Active

Contract Opportunity

This is a Sources Sought only. As part of its Market Research, NCO 21 is issuing this RFI to determine if there exists an adequate number of qualified interested contractors capable of providing Air and Ground Ambulance services as further described in the draft Performance Work Statement (PWS). The Government may use the responses to this RFI for information and planning purposes. The draft PWS describes only the currently contemplated possible scope of work and may vary from the work scope in a final PWS included in any Request for Quote (RFQ). The contractor will be providing Air and Ground Ambulance services for the Las Vegas VA Medical Center, 6900 N Pecos Rd, North Las Vegas NV, 89086.

There is no solicitation document as this time. The NAICS is 621910 Ambulance Services, with Small Business size of $22.5M. NOTE: Please ensure that System For Award Management (SAM) (www.sam.gov) indicates this NAICS code if you are interested in the requirement.
Only firms seriously interested and truly capable should send their information and/or capability statement and any questions by email to brandy.gastinell@va.gov no later than 2 PM Pacific Time, December 29, 2023.
If interested, please provide the following information. Failure to provide the following information completely and accurately may result in a determination that your company is not a viable source:
Name of Company
Point of Contact Name, phone number, and email address
DUNS number
Socio-economic status such as Service-Disabled Veteran Owned Small Business, VOSB, Women-Owned Small Business, etc. should be included. SDVOSB/VOSB status will be verified using VetBiz.
Capability statements that include the following:
Identify geographical areas your company currently services?
Approximately how many current employees do you have in the service area(s)?
Indicate prior experience for same/similar service in these geographical areas. If the experience is through government contract, please identify the contract number.
Are you a certified and authorized vendor to perform air and ground ambulance services?
If you will rely on a subcontractor to assist with performance, please clearly identify what functions your company will perform versus those of the subcontractor(s). When responding to the preceding questions, avoid using teaming language, e.g. Team ABC has 20 years of experience or Team ABC has placed 15,000 staff. Clearly identify what functions/experience/resources your company has and will be able to perform independently of a subcontractor. Ambiguous responses that lack clarity will affect the Contracting Officer s ability to determine if your company is a viable source for this requirement.

Before responding please carefully read and consider the following:

As this is a service acquisition, the Small Business Administration and the Federal Acquisition Regulation have a Limitations on Subcontracting requirement. For all small businesses, to include SDVOSB and VOSB, At least 50 percent of the cost of contract performance incurred for personnel shall be expended for employees of the concern. See FAR 52.219-14 and FAR 52.219-27 available in full text at https://www.acquisition.gov/far/html/52_217_221.html

The Service Contract Act will apply.

Please see the DRAFT Performance Work Statement attached for further details.
DISCLAIMER
This Sources Sought notice is issued solely for information and planning purposes only and does not constitute a solicitation. All information received in response to this request that is marked proprietary will be handled accordingly. The Government will not compensate an offeror for providing information in response to this sources sought. Furthermore, the Government reserves the right to cancel this requirement at its discretion. This is simply a sources sought notice.

PERFORMANCE WORK STATEMENT (PWS)

Ambulance - Air Ambulance Services with Ground Transportation
Background
Furnish Air and Ground ambulance services for eligible beneficiaries of the Southern Nevada VA Healthcare System.

Scope:

The purpose of this contract is to provide air and ground transportation as deemed medically necessary for Southern Nevada VA Healthcare System (VASNHS) enrolled and eligible Veterans to outpatient medical appointments or for inpatient admissions. These appointments and/or admissions are within the state of Nevada as well as other VA Facilities located in:
San Francisco, California
Palo Alto, California
Reno, Nevada
Phoenix, Arizona
Albuquerque, new Mexico
Tucson, Arizona
Los Angeles, California
Loma Linda, California
Long Beach, California
San Diego, California

Transportation for care from the VASNHS may be to other VA Facilities in the continental United States dependent of the type and level of care the Veteran requires. This includes but is not limited to VA Transplant Facilities in Utah, Oregon, Texas, Washington, Iowa or Wisconsin. Ground transportation is needed to transport Veteran from the VASNHS site to air field for transport to other locale via Air Ambulance appropriately equipped with for medical transport.

