SOURCES SOUGHT
V -- Air Ambulance Services, VAMCs located in Boise, Idaho and Spokane and Walla Walla, Washington
- Notice Date
- 6/5/2009
- Notice Type
- Sources Sought
- NAICS
- 621910
— Ambulance Services
- Contracting Office
- Department of Veterans Affairs, Walla Walla VAMC, Department of Veterans Affairs Medical Center, Department of Veterans Affairs;Contracting Officer (620);Jonathan M. Wainwright Memorial VAMC;77 Wainwright Drive;Walla Walla WA 99362-3994
- ZIP Code
- 99362-3994
- Solicitation Number
- VA-260-09-RP-0148
- Response Due
- 6/22/2009
- Archive Date
- 7/22/2009
- Point of Contact
- Charlene DuncanContracting Officer<br />
- E-Mail Address
-
Air Ambulance Service, VAMCs in BOI, SPO and WW
(charlene.duncan@va.gov)
- Small Business Set-Aside
- N/A
- Description
- INTENT: The intent of this sources sought notice is to determine the level of interest in providing medical air ambulance transport service to eligible beneficiaries. Upon receipt of the information resulting from this solicitation, the VA will determine the most appropriate method for obtaining these services and will refine the scope of work as necessary. Selection of contractors will be based on (1) compliance with federal and state codes and regulations covering medical air ambulance businesses, services and attending medical and emergency medical personnel; and (2) accreditation with the organizations listed in this solicitation. Regulatory compliance, accreditation and past performance are more importance than price. SCOPE OF WORK: The Department of Veterans Affairs medical centers located in Boise, Idaho, and Spokane, and Walla Walla, Washington (herein after known as the VA), require medical air transport services for eligible beneficiaries. A list showing historical distribution of the last 2 years by medical center is contained in Attachment 1. This list is provided for information only and does not imply or guarantee a minimum, maximum or specific number of air ambulance transports. Commission on Accreditation of Medical Transport Systems (CAMTS): For the purpose of the agreement, the VA requires that the Contractor meet or exceed the Accreditation Standards of Commission on Accreditation of Medical Transport Systems (herein after known as CAMTS, Current Edition) (www.camts.org). Contractor to provide an appropriate aircraft medical transport vehicle to transport personnel and patient care equipment and supplies in accordance with the specifications, terms, conditions and provisions of this agreement which meets or exceeds the standards set forth in the applicable sections of the CAMTS, Current Edition. Contractor to provide services to Department of Veterans Affairs Care facilities located in Boise, Idaho; Spokane, Washington; and Walla Walla, Washington. The agreement is effective indefinitely unless terminated by mutual agreement of the parties. In accordance with FAR Part 17, it shall be reviewed on an annual basis for applicability and effectiveness in meeting the needs of the VA. NOTE: For the purpose of this agreement, all patients are to be transported by critical care air transport when transfers occur from the Critical Care Unit or if the patient requires continuous ECG monitoring and/or physician designates a patient as a critical care transport. It is further understood that only a physician or registered nurse with critical care training and current advanced cardiac life support will be designated as the medical flight attendant in accordance to the standards of CAMTS for any critical care transport. Critical care air transports require an additional team member, for a minimum of two medical attendants, (for example but not limited to RN/RN, RN/PA, RN/MD.RN/EMT-P). All personnel shall be available for each transport within an agreed upon response time between the Contractor and the Department of Veteran Affairs Care facilities. For the purpose of this agreement, all patients who do not require monitoring or medication titration and have not been deemed a Critical Care Transport, as outlined above, will be considered a NON-CRITICAL AIR TRANSPORT. The Medical Flight Attendant on a non-critical air transport may be an EMT/paramedic. RESPONSE TIME: Contractor to respond to request for air transport via telephone within 15 minutes and shall arrive at patient bedside within 2.5 hours of initial telephone contact. If the Contractor cannot meet the 2.5 hour response time, the Contractor must notify the requesting facility and provide reason(s) for delay and new estimated time of arrival. LAYOVERS: The VAMC's will authorize payment for only those layovers necessitated by the patient, the