Loren Data's SAM Daily™

FBO DAILY ISSUE OF FEBRUARY 26, 2011 FBO #3381
DOCUMENT

V -- Special Needs Veterans Transportation Services Non-Emergency Wheelchair Transports - Attachment

Notice Date

2/24/2011
 

Notice Type

Attachment
 

NAICS

485991 — Special Needs Transportation
 

Contracting Office

Department of Veterans Affairs;Contracting Officer (10F-ACQ);VA Puget Sound Healthcare System;9600 Veterans Drive SW, Bldg 17;Tacoma WA 98493
 

ZIP Code

98493
 

Solicitation Number

VA26011RQ0572
 

Response Due

3/4/2011
 

Archive Date

3/14/2011
 

Point of Contact

Ross Byrne
 

Small Business Set-Aside

N/A
 

Description

THIS IS A SOURCES SOUGHT NOTICE ONLY. THIS IS NOT A REQUEST FOR PROPOSAL OR QUOTE; THE VA IS NOT SEEKING PRICING OR OFFERS. The Department of Veterans Affairs, VISN 20, in support of VA Puget Sound Health Care System, is performing market research to compile data regarding: (1) The availability and capability of qualified small business concerns; (2) Identify if there are sufficient number of qualified Service-Disabled Veteran-Owned Small Business, Veteran Owned Small Business, HUB Zone 8(a), Women-Owned Small Business, or Small Disadvantaged Business, Small Business concerns relative to the subject North American Industry Classification System (NAICS) code. Responses to the information requested will assist the Government in determining the appropriate procurement method, including any set-aside decision. Respondents should clearly describe their capabilities to include management experience, equipment and personnel or the ability to obtain them. Furthermore, interested sources must also meet all requirements of Federal, State, and Local Municipal codes regarding operations of this type service. The NAICS code assigned is: 485991 Special Needs Transportation (Non-Emergent) and the small business size standard is $7.0M. Not responding to this Sources Sought does not preclude participation in any future or potential solicitation, or Request for Quotation. It is the intent of VA Puget Sound Health Care System to use the information gathered for market research purposes only. If a formal solicitation is released, it will be posted via the Federal Business Opportunity (http://www.fbo.gov) DESCRIPTION OF THE REQUIREMENT: Provide Non-emergency Special Needs Transportation Services for Veterans living in Western Washington. This includes one way and/or round trip transportation services from the veterans' place of residence to any of the one of nine VA Puget Sound Health Care System facilities. The contractor shall furnish all management, supervision, labor, materials, equipment, specified supplies, and resources necessary to provide non-emergency transportation for wheelchair, and other beneficiaries. The contractor shall have and maintain the appropriate license(s) required to perform in accordance with (IAW) the attached Statement of Work. Service is required 6AM PST to 8PM PST Monday through Friday, (except Federal Holidays). The projected performance period consists of: One year base period (Anticipated start date is 1 Apr 2011 to 31 Mar 2012) with up to one (1) option year. These dates may be adjusted based upon actual date of award. POTENTIAL SOURCES SHALL PROVIDE THE FOLLOWING INFORMATION IN THEIR RESPONSE: 1. Company name, address, phone number, primary contact(s), e-mail address, NAICS code(s), business size i.e. SDVOSB, VOSB, 8A, etc., and DUNS Number. Proof of Central Contractor Registration and Vet Biz registry (if applicable) is highly desirable. Identify all Joint Ventures and other Teaming arrangements. 2. A brief capability statement demonstrating past performance with relevant contract services in Prime Contractor role. 3. Disclaimer: This notice does not obligate the Government to award a contract or otherwise pay for the information provided in response. The Government reserves the right to use information provided by respondents for any purpose deemed necessary and legally appropriate. After review of the responses received, a pre-solicitation synopsis and solicitation may be published in Federal Business Opportunities (http://www.fbo.gov). 