Specific Tasks:

Response Time:

Contractor shall be accredited by the Commission on Accreditation of Medical Transport Systems (CAMTS) and provide documentation showing current accreditation prior to the contract award.

Contractor shall respond within thirty (30) minutes of notification twenty-four (24) hours a day, three hundred sixty-five (365) days per year, including all Federal Holidays.
Contractor shall commence the flight within four (4) hours of notification of patient pick-up from the Contracting Officer s Representative (COR). In the event the contractor cannot begin the flight within this time frame, the VA Southern Nevada Healthcare System (VASNHS) may contact another Air Ambulance Company to provide the services.

Ground Ambulance:
The contractor shall coordinate all (origin and destination) ground transportation for VASNHS patients. These services shall be a Department of Transportation (DOT) approved ambulance staffed with appropriately trained medical personnel.

When available, the contractor shall utilize VA contracted ambulance providers, In the event that no VA contracted ambulance providers are available, then the contractor shall coordinate ground ambulance service through local providers.

Ground ambulance contractor invoice shall identify in detail all cost incurred for ground ambulance services.
Authorization:
Personnel authorized to order service shall make requests for service via telephone. A faxed information sheet shall follow each telephone authorization as soon as possible after completed by the VASNHS Staff.

VA Ordering Officials by position:
Travel Clerk
Transfer Coordinator
Health Administration Services (HAS) Administrative Officer of the Day (AOD)
Health Administration Services (HAS) Chief
Health Administration Services (HAS) Assistant Chief
Health Administration Services (HAS) Section Chief, Enrollment
Health Administration Services (HAS) Supervisor,
Travel
Contractor will be provided with patient s pick-up and delivery points and vehicle requirements. Under no circumstances shall orders or changes be accepted by any other party. In addition, Contractor shall make no deviation and is responsible for providing direction to its staff during transport to specified locations.
A list of authorized ordering personnel shall be made available upon award of the contract. Employees may be added or deleted from the list during the term of the contract at the discretion of the VASNHS. The contractor shall be notified to such changes as they occur.

Payments:
Payments shall be based upon one-way direct air mileage (Nautical Mile) is computed on the appropriate Sectional Aeronautical Chart prepared by the Coast and Geodetic Survey In case a circuitous route shall be employed by reasons of safety (such as unfavorable terrain or weather), a copy of the flight log showing the reason which necessitated the detour from a directed route, shall be provided to the COR.
Average distance per trip is estimated to be two hundred (200) nautical miles.
Billing is to be monthly in arrears. Invoices shall be fully itemized. The invoice must contain the following information:
Contract Number
Purchase Order Number
Date of Service
Patient s Full Name
Last Four Digits of Patient s Social Security Number
Origination and Destination points
Ground Ambulance Costs (if applicable)
Detailed Documentation of all items used and circumstances
Total Dollar Amounts

Submit Invoices Electronically to:
www.tungsten-network.com/us/en
Telephone: 877-752-0900 option #2
Rates:
The government will obtain compensation for late pickups according to the following chart:
Minutes Late* Deduction
15 to 30 25% of trip value**
31 to 45 50% of trip value**
46 to 60 75% of trip value**
61 to more Trips shall be at no cost to VA

*Minutes Late refer to when a team is available or estimated time provided when a team is unavailable.
**Trip value is the total of the basic trip for the scheduled trip.
The Government reserves the right to cancel any patient pick-up due to late response time at any time after the specified or latest pick-up time ordered. Government may employ the services of another source, contracted or non-contracted, for same day service. Contractor will be responsible for all additional costs incurred by the Government if another source is utilized.
The Government will not pay for services under this contract for late response time when such delays are not determined to be excusable by VA.
The Government reserves the right to cancel any patient pick-up.

DRY RUNS: 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.

