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INTRODUCTION TO DESCRIPTION On behalf of the Tennessee Valley Healthcare System, Network Contracting Office (NCO) 9 is issuing this Sources Sought Notice/Request for Information (RFI) notification as ... INTRODUCTION TO DESCRIPTION On behalf of the Tennessee Valley Healthcare System, Network Contracting Office (NCO) 9 is issuing this Sources Sought Notice/Request for Information (RFI) notification as a means of conducting market research to identify parties having an interest in and the resources to support this requirement for a firm-fixed price contract for ambulance transport services for Lexington, KY VAMC. The result of this market research will contribute to determining the method of procurement. The applicable North American Industry Classification System (NAICS) code assigned to this procurement is 621910. This RFI is issued solely for informational and planning purposes and does not constitute a solicitation. Responses to this notice are not offers and cannot be accepted by the Department of Veteran Affairs to form a binding contract. Respondents are solely responsible for all expenses associated with responding to this RFI. All interested parties should submit a capabilities statement to angela.freel@va.gov. No phone calls will be accepted in reference to the sources sought notice/request for information for ambulance transport services for Lexington, KY. STATEMENT OF WORK AMBULANCE SERVICE GENERAL INFORMATION 1. Title of Project: Ambulance Transportation Services 2. Scope of Work: The contractor shall provide all resources necessary to accomplish the deliverables described in this statement of work (SOW), except as may otherwise be specified. The overall project purpose and objectives is to provide Ambulance Transportation Services for the Lexington VA Health Care System. 3. Performance Period: The contractor shall complete the work required under this SOW from date of award, unless otherwise directed by the Contracting Officer (CO). If the contractor proposes an earlier completion date, and the Government accepts the contractor s proposal, the contractor s proposed completion date shall prevail. B. GENERAL REQUIREMENTS 1. All written deliverables shall be phrased in layperson language. Statistical and other technical terminology shall not be used without providing a glossary of terms. 2. Where a written milestone deliverable is required in draft form, the VA will complete their review of the draft deliverable within 14 business days from the date of receipt. The contractor shall have 14 business days to deliver the final deliverable from date of receipt of the Government s comments. 3. If for any reason any written milestone deliverable cannot be reviewed by the COR and delivered back to the contractor within the scheduled time frame, the COR is required to explain why in writing to the CO, including a firm commitment of when the work shall be completed. If deliverable cannot be delivered within the scheduled time frame, compensation may be due to the contractor. D. SPECIFIC MANDATORY TASKS AND ASSOCIATED DELIVERABLES The Contractor shall furnish all labor, tools equipment, materials, supervision, and quality control for the performance of this contract. Furnish 24-hour ambulance transportation service for the beneficiaries of the Lexington VA Health Care System Lexington, KY. This will involve trips to and from any location within the Primary Service Area (PSA) of the Lexington VA Health Care System. And beyond as appropriate. Trips are generally confined to within the PSA; however, they may encompass travel to points outside of the State of Kentucky or beyond, if necessary. Number of Patients: It is understood and agreed that only one (1) patient will be transported on a trip unless specifically authorized or requested by the Lexington VA Health Care System. When, pursuant to The Department of Veterans Affairs authorization, more than one patient is transported concurrently on a trip, reimbursement will be made only at the rates contained in the schedule of costs for transporting a single patient. Regardless of the number of patients transported concurrently on a single trip within Fayette County limits, the contractor will be reimbursed for only the base rate for one trip. Regardless of the number of patients transported concurrently on a single trip beyond Fayette County limits, the contractor will be reimbursed for the mileage rate for only one trip to the longest distance traveled with any one patient on that trip. Waiting Time: For time lost in waiting at either or both ends of the trip due to causes beyond the contractor s control, the contractor will be reimbursed per quarter hour as quoted in the schedule for each quarter hour or fraction thereof in excess of one-quarter hour for the time reported to the designated VA personnel. If the pick-up point is other than the Lexington VA Health Care System; the contractor shall call Beneficiary Travel at (859) 233-4511 ext.: 4951 or Supervisor, the VTS Mobility Manager (859) 233-4511 ext.: 3556, during administrative hours (8:00am trough 4:30pm, Monday through Friday) or the Administrative Officer of the Day (AOD) at (859) 233-4511 ext.: 4950 on duty during non-administrative hours (during evenings, nights, weekends, and holidays) as soon as it is anticipated that a delay may develop for which the contractor expects the claim reimbursement. This call is only for the purpose of verifying the arrive time at the pick-up