MEDEVAC 3

This notice constitutes Amendment 1 to the combined synopsis/RFQ for NNJ16580281Q entitled "MEDEVAC 3." This notice serves as the official amendment to subject synopsis/RFQ and a written amendment will not be issued. The purpose of this amendment is to provide potential Offerors with the following information: 1. Section III "Instruction to Offerors" was revised to provide further clarification regarding how the Government will evaluate the technical merit, past performance, and cost/price evaluation factors. This updated revised text is as follows: III. INSTRUCTIONS TO OFFERORS The Government will award a contract resulting from this solicitation to the responsible Offeror whose proposal represents the best value to the Government. This procurement shall be conducted utilizing a combination of technical merit, past performance and cost/price evaluation factors. The lowest price proposals may not necessarily receive an award; likewise, the highest technically rated proposals may not necessarily receive an award. Of the three evaluation factors, technical merit and past performance, when combined, are significantly more important than price. Technical Merit is more important than past performance. Past Performance and price are approximately equal in importance. Therefore, the current MEDEVAC 3 "Instructions to Offerors" Section is hereby deleted in its entirety and is replaced with the "Instructions to Offerors" Section below. 2. Section G "Additional Requirements" of the Statement of Work was revised to provide updated requirements related to the limited circumstances in which a contractor shall guarantee payment of hospital expenses in the event of a medical emergency in which time was critical to ensure the traveler's health and care was not being provided due to the traveler's inability to ensure immediate payment. Therefore, the current MEDEVAC 3 Statement of Work is hereby deleted in its entirety and is replaced with the Statement of Work provided below. 3. The "Relevant Documents" Section has been revised to include a copy of Standard Form (SF) 1449, which Offeror's shall sign and include as part of their Model Contract submission. 4. The "Relevant Documents" Section has been revised to include a document entitled "Submitted Questions and Answers," which provides the Government's response to questions received from industry for NNJ16580281Q. 5. The due date for receipt of offers is not extended. I. Statement of Work (SOW) A. Overview of Requirement The contractor shall provide resources necessary to accomplish an "Air Ambulance Evacuation" in response to an international medical emergency for all International Space Station (ISS) and Johnson Space Center (JSC) sponsored international travelers on a pre-paid basis. "Air ambulance evacuation" includes providing fully trained, licensed, and certified medical personnel and equipment to ensure the sick, or injured, international traveler is provided the proper services to be stabilized prior to and during air transportation of the traveler. Additionally, the contractor shall provide services for the traveler who is experiencing a medical condition that requires (1) accompanying medical escort during transport, (2) English (or other language native to the patient) speaking medical translation during either in-patient hospitalization or out-patient definitive medical care; (3) in situations where a traveler is hospitalized, the contractor will provide assistance with locating the nearest appropriate medical facility trained to U.S. standards of medical care. When a NASA ISS physician and/or family members are accompanying the individual on travel, the contractor shall provide air transportation for the NASA physician, as well as, at least one personal companion to accompany the patient. B. Evacuation Cost Responsibility If a medical event occurs, which triggers a medical evacuation, all evacuation costs shall be the responsibility of the contractor and no additional cost will be incurred by NASA for evacuation or for bed side case management. C. Decision to Evacuate The decision to perform an air ambulance medical evacuation shall be made jointly by the contractor and NASA based on the clinical judgment of NASA ISS physicians who will apply U.S. standards of medical care. Such services will include air ambulance evacuation and repatriation services to a hospital in the United States (U.S.) or NASA's hospital of choice. D. Enrollment Requirements Travelers shall not be required to be pre-enrolled in order for the contractor to provide services. The contractor shall provide a flat rate for group membership per contract period for 18,000 travel days per anum to the locations included, but not limited to, the locations in the attachment entitled "Historical Data of Travelers/Trips." The contractor shall also provide a unit price per additional travel day beyond the number of travel days for each period. E. Electronic Registration The contractor shall provide a secure electronic registration process options that: (1) Educates travelers on specific instructions to follow should an emergency occur (2) Provides a description of the scope of contractor's services. (3) Indicates any limitations of these services. (4) Provide any disqualifying reasons for not providing the services. (5) Captures critical traveler information that expedites an evacuation when necessary. F. Additional Medical Travel Assistance Services The contractor shall provide additional medical travel assistance services for the ISS and JSC travelers on international