government, or Federal Air Regulations pilot duty requirements. OPERATIONAL REQUIREMENTS AND PRACTICES: All aircraft shall be operated within Federal Aviation Administration (FAA) (www.faa.gov) rules and regulations governing air taxi operations. All Contractor personnel and passengers shall abide by applicable FAA rules and regulations. At the discretion of the pilot, passengers, such as family members, may accompany the patient when deemed in the best interest of the patient by an authorized VA official. All applicable FAA regulations must still be met. There shall be no extra cost to the VA. All Contractor facilities, including ramps, ramp areas, buildings, passenger areas, etc., shall be maintained in a clean and orderly condition, free from debris and any accumulation which may constitute an accident or fire hazard. Fences and warning signs shall be provided for public protection against hazards. NUMBER AND TYPE OF PATIENTS: It is understood that only ONE patient will be transported on a trip unless specifically authorized by the VAMC. 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; however, the longest distance over which a patient is transported may be claimed when more than one patient is transported in a single airplane concurrently. Under no circumstances will the VA order Air Ambulance Service for more than two patients for any one flight. The Contractor shall not refuse to accept patients; for example heart cases, the mentally disturbed, the critically ill or those with communicable disease. Contractor will not be expected to accept any patient unless a physician authorizes the flight and informs the Contractor regarding any special treatment or care required enroute such as administration of oxygen or medication. AIRCRAFT MAINTENANCE: All aircraft used in the performance of this agreement must be maintained in an airworthy condition in accordance with all applicable FAA Regulations and CAMTS procedures by means of an established inspection and maintenance plan. Line inspections shall be performed at least once in the twenty-four (24) hour period preceding a flight. Aircraft shall be handled exclusively by trained personnel. Contractor shall own and operate adequate maintenance facilities or shall have a contract or agreement with an acceptable shop to perform aircraft maintenance. Said contract/agreement to provide required maintenance shall be performed as and when required by the air taxi operator. SMOKING REGULATIONS AND PRECAUTIONS: In accordance with VA smoking policy and FAA regulations, no smoking will be allowed in the aircraft. Contractor shall comply with Federal Aviation Regulation 135.91b which prohibits smoking within 10 feet of oxygen storage and dispensing equipment carried on aircraft. Smoking should never be allowed within 50 feet of a parked air ambulance aircraft. LIFEGUARD FLIGHT PLANS: Operators engaging in air ambulance operations should use the word "Lifeguard" in the remarks section of their flight plan (see Airman's Information Manual). The term "Lifeguard" should only be used when expeditious handling is required. An Air Traffic Controller can help a pilot avoid significant weather and turbulence, and can pass information to ground personnel to help expedite the handling of patients. These additional services will be provided when the controller's workload permits. DEVIATIONS FROM FAA REGULATIONS: Deviations from Federal Aviation Administration Regulations shall be reported in accordance with Federal Aviation Administration Regulations Part 91.3 and 135.19. Deviation decisions related to flight safety can only be made by the pilot who must consider the safety of all persons aboard as well as the needs of the patient. Communications during a mission will be conducted according to the standards which meet or exceed CAMTS. PATIENT MEDICAL RECORDS / TRIP REPORT: Each air ambulance operation should maintain for a period of five (5) years, a record (Trip Report) of each air ambulance operation, including but not limited to the following: "Patient's name. "Date of flight "Diagnosis. "Originating and terminating points, and patient's condition upon departure and arrival. "An in-flight medical attendant's report of the patient's status, which meets/exceeds standards of CAMTS will be provided with-in 24 hours of flight completion. Reports will be sent to both the sending and receiving VA facility. (These notes can be vitally important to those who must provide subsequent care.) STANDARDS OF PRACTICE: Protocols and standing written guidelines which meets/exceeds standards of CAMTS will be provided to the VAMC initially and updates as changes occur as well