Number and types of Patients

The contractor will transport only one (1) VA patient per trip, unless specifically authorized by the COR and in agreement of the contractor. When more than one VA patient is transported on a trip, reimbursement shall be made at the rate not to exceed the cost of transporting a single VA patient; however, the longest over which a VA patient is transported may be claimed. Under no circumstances shall the VA order the contractor to transport more than two (2) VA patients for any one (1) flight.
The contractor shall not refuse to transport VA patients deemed transportable by VA medical staff.
Contractors shall not be expected to accept any VA patient unless the COR authorizes the flight and informs the contractor regarding any special treatment or care required on route (such as administration of oxygen or medications).
Passengers, such as family members may be carried at the discretion of the pilot in command, providing all applicable FAA regulations are met. There shall be no extra cost to the VA.
The contractor shall transport patient belongings and specialized equipment at no additional charge.
The contractor shall provide at the destination any VA patient mobility devices deemed by the contractor to be to large or heavy for air transport, at no additional charge to the VA.
VA Patient Confidentiality:

Contractor shall take reasonable measures to ensure patient privacy and confidentiality. The contractor agrees to take all reasonable precautions to safeguard patient information from unauthorized access or modification, in audio, electronic, and hard copy formats. That the undersigned understands all parties are bound by the requirements of the Health Insurance Portability and Accountability Act of 1996 which provide guidance on the protection of patient privacy and confidentiality. This Act Mandates all government agencies, and those bodies with whom they contract, must be compliance with the directives of the Act.

Contractor Qualification:
The contractor must obtain a State of Nevada Emergency Medical System s Air Ambulance Transportation Permit per required by Nevada State Senate Bill 285 (SB 285) for Air Ambulance performing emergency response services.

Driver/Pilot List:

Note: The term driver will be interpreted also as pilot and applicable and comparable vehicle control license requirements, character, qualifications, training, physical abilities, and behavior, shall be equally applied to aircraft transportation.

Contractor shall provide the COR a complete list of all drivers, utilized for this contract by the fifth day of each month. Updates must be submitted prior to drivers beginning to transport patients.

Driver/Pilot Qualification:
A record of each employee as to character, qualifications and physical capabilities of performing the duties of ambulance care driver or attendant must be maintained and made available for inspection upon request.

All drivers of said contractor MUST possess a valid state driver s license. The contractor shall ensure all drivers providing services under this contract will have less than five (5) current points on their driver s license, none of which were assessed for Reckless Driving. VASNHS will be provided copies of driver licenses and may independently verify the driving record of drivers at any time. VASNHS reserves the right to order the removal from service under this contract, any driver who violates the provisions of this section.

Driver Duties:
Contractor shall ensure its drivers will:
Perform their duties with due regard for the safety, comfort and convenience of customers and their property.
Comply with all applicable Federal and State laws, regulations and licensing requirements, including drug testing.
Have and maintain a current driver s license, valid in the state in which contractor s facility is located, with less than five current points, none of which were assessed for Reckless Driving.
Contact the Contractor s dispatcher before leaving the designated location without picking up the customer(s) and when encountering problems such as patient(s) not ready, incorrect addresses or addresses which are inaccessible to wheelchairs.
Drivers will also be required to dress in a professional manner at all times when transporting VA patients. Dress will contain and emblem of the transport company.
No passengers other than the patient and/or their attendant will be allowed in the vehicle during transport
Ensure smoking, eating and/or drinking in vehicles are not permitted by the drivers.
Ensure no playing of audio/visual equipment in vehicles will be allowed without the approval of the patient aboard.
Ensure its personnel comply with 49 Code of Federal Regulations (CFR) Parts 40, 653 and 654 on Substance Abuse Prevention, which are respectively incorporated herein by reference and made part of this contract.

