V--459-18-3-829-0036 Ground Ambulance Service (VA-18-00012218) (VA-18-00027409)

. General Information Document Type: Combined Synopsis/ Solicitation Solicitation Number: 36C26118Q0425 Posted Date: 23 April 2018 Original Response Date/Time: 25 April 2018 / 14:00 PDT Current Response Date: 25 April 2018 / 14:00 PDT Product or Service Code: V225 Set Aside: None NAICS Code: 621910 Contracting Office Address VA Southern Nevada Healthcare System 6900 N. Pecos Road, Building 6 North Las Vegas, NV 89086 Description This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Federal Acquisition Regulation (FAR) subpart 12.6, and using the Simplified Acquisition Procedures under the authority of subpart 13.5, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; quotations are being requested, and a written solicitation document will not be issued. This solicitation is a request for quotations (RFQ). The solicitation document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular 2005-97, dated 01-24-2018. The associated North American Industrial Classification System (NAICS) code for this procurement is 621910, with a small business size standard of $15.0M. The Department of Veteran Affairs Pacific Islands Health Care System (VANCHCS) is intending to negotiate for a Firm Fixed Price sole source award to International Life Support, Inc. DBA American Medical Response for providing ground ambulance services for a six month period of performance. The services are for the following: Services Line Item Description Estimated Qty/Unit Unit Price Total Price 0001 Basic Life Support (BLS) Transport in accordance with the enclosed Statement of Work. 200 Trips $ $ 0002 Mileage (unspecified trip per mile) 1 Mile $ $ 0003 Oxygen Fee 93 Each $ $ 0004 Waiting Time (15 Min Increments) 15 Each $ $ BLS Subtotal $ 0005 Advance Life Support (ALS) Transport (BLS) in accordance with the enclosed Statement of Work. 30 Trips $ $ 0006 Mileage (unspecified trip per mile) 1 Mile $ $ 0007 Oxygen Fee 10 Each $ $ 0008 Waiting Time (15 Min Increments) 15 Each $ $ ALS Subtotal $ Total Price Quote $ Statement of Work Ground Ambulance SCOPE: Licensed Contractor shall furnish Advance Life Support (ALS) and Basic Life Support (BLS) ground ambulance services on a 24 hour per day 365 days per year for the beneficiaries of the Department of Veterans Affairs Pacific Island Health Care System (VAPIHCS) Hawaii covering all Islands within the state providing primary or secondary 911 ground ambulance services. NUMBER OF PATIENTS: It is understood and agreed that only ONE patient will be transported on a trip unless specifically authorized by VAPIHCS. When more than one patient is transported on a trip, reimbursement will be made at the rate not exceeding the cost of transporting a single patient. When loaded mile is involved, the longest distance over which a patient is transported may be claimed when more than one patient is transported in a single ambulance concurrently. Contractor must ensure that pick-ups and drop-offs are scheduled so that the total distance traveled will result in the most economical charge to the Government. WAITING TIME: For time lost in waiting at either end or both ends of a trip due to causes beyond the Contractor s control, the contractor will be reimbursed at the rate proposed. This charge applies if the crew is delayed longer than 15 minutes at time of pickup or delivery. The proposed rate will be charged in 15-minute increments. If pickup is other than VAPIHCS the contractor will contact the VAPIHCS Travel Office or Administrative Officer on duty as soon as the contractor anticipates that a delay for which contractor expects to claim reimbursement. This call is only for the purpose of verifying the contractors arrival time at the pick-up point (verification is made by confirming the time of pickup with the VA Staff, or the patient when the pickup is made off the VA Campus) and is not necessary if the contractor anticipates no delay for which the contractor will claim reimbursement. RATES: Mileage cost will be paid in addition to the applicable rate per trip for any trip entirely within the state. Trip mileage shall be determined by the latest edition of the Rand McNally standard Mileage Guide. ORDERS: Requests for services will be made in writing or by telephone from authorized VA personnel. The Government will not be held liable for those services performed by the Contractor(s) which are ordered by people who are unauthorized. The request will specify a range of dates and times for acceptable delivery of a transported patient. The Contractor will notify the VAPIHCS within 15 minutes after receiving a request if they are able to provide the service. If the Contractor cannot provide the service requested the VA reserves the right to obtain the service from another source and will charge the contractor any excess cost resulting there from. VAPIHCS will be the sole judge in determining when to order service from another source. Contractor will be informed of the condition of the patient at the time of request for service. The Contractor will be required to assign appropriate personnel for the transportation of patient. It is