Emergency Transport Service Ann Arbor VA Healthcare System
STATEMENT OF WORK
The Contractor shall provide Basic Life Support (BLS) Ambulance Service and Advanced Cardiovascular Life Support (ACLS/ALS) Ambulance Service, as specified herein, for eligible beneficiaries of the Department of Veterans Affairs, Ann Arbor Medical Center (VA), 2215 Fuller Rd, Ann Arbor, Michigan, 48105 including its Community Based Outpatient Clinics. Services shall be provided on a twenty-four hour per day, seven day per week basis.
The Contractor shall perform required services in accordance with the standards of the Commission on Accreditation of Ambulance Services (CAAS) http://www.caas.org/ and established principles and ethics of the medical profession.
The contractor shall transact all business, there under, with the Contracting Officer (CO) and/or the Contracting Officer s Representative (COR) or his/her designee, and in no case shall deal directly with or solicit from beneficiaries of VA.
1. GENERAL DESCRIPTION:
(a) The services of this contract shall be used primarily for but not limited to; trips between the Ann Arbor VA Medical Center including its Community Based Outpatient Clinics, other VA medical centers, clinics both inside and outside of the state of Michigan, The University of Michigan Medical Center, Transportation to and from nursing homes, and patient homes both within and outside Washtenaw county, MI may be covered under this contract on a limited basis. The VA does not guarantee any of these estimated quantities or any percentage of these estimated quantities; however, it is believed they are a realistic expectation of our requirements for the period of this contract.
(b) Contractor shall provide or subcontract at contract rates all requests for SMT transport received from the Ann Arbor VA medical center and its Community Based Outpatient Clinics including but not limited to transportation requirements both locally and from outlying areas. In addition, the Contractor shall make available as needed a bariatric cot which shall be provided to VA, when requested by VA.
(c) Contractor shall notify the COR as soon as possible of those instances in which the Contractor knows that he will be unable to provide the required service at any specific time. This notice shall enable the VA to secure the service elsewhere to meet the requirements. In the event the Contractor has the required number of BLS/ALS ambulances out on service runs for this Medical Center, the Contractor shall be required to sub-contract to other providers to ensure SMT transportation services are provided.
(d) Immediate Notification: It is the responsibility of the Contractor to immediately notify the AAVAMC ordering office when unable to make a pick-up or delivery by the exact time specified for previously scheduled trips; or unable to dispatch an ambulance to a designated pick-up point within the required time frame for unscheduled requests for services. The immediate notification shall include the reason for the delay and whether the pick-up or delivery can be made at a later time and if so, specification of that time. However, it shall be the sole discretion of the AAVAMC ordering office to accept the later pick-up or delivery time, and based upon the reason for delay, present the delay for payment reduction or refuse the later pick-up or delivery time and order the services from another source (the applicable ordering office shall be the sole entity for determining when to request the services from another source), and present the reason for the delay to the CO as an occurrence that may be subject to default. Based upon the reason for the delay, the Contractor may be charged with excess costs incurred by the AAVAMC in ordering the service from another source or other appropriate contractual action may be taken by AAVAMC. However, if the Contractor states that he/she will provide additional ambulance(s) upon a specific request of the VA and is unable to provide the additional ambulance(s) within one hour of the request, and if the Contractor fails to notify the VA ordering officer of this inability to so provide, the Contractor shall be required to pay any difference in costs. Failure to notify the VA of any instance of inability to provide a required ambulance may reflect upon the Contractor s ability to perform under this contract and may constitute sufficient cause for termination of the existing contract.
(e) For purposes of clarification, the Contractor shall be responsible for having sufficient BLS/ALS ambulances and qualified personnel to meet the estimated annual requirements of this Medical Center. The Contractor shall not be required to maintain a standby group of vehicles at any one time, but should use good business judgment in having sufficient BLS/ALS ambulances to best meet our estimated requirements. If the Contractor provides more than the minimum number of vehicles required by this contract at any time, upon a specific request of VA during the contract period, the Contractor shall charge and VA will pay for such additional services only in accordance with the prices or rate of the Schedule by the Contractor.
VA HOSPITAL AND OUTPATIENT CLINIC LOCATIONS
VA Ann Arbor Healthcare System
2215 Fuller Road
Ann Arbor, MI 48105
Wayne County
Flint VA Community Based Outpatient Clinic
2360 Linden Rd
Flint, MI 48532
Genesee County
Jackson VA Community Based Outpatient Clinic
4328 Page Ave
Michigan Center, MI 49254
Jackson County
Toledo VA Outpatient Clinic
1200 S Detroit Ave
Toledo, OH 43614
Lucas County
Battle Creek VA Medical Center
5500 Armstrong Rd
Battle Creek, MI 49037
Calhoun County
Aleda E Lutz VA Medical Center
1500 Weiss ST
Saginaw, MI 48602
Saginaw County
John D Dingell VA Medical Center
4646 John R Street
Detroit, MI 48201
Wayne County
CONTRACT DEFINITIONS/ACRONYMS
) Administrative Officer of the Day (AOD) - VA official that works in the admissions area during evenings and nights, and monitor hospital activities during other than normal working hours. This person is located at the main site of the Ann Arbor VA Medical Center (AAVAMC) and acts as hospital administrator during off-hours.
Advanced Cardiovascular Life Support (ACLS) ACLS shall be provided by ambulance vehicles containing, at a minimum, two on-board attendants and shall be staffed in accordance with current Michigan State laws and regulations governing the certification and licensure of private ambulances. Ambulance services shall also include cardiac monitoring, Advanced Cardiovascular Life Support (ACLS) drugs and procedures, advanced airway management and medication monitoring and administration.
Base Rate Base rate is defined as the rate paid for one-way transportation from a designated pick-up point to a designated delivery point. For every trip traveled outside the mileage threshold, Contractor shall be reimbursed at the base rate plus mileage. This rate shall be paid for all authorized one-way trips ordered under this contract action, with employees receiving, at a minimum, the Department of Labor Service Contract Act wage rates (included herein), during all phases of the trip made on behalf of the Government. Attached Service Contract Act wage rate determinations shall be updated each option year when/if new revisions are issued. That Base Rate shall constitute full compensation for one-way trips which do not exceed the Mileage Threshold .
