V225--VA Sierra Nevada Health Care Air Ambulance Services

Question and Answer
How was it determined that the NAICS Code of 621910 Ambulance Services would be used for this requirement. VA Response In accordance with FAR 19.102(b), the Contracting Officer determined the appropriate NAICS code by classifying the service being acquired in the one industry that best describes the principal purpose of the supply or service being acquired. NAICS 621910 is the most appropriate because the requirement is for ambulance services. How was the set-aside strategy for this requirement determined? VA Response This strategy was formulated from market research which included responses received from a sources sought notice posted to SAM.gov.
Billing when using VA-contacted ground ambulance providers. Reference: PWS, Section 6 Specific Tasks, paragraph titled Ground Ambulance (requirement to use VA-contracted ambulance services when available). The PWS states that, when available, the contractor shall utilize VA-contracted ambulance services for ground transport. When the air ambulance contractor uses a destination ground ambulance provider that already has a VA contract, how does billing work? Specifically, does the VA intend for those ground ambulance providers to bill VA directly under their existing VA contract, or will the selected air ambulance contractor be responsible for paying the ground ambulance provider and then invoicing VA for those costs under this Firm-Fixed-Price (FFP) IDIQ, so that we can structure billing and coordination in accordance with VA s preferred process?
VA Response Ground transportation to/from airport is the responsibility of the contractor and cost should be included in the quote provided. PWS was revised to remove language related to VA ground ambulance contract.
Destination facilities list to support ground pricing. Reference: PWS, Section 6 Specific Tasks, Ground Ambulance paragraph. If the Government intends for the prime contractor to pay the ground ambulance provider and then invoice VA, does the Government have a list of facilities to which patients are expected to be flown (destination hospitals/clinics), so that the contractor can ensure consistent availability of ground ambulance providers serving those areas and determine appropriate pricing for ground ambulance providers serving those areas? VA Response Destination facilities include typically include Palo Alto VA Medical Center (VAMC), Sacramento VAMC, San Francisco VAMC, University California Davis Medical Center (Davis, CA), and Stanford Medical Center (Palo Alto, CA). Historical destination facilities list (last 12 months). Reference: PWS Section 4 Scope (sample RENO-to-VA routes and mileages) and PWS Section 6 Specific Tasks, Ground Ambulance (VASNHCS catchment area language). The PWS provides example flight plans and mileages (e.g., Reno to San Francisco VA, Palo Alto VA, Mather, Los Angeles VA, and Salt Lake City VA) and notes that patients may be transported from various locations within the VASNHCS catchment area. To properly plan operations, staffing, and price this requirement, would the Government be able to provide a list of destination facilities used for VASNHCS air ambulance transports over the previous 12 months, along with the best available historical utilization data (e.g., approximate number of trips per destination during that period)?
VA Response All services requested will originate from the VA Sierra Nevada Health Care System, 975 Kirman Ave. Reno, NV 89502. The PWS was revised to remove mention of VASNHCS catchment area under section 6.
Destination Facilities within last 12 months: Palo Alto VAMC x 6 trips Sacramento VAMC x 5 trips San Francisco VAMC x 1 trips U.C. Davis (Davis, CA) x 1 trips Stanford Medical Center (Palo Alto, CA) x1 trips
HCFA 1500 (OMB-form-1500) requirement vs. Tungsten. Reference: PWS Payments paragraph (HCFA 1500 requirement) and clauses referencing VAAR 852.232-72 Electronic Submission of Payment Requests and use of Tungsten Network. Can the Government please confirm whether submission of a separate OMB-form-1500 (HCFA) is still required under this contract, or whether it is sufficient for the contractor to enter the equivalent claim information directly into Tungsten Network without attaching the HCFA 1500 form? VA Response HCFA 1500 must be attached when submitting invoice in TUNGSTEN
Maximum aggregate value of orders. Reference: Section B.2 Price/Cost Schedule, first paragraph (guaranteed minimum and maximum aggregate value of orders $3,200,000.00 ). The Price/Cost Schedule states that the maximum aggregate value of orders that can be placed under this contract is $3,200,000.00. Please clarify whether the $3,200,000 ceiling applies to: (a) the entire contract term (all ordering periods combined), or (b) each individual ordering period (e.g., per year/ordering period) so that we can accurately plan ordering, performance capacity, and subcontracting compliance.