4. Submit Capability Statements to: Department of Veterans Affairs, VISN 20 Attn: Ross Byrne, no later than 4:00 PM, 3 Mar 2011. Responses must be submitted via e-mail to: Ross.Byrne@va.gov and Aaron.Tong@va.gov. Note: Do not include Proprietary, classified, confidential, or sensitive information in responses. B.3 STATEMENT OF WORK-Draft 1.0 BACKGROUND The Veterans Affairs Puget Sound Health Care System (VAPSHCS) has a requirement to provide non-emergency transportation to veterans living in Western Washington. Patients may be transported to and/or from any VA designated health care facility within the defined service area, encompassing the Western Washington, to include county-to-county transports and within county transports for wheelchair ambulatory patients. VA Puget Sound Health Care System serves Veterans living in western Washington. In FY09, the Veteran population in the region was 462,678 Veterans. Of those Veterans, 110,495 were enrolled and 67,670 unique Veterans were treated. Workload for FY09 included 810,255 outpatient visits, 8,955 admissions and 19,006 emergency visits. The VAPDHCS has grouped the Western Market into four distinct Veterans Transportation Service Areas and potential veteran users. Region 1: Grays Harbor, Thurston and Pierce County (20,589); Region 2: Snohomish and King County (17,989); Region 3: Clallam, Jefferson and Kitsap and Mason County (4,879); Region 4: Skagit, Whatcom, San Juan and Island County (3,463). 2.0 SCOPE OF WORK The Department of Veterans Affairs intends to award a base contract plus one (1) option year. This will be a Firm Fixed Price contract. VAPSHCS consists of two campuses, one located in Seattle and one at American Lake near Tacoma, Washington. In addition, the health care system includes seven Community Based Outpatient Clinics (CBOC) located throughout the Puget Sound region. The Contractor shall furnish all management, supervision, labor, materials, equipment, specified supplies, and resources necessary to provide non-emergency transportation for wheelchair, and other beneficiaries to veterans living anywhere in the Western Washington. This includes one way and/or round trip transportation services from the veterans' place of residence to any of the following location listed below. In some cases, veterans may require to attain medical services at multiple locations. In that event, the Contractor shall be able to pick up veterans at their residence, drop off at one VA medical facility listed below, pick up and drop off at another VA medical facility listed below, and finally, drop off veterans at their residence. Campuses "Seattle Division 1660 South Columbian Way Seattle, WA 98108 "American Lake Division 9600 Veterans Drive Tacoma, WA 98493 Community Based Outpatient Clinics (CBOC) "Mt. Vernon CBOC 307 S. 13th St. Mount Vernon, WA 98274 "North Seattle Valor Clinic 12360 Lake City Way NE, Suite 200 Seattle, WA 98125 "Bellevue Valor Clinic 13033 Bel-Red Road Suite 210 Bellevue, WA 98005 "Federal Way Valor Clinic 34617 11th Place South Suite 301 Federal Way, WA 98003 "Port Angeles Clinic 1005 Georgianna St Port Angeles, WA 98362 "Bremerton CBOC 925 Adele Avenue Bremerton, WA 98312 "South Sound CBOC 151 NE Hampe Way Suite B2-6 Chehalis, WA 98532 3.0 REQUIREMENTS The Contractor shall pick up and deliver veterans and patients at and/or between any of the listed location above. These services will be made available from Monday through Friday 6:00 a.m. PST - 8:00 p.m. PST (except holidays). The Contractor shall offer various modes of transportation to accommodate both ambulatory and wheelchair patients. The Contractor shall offer a centralized call center with a high-capacity telecommunication system. Include a 1-800 toll-free number for Western Washington Veterans to utilize for transportation requests. This system should be staffed appropriately to enable calls to be answered within a timely manner or called back within one hour. The Contractor shall offer a website that will allow Veterans to request trips online. The website should be staffed appropriately to allow for swift responses and scheduling to occur within a twenty four hour period. The Contractor shall provide an Interactive Voice Response system to help clients remember their scheduled rides. The Contractor shall provide RouteMatch scheduling software to which VA will be compatible with the VA system. The Contractor shall provide a roundtrip transportation that includes door to door service to their VA appointment at the appropriate VA Puget Sound Health Care location. The Contractor shall provide non-emergency transportation for wheelchair, and other ambulatory beneficiaries of the VA Puget Sound Health Care System. The Contractor shall provide transportation services during Monday through Friday 6:00 a.m. PST - 8:00 p.m. PST (except holidays). The Contractor shall provide all manpower, equipment, vehicles, fuel, materials and supplies and supervision necessary to perform all tasks. Identification badges: All Contractor employees shall wear appropriate identification that clearly identifies them by name, title, and job performed. The Contractor shall comply with the