required that the contractor will furnish an Emergency Medical Technician (EMT) on all requests, however, the VAPIHCS reserves the right to request the services of a EMT Paramedic level if available in lieu of the EMT Basic and Intermediate. LIFE THREATENING EMERGENCY CALLS: Contractor will dispatch ambulance no later than five (5) minutes after notification by VAPIHCS authorized personnel of a life threatening emergency call. If the Contractor is unable to provide an immediate pickup (within fifteen (15) minutes after notification) in a threatening emergency situation, the Contractor will obtain services for the VA through 911 systems. Any additional costs incurred for the 911 services shall be borne by the contractor. AUTHORIZING PERSONNEL: The following VAPIHCS personnel are authorized to request or authorize ambulance services for VAPIHCS Hawaii: Chief of Staff Medical Officer of the Day (MOD) Chief, HAS Supervisor, HAS Patient Travel Assistant Administrative Officer of the Day (AOD) LOADING/UNLOADING PATIENTS: Contractor(s) will be required to assist patient from point of pick-up to ambulance and from ambulance to point of destination. REIMBURSEMENT: VA Pacific Island Health Care System, Hawaii, will review each invoice for transport. The VA will only reimburse those veteran patients eligible for transportation. Contractor will invoice each transportation call separately. TOLL CHARGES: Not Applicable QUALIFICATIONS: The contractor must be licensed as both an advanced and basic life support ambulance service by the State of Hawaii to provide Emergency Medical Services. The contractor must maintain licensure/certification with the State of Hawaii, throughout the life of the contract. License/certification lapses or expiration is grounds for termination of the contract or discontinuance of further ordering from the contractor. The contractor must maintain documentation demonstrating they meet all requirements of Federal, State, County or City codes regarding operation of this type of service. Documentation shall be made available to the VA immediately upon request for the duration of this contract. The contractor shall comply with the provisions of the Privacy Act of 1974, the Health Insurance Portability and Accountability Act (HIPAA) of 1996, as well as all applicable VHA regulations pertaining to fire safety and blood borne pathogens, which will be provided by the Contracting Officer s Representative (COR). COMMISSION ON ACCREDITATION OF AMBUALANCE STANDARDS: The contractor shall perform required services in accordance with the standards of the Commission on Accreditation of Ambulance Services, established principles and ethics of the medical profession established by the American Medical Association (AMA) and American College of Emergency Physicians (ACEP) The contractor, upon request, shall provide quality data and information related to services provided and participate in VA Pacific Island Health Care System, Hawaii Performance Improvement Programs when requested to do so. Upon request the contractor shall also provide documentation of the competency of staff that will be providing the contracted services. The contractor shall be responsible for ensuring contractor employees providing work on this contract are fully trained and completely competent to perform the required work; they shall also be required to maintain records that document competence/performance level of employees working on this contract. Upon request the contractor shall provide a current copy of the competence assessment checklist and annual performance evaluation to the COR for each contractor employee working on this contract. HEALTH INFORMATION PORTABILITY AND ACCOUNTABILITY ACT (HIPPAA) The contractor shall comply with the provisions of the Privacy Act of 1974, the Health Insurance Portability and Accountability Act (HIPAA) of 1996, as well as all applicable VHA regulations, which are obtainable at: http://www.hipaa.org/ and http://www1.va.gov/vhapublications/ The contractor shall not maintain and/or share sensitive or patient identifiable information in any form or for any purpose, other than what is needed to perform its obligation under the established business agreement. CONTRACTOR PERSONNEL: The contractor shall ensure that the following personnel, Emergency Medical Technicians (EMT- Basic, Intermediate and Paramedics), and Non-Emergency Attendant/Driver s requirements are met: Ensure and certify that personnel performing the services required under this contract are properly licensed and fully trained in the use of the vehicle and equipment that will be used in the carrying out contracted services. The contractor shall ensure minimum staffing requirements as mandated by the State of Hawaii are met. Each vehicle shall be operated with sufficient personnel for adequate patient care, at least one of whom shall be an Emergency Medical Technician (EMT B, I or P Level). Contractor must maintain records of each employee as to character and physical capabilities of performing the services of a driver and/or attendant. - A record of each employee as to character, physical capabilities, and qualifications performing the