Basic Life Support (BLS) BLS is defined as services required for non-critical patient care in which a patient requires an ambulance, staffed in accordance with current Michigan State laws and regulations governing the certification and licensure of private ambulances. This ambulance, at a minimum, shall be staffed with two Emergency Medical Technicians (EMT), and be capable of providing basic airway management.
Beneficiary Veterans and other members determined to be eligible for benefits by the VA.
Business Hours/Days Business hours/days are defined as the time of 8:30a.m. to 5:00p.m., Monday through Friday, except Federal holidays. Federal holidays include New Year s Day, Martin Luther King Day, Presidents Day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans Day, Thanksgiving Day, Christmas Day, New Year s Day, and any other day specifically designated by the President of the United States to be a national holiday. Off Business hours/days are defined as the time of 5:01p.m. to 8:29a.m.Monday through Friday, 5:01pm Friday through 8:29a.m. Monday, and Federal holidays.
Contracting Officer (CO) VA official with the authority to enter into, administer, and/or terminate contracts, make related determinations and findings, and who is a member of the vehicle inspection team.
Contracting Officer s Representative (COR) VA official responsible for providing contract oversight and technical guidance to the Contracting Officer. Responsibilities include certification of invoices, placing orders for service, providing technical guidance, overseeing technical aspects of the contract, and serving as a member of the vehicle inspection team. All administrative functions remain with the Contracting Officer.
Contractor The term Contractor used herein refers to both the prime Contractor and his employees, and any subcontractors and their employees. The Contractor shall be responsible for assuring that all subcontractors comply with the provisions of this contract.
Emergency Medical Care Vehicle-Vehicle outfitted out with all personnel, supplies and equipment necessary to furnish BLS or ACLS emergency care to the patient during transport
Emergency ALS/ BLS Set of clinical interventions for the urgent treatment of cardiac arrest, stroke and other life-threatening medical emergencies, as well as the knowledge and skills to deploy those interventions. These need a response from the contractor in a much lower amount of time than the regular ALS and BLS.
Gender - For the purpose of equal rights wherever the masculine gender is used in this solicitation, and the resulting contract, it shall be considered to include both masculine and feminine gender.
Joint Commission (formerly known as JCAHO) A national organization dedicated to improving the care, safety and treatment of patients in a health care facility and environment.
Specification - Each ground ambulance used in the performance of this Contract must meet the current specifications of Federal Specification KKK-A-1822F (http://apps.fss.gsa.gov/vehiclestandards/
Lie-Down Transportation-Transportation of a veteran when it is not anticipated that the patient will require any emergency treatment, but rather safe and secure non-emergent, non-ambulatory transportation.
Mileage Rate Mileage for ground ambulance services is the rate paid for each mile traveled beyond the specified Mileage Threshold for each applicable medical facility. This rate applies to one-way transportation only. In no event, shall the Contractor receive this rate for miles traveled within the specified Mileage Threshold.
Mileage threshold- The Mileage threshold for the AAVAMC is a 25-mile radius from the point of pickup for each trip as determined by Rand McNally Standard Mileage Guide and verified by MapQuest.com .
Quality Assurance - Those actions taken by the Government to assure services meet the requirements of this Contract.
Quality Assurance Evaluator - Government personnel responsible for surveillance of Contractor performance.
Quality Assurance Surveillance Plan - An organized written document used for quality assurance surveillance. The document contains specific methods for performing surveillance of the Contractor s continuous performance
Rates Rates are defined as the rate paid for one-way transportation from a designated pick-up point to a designated delivery point. For every trip traveled outside the city limits, Contractor shall be reimbursed at a fixed rate plus an amount for any mileage traveled outside of the mileage threshold. This rate shall be paid for all authorized one-way trips ordered under this contract action with employees receiving, at a minimum, the Department of Labor Service Contract Act wage rates (included herein), during all phases of the trip made on behalf of the Government. Attached Service Contract Act wage rate determinations shall be updated each option year when/if new revisions are issued.
Scheduled Trip(s) The term Scheduled Trip as used in this contract refers to those trips in which the Contractor has been given advance notice of required services and a specific pick-up time. Advance notice is defined as notice given by 4: 30p.m.the prior business day.
Service Hours/Days Service shall be provided on a twenty-four hour per day, seven day per week basis.
Sensitive Information- VA sensitive information is all Department data, on any storage media or in any form or format, which requires protection due to the risk of harm that could result from inadvertent or deliberate disclosure, alteration, or destruction of the information. The term includes information whose improper use or disclosure could adversely affect the ability of an agency to accomplish its mission, proprietary information, records about individuals requiring protection under various confidentiality provisions such as the Privacy Act and the HIPAA Privacy rule, and information that can be withheld under the Freedom of Information Act. Examples of VA sensitive information include the following: individually-identifiable medical, benefits, and personnel information; financial, budgetary, research, quality assurance; confidential commercial, critical infrastructure, investigatory, and law enforcement information; information that is confidential and privileged in litigation such as information protected by the deliberative process privilege, attorney work-product privilege, and the attorney client privilege; and other information which, if released, could result in violation of law or harm or unfairness to any individual or group, or could adversely affect the national interest or the conduct of federal programs.
Trip One way transportation from a designated pick-up point to a designated delivery point.
Unscheduled Trip(s) - The term Unscheduled Trip as used in this Contract refers to those trips required on an as needed basis and advance notice is not given.
Universal Precautions- Universal Precautions is an approach to infection control. According to the concept of Universal Precautions, all human blood and certain human body fluids are treated as if known to be infectious for HIV, HBV, and other blood-borne pathogens.
Unscheduled Trip(s) The term Unscheduled Trip as used in this contract refers to those trips required on an as-needed basis and advance notice is not given.
Vehicle(s) The term Vehicle(s) as used in this contract refers to ambulance transportation provided under the requirements of this contract.