VA Response the $3,200,000 ceiling applies to the entire contract (all ordering periods combined).
Minutes Late metric and delays caused by VA/patient. Reference: Quality Assurance Surveillance Plan (QASP) / Performance Requirements Summary table, where Minutes Late or on-time performance is defined and tied to performance expectations. Will the Government confirm that Minutes Late (or any similar timeliness metric) will not be assessed against the contractor when the aircraft and crew are on site and ready at the scheduled pickup time, but any delay in departure or transport is due to patient readiness, VA clinical decisions, or Government/facility processes outside the contractor s control?
VA Response If delay is the result of government/facility the Minutes Late performance expectation will not be used to seek compensation as long as the ground transport was at the facility at the requested time.
Standby charges and crew duty-time limits for VA/patient-caused delays. Reference: Same as Q6 QASP Performance Requirements / Minutes Late metric and any PWS language regarding being ready to transport and waiting times. Would the Government consider adding reciprocal language allowing the contractor to invoice a mutually agreed-upon standby charge when the aircraft and medical team are required to wait beyond a reasonable grace period due to Government- or patient-caused delays, while the contractor is otherwise on time and ready to perform and continues to fully support clinical decision-making and patient readiness requirements? Additionally, if extended VA- or patient-caused delays result in the flight crew reaching applicable duty-time limits before initiating or completing the transport, how does the Government expect such missions to be handled (e.g., relief crew, mission cancellation, rescheduling), and how will any associated costs (such as crew changes, aircraft repositioning, or rescheduled departures) be treated for payment and performance-evaluation purposes?
VA Response PWS states If the delivery order is cancelled by the Requesting Physician, the Contractor will be paid for actual statute miles traveled at the time of the cancellation, plus the necessary statute miles the Contractor's aircraft must travel to return to its starting location. The return mileage is only reimbursable if the contractor does not have another destination on its flight plan.
The contractor shall be reimbursed at the full contract amount for dry runs (trips made by the contractor when the VA patient is not available at the scheduled pick-up time). This charge shall not be allowed if the trip is cancelled by the COR (authorized VA personnel) within one (1) hour before the scheduled pick-up time.
Fuel price volatility / economic price adjustment. Reference: Section B Price/Cost Schedule (unit price per trip and mileage), contract type stated as FFP IDIQ, and clauses incorporating FAR 52.212-4 Contract Terms and Conditions Commercial Items. This requirement covers air ambulance services over a multi-year period of performance during a time of significant volatility in aviation fuel prices, and we want to ensure stable, predictable service for VA throughout the contract. A) Does the Government intend for the base rate and per-mile pricing to remain firm and not subject to adjustment for fuel cost changes over the full period of performance (base and option periods)? B) If so, would the Government consider adding an economic price adjustment / equitable adjustment mechanism tied to an objective fuel price index (e.g., an aviation fuel/Jet-A index) to address substantial increases or decreases in fuel prices during contract performance? C) If the Government is open to such a mechanism, would it consider a fuel-related adjustment (upward or downward) to the base and/or mileage rates when documented fuel costs vary by more than an agreed-upon threshold from the baseline at time of award?
VA Response EPA clause will not be added to the solicitation/contract.
VA doctor/nurse accompanying patient and return leg. Reference: PWS, Flight Crew paragraph (under Contractor Aircraft / Medical Equipment and Supplies / Flight Crew). The PWS states that, if VA deems necessary, a VA doctor or VA nurse may accompany the VA patient at no additional cost to the VA, in addition to the required minimum flight crew. Please clarify whether the contractor is also responsible for transporting that VA clinician on the return leg at no additional cost, including situations where the clinician: (a) returns without the patient, or (b) must return on a separate flight at a different time.