duties of an ambulance driver or attendant must be maintained at the contractor's establishment and made available for inspection upon request of the contracting officer or COR. b. A roster of Emergency Medical Technicians (EMT-All Levels), Registered Nurses (RN), and Non-Emergency Attendant Drivers (EMTs and LPNs if used to provide these services) shall be furnished to the contracting officer or COR upon request, and shall contain the following information: Name EMT license number Driver's license number Date of initial training Date of refresher training USE OF SUB CONTRACTORS: The contractor is free to subcontract service in order to satisfy the VA s requirements. All companies utilized as subcontractors are subject to approval of the VA and must meet all requirements of this contract. The contractor shall disclose use of any subcontractors and ensure all certification and training requirements are in compliance with federal, state, and county regulations governing ambulance services. The contractor shall be responsible for all subcontracting services provided under this contract. Subcontractor s invoices shall not be submitted directly to the VA, but rather shall be incorporated as part of the prime contractor s regular monthly invoicing. TRAINING: Emergency Medical Technicians providing emergency services on this contract must meet the following training requirements: Have completed training in accordance with the standard published by the US Department of Health and Human Services (PL 93-154) and follow State of Hawaii Statutes requiring a minimum of 110 hours, with at least 20 hours of supervised clinical supervision, including 10 hours in a hospital emergency department. EMTs must also meet ongoing re-certification requirement standards determined by the State of Hawaii. Evidence of the "equivalent" training program successfully completed by the EMT must be submitted to the contracting officer before award. Failure to provide the requested evidence of training will result in an offer of being determined non-responsive and that offer will not be considered for award. The EMT must 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. Current and updated certifications of EMTs providing service under this contract must be submitted to the contracting officer through the COR. Emergency Medical Technicians (all Levels) providing emergency services on this contract must have the following qualifications: Have completed the required all emergency medical technicians (all levels) re-certification training. The rules shall provide that all re-certification training equals at least 700 hours of training that provide didactic and skills practice components, including a field internship experience aboard an advanced life support permitted ambulance. - The EMT s (all levels) must 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. Must possess EMT B Card EMT I Card EMT P Card Evidence of the "equivalent" training program successfully completed by the Paramedic with a copy State of Hawaii Certification Certificate must be submitted to the contracting officer or COR. Drivers: 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. - Contractor shall ensure each ALS and BLS driver who operates a permitted vehicle meets qualifications as required by the State of Hawaii, and shall be responsible for assuring that its drivers are knowledgeable and competent in emergency vehicle operations and thoroughly familiar with the vehicles assigned. Ambulance drivers must complete all State of Hawaii licensing requirements. Attendant/driver must have successfully completed standard and advanced first aid courses including use of cardiopulmonary resuscitation techniques (CPR) of the American Red Cross, U.S. Bureau of Mines, or equivalent; be able to safely use all associated equipment, such as wheelchair lifts, and fire extinguishers; and been fully briefed and trained in passenger assistance techniques. Proof in the form of a current certificate that first aid training has been successfully completed must be available upon request. All contractor employees must be enrolled periodically in refresher continuing education or advanced training programs as approved and required by the State of Hawaii, Department of Health Bureau of Emergency Medical Services. Such refresher training shall be submitted to the contracting officer upon request for verification of compliance. In no instance may this continuing education training be less frequent than every two years. VEHICLES: The ambulances used under the terms of this contract shall be licensed and meet the minimum requirements governing emergency vehicles that is mandated by the State of Hawaii. Licensure must be maintained in current status throughout the term of the contract and a copy of updates provided accordingly. The contractor must have an adequate number of vehicles to meet the requirements of this contract, along with the evidence of satisfactory vehicle inspection prior to use under this contract. Every ambulance operated must have at least two personnel, At least one person shall be licensed in cardiopulmonary resuscitation or first aid and the person in the emergency