function, recognizes any malfunction and intervening appropriately, assumes responsibility for the care of integrated patients requiring mechanical ventilation, including appropriate utilization of P.E.E.P., adjusting ventilatory settings according to physician orders, assessing/ troubleshooting that ventilator/patient problems and making adjustments as indicated and can appropriately ventilate by hand (Ambu-bag) when needed.

Medical flight attendants will have training in accordance with standard industry practices, FAA and EMSRB, with emphasis placed on the airborne environment, I.E. Responsibilities during preflight, in flight, impose flight phases of an air ambulance mission; legal considerations of air ambulance service, record keeping for air ambulance service, lifting and moving of patients; General adjustments that are required when changes in the time zone are made, medical equipment used a board aircraft, changes in barometric pressure, decompression sickness and air embolism; changes in partial pressure of oxygen; other environmental factors affecting patient care such as humidity, temperature, ventilation, noise, etc., Aircraft systems, electrical, pressurization, lighting, ventilation; Aircraft emergencies such as electrical failure, rapid decompression, and emergency landing; and principles of survival.

That air ambulance contractor will have access to an aeronautical consultant to act as technical adviser to assist the contractor and attending physician and identifying precautions and care required in-flight.

A record of qualifications in training of each medical flight attendant and other employees performing under this contract must be maintained and made available for inspection by the VA upon request that anytime during the term of this contract.

The VA serves the right to have an escort, such as a relative or care provider of the beneficiary, accompanying the beneficiary when the VA determines that such an escort is in the best interest of the beneficiary. The VA will also be the sole judge in determining when an escort is required. There shall be no additional charges to the VA when escorts are authorized to travel with the beneficiary. Contractor shall only be required to transport ask work with the patient and shall not be required to return the escort back to point of origin.

Incident\accident reporting procedures: in all cases where an incident or an accident occurs while a VA patient is in the contractor s care, Minneapolis VA Will be contacted immediately. In cases where an immediate emergency medical treatment is deemed necessary, Notification will be required upon arrival at the nearest facility. In all cases, patients must be cleared by the Minneapolis VA s emergency room physician. Clearance must be documented. Contact can be made with the travel office during normal business hours and with the administrator on duty during off hours. Written reports are required by 10 AM the first working day following the incident/accident.

Aircraft equipment and design:

Aircraft: all ambulance aircraft used in the performance of this contract must be pressurized turbine, fixed wing craft suitable for all weather operations. Air ambulance shall comply with the regulations of the FAA and the rules of the Minnesota Department of Transportation aeronautical division. Particular s include:

Electrical: Aircraft must have an electrical inverter system for simultaneously requiring electrical supply for emergency medical equipment, the voltage of which is compatible to the medical equipment required.

Heating system: the heating system should have the capability of maintaining the cabin temperature at around 75°F during all phases of operation.

Communication systems: the aircraft must have radio capabilities to communicate air to ground and air to air.

Lighting systems: interior Lighting should be adequate for patient observation and care under all circumstances. During my operations a curtain should be used if necessary, to protect the cockpit from lights and the patient section.

Loading stretchers and litters: Aircraft doors should be large enough to allow a stretcher or litter to be loaded without rotating it more than 30° about the longitudinal (roll) axis or 45° about the lateral (pitch) axis.

Positioning the structure or litter: the stretcher later should be positioned so as to allow the medical attendant a clear view of access to any part of the patient s body that may require attention. The attendant should always have access to the patient s head and upper body. The upper surface of the litter should not be less than 30 inches from the ceiling of aircraft or under the surface another litter. To conduct a CPR, as much as 40 inches may be desired. A conventional structure or litter will be at least 19 inches wide and 73 inches long. Between 12 and 18 inches of clear aisle at the head and on the side of the litter is minimally excepted tolerance. When possible, litters should be installed laterally in the aircraft to provide better restraint against forces which may be encountered in a crash.

Isolating the pilot from the patient section: the patient should be sufficiently isolated from the cockpit to minimize in-flight distractions and interference that would affect flight safety.

All medical equipment and the aircraft must be secured and approved racks, bins, or compartments during flight. It is critical that oxygen containers be properly restrained.

In accordance with standard industry practice, provide medical equipment meeting the requirements as indicated in chapter 4690. 1300 entitled Air Ambulance Equipment

Maintenance of medical equipment and supplies shall include the following:

Each piece of linen (blankets, sheets, stretcher pads, mattress and pillow covers) used for a patient should be cleaned after each use and disinfected as necessary.