as annually. EQUIPMENT AND SERVICE: All ambulance aircraft shall comply with the regulations of the FAA, Federal Aeronautics Regulations (Parts 135/121) and rules and regulations of the state in which Contractor conducts business. All ambulance aircraft used in the performance of this agreement must be equipped with functioning two-way radios. Such aircraft must be equipped with all flight instruments required by the Federal Aviation Agency (FAA) regulations for the type of flight operations to be conducted. Such aircraft must also have the facilities to maintain proper cabin temperatures under all flight conditions. It is agreed and understood that only the aircraft listed on record at the VA will be employed in the performance of the services covered by this agreement and that no additional aircraft will be added to the agreement without the written approval of the Contracting Officer. Offeror shall indicate in the spaces below, a list of all Contractor owned aircraft which will be utilized in the performance of the services covered by this agreement. The list must include the make, type, number of engines, passenger and stretcher capacity (excluding pilot.) CONTRACTOR TO PROVIDE SUFFICIENT FIXED WING OR ROTARY AIRCRAFT TO PERFORM REQUIREMENTS OF THIS AGREEMENT. MULTIPLE TRIPS FROM MULTIPLE LOCATIONS ON THE SAME DAY MAY BE REQUIRED; i.e., BOISE TO SEATTLE, SPOKANE TO PORTLAND, WALLA WALLA TO SPOKANE, ETC. MAKE TYPENO. OF ENGINESPASSENGER CAPACITYSTRETCHER CAPACITY ELECTRICAL: Aircraft must have an electrical inverter system for simultaneously required electrical supply for emergency medical equipment; the voltage of which is compatible to the medical equipment required. HEATING SYSTEM: The heating system should have the capacity of maintaining the cabin temperature at about 75 degrees Fahrenheit during all phases of operation. COMMUNICATIONS SYSTEM: The aircraft must have radio capability to communicate air to ground and air to air which meets/exceeds standards of CAMTS. LIGHTING SYSTEM: Interior lighting should be adequate for patient observation and care under all circumstances. During night operations, a curtain should be used if necessary to protect the cockpit from lights in the patient compartment. LOADING STRETCHERS AND LITTERS: Aircraft doors should be large enough to allow a stretcher or litter to be loaded without rotating it more than 30 degrees about the longitudinal (roll) axis or 45 degrees about the lateral (pitch) axis. POSITIONING THE STRETCHER OR LITTER: The stretcher or litter should be positioned so as to allow the medical attendant a clear view of the access to any part of the patient's body that may require attention. The attendant should always have access to the patient's head and upper body. The upper surface of the litter should not be less than 30 inches form the ceiling of the aircraft or the under surface of another litter. 40 inches is required between the upper surface of the litter to the aircraft ceiling in order to conduct CPR. A conventional stretcher or litter will be at least 19 inches wide and 73 inches long. Between 12 and 18 inches of clear aisle at the head and on one side of the litter is desirable. When possible, litters should be installed laterally in the aircraft to better restrain against forces, which may be encountered in a crash. BASIC MEDICAL EQUIPMENT REQUIRED FOR EACH FLIGHT: Air ambulance equipment must meet the requirements which meets/exceeds standards of CAMTS. Medications/intravenous solutions, dressings, catheterization kits, etc., for specific patient problems will be provided by the respective VA medical center. Maintenance of medical equipment and supplies shall meet/exceed standards of CAMTS. The equipment required in each aircraft used in the performance of services under this agreement shall meet/exceed standards of CAMTS. GROUND AMBULANCE: The Contractor is responsible for making ground ambulance arrangements with the appropriate VA or local ground ambulance company if the VA does not have a ground ambulance contract or agreement for the area. If arrangement is made by the air ambulance Contractor, the ground ambulance subcontractor will invoice the air ambulance company who will invoice the VA. The air ambulance Contractor will not release the patient until ground transportation is available. In order to provide continuity of transportation, the air ambulance operator should coordinate aircraft departures and arrivals with required surface transportation to avoid any delays at the points of origin or destination. Generally, the air ambulance should be available for immediate boarding at origin, and ground transportation