point and is not necessary if the contractor anticipates no delay for which reimbursement will be claimed. The contractor s failure to notify the travel section when waiting beyond the grace period will result in non-payment for waiting time. Completed Trip: When ambulance service under the terms of this contract involves pick-up of a patient who is to be brought to Lexington VA Health Care System or to another hospital, and/or clinic for hospitalization or treatment, the trip will be considered complete when the patient is delivered by ambulance personnel to the admission/evaluation unit, a specified ward or unit, or the location specified at the time the trip is requested. Non-Pick-Up of Patient: When ambulance service involves a trip to for from the Lexington VA Health Care System, patient s residence, or patient refusal, but due to unforeseen circumstances the patient is not available for pick-up, the contractor will collect for the trip at the rates applicable under the schedule portion of the contract. The VA reserves the right to substitute patients in these instances to prevent the no-load situation. Non-Arrival of Patient: When ambulances service involves the pick-up of a patient scheduled to arrive by air and the ambulance driver finds such patient does not arrive as scheduled, the ambulances driver shall contact the Beneficiary Travel, VTS Mobility Manager, or AOD and inquire as to the status of the arrival. If appropriate, waiting time may be authorized for time lost in waiting in accordance with the rate applicable under the schedule of cost of this contract. If contractor reported as scheduled and no patient is transported, contractor will be reimbursed at the rates applicable under the scheduled of costs of the contract. Basic Life Support (BLS): If the Lexington VA Health Care System is unable to established telephone contact with the contractor for EMERGENCY BLS service withing (2) minutes of calling or contractor fails to furnish an BLS Ambulance within fifteen (15) minutes after receiving the request, the Lexington VA Health Care Systems reserves the right to obtain service from another source. If, within five (5) minutes after receiving the request for BLS service, the contractor determines they are unable to provide this service within fifteen (15) minutes, the contractor shall contact Lexington Fire Department at 911 to response to the call, providing them with the location and the needs for BLS unit. If the contractor fails to furnish BLS NON-EMERGENCY service withing 45-minutes of the scheduled pick-up time, the Lexington VA Health Care System reserves the right to obtain the service from another source and the contractor s compliance rate will be adversely affected. The Lexington VA Health Care System will be the sole judge in determining when to order service from another source. In no instance, will the contractor be required to furnish more than five (5) ambulances at one time. The contractor must meet a 90% acceptable quality level for 2-minute and 45-minutes after receiving request for BLS. Contractor will provide a report monthly or quarterly. Advanced Life Support (ALS): ALS is defined as any transport that meets the definitions of Advanced Life Support as defined by Medicare regulations. If the Lexington VA Health Care System is unable to established telephone contact with the contractor for EMERGENCY ALS service withing (2) minutes of calling or contractor fails to furnish an ALS Ambulance within fifteen (15) minutes after receiving the request, the Lexington VA Health Care Systems reserves the right to obtain service from another source. If, within five (5) minutes after receiving the request for ALS service, the contractor determines they are unable to provide this service within fifteen (15) minutes, the contractor shall contact Lexington Fire Department at 911 to response to the call, providing them with the location and the needs for ALS unit. If the contractor fails to furnish ALS NON-EMERGENCY service withing 45-minutes of the scheduled pick-up time, the Lexington VA Health Care System reserves the right to obtain the service from another source and the contractor s compliance rate will be adversely affected. The Lexington VA Health Care System will be the sole judge in determining when to order service from another source. In no instance, will the contractor be required to furnish more than five (5) ambulances at one time. The contractor must meet a 90% acceptable quality level for 2-minute and 45-minutes after receiving request for ALS. Contractor will provide a report monthly or quarterly. The contractor shall furnish qualified Advanced Cardiac Life Support (ACLS) personnel who are competent to perform ACLS protocols. Response Time: The contractor shall maintain at a minimum, a 95% compliance rate on response to pick-up or deliver during contract year. Reporting Requirements: For all scheduled appointments, the patients shall enter the building at main entrance at the Troy Bowling Campus and the building number at the Franklin R Sousley Campus. Direct admissions shall enter through the Emergency Department (ED) entrance. Ambulance personnel shall stop at the ED desk to let the clerk and nurse know the patient has arrived and to get any additional instructions and need to have a warm handoff to VA clinicians or designees. Government Owned Equipment or Supplies: Any an all-government equipment, linens, etc. taken with patients must be returned. The contractor shall furnish all linens, blankets, and