compartment shall be certified at the least as an emergency medical technician-basic. EMT-Paramedic preferred. BLS vehicles are required to have at a minimum an Emergency Medical Technician attending the patient and a driver meeting minimum ambulance driver requirements of the State of Hawaii. b. ALS vehicles are required to have at a minimum a paramedic attending the patient and an EMT, meeting requirements as a driver. Vehicles and equipment used in the performance of this contract must be clean, orderly, and in excellent operating condition at all times, and records of maintenance/preventive maintenance must be made available for inspection upon request. All vehicles shall be smoke free and have No Smoking signage posted. The contractor shall notify the contracting officer of any vehicle and equipment added/changed/deleted after award of contract. The Department of Veteran Affairs reserves the right to thoroughly inspect contractor vehicles prior to award and at any time during performance of any awarded contract. Mechanical defects noted at the time of inspection must be corrected and the ambulance (s) re-inspected prior to use under the contract. AMBULANCE MEDICAL EQUIPMENT AND SUPPLIES: Every ambulance in service under this contract shall be equipped as required by the State of Hawaii and carry at least the minimal equipment necessary for the type of service to be provided, as determined by standards adopted by the State of Hawaii. Each emergency care vehicle shall have patient compartment facilities, oxygen and suction systems and equipment, environmental climatic equipment communications and additional systems equipment accessories and supplies as required by the applicable codes, rules and regulations established by Federal, State and Local regulating authorities. The contractor will be responsible for all medical and non-medical supplies needed to perform services. INSURANCE COVERAGE: Throughout the effective period of this contract, the contractor shall possess insurance coverage in the minimum amounts to satisfy contract clause 852.237-71, Indemnification and Insurance, or State of Hawaii requirements, whichever are higher. Any lapse in required coverage could result in discontinuance of further ordering. Prior to the start of contract performance, the contractor must submit to the contracting officer their certificate of insurance coverage evidencing required levels. RESPONSE TIME Response time will be calculated from the receipt of the telephonic request for service. At the time of the request, the contractor shall acknowledge their ability to provide the service within the requested response time. If the contractor cannot provide the service for any reason, they must notify the VA staff person requesting the service of their inability to provide the service. Stat Orders are urgent orders that require response times quicker than standard orders. Response times for STAT Orders: Contractor shall arrive at the point of pickup no later than 30 minutes from the time of request. Response times for Standard Orders: Contractor shall arrive at the point of pickup no later than 45 minutes from the time of request. Response time for Long Hauls: Contractor shall arrive at the point of pickup no later than 2 hours from the time of request. If the contractor fails to furnish service within the required response times, the VA reserves the right to obtain this service from another source and may charge the contractor with any excess cost which may result, and could be deducted from their monthly invoice. The VA will be the sole judge in determining when to order service from another source. Repeated failure to meet required response time may result in termination of the contract, or discontinuance of further orders. Response time will be calculated from the contractor s receipt of the telephonic/fax request for service. The contractor shall not charge the VA a cancellation fee when cancellations are made prior to the ALS/BLS vehicle embarking upon the dispatch. ORIGIN AND DESTINATION: Contractor shall provide services to beneficiaries of the Hawaii VAPIHCS to or from any designated location within the defined service area. The VA staff will specify the points of origin and the destination of every trip. PATIENT CONDITION UPON ARRIVAL: Upon arrival at the patient pick-up point, if the contractor determines the condition of the patient scheduled for pick-up is different than what was stated on the travel request, the contractor shall notify the Travel Office or Administrative Officer of the Day (AOD) for further instruction. TRIP DOCUMENTATION: The contractor shall document each VA authorized transport with an appropriate document that specifies the date, patient name and identification #, time of pick up, destination, time of drop off, mileage, and 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 transmit a copy of the trip ticket within 24 hours of providing the service. These forms will serve as documentation of the transport and will be a source document for reconciliation of the contractor s requests for payment. NON-PICK UP OF PATIENT: When ambulance service under the terms of this contract