Waiting Waiting as used in this contract is defined as the time required and verified by authorized medical facility personnel, for the Contractor to wait at designated pick-up and/or delivery points when performing contract services.
Waiting Grace Period - The waiting grace period is defined as fifteen (15) minutes prior to the time waiting charges commence. The base rate for ambulance services shall include a fifteen (15) minute waiting grace period at origin and destination
SCOPE: Provide Basic and Advanced Cardiovascular Life Support Ambulance Transportation Services for the Department of Veterans Affairs Ann Arbor Medical Center (VA), Ann Arbor, Michigan including its Community Based Outpatient Clinics for a base year with four pre-priced option years. The intent of this Contract is to have contract for ground ambulance emergency services to provide transportation to patients at the AAVAMC including its Community Based Outpatient Clinics. Contractor shall provide all vehicles, personnel, management, supplies, transportation, equipment and reports necessary to cover ground ambulance transport service. Contractor care shall cover the full range of paramedic and ambulance services provided in the local community. Paramedics responding to codes will bring equipment/supplies required by state regulations, and Advanced Life Support (ALS) equipment and medication to include, but not limited to, cardiac monitoring, intubation equipment, automated external defibrillator (AED), video laryngoscope, pulse oximetry, glucometer, portable oxygen, protective clothing and written procedures. The Contractor shall have available the appropriate number of vehicles to provide services in a timely manner as outline by the contract. Performance shall be in accordance with the requirements contained in this SOW and standards of the Pennsylvania DOH, Bureau of Emergency Medical Services, and The Joint Commission
Contract Period: 1 year with 4 option years.
AAVAMC Locations: AAVAMC consists of multiple offsite clinics, Community Based Outpatient Clinics and its Main location.
Ambulance Transportation Services:
The Contractor shall be responsible for providing all vehicles and personnel, necessary to meet all ACLS/ ALS and BLS transport requirements of this Contract. The Contractor shall be authorized to utilize another ambulance service company, as a subcontractor (certified to be within all requirements of this Contract) to complete these transportation requests only if prior approval for the subcontractor has been received from the CO. The Government has a business relationship with the Prime Contractor only. Only the Prime Contractor may bill the Government for services. All bills for this subcontractor service will be paid directly to the Prime Contractor at the Contract rate, and the Prime Contractor shall make payment to the subcontractor at their agreed rate. In the event the Contractor is unable to perform services or have services performed as required, the Contractor shall immediately notify the COR and provide a justification for non-performance. The VA reserves the right to re-procure services which cannot be performed by the Contractor, in accordance with the terms, conditions, and schedule of this Contract. The Contractor is responsible for excess re-procurement costs which may result from the Contractor s inability to perform the required service. Payment of re-procurement costs shall not relieve the Contractor from any other provision in this Contract covering inspection, acceptance and deductions from payment. The VA will be the sole judge in determining when services will be re-procured. The failure of the Contractor to perform services within the required time frames and in accordance with terms and conditions may also provide cause for termination of the Contract for cause, (see FAR clause 52.212-4(m)).
Vehicle Response Times:
The Contractor shall be at AAVAMC or its Community Based Outpatient Clinics within 30 minutes after notification for an Emergency Advanced Cardiac Life Support/Advanced Life Support Transport (ACLS/ALS) and/or Emergency Basic Life Support Life Support (BLS) vehicle. Exceptions to the 20-minute expectation (i.e., weather emergencies, traffic emergencies, etc.) will be investigated and analyzed, including the identification of corrective actions if applicable. As determined appropriate, Contractor shall take corrective actions to ensure timely response. The Contractor shall respond to all calls immediately for emergency ground ambulance transport service for the AAVA Medical Center. The Ann Arbor VA Medical Center contractor shall provide and respond to all emergency calls in accordance with Federal, State, and Local regulations, governing dispatch of emergency medical (ambulance) vehicles and medical care of on-board Patients, to include the use of sirens and other measures to ensure timely arrival at the designated VA Medical facility.
The Contractor shall be at AAVAMC or its Community Based Outpatient Clinics within 60 minutes after notification for ground ambulance transport service for a Non-Emergency Advanced Cardiac Life Support/Advanced Life Support (ACLS/ ALS) vehicle and/or Non-Emergency Basic Life Support Vehicle (BLS). Exceptions to this time requirement will be assessed similar to paragraph 1 above.
Response Time Compliance Rate: The Contractor shall maintain, at a minimum, a 95% compliance rate on responses to pick-up or deliver during the Contract year. Failure of the Contractor to perform in accordance with this compliance rating may constitute sufficient cause for termination of the Contract for cause, (see FAR clause 52.212-4(m)) or other appropriate contractual action
If the time period for pick-up, stated herein, is physically impossible due to location of Patient, the Contractor shall contact the COR and inform him/her of the anticipated time required for pick-up and delivery of said Patient.
Should the VA determine that immediate transportation is essential to prevent loss of life or serious bodily harm, transportation services may be procured without referral to the ambulance Contractor. However, in these extremely rare cases, no charge shall be levied against the Contractor.
BASIC LIFE SUPPORT (BLS) ambulances shall be staffed, at a minimum, with two EMTs. Ambulance shall be on-site within one (1) hour after Contractor receives a request for BLS ambulance. The contractor shall be required to provide a minimum of three BLS ambulances at any given time; however, additional ambulances requested shall be furnished, if available, and at the contract price.
ADVANCED CARDIOVASCULAR LIFE SUPPORT (ACLS) ambulance shall be staffed with two attendants. One shall be a Paramedic and the other shall be a Paramedic or Certified Emergency Medical Technicians (EMT) with controlling capabilities for Endotracheal Intubation, IV Therapy, Cardiac Monitoring, Defibrillation, and Drug Therapy. Ambulance shall be on-site within thirty (30) minutes after Contractor receives a request for ACLS ambulance. The contractor shall be required to provide a minimum of one ACLS ambulance at any given time; however, additional ambulances requested shall be furnished, if available, and at the contract price.