should be awaiting the flight at the destination. If a delay is unavoidable, the patient must be protected from inclement weather, including temperatures that could adversely affect his/her condition. The Medical Flight Attendant will accompany the patient from the transferring facility of pick-up to the receiving facility. Upon transfer of the patient, the Medical Attendant will annotate the receiving facility's medical personnel name and include this on the in-flight Medical Attendant's report detailed, above. ATTENDANTS: A record of each employee's background, clinical experience and appropriate certifications that meet or exceed standards in CAMTS as well as the character and physical capabilities of performing the duties of an air ambulance operator or attendant shall be maintained and made available for inspection upon request. The VA reserves the right to request qualifications prior to award. Offer submissions shall include personnel qualifications, certifications and record of each employee's character and physical capabilities. Contractor will provide the VA with updated records on an annual basis and when changes in personnel occur. Medical Flight Attendant is defined as any licensed physician, nurse, physician assistant, or emergency medical technician/paramedic that has had additional training in various aspects of aero medical transportation which meets/exceeds standards of CAMTS and also, as specified, below. A Medical Flight Attendant may not serve simultaneously as a required pilot or crewmember on the flight. Registered Nurse trained in critical care and ACLS will be the primary Medical Flight Attendant when medical conditions require nursing care that is not part of physician assistant or emergency medical technician scope of practice. A qualified Registered Nurse, for the purposes of this agreement, is one who meets/exceeds standards of CAMTS and has received education in critical care nursing, aeronautical concepts and ACLS. Documentation of annual competency assessment will be provided for all medical attendants. MEDICAL FLIGHT ATTENDANTS TRAINING: To qualify as a Medical Flight Attendant, an individual shall meets/exceeds standards of CAMTS with specialized emphasis placed on the airborne environment: For those medical personnel who have to receive training in emergency medical care, complete an EMT-P course in accordance with the Department of Transportation curriculum or an equivalent program of instruction approved by the Department of Transportation and meets/exceeds standards of CAMTS. WAITING TIME: The Contractor will not be expected to wait over one (1) hour for patients without receiving further payment. Delays due to causes beyond the control and without the fault of the VAMC or the beneficiary patient concerned will not be considered waiting time for the purpose of this agreement. Such causes may include but are not restricted to acts of God or of the public enemy, fires, floods, epidemics, quarantine restrictions, strikes, freight embargoes, or delays caused by weather conditions. DRY RUNS: The Contractor will be reimbursed at the full agreement amount for "dry runs", (trips made by the Contractor when the VA beneficiary is not available for pickup). The charge will not be allowed if the trip is canceled by authorized VA personnel at least one (1) hour prior to the scheduled pickup time. UNUSUAL EVENTS: Contractor is required to notify the Contracting Officer or his/her designee of any unusual events, including but not limited to accidents or safety problems that occur involving any VA beneficiary being transported under this agreement. This notification will be made within one (1) hour by telephone and, if requested by the VA, a written report of the event will be delivered to the Contracting Officer or his/her designee by close of business the next working day. INSPECTION PRIOR TO AWARD: The Government reserves the right to thoroughly inspect and investigate the establishment facilities, business reputation and other qualifications of any offeror and to reject any offer, irrespective of price, that shall be administratively determined lacking in any of the essentials necessary to assure acceptable standards of performance. If any air ambulance equipment is added after inspection, subsequent to execution of agreement, it shall be inspected and approved by the Contracting Officer before being placed in use under the agreement. All aircraft to be used in the performance of this agreement shall be inspected by an inspection team at the VA facility closest to the Contractor. AUTHORITY: This solicitation adheres to the procedures defined in FAR 12.303 