supplies. The Lexington VA Health Care System will not participate in a linen exchanged program or any supply exchange program. The contractor will not be permitted to borrow medical equipment from the Lexington VA Health Care System. The contractor shall provide all medications required while in transport, sheets, and blankets, and other equipment and supplies required for use while in transport, for direct patient care. The contractor will at no time and under any circumstances exchange supplies, equipment, and/or medications with the Lexington VA Health Care System. Transport of Equipment: The contractor will transport wheelchairs, crutches, and/or walkers if the ambulance is able to secure items during transport and as room. The contractor will not transport electrical scooters or wheelchairs. The contractor will not make a 2nd trip to transport a wheelchair, crutches, and or walker. The Lexington VA Health Care System or beneficiary will make separate arrangements for the items to be transported if required. Records: At the option of the Government, the contractor may be required to transport records with patients from station to station. Incident Report: Should an incident and/or accident occur involving the welfare of a beneficiary, the contractor shall immediately notify Beneficiary Travel, VTS Mobility Manager, Patient Support Unit or the AOD during evenings, nights, weekends, and holidays. This notification shall be made by telephone within one (1) hour. A written report of the incident shall be filed with the COR by the close of business the next business day. Patient Welfare and Abuse: The contractor shall be held responsible for patient welfare during transport. The contractor shall be held responsible for patient and/or Government property during transport. Any damage or lost wheelchairs, crutches, or personal belongings shall be replaced by the contractor at the no additional cost to the Government or beneficiary. The Government requires the contractor to exercise extreme caution and care in the handling of patients. Any abuse of patients will be grounds for default action for termination of the contract. In the event a patient s condition worsens during transport, the contractor shall transport the patient to the close facility appropriate for the required care. In the event a patient should expire during transport the contractor shall return to Lexington VA Health Care System. Joint Commission Standards: Where the solicitation does not require Joint Commission accreditation or other regulatory body requirements, the contractor must perform the required work in accordance with Joint Commission Standards. A copy of these standards may be obtained from the Joint Commission, One Renaissance Blvd. Oakbrook Terrace, IL 60181. Vehicles: Per Kentucky Administrative Regulations 202 KAR 7:501 Ambulance provides and medical first response agencies: Ambulances used under this contract shall be licensed by the State of Kentucky and shall meet the minimum vehicle requirements as mandated by Kentucky Department of Transportation and the Fayette Urban County Government. 202 KAR 7:501 Section 2. Provider Licensing Requirements A person or entity shall not provide, advertise, or profess to engage in the provision of ambulances services or ALS medical first response originating in Kentucky without having first obtained a license from the board pursuant to this administrative regulation and certificate of need if appropriate A provider shall comply with local ordinances, state and federal statutes and administrative regulations. A provider shall display its license in a prominent public area at the service base station The following information shall be included on the license: Operating name of provider. Physical location of the base station. The number and physical location of satellite stations, if any, operated by licensee. The license classification. The level of service provided. The number of vehicles operated by the provided. The specific geographic area to be served by the licensee Providers shall provide the Kentucky Board of Emergency Medical Services (KBEMS) office with an accurate map and a written description of its geographic service area within the Commonwealth, which shall identify with specificity the complete boundary of the area served by the provider when applying for initial license or if the service area has changed since the last map was provided to the KBEMS office. The map shall accurately reflect the service area as identified by the provider s certificate of need, if appropriate. A licensed provided may respond to call outside of its geographic service area only if the provider is providing: Mutual aid under an existing agreement with another licensed provider whose geographic service area includes the area in which the emergency call is made. Disaster assistance. Non-emergency transfers from damage or closed health facilities. Inter-facility care to residents of its service area, who are patients in facilities outside of its service area, for the purpose of returning the patients to their home service area or transporting them to another health facility. Ambulance Medical Equipment: Each emergency medical care vehicle shall have patient compartment facilities, oxygen and suction systems and equipment, environmental climate equipment, communications equipment, and any additional systems, equipment, accessories, and supplies as required by the State of Kentucky. Each advance life support (ASL) vehicle