involves a trip to or from a VA facility, but due to unforeseen circumstances the patient is not available for pick-up, the contractor shall collect for the trip at the rates applicable under the pricing portion of this contract. The VA reserves the right to substitute beneficiary requiring service at any time during the performance of the contract to prevent Unloaded Trips , delays, and cancellations. There shall be no additional charge to the VA when such changes occur. ESCORT: - Subject to limitations of current regulations, the VA reserves the right to have an escort, such as a relative, or care provider of beneficiary or VA staff accompany beneficiary when the VA determines that such an escort is in the best interest of the beneficiary. The VA will also be the final judge in determining when an escort is required. There shall be no additional charge to the VA when escorts are authorized to travel with beneficiary. Contractor shall only be required to transport escort with patient and shall not be required to return the escort back to point of origin. INSPECTIONS: Before award or during the effective period of the contract, the VA reserves the right to thoroughly inspect and investigate the establishment, facilities, business reputation, and other licensure and qualifications of the contractor. INCIDENT/ACCIDENT REPORT: Any adverse events involving the welfare of a VA beneficiary while in the care of the contractor during transport shall be recorded and reported to the COR or to the AOD after normal business hours (4:00pm-7:30am) within 24 hours of the event. The contractor shall make initial contact immediately after the event via telephone, fax, or email notifying the VA of any incident, accidents, or medication or transfusion errors involving injury to VA patients during transport. The VA will provide POC s and phone numbers after contract award and prior to service start. The contractor must prepare and submit a detailed incident report with all information necessary to conduct a full review (date, time, patient, place of pick, place of incident, names of parties involved, a detailed summary of events etc.) with recommended/implemented corrective action within 24 hours of such incident to the contracting officer with a copy to the Chief, Member Services of VA Pacific Island Health Care System, Honolulu. PATIENT RIGHTS: The contractor shall be courteous to VA beneficiaries under their care. Any substantiated mistreatment of patients in the performance of this contract may be cause for termination of the contract, or discontinuance of further placement of orders. The VA reserves the right to request driver removal from transporting VA patients if mistreatment is substantiated. Drivers must be courteous and considerate of all patients they are transporting. The contractor shall notify the COR, in writing within 24 hour of any complaints made by the patients regarding service issues, providing recommendations for improved services. SAFETY REQUIREMENTS: In order to protect the lives and health of patients, the contractor shall take such safety precautions as the contracting officer, or COR may determine to be reasonably necessary. The contracting officer or COR will notify the contractor of any safety non-compliance and the action to be taken. The contractor shall, after receipt of such notice, immediately correct the conditions to which attention has been directed. If the contractor fails or refuses to comply promptly, the contracting officer may issue an order stopping all or any part of the work and discontinuance of further order placement. INFECTION CONTROL: Contractor employees shall receive ongoing training on universal precautions and infection control as appropriate to their duties. Contractor drivers and attendants shall use universal precautionary measures at all times for the prevention and control of the spread of infectious agents to all persons. The contractor shall delay using drivers and/or attendants who have the cold, flu, chickenpox, measles, or have been around someone who is sick on trips until well or no longer symptomatic. DISPOSAL OF HAZARDOUS WASTE: Contractor employees shall be trained on how to handle bio-hazardous waste during transport and how to properly dispose of bio-hazardous waste in designated containers, including how to dispose in designated containers when onsite at VA Pacific Island Health Care System or Tripler Army Medical Center (TAMC). The contractor shall not dispose of any bio-hazardous materials at any location on the premises except as specified by the contracting officer. CONTRACTOR S QUALITY CONTROL PROGRAM (QCP): The contractor shall establish and maintain a complete QCP to assure the requirements of this contract are provided as specified, during the life of the contract. The contractor s QCP shall include the following: An inspection plan covering all services required by this contract: The inspection plan must specify the type of inspections (i.e. scheduled, unscheduled), areas for inspection, frequency of inspections and documentation of inspections, and who will conduct the inspections, with his or her title specified. On-site records of all