Driver Conduct:

The following acts are not permissible by drivers, which provide services under this contract or while on VA premises. Violations will be reported to the appropriate law enforcement agency:
Use of intoxicating liquor, narcotics or controlled substances of any kind (excluding doctor prescribed medications which do not impair driver s driving ability) while on duty or reporting for duty while under the influence.
Smoking and other uses of tobacco while on duty
Carrying of pistols, firearms or concealed weapons
Resorting to physical violence to settle a dispute with a fellow employee, patient(s) or the general public while on duty.
Spitting in prohibited places or other unsanitary, offensive or insensitive practices or behavior
Use of loud, indecent or profane language and/or making threatening or obscene gestures toward customers or other employees.
Stopping for personal business, including use of the restroom facilities, while vehicle is occupied by a passenger. The driver shall not leave the vehicle with the key in the ignition at any time. Patient must be attended at all times by at least one contract staff member
Engaging patient or family member in a verbal confrontation in any attempt to settle a disagreement. Should a disagreement arise, the driver is to contact his dispatcher/supervisor via the radio system
Soliciting or accepting tips from customers, companions or others at any time.
Use of loud music
Lack of security/confidentiality of patient health information (HIPAA violations)

Aircraft Certification:
All aircraft shall hold a valid Air Carrier Operating Certificate issued by the Federal Aviation Administration (FAA) for an air operator and provide a copy to the COR. The operations authorized under this certificate shall be such that he/she can perform the services required by this contract. The contractor shall abide by all applicable FAA regulations. Each pilot who performs under this contract shall hold a valid commercial airman s certificate with the appropriate ratings for the conditions of the flight being undertaken, and operate under the air taxi rules for that certificate. The contractor shall comply with all applicable Federal, State and Local Regulation governing the operation of an air ambulance service.

A FAA flight plan shall be filed and used for any aircraft used for air ambulance flight under this contract. Whenever practicable and possible, the pilot shall take advantage of all existing ground and air communication facilities. Before each flight, the pilot shall obtain the latest information relative to weather, airport conditions and navigational facilities and, further, shall be satisfied that all conditions are such that they shall not constitute a hazard. In the event a flight is interrupted short of destination, the contractor shall immediately notify the COR by telephone. When appropriated medical personnel accompanying the flight determine that the patient requires medical attention, the contractor shall obtain authorization from the COR and make the necessary arrangements.

Pilots shall use the LIFEGUARD call sign only when time critical medical and emergency operations warrant such service.

Evidence of Insurance Coverage:
After award of a contract, the contractor shall furnish to the Contracting Officer a certificate of insurance which shall contain an endorsement to the effect that cancellation of, or any material change in the policies which adversely affect the interest of the Government in such insurance cancellation, shall not be effective unless a thirty (30) day written notice of cancellation or change is furnished to the Contracting Officer.
Certification of insurance per contract clause VAAR 852-237-71, must be provided to the Contracting Officer no later than 10 days after notification of award, but SHALL BE SUBMITTED PRIOR TO THE START OF WORK.
It shall be the responsibility of the Contractor to provide insurance in the amounts required by law.
Contractor shall resolve patient complaints of damage to personal material. Contractor will be responsible for repair replacement of patient personal property damaged while in the custody of the contractor until delivery and turnover of patient.
Training :
The contractor will provide documentation of training on transporting/assisting disabled passengers for all personnel who will be assigned to work performing any transportation for VA patients under this contract. Training shall be in place covering Blood borne Pathogens, Age Related Personal interactions and communication,, Body Mechanics, and HIPAA (as stated in Clause 852.273-75 Security Requirements for Unclassified Information Technology Resources). Copies of this documentation of training will be submitted to and held by the COR.
Operating Practices
All operations under the contract shall be supervised by competent, trained personnel who adhere to safe practices.

VA patients and accompanying guest shall only board and depart the aircraft when engines are not running. Definite precautions shall be taken to keep passengers and spectators away from aircraft when the power is on.

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.

No aircraft shall be refueled with the VA patient and accompanying guest on board. If completely unavoidable, all precautions shall include but are not limited to an attendant on watch near the cabin door, a dependable fire extinguisher, and adequate grounding of aircraft, fueling nozzle and fuel truck.