Authorized Medical Center Personnel: Prior to performance, the COR shall provide the Contractor with a list of names or position titles and phone numbers of authorized Government personnel who may request services and receive calls from Contractor regarding Contract performance. This list will be updated and submitted to the Contractor as changes occur. The Contractor shall ensure that requests for services are received from authorized medical center personnel. Services rendered in response to requests from other than authorized personnel shall be at the risk of the Contractor and any cost related thereto shall be borne by the Contractor.
Mileage Threshold for Ground Ambulance Services: The Mileage Threshold for the AAVAMC is a 25 mile radius from the designated pick-up point for each trip (i.e., Contractor is required to pick-up Patient at the VA, the Mileage Threshold would be a 25 mile radius from the VA). Charges for travel within this Mileage Threshold shall be inclusive with the base rate. One way mileage for travel beyond the 25 mile Mileage Threshold shall be claimed under the applicable mileage rate.
Contractor Reimbursement:
Reimbursement for mileage outside the Contract Mileage Threshold of coverage, shall be at the mileage rate stated in the price schedule, and shall be based upon the miles from the pick-up point to the specified destination. Any mileage from the place of business and/or location of vehicle and the pick-up point, or from the delivery destination back to the place of business and/or location of next trip are not considered as a separate item of this reimbursement, but would be expected to be incorporated into the mileage rate that is the Contractor s responsibility as part of the administrative costs (or costs of doing business). Trip mileage under the contract shall be determined by using the internet web site of Bing Maps; Google Maps will be used when Bing Maps is not available. Allowable charges for mileage outside the Contract Mileage Threshold areas of coverage shall not exceed +5% of the current Rand McNally Standard Mileage Guide.
Should the VA make a determination that a previously scheduled trip may be cancelled, and a vehicle has already been dispatched to the designated pick-up point, VA may notify the Contractor to cancel the order. For orders that are cancelled while the Contractor is already in route to the designated pick-up, the Contractor shall be entitled to receive cancellation rate for the trip, as provided in Schedule of Supplies or Services and Prices/Costs. This charge shall not include any mileage charge.
If the Contractor fails to meet the time requirements in this Contract, AAVAMC will not be charged for these instances.
Other Charges: It is understood that the prices listed in the accepted Schedule of Supplies or Services and Prices/Costs shall be inclusive of all ferry, bridge, tunnel or road toll charges. Contractor shall not bill the VA for any such separate charges. If the Contractor s place of business is located beyond the local telephone call zone of the VA, the Contractor agrees to accept telephone orders for service on a collect basis. It is estimated that approximately seventy (70) orders will be placed by telephone per month.
WAITING TIME: For time lost in waiting at either or both ends of a trip, due to causes beyond their control, the Contractor shall be reimbursed at the rate set forth in the Pricing Schedule, for each quarter hour in excess of the first quarter hour from the time the Contractor reports to the designated person. If the pick-up is other than at the VA, the contractor shall call the Travel Clerk, or Supervisor of Patient Administration Service (contact numbers to be provided at time of award). This call is only for the purpose of verifying arrival time at the pick-up point and is not necessary if the contractor anticipates no delay for which a claim for reimbursement shall be made. Waiting time includes an attendant remaining with the patient at all times.
RATES: Rates shall refer to transportation of only one patient per ambulance. Payment for mileage traveled beyond the mileage threshold shall be limited to "one way only" (Mileage shall be reimbursed for one way only, regardless if patient(s) is transported round trip). Such mileage costs shall be paid in addition to the applicable rate per trip. Mileage shall not be paid for trips entirely within the mileage threshold. Trip mileage shall be determined by the latest edition of the Rand McNally Standard Mileage Guide. For purposes of verifying mileage claimed on invoices, www.mapquest.com shall be utilized. Total invoice shall not exceed Medicare/Medicaid maximum amounts.
ORDERS: Requests for services shall be made by telephone and subsequently confirmed by Veterans Transportation Program. If the contractor fails to furnish the required services within the time frames established in paragraphs above, the VA reserves the right to obtain the service from another source and to charge the contractor with any excess cost which may result. The VA shall be the sole judge in determining when to order service from another source. Services shall be primarily to the VA, 2215 Fuller Rd, Ann Arbor, Michigan 48105.
Response Time Compliance Rate: The Contractor shall maintain, at a minimum, a 95% compliance rate on responses to pick-up or deliver during the Contract year. Failure of the Contractor to perform in accordance with this compliance rating may constitute sufficient cause for termination of the Contract for cause, (see FAR clause 52.212-4(m)) or other appropriate contractual action
VEHICLES: The ambulances under the terms of this contract shall be licensed and meet the minimum ambulance requirements, as mandated by the State of Michigan, and Federal Specifications KKK-A-1822F, dated July 1, 2007 (copy attached).
The Contractor must have an adequate number of ambulances to meet the requirements of this contract, along with evidence of satisfactory ambulance inspection prior to use under this contract. Ambulances and equipment must be clean, orderly, and in excellent operating condition at all times. Records of maintenance/preventative maintenance must be made available for inspection upon request.
Subject specification applies to Emergency Medical Care Vehicles Only. Subject specifications are mandatory as minimal requirements for such vehicles, but chassis or compartment modifications are permissible when they clearly exceed the minimal specifications.
The basic emergency care vehicle contracted for shall be of the Type I, Type II, or Type III ambulance (See KKK-A-1822F).
If the contractor s facility operates two Type I, Type II, or Type III model vehicles, and one is used for emergency services and the other for lie-down transportation, the equipment meeting the specifications for the emergency medical care vehicle can be transferred, when necessary, (i.e., when down for maintenance), to the lie-down transport vehicle, which then may operate as an ambulance, provided it otherwise meets the specifications of emergency.
All ambulances shall have restraints for securing wheelchairs. All ambulances shall be smoke free and have No Smoking signage posted.