travel. Examples of these services include the following: - Pharmacy assistance; - Obtaining medical monitoring; - Obtaining medical referrals and consultations with English-speaking doctors; - Hospital admittance; - Coordination with medical providers to ensure timely access to medical care; - Facilitation of hospital payments; - Coordination of insurance information between the patient, insurer, and Medical providers; - Assistance obtaining medications, vaccines, blood transfers, and medical devices; - Repatriation of mortal remains for overseas travelers; - Provide guarantee of payment services, when necessary, after exhausting other possibilities including traveler's health insurance, traveler or family members' credit card, etc. - Additional bed side case management services such as in-person interaction and care at no additional cost; - Provide medical translation and interpretation to include telephonic language assistance with medical incidents and medical translations of medical records to the extent required to resolve the medical emergency. NASA will co-develop the notification process for timely communication and dissemination of confidential medical reports with the contractor. G. Additional Requirements The contractor shall participate with NASA contingency planners in Table Top simulations of evacuation events to validate communication plans and decision making procedures. NASA anticipates approximately two exercises per year. Historically, the exercises are held by a telecom or videoconferencing. Total time involved in the simulations is approximately 10 hours per year and is a paper exercise to test contingency scenarios related to medical emergencies. The contractor shall visit JSC for a face to face meeting with JSC senior management and JSC medical operations personnel within the first six months of the contract with a second visit to occur during the base period of performance. The contractor is responsible for all costs, excluding medical bills, which are the responsibility of the traveler receiving medical attention. The contractor shall collect the necessary insurance information from the traveler when required and coordinate payment of medical expenses directly with the traveler receiving medical attention and his or her insurer. In limited circumstances, the contractor shall guarantee payment of hospital expenses in the event of a medical emergency in which time was critical to ensure the traveler's health and care was not being provided due to the traveler's inability to ensure immediate payment. However, once the immediate medical event is resolved, the traveler would ultimately be responsible for guarantee of payment of medical expenses. There shall be no request for equitable adjustment or additional costs added to the contract for this requirement. II. PERIOD OF PERFORMANCE The period of performance for the contract base of this contractual action is October 1, 2016 - September 30, 2018. Option 1 The period of performance for Option 1 of this contractual action is October 1, 2018 - September 30, 2020. Option 2 The period of performance for Option 2 of this contractual action is October 1, 2020 - September 30, 2021. The overall period of performance (including Option 1 and Option 2) for this contract is October 1, 2016 - September 30, 2021. III. INSTRUCTIONS TO OFFERORS The Government will award a contract resulting from this solicitation to the responsible Offeror whose proposal represents the best value to the Government. This procurement shall be conducted utilizing a combination of technical merit, past performance and cost/price evaluation factors. The lowest price proposals may not necessarily receive an award; likewise, the highest technically rated proposals may not necessarily receive an award. Of the three evaluation factors, technical merit and past performance, when combined, are significantly more important than price. Technical Merit is more important than past performance. Past Performance and price are approximately equal in importance. In providing these instructions, the Government's intention is to solicit information that will permit a competitive evaluation of the Offeror's proposal. The information solicited will demonstrate the Offeror's competence and understanding of requirements and the capability to successfully complete the requirements specified in the MEDEVAC Statement of Work (SOW). All responsible sources may submit an offer, which shall be considered by the agency. The Government intends to make a single award for all items on an "all or none" basis; therefore, Offerors must provide a proposal that responds to all items below. Partial quotes will not be accepted. A. Technical Merit Technical merit will be determined by review of information submitted by the Offeror to the following Sections: 1. Technical Merit Questions/Responses 2. Scenarios 3. Description of Joint Determination Decision Process Offerors must provide responses to these areas in sufficient detail to demonstrate that the Offerors' approach meets, or exceeds, the Government's requirements. 