Contractor aircraft:

Shall comply with all FAA criteria.
Shall provide a climate controlled environment to prevent temperature extremes that would adversely affect patient care.
Shall have an entry that allows loading and unloading without excessive maneuvering of the VA patient and does not compromise functioning of monitoring systems, IV lines, manual or mechanical ventilation.
Shall be configured in such a way that the medical transport personnel have access to the patient in order to begin and maintain both basic and advanced life support.
Shall have interior lighting to ensure adequate observation of the patient. Aircraft cockpit should be capable of being shielded from the light in the patient care area.
Shall provide sufficient isolation from the patient care area to minimize in-flight distractions and interference.
Shall provide an inverter or appropriate power source with sufficient output and outlets to meet the requirement of the complete specialized equipment without compromising the operation of any electrical aircraft equipment.
Shall be configured so all equipment, stretchers and seating allow for rapid and safe transport of the veteran.
Shall be configured so that all equipment and supplies are secured in racks, compartments or straps to meet or exceed all FAA Regulations.
Shall be equipped with sufficient quantities of medical supplies and equipment specific to the type of mission being assigned and adhere to all local and state requirements. VA Medical Centers shall not provide supplies replenishment. These supplies shall include, but are not limited to:

Industry standard medications and disposable medical bandages and supplies.
b) Airway management equipment including oxygen, mechanical suction, intubation equipment and ventilator support equipment.
c) Cardiac monitor/defibrillator.
d) ACLS drugs and therapeutic modalities; or equivalent specific to type of mission assigned.
e) Other electronic devices deemed necessary to deliver specific patient care for the mission assigned.

Medications/intravenous solutions, dressing, catheterizations kits for specific patients needs shall be provided by the VA.

xi. Shall be equipped with sharps disposal container for contaminated needles. Disposal of all contaminated materials from aircraft and/or ambulance shall meet Federal OSHA Guidelines.

xii. Shall be equipped with collection container for soiled and disposable items.
6. Medical equipment and supplies

Each piece of linen (including blankets, pillows, sheets) that has come into contact with the patient shall be thoroughly cleaned and if necessary disinfected after each flight. Disposable or single use items may be used, but shall be disposed after usage.

i. Each piece of equipment that has come into contact with the patient shall be properly washed and disinfected after each flight.

ii. Each stretcher pad, mattress, and pillow shall be impervious to moisture.

7. Hazardous Material

All hazardous material shall be contained and disposed of in accordance with Federal, State, Local laws, regulations and procedures.

8. Contractor shall maintain all medical equipment in accordance with manufacturer s recommendations, be functional at all altitudes and shall not interfere with aircraft avionics. Likewise, aircraft avionics shall not interfere with medical equipment. Adequate records showing maintenance and calibrations shall be kept and presented to the Contracting Officer or COR upon written request.

9. All communication equipment shall be capable of transmitting and receiving clear and understandable voice communications to and from the base station at a reasonable distance.
All communication equipment shall be maintained in full operating condition and in good repair. Radios on aircraft (as range permits) shall be capable of communicating with the following:
i. Medical advice and direction
ii. Communication center
iii. Air traffic control
iv. EMS and law enforcement agencies

10. The aircraft shall be equipped with appropriate survival equipment.

11. Contractor shall use FAA approved air medical stretchers.

Flight Crew:

At a minimum, Flight crew shall consist of three (3) personnel:

1. One (1) Pilot in command
i. Pilot(s) shall not be considered as part of the medical crew.
ii. Shall meet or exceed the minimum requirements of the FAA for type of aircraft being used in fulfillment of this contract
iii. Shall follow all FAA flight regulations
iv. Shall be responsible for all in-flight security for the patient and crew.

2. Designated Flight Nurse (a Flight Physician may be substituted for a Critical Care Nurse) with the following minimum qualifications as required for the mission assigned:
i. Certified in BLS and ACLS. (Certification by Board of Emergency Nursing (CFRN) is desired.)
ii. Be ventilator certified from an accredited program.
iii. Shall be current on certifications and continuing education.