AMBULANCE MEDICAL EQUIPMENT/SUPPLIES: Each emergency medical care ambulance shall have patient compartment facilities, oxygen, suction systems and equipment, and additional systems equipment, accessories and supplies (See KKK-A-1822F), as well as environmental climatic equipment, and communications equipment.
The Contractor shall provide Ambu-bag and/or respirator for respirator dependent patients who may or may not be prior intubated by tracheostomy or end tracheal tubes and/or respirator for respirator dependent patients who may or may not be prior intubated by tracheostomy or end tracheal tubes. Contractor shall choose respirator or Ambu-bag, as appropriate. However, for trips outside the Ann Arbor city limits, contractor is required to "bag" the patient.
The contractor shall provide blood transfusion monitoring if prior established and shall maintain in-place IV line with appropriate pressure of either a Swan Ganz catheter, Arterial line, or both.
The acuity of the patient with any of the above may require a VA provided RN or Physician to accompany the patient in transport from the Medical Center.
Contractor Employees:
AAVAMC reserves the right to restrict any Contractor employees from performing services under this Contract who do not meet the required qualifications for the services they are to perform, who violate Federal and/or any applicable regulations, or are identified as a potential threat to the security, safety, health and/or operational mission of the VA and its veteran population. The restriction of such Contractor personnel shall not relieve the Contractor from performing all the required services, in accordance with all terms, conditions, and schedules contained herein.
The Contractor shall furnish qualified personnel as required by the Contract specifications to accomplish all services under this Contract.
The Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S. Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services under this Contract.
Contractor personnel performing services to the VA shall at all times conduct themselves in a professional manner, maintain personal hygiene, wear clean, neat uniforms and be identified by having the company name, and employee name affixed to the uniform. The Contractor shall be responsible for furnishing all vehicles, personnel, equipment and supplies, vehicle fuel, uniforms, nametags and/or badges for performance of services under this Contract. Employee identifications shall be worn in clear view above the waist. Contractor personnel shall not smoke in vehicles while transporting VA Patients.
Contractor employees shall not represent themselves as VA employees while performing under this Contract.
Contractor shall provide an ACLS certified Paramedic when requested. Paramedics or advanced Emergency Medical Technicians do not meet this requirement unless they have received an ACLS certification.
Emergency Medical Technicians (EMT) providing emergency services under this contract shall maintain the qualifications listed below:
The EMT shall be certified, licensed or otherwise officially recognized by the local, state, or regional government or public entity where the emergency ambulance service is operated or by which it is governed. The contractor shall provide current copies of BCLS, ACLS or other required training certifications with the submission of their bid.
The EMT shall be enrolled periodically in "refresher" continuing education, or advanced training programs as required by the local or state government entity in which the service is rendered to veterans but in no instance shall this be less frequently than every two years. Such "refresher" training shall be equivalent to that developed by the Department of Transportation, National Highway Safety Administration. Evidence of successful completion for refresher training shall be submitted to the COR upon request.
EMTs and paramedics shall be capable of administering oxygen and have successfully completed the Standard and Advanced First Aid Courses of the American Red Cross or U.S. Bureau of Mines, or equivalent. Proof in the form of a current certificate that such first aid training has been successfully completed shall be submitted to the COR upon request. Drivers providing service under this contract shall have a valid ambulance personnel license with a driver designation as required by Federal, State, and local law.
AUTHORIZED ATTENDANCE BY RELATIVE: An authorized official of the VA may, in the best interest of the beneficiary, allow a relative to accompany a patient at no cost to the VA.
GOVERNMENT OWNED EQUIPMENT/SUPPLIES: Any and all equipment and linens taken with patients from VA Medical Center must be returned to the Medical Center. The Contractor must provide its own linens and contractor linens shall not be exchanged with VA linens.
UNIVERSAL PRECAUTIONS: Universal Precautions shall be observed at all times during transport of, or waiting with, all VA patients.
INSPECTIONS: The contractor s facility and all vehicles intended for use under this contract shall be inspected and approved by a VA Inspection Team prior to start of work under this contract and annually thereafter. The contractor shall make every effort to coordinate availability of vehicles on the date mutually agreed upon for the inspection of the facility and vehicles. The contractor shall be notified in writing of deficiencies found during inspections. Failure to correct deficiencies within the time frame allowed by the Contracting Officer, or to comply with all Federal, State, and local Safety requirements as specified herein, may result in action to terminate the contract for cause.
PERSONNEL POLICY: The Contractor shall be responsible for protecting the personnel furnishing services under this contract. To carry out this responsibility, the contractor shall provide Worker's Compensation, Professional Liability Insurance, Health Examinations, Income Tax Withholdings, and Social Security Payments. The parties agree that such personnel shall not be considered VA employees for any purpose and shall be considered employees of the Contractor.
INSURANCE REQUIREMENTS:
1. LIABILITY: Worker's Compensation and Employer's Liability: Contractors are required to comply with applicable Federal and State workers' compensation and occupational disease statutes. If occupational diseases are not compensable under those statutes, they shall be covered under the employer's liability section of the insurance policy. Employer's liability coverage of at least $1,000,000 shall be required.
2. GENERAL LIABILITY: The contracting officer shall require bodily injury liability insurance coverage written on the comprehensive form policy of at least $500,000 per occurrence.
3. AUTOMOBILE LIABILITY: The contracting officer shall require automobile liability insurance written on the comprehensive form of policy. The policy shall provide for bodily injury and property damage liability covering the operation of all automobiles used in connection with performing the contract. Policies covering automobiles operated in the United States shall provide coverage of at least $200,000 per person and $500,000 per occurrence for bodily injury and $20,000 per occurrence for property damage. The amount of liability coverage on other policies shall be commensurate with any legal requirements of the locality and sufficient to meet normal and customary claims.
The above referenced insurance coverage minimums are in reference to FAR Clause 52.228-5 listed in Addendum to FAR 52.212-4, and FAR 28.307-2.
Certificates of Insurance shall be received by the Contracting Officer before commencing work under this contract.
THE JOINT COMMISSION COMPLIANCE STANDARDS: The Contractor shall continuously meet or exceed all standards of The Joint Commission (formerly known as JCAHO). All applicable VA policies and procedures shall be followed by the Contractor.