inspections conducted by the Contractor: The inspection records must note findings and necessary corrective action taken, the timeframe, and follow-up responsibility/issues. The VA reserves the right to request copies of any and/or each inspection. Internal procedures for updating medical service protocols: The contractor must have established internal procedures for updating medical service protocols, which have been revised, requires changes and/or incorporation of new protocols since licensing. The changes to processes, equipment, and/or protocol that may affect performance of contract must be communicated in writing to the Contracting Office. Methods for identifying and preventing deficiencies: The contractor must have quality improvement mechanisms in place that allows the business to evaluate the quality of services performed by using established methods for identifying and preventing deficiencies before the level of performance becomes unacceptable. Specific organizational monitoring functions and areas must be identified with levels of responsibility associated, noting intermediate supervisory responsibility and overall management responsibility for ensuring total acceptable performance. On-site competency records of each employee: The contractor must have employee records available on-site that identifies the character, physical capabilities, certifications, and ongoing training records of each employee performing services under this contract. On-site records for tracking of customer complaints and actions taken: The contractor shall keep onsite records for tracking customer complaints or problems with the procedures or initiatives implemented for correction and/or elimination of the problem before negative effects caused interruption of performance on contract. - Drug Testing Policy: The contractor shall have internal policies and procedures for addressing drug and alcohol abuse: Patient Satisfaction Survey: Contractor shall develop a patient satisfaction survey for the VA s approval. Once approved contractor shall report results of the survey semi-annually. MISCELLANEOUS: Contractor employees shall conduct themselves in a professional manner at all time while on VA premises. VA Vehicles transporting VA beneficiaries must be dedicated exclusively to VA transports. The contractor may not carry private pay patients with VA beneficiaries under this contract. All employees shall be dressed in uniform with a name badge displayed. Federal Legal Holidays The following Federal legal holidays are observed by this facility: New Year s Day 1 January Martin Luther King s Birthday Third Monday in January President s Day Third Monday in February Memorial Day Last Monday in May Independence Day 4 July Labor Day First Monday in September Columbus Day Second Monday in October Veteran s Day 11 November Thanksgiving Day Fourth Thursday of November Christmas Day 25 December Any other day declared by the President as a Federal Holiday. Note: Any of the above holidays falling on Saturday will be observed on the preceding Friday; holidays falling on Sunday will be observed on the following Monday. DEFINITIONS: CONTRACTING OFFICER (CO): The contractor is advised that only the contracting officer, acting within the scope of the contract and his/her duties and responsibilities has the authority to make changes that affect contract prices, quality, quantity, delivery terms and conditions, term of contract. Under no circumstances shall any understanding or agreement, contract modification, change order, or other matters in deviation from the terms of this contract 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 contractual document executed by the contracting officer. CONTRACTING OFFICE REPRESENTATIVE (COR): Is the designee to represent the Contracting Officer in furnishing technical guidance and advice or generally administer the work being performed under this contract. The foregoing is not to be construed as authorization to interpret or furnish advice and information to the Contractor(s) relative to financial or legal aspects of the contract. Enforcement of these segments is vested in and is the responsibility of the Contracting Officer. BASIC LIFE SUPPORT (BLS) Staffed by two Hawaii State Certified Emergency Medical Technicians (EMT all levels)). Transport the sick and injured non-life-threatened patient. Transport patients requiring oxygen therapy and extrication. BLS units can transport patient with clear I.V. fluids. BLS units cannot start I.V. lines or transport medicated lines unless on a locked-out pump. ADVANCED LIFE SUPPORT (ALS) Staffed by a Hawaii State Certified Emergency Medical Technician -Paramedic. Heart monitor with defibrillator and pacing capabilities. Establishing or maintaining I.V. accesses to include antiarrhythmics, narcotics, vasopressors and I.V. fluids. Monitoring/maintaining respiratory status to include intubation and pulse oximetry as needed. CONFIDENTIALITY OF PATIENT RECORDS: - The Parties agree to hold all individually identifiable health information as that term is defined in the Health Insurance Portability and Accountability Act and regulations promulgated there under (...