3. Medical Flight Attendant with minimum qualifications, education, and certifications of an EMT. An additional Flight Nurse meeting the qualifications as Number 2 above shall meet the requirement.

4. If VA deems necessary, a VA Doctor or VA Nurse may accompany the VA patient at no additional cost to the VA. This person would be in addition to the required minimal three (3) person flight crew.

5. Flight Crew shall have access to a program Medical Director to act as a technical advisor to assist the Flight Crew and attending physician in identifying precautions and care while inflight.

Aircraft Maintenance:

All aircrafts used in the performance of this contract shall be maintained in an air worthy condition in accordance with all applicable FAA regulations by means of an established inspection and maintenance plan. Line inspections shall be performed at least once in twenty-four (24) hours preceding a flight. Aircraft shall be handled exclusively by trained personnel.

Contactor shall own and operate adequate maintenance facilities or shall have a contract with an acceptable shop to perform aircraft maintenance; said contract to provide that maintenance shall be performed as and when required by air taxi operator per FAA regulations.

All ambulance aircraft shall be maintained in clean condition, including cabin interior, windows and aircraft exteriors.

Smoking
There shall be no smoking:

1. Within 10 feet where oxygen is stored, dispensed or is in use.
2. Aboard aircraft in which VA patients shall be transported
3. In ground ambulances where VA patients shall be transported
4. Within 50 feet of any Government building.
5. In an areas where prohibited by Federal, State, Local ordinances.

ID Badges

All Contractor personnel required to wear identification (ID) badges during the entire time they are on the VA grounds. ID badges shall have an identification picture, name of the individual and the represented company depicted on it.

Parking

It is the responsibility of Contractor personnel to park only in designated parking areas. Parking information is available from the VA Police Service. The VA shall not validate or make reimbursement for parking violations of the Contractor s personnel under any circumstances.

Contract Changes

Changes determined by the assigned Contracting Officer to be within the general scope and intent of this contract shall be made in accordance with FAR 52.212-4, Contract Terms and Conditions (c) Changes, and shall not necessitate a new procurement actions.

Changes can only be made by the Contracting Office. Any deviation/changes from this contract by the Contractor shall not be paid nor authorized by the VA.

Performance Monitoring:
The Contractor will provide a list of all drivers, copies of certifications of operations, a certificate of insurance, and if requested by the COR any copies of maintenance schedules. The COR will review each request for transport and once approved, receive a copy of the rate quote. The COR will maintain each rate quote on a spreadsheet to compare and verify when the invoice is received that the charges are accurate before paying the invoice. The COR will track any patient related issues or complaints, meet with the Contractor to coordinate any respond and answer the issue or complaint timely to ensure quality; if the issue is medical in nature, the COR will seek guidance/review with the Chief of Staff s office.

Security Requirements.
1) a. The contractor and their personnel shall be subject to the same Federal laws, regulations, standards and VA polices as VA personnel, regarding information and information system security. These include, but are not limited to Federal Information Security Management Act (FISMA), Appendix III of OMB Circular A-130, and guidance and standards, available from the Department of Commerce s National Institute of Standards and Technology (NIST). This also includes the use of common security configuration available from NIST s Web site at: http://checklists.nist.gov.

b. To ensure that appropriate security controls are in place, contractors must follow the procedures set forth in VA Information and Information System Security/Privacy Requirements for IT Contractors located at the following site: http://www.iprm.oit.va.gov.

c. These provisions shall apply to all contracts in which VA sensitive information is stored, generated, transmitted, or exchanged by VA, a contractor, subcontractor or a third-party, or on behalf of any of these entities regardless of format or whether it resides on a VA system or contractor/subcontractor s electronic information system(s) operating for or on the VA behalf.

Government-Furnished Equipment (GFE)/Government-Furnished Information (GFI).
Not applicable
Risk Control
See specific tasks section.
Place of Performance.
Work will be performed at the contractor s site, however, Southern Nevada VA Healthcare beneficiaries will be retrieved from main facility at 6900 North Pecos Road, North Las Vegas, Nevada 89086.

Attachments/Links