The patient population treated at the VA Ann Arbor Health Care System, Ann Arbor, Michigan, consists of veterans with varying physical, psychiatric, and psychological needs. Their conditions are, in many cases, directly related to the individual s service to this country. Contract personnel shall provide compassionate care with respect for the special needs of the veteran population served, and show professional courtesy toward the VA support staff as an integrated part of the medical center s mission, vision and values as stated below.
Mission: The Mission of the VA Ann Arbor Health Care System, including Community Based Outpatient Clinics, is to provide timely, compassionate and high quality care to those we serve by encouraging teamwork, education, research, innovation, and continuous improvement.
Vision: The Vision of the VA Ann Arbor Health Care System for the next decade is to be recognized as a leader in healthcare with a focus on meeting the unique healthcare needs of our surrounding community. This shall be accomplished by integrating healthcare delivery to veterans; providing a seamless continuum of care; supporting education; promoting community health and becoming an employer of choice.
Values:
Patients are our top priority
Trust, integrity, mutual respect, compassion, and dignity guide our interactions
We are dedicated to excellence through continuous improvement
Teamwork, innovation and effective communication are essential to meeting our mission
Our actions demonstrate commitment to ethical practices, pride in our workplace and our sense of responsibility. We embrace diversity as a positive value in relationships with patients, their families, our coworkers and others.
We promote a workplace where contributions of all people are important
We actively support and participate in the efforts of federal and other community agencies to improve our capabilities in homeland defense, disaster reaction and relief, and emergency preparedness at time of crisis.
Patient Rights: The Contractor shall respect the patient s beliefs, values and cultural influences. Protection of all patient rights is of highest priority. Patient privacy and confidentiality shall be maintained at all times. The medical record contains information about current Advance Directives, which shall be reviewed and honored by the Contractor. All required documentation shall be fully completed within VA-required timeframes. The Contractor patient care services provided shall be included in VA data collection activities related to patient compliments, complaints and satisfaction. All patient complaints which are unable to be resolved by the Contractor shall be referred to the Patient Representative. The Contractor shall abide by the VA Code of Ethics, which addresses marketing, admission, transfer, referral, discharge processes, and billing issues.
Care of Patients: Contract work shall consist of transportation of patients with varying medical needs. Medication control, security and safety shall be maintained at all times. Medications shall only be dispensed, prepared, and administered to patients by appropriately licensed and competent individuals. Verbal, written or electronic communication between any VA/VISN staff and contracted staff shall not be restricted by the Contractor. VA policies and procedures shall prescribe which information (i.e. Advance Directive, allergies, treatment plan, etc.) is to be shared among care settings at time of admission, discharge, referral or transfer. No samples shall be accepted from vendors or given to patients. All care provided shall be based on assessed patient needs. Findings from assessment and reassessment shall be clearly documented in the medical record, which is used by all members of the interdisciplinary care team in care planning and treatment. All required documentation shall be fully completed within VA-required timeframes.
PATIENT SAFETY: Patient Safety shall be a primary focus of the Contractor. The Contractor shall comply with all National Patient Safety Goals found at http://www.jointcommission.org/PatientSafety/NationalPatientSafetyGoals . Every effort shall be made by the Contractor to prevent medication errors, falls and patient injury caused by acts of commission or omission in the delivery of care. The VA shall inform the Contractor of all applicable Sentinel Events or other patient Safety Alerts received by the VA. For every applicable alert, the Contractor shall take the necessary steps to redesign processes to prevent occurrences, and provide written feedback to the COR describing prevention actions taken. All events related to patient injury, medication error and other breeches of patient safety shall be documented utilizing the Contractor s format, and reported to the COR. The Contractor shall maintain a safe environment at all times and follow all safety and emergency preparedness policies. Compliance with all safety management plans shall be continually demonstrated. The VA shall provide the Contractor with VA Sentinel Event definitions in the start-up phase. The Contractor shall verbally notify the VA COR immediately when a Sentinel Event has occurred, which is to be followed by written notification within three working days. The VA shall determine when a Root Cause Analysis (RCA) is required of the Contractor. The Contractor shall conduct all RCA s according to VA policy, and within established timeframes. Completed RCA s shall be provided to the VA COR.
Environment of Care: The VA shall approve the Contractors Emergency Preparedness Plan prior to the provision of patient care. The Contractor shall conduct annual field and disaster drills. The Contractor shall conduct monthly fire extinguisher inspections and ensure annual maintenance is performed. Routine and recurrent preventive maintenance inspections shall be the responsibility of the contracted ambulance service. All significant problems identified shall be reported verbally to the COR within twenty-four hours. A written corrective plan of action shall be submitted to the COR within five working days. Timeframes and priorities for completion of action plan items shall be mutually agreed upon by the Contractor, the COR, the Contracting Officer and the VA Safety Officer. An annual compliance report addressing preventive maintenance inspections, as well as Safety, Environmental, and Infection Control inspections shall be reported to the COR. Environmental safety shall be the responsibility of the Contractor, who shall provide vehicle upkeep and stocking of the emergency vehicle. Contracted staff shall complete all VA-required Safety education and training, as evidenced by attendance records provided to the COR on an annual basis. The Contracting Officer will provide the Contractor with written instructions describing how Contractor personnel complete the required VA Privacy and Security training online.
COMPETENCY ASSESMENTS: Competency Assessments and annual reviews are required for VA accreditation by The Joint Commission (formerly known as JCAHO) and shall be maintained on site for all Contractor personnel.
The Contractor shall submit a copy of the competency assessment standards, a current competency assessment checklist and the most recent competency assessment review for each employee to the COR and Contracting Officer for approval prior to starting work under this contract.
The Contractor shall be required to replace any employee who does not meet or exceed the contractors approved competency standards and/or fails to meet or exceed those competency standards under an approved improvement plan.