Each piece of equipment coming in contact with the patient should be properly washed and disinfected after each use.

A medical equipment and emergency medication used in the air ambulance operations must be maintained according to the manufacturer s recommendations, and adequate record should be available to indicate that the required maintenance has been performed.

Operating procedures:

Inspection:

The government has the right to inspect the contractor s premises, maintenance records of medical equipment and aircraft(s), flight logs, and dispatch records being used for the contracted services. Furthermore, annual leave the contractor will provide proof of insurance and copies of licenses for all staff providing services under this contract.

Cancellation:

If the delivery order is canceled by the travel coordinator, the contractor will be paid for actual nautical miles traveled at the time of the cancellation, plus the necessary nautical miles the contractor s aircraft must travel to return to its starting location. The return mileage is only reimbursable if the contractor does not have any destination on its flight plan.

Quality:

Contractor will ensure that each beneficiary is treated in a professional manner, keeping in mind diversity of our beneficiaries. Each beneficiary will be treated with the highest quality of care and standards established in the industry. Some other areas to be assessed are:

Patient safety

Medical services

Equipment and aircraft maintenance program

Timeliness:

Upon receipt of the request for service for an authorized travel coordinator, specifying the government performance requirements, the contractor to dispatch we ll respond within a reasonable amount of time not to exceed thirty (30) minutes and will coordinate the transportation of the beneficiary. In response to a request for services under a delivery order, the contractor will have no more than two (2) hours to arrive fully staffed at the pick-up location on must prior approval for additional time is granted by the travel coordinator.

Invoicing:

The contractor shall furnish the following to the receiving facility:

Contract number/ delivery order number

Date of flight and number of nautical miles flown

Name and phone number of the authorize ordering patient travel coordinator and facility

Originating and terminating points

Name of each patient

An in-flight medical attendance report of the patient s status, including vital signs, the level of consciousness, drugs administered, details of therapeutic intervention, and the names and qualifications of all attendance working on that flight

Any unusual circumstances encountered during the flight, including, but not limited to, in ordinate altitudes flown, turbulence, and time is associated with these abnormal conditions

After all work has been completed, the contractor will furnish the information listed above, along with the invoice, directly to the beneficiary travel coordinator who placed the request for services under the delivery order. The beneficiary travel coordinator we ll process the invoice for payment. The invoice and the required information shall be submitted no later than 15 working days after completion of trip.

Business relations: the working relationship will be assessed based on beneficiary and/or travel coordinator satisfaction to include, Direct professional interaction between the contractor and the contracting officer. A few of the contract to be monitored, which is not directly related to cost, schedule, or performance are:

Integration and coordination of all activities needed to execute the contract, change proposal submissions, in the contractor s history a professional behavior with all parties.

Actively work to eliminate obstacles to ensure excellent performance.

Factor No.

Performance Indicator

Performance Standard

AQL Maximum Allowable Degree of Deviation

Method-Type of Surveillance Reduction when AQL Exceeded

Deduction Amount on Payment, or possible termination

1

Patient Safety

Consistent with Standards & Safety Guidelines

Two (2) occurrences per year

Patient condition monitored at conclusion of each flight

2% per occurrence

2

Medical Services

Qualified staff to provide appropriate services

Two (2) occurrences per year

Patient condition monitored at conclusion of each flight

2% per occurrence

3

Equipment & Aircraft Maintenance Program

In accordance with established Local, State and Federal Regulations.

Two (2) occurrences per year

Equipment & Aircraft maintenance logs reviewed semi-annually

15%

4

Dispatch Response

Within thirty (30) minutes

Four (4) occurrences per year

Monitor through travel coordinator logs

15%

5

Air Ambulance Response

Within two (2) hours

Four (4) occurrences per year

Monitor through travel coordinator logs

2% per occurrence

6

Submit Patient Data

Within fifteen (15) working days

Two (2) occurrences per quarter

Monitor through travel coordinator

2% per occurrence

7

Submit Invoice

Within fifteen (15) working days

Two (2) occurrences per quarter

Monitor through travel coordinator

2% per occurrence

8

Patient Satisfaction

Per occurrence

1 occurrence per quarter

Monitor through travel coordinator

2% per occurrence

9

Professional Interaction

Per occurrence

1 occurrence per quarter

Monitor through contracting officer & travel coordinator

2% per occurrence

10

Integration & Coordination

Per occurrence

2 occurrences per quarter

Monitor through contracting officer & travel coordinator

2% per occurrence