1. Technical Merit Questions/Responses a. Does your company provide additional services that might be beneficial to NASA for this procurement beyond what is described in the SOW? Please provide a through and complete explanation regarding how these additional services would provide a benefit to the Government. b. Please provide a complete copy of any additional terms and conditions and exclusions that your company would apply to this procurement. The copy should provide sufficient detail to enable an analysis by the Government of potential benefits and risks. c. Please describe the transportation assets your company uses for medical transport. Are these assets certified by appropriate civil aviation authority (for example, the FAA) to fly commercial transport flights? Does your company own, or lease, fixed wing aircraft capable of transoceanic medical transportation flights? Does your company have own, or have access to, rotary wing aircraft? d. How will your company apply US standards of medical care for travelers under this contract? e. Please provide evidence showing your company is capable of providing each of the following services: 1. Advanced airway management including ventilator support/oxygenation 2. Advanced medication management in flight (anti-seizure meds, IV meds, etc.) 3. Advanced Cardiac Life Support 4. Medical Escort Services f. Please provide evidence that demonstrates how your quality assurance program ensures that only appropriately trained, certified, and credentialed medical staff provide services within your company's limits. 2. Scenarios Offerors shall describe how they would respond to (4) four medical response scenarios provided below. Offerors must demonstrate their ability to apply US standards of medical care to its patients during a MEDEVAC scenario. Offerors must also demonstrate their ability to include NASA ISS officials in the medical transportation decision process as well as demonstrate its quality assurance program, which ensures that only appropriately trained, certificated and credentialed medical staff provide medical care within the company's limits. The response for each scenario shall not exceed two pages each. A) A previously healthy 40-year old male, NASA employee, is on travel in Tsukuba, Japan. He collapses during a meeting while there and is admitted to a local hospital ICU. He is diagnosed with a brain tumor, advanced, requires ventilator support and anti-seizure medications. Otherwise, he is stable and non-operative. He is from North Carolina and his family is there now. The patient is non-communicative, but the next of kin indicates the desire to have the patient transferred to North Carolina and mentions "Cancer Center of North Carolina" near their home. At this point NASA notifies the contractor of the situation and requests assistance. Describe your organization's response/action plan to Scenario A. Please include info related to assets used, timing of responses, travel route to hospital of choice, and any other information that will illustrate your organization's capabilities. B) A 58-year old NASA scientist becomes ill while on travel orders with NASA. She is on the Kwjalein Atoll in the Marshall Islands. The local medical facility has treated her to their maximum ability and they recommend medical evacuation to a higher level of care. At the time NASA contacts you, she is on IV hydration and pain control. The presumptive diagnosis is acute pancreatitis though the local facility cannot confirm. She is from Houston and requests travel there for hospitalization and further evaluation. Describe your organization's response/action plan to Scenario B. Please include info related to assets used, timing of responses, travel route to hospital of choice, and any other information that will illustrate your organization's capabilities. C) A 52-year old NASA astronaut is performing survival training at a Russian training facility on the Black Sea. During this training, the astronaut is noted to have atrial fibrillation. The astronaut is placed on rate control medication and anticoagulant and is determined by accompanying NASA flight surgeon to be stable, but is requiring return to the US - Cleveland Clinic (Cleveland, OH) - for appropriate care. At this point NASA notifies the contractor with the request. Describe your organization's response/action plan to Scenario C. Please include info related to assets used, timing of responses, travel route to hospital of choice, and any other information that will illustrate your organization's capabilities. D) A 32-year old female NASA sponsored traveler is at Baikonur Cosmodrome, Kazakhstan. Early in the day, her husband launched aboard a Soyuz headed to the space station. She is 20 weeks pregnant and she develops abdominal pain and vaginal spotting. Local medical capability cannot provide appropriate care for her. NASA has a physician onsite supporting her. Her 10-year old son is also present at Baikonur. NASA contacts you requesting urgent medical evacuation. The patient is requesting transportation to Houston where her OB-GYN doctor will see her. She also insists on having her son return on the same aircraft with her. Describe your organization's response/action plan to Scenario D. Please include info related to assets used, timing of responses, travel route to hospital of choice and any other information that will illustrate your organization's capabilities. 