INFECTION CONTROL: Contracted patient care activities shall be integrated into the VA Infection Control program, and contract staff shall adhere to VA Infection control policies and procedures. Any patient who has, or is suspected to have, Tuberculosis (TB) or other infectious diseases requiring airborne precautions, shall be transported by themselves and shall be accompanied by ambulance attendants who are trained, medically screened, and shall have been fit tested with, at minimum, an N95 Respirator. These patients shall be identified due to the fact that they will be under isolation known as airborne precautions.
PERFORMANCE IMPROVEMENT: The Contractor shall fully participate in the VA Performance Improvement (PI) program. This shall entail monitoring of clinical processes, patient outcomes and satisfaction, data analysis and collaborative design and operationalization of improvement opportunities. Contractor PI activities may be directed by the VA, VISN or VHA, as well as accreditation or licensing bodies. The Contractor shall abstract, compile, format report, and reporting deadlines shall be defined by the VA. It is noted that PI activities are dynamic and subject to change, as driven by current priorities and resources. In all cases, the Contractor shall continually assess for, and act upon, clinical and administrative improvement opportunities. High priority shall be given by the Contractor to the prevention of risk for the patient. The Contractor shall implement process-related internal controls to prevent risk to the veteran. Monitoring for continuous compliance with The Joint Commission standards shall be directed by VA staff and communicated to the Contractor through the COR. Measures related to contract compliance shall be identified by the COR.
QUALITY REQUIREMENTS: The COR shall require the contractor to submit an annual report. The following shall be monitored: number of veterans arresting during transport, number of arresting patients with an Advance Directive, number of veteran arrests where the Advance Directive was honored, use of double identifiers, free-flow protection of IV pumps, routine testing and preventive maintenance of clinical alarms, medication errors, lack of VA ambulance transport form or pertinent medical information, percentage of staff with current driver s license, BLS certification, ACLS certification, competency testing, and VA orientation.
QUALITY CONTROL SYSTEM: The Contractor shall implement and maintain a Quality Control (QC) System that results in prevention and/or correction of potential and actual problems throughout contract performance. The QC System shall contain processes for corrective actions without dependence upon Government direction and shall maintain records of all Contractor QC inspections and corrective actions.
HIPAA COMPLIANCE, PRIVACY AND CONFIDENTIALITY: Contractor shall comply with to the provisions of Public Law 104-191, Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the National Standards to Protect the Privacy and Security of Protected Health Information (PHI). A Business Associate Agreement (BAA) is required to be executed by the Contractor and VA prior to commencement of performance under this contract. Please refer to Section D of this solicitation/contract. Contractor shall comply with applicable confidentiality statutes, including 38 U.S.C. 5701, 38 U.S.C. 5705, 38 U.S.C. 7332, and 5 U.S.C. 552a (Privacy Act).
REQUIREMENT FOR BACKGROUND SECURITY INVESTIGATIONS:B B The Contractor is required to comply with all of the provisions of the Privacy Act of 1974, the Health Insurance Portability and Accountability Act (HIPAA) of 1996, as well as all applicable Veterans Health Administration (VHA) regulations, which are available at http://www.hhs.gov/ocr/privacy and http://www1.va.gov/vhapublications. The Contractor shall insure the confidentiality of all patient and employee information and shall be held liable in the event of a breach of confidentiality according to federal regulations contained in HIPPA.B Any person who knowingly or willingly discloses confidential information from the VA may be subject to fines of up to $50,000.00 and may be subjected to civil litigation from the patient.
Background Investigations: Contractor personnel performing work under this contract shall satisfy all requirements for appropriate security eligibility in dealing with access to sensitive information systems belonging to or being used on behalf of the Department of Veterans Affairs.
The Contractor is expected to maintain a Drug-free Work Place in accordance with Federal regulations.B B The Contractor shall establish and maintain a drug-free workplace program. The administration of this program shall be the responsibility of the contractor, as well as, the establishment of disciplinary actions.
All costs associated with obtaining clearances for Contractor provided personnel shall be the responsibility of the Contractor.B Further, the Contractor shall be responsible for the actions of those individuals they provide to perform work for the VA under this contract.B In the event that damages arise from work performed by Contractor provided personnel, under the auspices of this contract, the Contractor shall be responsible for all resources necessary to remedy the incident.
TRIP REPORT: The Contractor shall document each VA authorized transport with the following information:
Date
Patient Name
Patient identification number
Pick-up Origin
Time of Pick-up
Destination
Time of Delivery
Mileage
Any notes regarding issues particular to the specific transport, including recording oxygen, cardiac monitoring, and other services provided (i.e. material items, supplies).
The Contractor shall include a copy of this report with all invoices and also provide the trip documentation form upon request by the VA. Trip reports must be submitted through regular mail. Trip reports shall not be transmitted via e-mail. These reports shall serve as documentation of the transport and shall be a source document for reconciliation of the Contractor s requests for payment.
The Travel Clerk or Contracting Officer s Representative (COR), or designee shall be the point of contact for service requests, followed by the Administrative Officer of the Day (AOD). If medical consultation is required, the COR or designee will set up a conference call with the appropriate medical staff.
INVOICE PROCEDURES:B The Contractor shall use an itemized billing format detailing the trip report information and resources furnished when submitting ambulance service invoices.
Invoices shall be submitted no later than fifteen calendar days following the end of the month of services and shall include all services provided under the agreement for the preceding month. The Invoices shall specify the contract number, purchase order number, patient name and identification number, date of service, place of departure, destination, total mileage and pick-up time.B Invoices shall be submitted to the VA s Financial Services Center.B Invoices submitted in any other format or to any other VA representative will not be accepted. Any patient identifying information electronically transmitted must be encrypted in order to safeguard said information.
E-MAIL TRANSMISSIONS: Any e-mail transmission from the contractor which includes patient-sensitive information must be transmitted via secured/encrypted e-mail.