VA Response Contractor would only be responsible if VA clinician is travelling with a patient. If no patient is present, contractor is under no obligation to transport VA clinician.
List of VA-contracted ground ambulance providers. Reference: PWS Section 6 Specific Tasks, Ground Ambulance paragraph. To support pricing, route planning, and coordination, can the Government provide a current list of VA-contracted ground ambulance providers (including contract numbers and primary service areas) that are expected to be used in connection with this requirement?
VA Response Ground transportation to/from airport is the responsibility of the contractor and cost should be included in the quote provided. PWS was revised to remove language related to VA ground ambulance contract.
VAAR 852.219-75 in an Unrestricted procurement. The solicitation is labeled Set-Aside: None / Unrestricted. However, in Section C, VAAR 852.219-75, Limitations on Subcontracting, is included and the Services provision is checked. There is no reference to VAAR 819.7011(b) or to VAAR 852.219-73 / 852.219-74, and there is no explicit Section L/M language discussing SDVOSB/VOSB set-aside requirements. Can the Government please confirm: A) Whether the inclusion of VAAR 852.219-75 (Services) was intentional for this unrestricted procurement; and B) If so, how the Government intends to measure compliance with the 50% limitation on subcontracting for services under the Firm-Fixed-Price IDIQ per trip pricing structure (e.g., by total dollars paid over the base and option periods, by personnel costs, or another metric)?
VA Response Although this is being solicited as unrestricted, the inclusion of 852.219-75 was intentional to determine if offerors can receive credit for SDVOSB/VOSB status. As stated in in the clause, will not pay more than 50% of the amount paid by the government to it to firms that are not certified SDVOSBs listed in the SBA certification database as set forth in 852.219 73 or certified VOSBs listed in the SBA certification database as set forth in 852.219 74.
Tungsten vs. VetRide for invoicing. Reference: Invoice and payment instructions referencing VAAR 852.232-72 Electronic Submission of Payment Requests and Presentment and Payment System / Tungsten Network, and PWS language referencing VetRide for scheduling and trip management. The solicitation references VAAR 852.232-72 and requires electronic submission of payment requests through Tungsten Network. If the selected contractor is already using VetRide for scheduling and trip management, can invoicing and payment requests be submitted through VetRide in lieu of Tungsten, or is Tungsten Network still the mandatory system of record for all invoices under this contract? If VetRide can be used, please clarify the process and any integration expectations. If not, we will plan to use VetRide solely for internal scheduling and Tungsten as the system of record for all invoices.
VA Response All invoices will be submitted through TUNGSTEN.
Definition of VASNHCS catchment area. Reference: PWS Section 6 Specific Tasks, Ground Ambulance paragraph. The PWS states that there is a possibility patients may need transported from various locations within the VASNHCS catchment area. We are unsure what is encompassed in the VASNHCS catchment area. Could the Government please define the VASNHCS catchment area for this requirement (e.g., list of counties, facilities, and/or typical originating locations), so that we can accurately plan routing, staffing, and pricing?
VA Response All services requested will originate from the VA Sierra Nevada Health Care System, 975 Kirman Ave. Reno, NV 89502. The PWS was revised to remove mention of VASNHCS catchment area under section 6.
Backup air provider vs. VA making alternate arrangements. Reference: PWS Section 6 Specific Tasks, Response Time paragraph. The PWS states that if the contractor cannot begin the flight within four (4) hours of notification, VASNHCS may contact another air ambulance company to provide the services. Would the Government prefer that the prime contractor identify and maintain a pre-arranged backup/subcontractor to cover missions when the prime cannot meet the required response timeframe, or does VASNHCS intend to make those alternate air ambulance arrangements independently on a case-by-case basis? VA Response Contractor is expected to meet the required response time. VASNHCS does not intend to make alternate arrangements. Contractor is required to notify timely if unable to meet the requirement.