for the acquisition of commercial products. The authority for this agreement is found in Public Law (PL) 104-262 "Veterans' Health Care Eligibility Reform Act of 1996" (as amended), and Title 38 U.S.C. 8153. The procedures used under this procurement are those described in FAR Subpart 12.6, and Part 16.703 Basic Ordering Agreements, and supplemented with additional information included in this solicitation. This document represents a Request for Proposal. PERFORMANCE STANDARDS The Contractor is expected to meet all of the requirements of this contract at all times. Due to the nature of this requirement, if the services are not performed in a timely and professional manner patient health and safety may be compromised, the following performance standards are included. The last month of each contract year the Contracting Officer will review contract compliance reports submitted by the COTR. When total compliance falls to 98% or below, an amount equaling 1% of the expenditures for the contract year will be deducted from that month's payment. Amounts deducted from billing may be reduced by the Contracting Officer upon submission of mitigating evidence by the Contractor. PERFORMANCE SURVEILLANCE PLAN / MONITORING PROCEDURES The Quality Assurance Surveillance Plan (QASP) is designed to monitor contract compliance. The COTR will implement the plan to provide effective and systematic surveillance of all aspects of this contract. The surveillance plan will employ various monitoring methods. Forms to use in carrying out the QASP are: Attachment 3 - Surveillance Activity Matrix Attachment 4 - Discrepancy/Complaint Report Attachment 5 - Contract Discrepancy Report Periodic Inspection: The contractor's facility, methodologies, and quality control procedures may be examined by the COTR at any time during the life of the contract. Examinations may be either scheduled or random findings documented by the COTR, or authorized designee, on the Surveillance Activity Checklist. Random Basic Inspection: Contract requirements are to be monitored on a random basis. The COTR, or authorized designee, will randomly visit areas to check for compliance with contract requirements. Findings will be recorded on the Surveillance Activity Checklist. The objective of the QASP is to evaluate how the contractor is performing in key areas. Of primary interest is the quality of the services provided in accordance with contract requirements. Specific areas as outlined in Exhibit A will be closely scrutinized. Revisions to the QASP are the joint responsibility of the Contracting Officer and COTR. Historical Distribution - Attachment 1 VISN 20 EAST BRANCH ESTIMATED AIR AMBULANCE USEAGE TWO YEAR HISTORICAL DISTRIBUTION NAUTICAL MILES FROM - http://www.infoplease.com/atlas/calculate-distance.html FROMTO# TRIPSMILES Boise, IDPortland, OR15300 Boise, IDSan Francisco, CA1450 Boise, IDSalt Lake City, UT6258 Boise, IDSeattle, WA141352 Hermiston, ORPortland, OR1144 Hermiston, ORSeattle, WA0164 LaGrande, ORPortland, OR1194 LaGrande, ORSeattle, WA1223 Moses Lake, WAPortland, OR0171 Moses Lake, WASeattle, WA1128 Richland, WAPortland, OR2150 Richland, WASeattle, WA0148 Spokane, WAPortland, OR0252 Spokane, WASalt Lake City, UT1478 Spokane, WASeattle, WA36199 The Dalles, ORPortland, OR063 The Dalles, ORSeattle, WA1130 Walla Walla, WAPortland, OR2185 Walla Walla, WASeattle, WA6189 Walla Walla, WASpokane, WA1103 BACKGROUND INVESTIGATION REQUIREMENTS (Attachment 2) All contractor employees who require access to the Department of Veterans Affairs' computer systems containing patient information or other information deemed of a sensitive nature shall be the subject of a background investigation and must receive a favorable adjudication from the VA Office of Security and Law Enforcement prior to contract performance. This requirement is applicable to all subcontractor personnel requiring the same access. If the investigation is not completed prior to the start date of the contract, the contractor will be responsible for any costs or damages that result because of the inability to perform. Additionally, contracts may be subject to immediate termination. Initiation of contract performance prior to completion of all background investigations may be waived by the expressed written consent of the Contracting Officer and only when extraordinary circumstances are documented. 1.Position Sensitivity - The position sensitivity has been designated as Low Risk by the installation Security Officer on VA Form 2280a. 2.Background Investigation - The level of background investigation commensurate with the required level of access is National Agency Check with Written Inquiries. 