REQUIRED REGISTRATION WITH CONTRACTOR PERFORMANCE ASSESSMENT REPORTING SYSTEM (CPARS): As prescribed in Federal Acquisition Regulation (FAR) 42.15, the Department of Veterans Affairs evaluates Contractor Past Performance on all contracts that exceed $150,000, and shares those evaluations with other Federal Government contract specialists and procurement officials. The FAR requires that the contractor be provided an opportunity to comment on past performance evaluations prior to each report closing. To fulfill this requirement the VA uses an online database, the Contractor Performance Assessment Reporting System (CPARS). The CPARS database information is shared with the Past Performance Information Retrieval System (PPIRS) database, which is available to all Federal agencies.
Each contractor whose contract award is estimated to exceed $150,000 is required to register with the CPARS database at the following web address: http://www.cpars.gov/. Help with registering can be obtained by contacting the CPARS Support E-mail webptsmh@navy.mil) or by calling (207) 438-1690. Registration shall occur no later than thirty days after contract award, and shall be kept current.
For contracts with a period of one year or less, the contracting officer shall perform a single evaluation when the contract is complete. For contracts exceeding one year, the contracting officer shall evaluate the contractor s performance annually. Interim reports shall be filed each year until the last year of the contract, when the final report shall be completed. The report shall be assigned in CPARS to the contractor s designated representative for comment. The contractor representative shall have thirty days to submit any comments and re-assign the report to the VA contracting officer.
CONTRACTING OFFICER: The Contracting Officer named below is responsible for the overall administration of the contract: To be named
QUALITY ASSURANCE SURVEILLANCE PLAN (QASP)
QASP from Ann Arbor VA Medical Center (AAVAMC)
QUALITY ASSURANCE SURVEILLANCE PLAN (QASP)
Contract Description: The Contractor shall furnish ground ambulance services to eligible veterans of AAVAMC and its Community Based Outpatient Clinics. It will be necessary for the Contractor to have a staff of certified personnel to receive radio command medical orders from an appropriate hospital, thereby being able to render life-saving techniques to patients. The sole purpose of this contract is to provide cost effective, efficient, and expeditious transfer of patients (to include in-hospital pick-up and delivery) services as communicated by CMCVAMC Transportation dispatchers.
Contractor s name: Upon award, Government will enter Contractor s name (hereafter referred to as the Contractor).
PURPOSE
This QASP provides a systematic method to evaluate performance for the stated contract. This QASP explains the following:
What will be monitored
How monitoring will take place
Who will conduct the monitoring
How monitoring efforts and results will be documented
This QASP does not detail how the Contractor accomplishes the work. Rather, the QASP is created with the premise that the Contractor is responsible for management and quality control actions to meet the terms of the contract. It is the Government s responsibility to be objective, fair, and consistent in evaluating performance.
This QASP is a living document and the Government may review and revise it on a regular basis. However, the Government shall coordinate changes with the Contractor. Copies of the original QASP and revisions shall be provided to the Contractor and Government officials implementing surveillance activities.
GOVERNMENT ROLES AND RESPONSIBILITIES
The following personnel shall oversee and coordinate surveillance activities:
Contracting Officer (CO) - The CO shall ensure performance of all necessary actions for effective contracting, ensure compliance with the contract terms, and shall safeguard the interests of the United States in the contractual relationship. The CO shall also assure that the Contractor receives impartial, fair, and equitable treatment under this contract. The CO is ultimately responsible for the final determination of the adequacy of the Contractor s performance.
Contracting Officer s Representative (COR) - The COR is responsible for technical administration of the contract and shall assure proper Government surveillance of the Contractor s performance. The COR shall keep a quality assurance file. The COR is not empowered to make any contractual commitments or to authorize any contractual changes on the Government s behalf.
CONTRACTOR REPRESENTATIVES
The following employees of the Contractor serve as the Contractor s program manager for this contract.
Program Manager Government will enter name upon contract award.
Other Contractor Personnel - Government will enter other names upon contract award.
Required Services
(Tasks)
Performance Standards
Acceptable Quality Levels
Methods of Surveillance
Incentive (Positive and/or Negative Impact on Contractor Payments)
Ground Ambulance Service
Response
Provide patient pick-up for trips within timeframes listed in SOW.
98%
Review of Trip Log and Customer Feedback
Incentive:
Favorable Contractor performance evaluation.
Disincentive:
--Unfavorable Contractor performance evaluation
.
Certifications and Training
Contractor/employee to maintain current proper licenses and ensure all attendants are properly trained and competent to provide service
100%
Random Surveillance/
Customer Feedback
Incentive:
Favorable Contractor performance evaluation.
Disincentive:
--Unfavorable Contractor performance evaluation
Submit invoices
All invoices submitted within 30 calendar days of invoice date
98%
100% inspection of all monthly invoices
Incentive:
Favorable Contractor performance evaluation.
Disincentive:
--Unfavorable Contractor performance evaluation
.
Ambulance Maintenance/Safety
Ensure all ambulances are in proper condition and fit for patient and public safety
100%
Random Surveillance
Incentive:
Favorable Contractor performance evaluation.
Disincentive:
--Unfavorable Contractor performance evaluation
.
The Contractor is advised that only the Contracting Officer, acting within the scope of the contract and her duties and responsibilities, has the authority to make changes that affect price, scope, period of performance, and terms and conditions. Under no circumstances shall any understanding or agreement/contract modification between the Contractor and a person other than the Contracting Officer be effective or binding upon the Government. All such actions must be formalized by the proper document executed by the Contracting Officer.
METRIC SYSTEM OF MEASURE
Section 5164 of the Omnibus Trade and Competitiveness Act of 1988 (Public Law 100-418) designates the metric system of measurement as the preferred system of weights and measures for United States trade and commerce. It required that each Federal agency use the metric system of measurement in its procurements, grants and other business related activities. Offerors are advised that the use of the metric system of measurement is highly encouraged and that offers shall be provided utilizing the metric system of measurement. Offerors are also advised that, at the ordering activity level or as a result of a standardization effort, they may be required to submit all units of measure for products offered utilizing the metric system of measurement or they may be required to identify the conversion on a separate document.
For purposes of this transportation contract, distance traveled shall be measured in miles.
Christopher Gundy
Contracting Officer