shall have certified paramedics, patient compartment facilities oxygen, heart monitor, suction systems, and intravenous IV equipment, environment climate equipment, communications equipment and any additional systems, equipment, accessories, and supplies as required by the State of Kentucky. Patient Rights: The contractor shall be courteous to VA beneficiaries and shall not smoke while transporting patients. Patients may bring a reasonable number of belongings such as a personal suitcase. Confidentiality: Protects printed and sensitive data in accordance with the provisions of the Privacy Act of 1974 and other applicable laws. This confidentiality protects the data from unauthorized release or from loss and alternations. Training: To be eligible to perform under this contract, each contract employee must meet the minimum training required outline below and minimum contractor furnished training outlined in paragraph (2) (c), (1) through (8) Contractor furnished training: The contractor shall submit the CO-written certification that each contract employee has been trained in the subject areas outlined in paragraph C prior to assignment under this contract. For replacement or new employees documentation of prior training must be submitted or the individual contract employee must complete the required training before being employed in support of this contract. All formal training required shall be administered (i.e., taught, presented) by persons who are certified as being qualified to instruct or teach, the specific subjects or tropics required. Certification to instruct the specific subject shall be in the form of a certificate issued by an accredited institution of learning (school, college, university), a governmental (Federal, State, County, etc.) educational certification body (agency, board, commission), or by documentation that the person instructing has sufficient experience in/with the subject to be able to instruct the subject in an authoritative, practical, and current manner. In addition to the formal training, the contractor shall provide sixteen (16) hours of orientation training for each employee fourteen (14) days after his or her initial assignment to duty. This orientation may be accomplished while the employees are on duty. The contractor shall certify to the COR as the completion of the orientation for each employee withing 45 days following assignment to duty. The follow-up orientation for each employee withing 45 days following assignment to duty. The follow-up orientation should include the following subjects and instructional times periods as well as other subjects as may be required. Accident and incident reporting (2 hours) Safe operation of emergency vehicles (2 hours) Quality Assurance (2 hours) Fire and emergency preparedness planning (2 hours) Handling patient complaints (1 hours) Infection control (2 hours) Universal precautions (policy and procedures) (2 hours) Safety and occupational health procedures (3 hours) The EMT/Paramedics must be enrolled 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 or, a yearly basis. Such refresher training must be equivalent to that developed by the Department of Transportation or National Highway Safety Administration. Evidence of successful completion for refresher training must be provided by the Co for inspection. Personnel Requirements: Minimum of two (2) years experience. Minimum qualifications standards include contractor education/experience: possess a high school education or equivalency, and have two (2) years of experience demonstrating the ability to meet and deal with the general public, to read, understand and apply printed rules, detailed orders, instructions and training materials; to maintain pose and self-control under stress; and to construct and write clear, concise, accurate and detailed reports as determined by successful, high level of performance with other customers. Any type of military service may be credited toward meeting the requirements. In lieu of above, each employee shall have two years relevant education at a residency school above the high school level, or any combination of relevant education above the school level and relevant experience total two (2) years. Drivers: education/experience: process a high school education or equivalency and have two (2) years of experience demonstrating the ability: to meet the deal with the general public; to read, understand and apply printed rules, detailed orders, instructions, and training materials: to maintain pose and self-control under stress; and to construct and write clear, concise, accurate, and detailed reports as determined by successful, high level of performance with other clientele. Possess a valid American Red Cross standard first aid and personal safety course card or its equivalent. Driver must provide full name, date of birth, and social security number to VA prior to operating vehicles with VA beneficiaries. Proof in the form of a current certificate that such first aid training has been successfully completed must be available upon request. Possess a working knowledge of route specific to the area and knowledge of the nearest hospital available. Contractor must provide an annual statement that drivers are screened, trained and competent to safely transport patients. This annual statement of driver competency must include any advanced certifications, such as Advanced Cardiac Life Support or specialized training to assist and secure patient by stretcher or wheelchair. Attendants-emergency