3.Contractor Responsibilities: a.Background investigations shall be conducted by the VA Security Identification Center, Little Rock, Arkansas. The cost of the background investigation shall be born by the contractor. Costs for background investigations range from $232.00 for low risk level to $782.00 for high risk level per investigation. b.The contractor shall prescreen all personnel requiring access to the computer systems to ensure they maintain a U.S. citizenship and are able to read, write, speak and understand the English language. c.The contractor shall submit or have their employees submit the following required forms to the VA Office of Security and Law Enforcement within 30 days of receipt: (i)Standard Form 85P, Questionnaire for Public Trust Positions. (ii)Standard Form 85P-S, Supplemental Questionnaire for Selected Positions. (iii)FD 258, U.S. Department of Justice Fingerprint Applicant Chart. (iv)VA Form 0710, Authority for Release of Information Form. (v)Optional Form 306, Declaration for Federal Employment. (vi)Optional Form 612, Optional Application for Federal Employment. d.The contractor, when notified of an unfavorable determination by the Government, shall withdraw the employee from consideration from working under the contract. e.Failure to comply with the contractor personnel security requirements may result in immediate termination of the contract. 4.Government Responsibilities: a.The VA Security Identification Center will provide the necessary forms to the contractor or to the contractor's employees after receiving a list of names and addresses. b.Upon receipt, the VA Security Identification Center will review the completed forms for accuracy and forward the forms to OPM to conduct the background investigation. c.The VA facility will pay for investigations conducted by the VA Security Identification Center in advance. In these instances, the contractor will reimburse the VA facility within 30 days. d.The VA Office of Security and Law Enforcement will notify the Contracting Officer and contractor after adjudicating the results of the background investigations received from VA Security Identification Center e.The Contracting Officer will ensure that the contractor provides evidence that investigations have been completed or are in the process of being requested. SURVEILLANCE ACTIVITY MATRIX (Attachment 3) REQUIRED SERVICEREVIEW RESPONSIBILITYREVIEW DATESAMPLE SIZECOMPLIANCE (%)COMMENTS Response TimeCOTR/ ContractorMonthly10%100%Unexcused tardy response HIPAA ComplianceCOTR/ ContractorQuarterly10%100% Background ChecksCOTR/ ContractorQuarterly10%100% Patient SafetyCOTR/ ContractorMonthly100%100%Events putting patient at risk Invoice ProceduresCOTR/ ContractorQuarterly10%100% DISCREPANCY/COMPLAINT REPORT (Attachment 4) The COTR will document all discrepancies. This documentation will be a simple listing of the date and the discrepancy. The purpose of keeping this information is to note development of a pattern of unsatisfactory performance which the QASP may have or may not have identified. DATEPATIENT IDDISCREPANCY/COMPLAINT CONTRACT DISCREPANCY REPORT (Attachment 5) When the Contractor does not achieve satisfactory performance (an acceptable quality level), a Contract discrepancy Report is to be issued by the Contracting Officer to the Contractor. Issued By: Contract No. _____________ Contract Officer's Signature: ___________________________ Date Prepared: _________________ Patients Name and ID: ____________________________________________________________________________ Described Discrepancy: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ (Forward to Contractor for Response) Date Received by Contractor: __________________ Contractor's Response (cause of problem, corrective action, preventative measures, completion date, etc. Attach continuation sheet if necessary): ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________ Contractor's Signature and Date (Return to VA Puget Sound Health Care System's Contract Officer for evaluation) VA Evaluation of Response (acceptance, partial acceptance, or rejection: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ VA Action Required (payment reduction, cure notice, show cause, other): ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Close Out: ___________________________________________________________________ Contractor: ___________________________________________________________________ (Name, Title, Signature, & Date) Contracting Officer: ____________________________________________________________ (Name, Title, Signature, & Date)
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