3. Description of Joint Determination for Decision to Evacuate Per the SOW, the decision to perform an air ambulance medical evacuation shall be made jointly by the contractor and NASA ISS representatives based on the clinical judgment of NASA ISS physicians who will apply U.S. standards of medical care. Such services will include air ambulance evacuation and repatriation services to a hospital in the United States (U.S.) or NASA's hospital of choice. Describe your approach to meet NASA's requirement for a joint determination decision making process. B. Price Offerors shall provide pricing on the attached "Attachment 2: Proposal Pricing Sheet." As this procurement will result in a firm-fixed-price purchase order, Offerors shall provide firm-fixed pricing that is all inclusive (including profit and fees) for the required services on the Proposal Pricing Sheet. Offerors' pricing shall include all Permanent Change of Station (PCS) and Temporary Duty (TDY) employees, as well as dependents of PCS employees. PCS travel is analogous to expatriate travel where the employee lives 24/7/365 outside of the US. TDY is not a permanent travel arrangement and can range from a few days to a few months or longer. C. Past Performance The evaluation of Past Performance will be conducted in accordance with FAR 15.305(a)(2), "Proposal Evaluation," and NFS 1815.304-70, "NASA Evaluation Factors". The Past Performance evaluation is an assessment of NASA's confidence in the Offeror's ability to perform the solicitation requirements, based upon the Offeror's relevant performance under previously awarded contracts. Offerors shall provide a maximum of three Past performance references that demonstrate their expertise and ability to successfully perform the SOW requirements. Past performance responses shall be no more than three pages total per past performance reference. The offeror shall provide information that demonstrates its experience with accomplishing tasks similar to those described in the statement of work. Past performance information provided shall be relevant, and similar in size, scope, and magnitude to the service being procured under the subject RFP. Offerors shall also consider the recency and relevancy of its past performance submission as they specifically relate to this requirement. The Government will only consider past performance with contract period of performances within three years from the date of when the MEDEVAC solicitation issued. Within this three year period, more recent performance will receive greater consideration in the performance confidence assessment than those with more distant performance, assuming all other considerations to be equal. Offerors with no past performance experience shall state so. D. CONTACT INFORMATION AND RESPONSE TIME All responsible sources may submit an offer which shall be considered by the agency. The Government intends to make a single award for all items on an "all or none" basis; therefore, Offerors must propose all items. Partial quotes will not be accepted. All contractual and technical questions must be emailed to Jon Prihoda (contact@example.gov) no later than June 17, 2016 at 4:00 PM. Telephone questions will not be accepted. Offers for the items(s) described above are due by 4:00 PM Central Time on July 15, 2016 to contact@example.gov and must include, solicitation number, FOB destination to this Center, discount/payment terms, warranty duration, taxpayer identification number (TIN), identification of any special commercial terms, and be signed by an authorized company representative. Offerors are encouraged to use the Standard Form 1449, Solicitation/Contract/Order for Commercial Items form found at URL: http://server-mpo.arc.nasa.gov/Services/NEFS/NEFSHome.tml Offerors shall provide the information required by FAR 52.212-1 (OCT 2015), Instructions to Offerors-Commercial Items, which is incorporated by reference. If the end product(s) offered is other than domestic end product(s) as defined in the clause entitled "Buy American Act -- Supplies," the offeror shall so state and shall list the country of origin. FAR 52.212-4 (APRIL 2016), Contract Terms and Conditions-Commercial Items is applicable. Addenda to FAR 52.212-4 are as follows: none. FAR 52.212-5 (MAR 2016), Contract Terms and Conditions Required To Implement Statutes or Executive Orders-Commercial Items is applicable and the following identified clauses are incorporated by reference: 52.203-6, 52.204-7, 52.212-4, 52.219-28, 52.222-3, 52.222-17,52.222-19, 52.222-21, 52.222-3, 52.223-16, 52.223-18, 52.225-1, 52.225-13, 52.232-33, 52.226-6, 52.247-34, 1852.237-72, 1852.237-73, and 1852.246-73. The FAR may be obtained via the Internet at URL: http://www.acquisition.gov/far/index.html The NFS may be obtained via the Internet at URL: http://www.hq.nasa.gov/office/procurement/regs/nfstoc.htm Offerors must comply with the required terms and conditions. See attached document for model contract. Selection and award will be made to that offeror whose offer will be most advantageous to the Government, with consideration given to the factors of proposed technical merit, price, and past performance. It is critical that Offerors provide adequate detail to allow evaluation of their offer. Offerors must include completed copies of the provision at 52.212-3 (MAR 2016), Offeror Representations and Certifications - Commercial Items with their offer. The provision may be obtained via the internet at URL: http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/52_000.htm. These representations and certifications will be incorporated by reference in any resultant contract. NASA Clause 1852.215-84 (NOV 2011), Ombudsman, is applicable. The Center Ombudsman for this acquisition can be found at http://prod.nais.nasa.gov/pub/pub_library/Omb.html . Prospective offerors shall notify this office of their intent to submit an offer. Potential offerors will be responsible for downloading their own copy of this combination synopsis/solicitation and amendments Documents related to this procurement are available over the Internet. These documents reside on a World Wide Web (WWW) server which may be accessed using a WWW browser application.