medical technician (EMT) and paramedics prices quote din the schedule shall include the services of a minimum of two (2) emergency-medical technicians (EMT) for BCLS and minimum of one (1) EMT and one (1) paramedic for every ACLS Service. In the event the Lexington VA Health Care System determines it necessary for the patient to have more than one ACLS attendant at the bed side during transport, the contractor must provide the additional attendant. In the event that the patient being transported requires mechanical ventilation, and the contractor is responsible for his or her own mechanical ventilator and the care of the patient during transport. In the event that the patient being transported requires accompaniment by an RN, and the contractor does not supply the RN, and RN shall accompany the patient during transport. The RN s responsibilities during transport shall be clearly outlined in written physician orders. In the event emergency the care of the patient in transport shall be clearly outlined in written physician orders. In the event of emergency, the care of the patient in transport shall be the responsibility of the EMT/paramedic. EMT s and Paramedics: EMT s and paramedics must provide full name, date of birth and social security number to VA prior to assignment on vehicles with VA Beneficiaries. Paramedics shall be licensed in advanced and basic life support t and having completed an appropriate training course in the last two years. Attendant should have a minimum of four hours of training in crisis intervention (documented), since some of the patients requiring an attendant shall be a psychiatric patient. An attendant shall always be required for stretcher patients strictly for their safety during the trip and help during transfer to and from van. EMT s must be licensed in basic life support and having completed an appropriate training course in the last two years. Attendant should have a minimum of four hours of training in crisis intervention (documented), since some of the patients requiring an attendant shall be psychiatric patients. An attendant shall always be required for stretcher patients strictly for their safety during the trip and help during transfer to and from van. Age: contract and employee performing work under this contract shall be a minimum of eighteen (18) years of age or as required by local laws. Health and Physical Fitness Requirements: All employees assigned by the contractor to work under this contract shall be physically able to perform all general duties, functions, and activities; shall free from any communicable disease, shall be in good general health without physical defects for abnormalities which would interfere with the performance of these duties, shall possess binocular vision correctable to 20/30 (Snellen), shall be free of color blindness, and be capable of hearing ordinary conversation at 15 feet with either ear without benefit of a hearing aid. Certify under oath that he is not addicted to alcohol or any controlled substances. Physical examination report to describe above requirements for each drover shall be provided upon request. All employees shall be literate and able to communicate (speak) with clients in English to the extent of reading and understanding printed regulations, detailed written orders, training instructions and material, and shall be able to compose reports which convey complete information. The contractor is to certify that ability of all employees designated to provide service for this contract. Any lapse in any contractor license that is not immediately corrected shall result in the contractor being terminated for cause. When a patient is transported with any VA owned equipment shall be returned to the respective VA Medical Center within 24 hours in the same condition as it was released at no addition cost to the Government. Miscellaneous: At no time shall the contractor leave vehicles on VA premises unless a pick-up or delivery is in process. Once a patient has been removed from the vehicle and properly secured with Emergency personnel, the running vehicle shall be removed from the Emergency Department exit door to prevent environmental hazards due to exhaust fumes. Contractor employee s hall always conduct themselves in a business-like manner while on VA premises and while transporting patients. When transporting patients to or from medical facilities, the driver, acting for the contractor shall ensure that the patient s luggage, medical records, medications, and prosthetics devices are properly accounted for and delivered with the patient as required. Contractor shall provide a Run Sheet as part of the patient s permanent record. This run sheet shall include a records of the patient s vital signs, medications used, oxygen use, patient s emotional attitude, and any changes in the patient s condition. The list stated here shall not be construed to be as all-inclusive; the contractor shall provide all pertinent information. Due to Kentucky Regulations regarding ambulance licensing, the contractor cannot guarantee pickups outside of Fayette County. When requested the contractor will work in good faith to accommodate the request. Long distance trips to be scheduled with a notification period of 24 hours for trips travel greater than 75 miles and 48 hours notice for trips traveling over 250 miles. Specialty care is defined as anything exceeding an ALS 2 level of care as defined by Medicare. Bariatric care is defined as any patient weighing over 350 lbs.