provisions of the Privacy Act of 1974, the Health Insurance Portability and Accountability Act (HIPAA) of 1996, as well as all applicable VHA regulations. The Contractor shall not maintain and/or share sensitive or patient identifiable information in any form or for any purpose, other than what is needed to perform its obligation under the established business agreement. The Contractor shall have internal policies and procedures, in accordance with HIPAA, that protect and maintain the confidentiality of individual patient information and shall comply with the Privacy Act/HIPAA as it pertains to general patient information, HIV, drug and alcohol abuse, and sickle cell anemia. The VA reserves the right to thoroughly inspect and investigate the establishment, facilities, equipment, business reputation, and other qualifications of the contractor for the duration of this contract. Wheelchair equipped vehicle shall have: "A lift facility, operated electrically, hydraulically or mechanically, with sufficient capacity to safely and smoothly lift passengers into the vehicle. "A secure latching apparatus for locking the wheelchair to the vehicle for each passenger transported a positive means of securely latching or locking to the vehicle the wheelchair, in which the passenger will ride. The latching device shall be designed to prevent any lateral, longitudinal or vertical motion of the passenger conveyance within the vehicle inconsistent with the motion of the vehicle itself. "Restraining belts or straps, designed to securely confine passengers to wheelchairs in which they are transported. "Air-conditioning and heating. "An inside rear-vision mirror, in addition to the rear-vision mirrors, which will enable the driver to view the entire passenger compartment, at the level at which the passengers ride. "Latching devices on the vehicle entry and exit doors sufficient to retain individual passenger conveyances within the passenger compartment of the vehicle regardless of the motion of the vehicle. "An easily accessible and fully operational fire extinguisher. Multiple riders is defined as, more than one patient is transported simultaneously in one vehicle at any given point during a trip. When more than one patient is transported on a trip, payment will be made at the single patient loaded mileage rate (from pick up to final destination), or single patient pickup charge, as applicable. VA maintains the right to require multiple patient transports. When more than one patient is transported simultaneously from the same point of pick up to the same destination, the contractor shall receive payment based on the single patient loaded mileage rate from the initial pick-up point to the final drop-off point, and the base rate if applicable. Total mileage billed for multiple riders shall equal the actual vehicle mileage at the single patient loaded mileage rate. When more than one patient is picked up from different locations, but transported simultaneously to the same destination, the contractor shall receive payment based on the base rate if applicable, and the single patient loaded mileage rate of the first pick-up to the final destination. The contractor shall receive base rate payment only for the second pick-up. When more than one patient is picked up from the same pick-up point to different destinations, the contractor shall receive payment based on the base rate if applicable, plus mileage from the pick-up to Patient A's destination and from Patient A's destination to Patient B's destination. The Contractor shall note the number of riders on all trip tickets. Waiting Times - Billable wait time begins after the 15-minute grace period and the successful notification of the VA VTS Coordinator or the AOD (during irregular hours), and ends at the beginning of the patient loading process. For time lost in excess of 15 minutes' waiting at either end of a trip due to causes beyond his control, the Contractor will charge the Veterans Affairs. If the pick-up is at other than the VA Puget Sound Health Care System, the Contractor will call the VA VTS Coordinator (between 7:00 a.m. and 4:30 p.m. Monday through Friday), or the AOD on duty at (between 4:30 p.m. and 7:00 a.m. and on weekends and holidays) as soon as he anticipates that a delay may develop for which he expects to claim payment. This call is only for the purpose of verifying his arrival time at the pick-up point and is not necessary if the Contractor does not anticipate a delay for which payment will be requested. Record of each employee as to character and physical capabilities of performing the duties of a medical patient transport driver/attendant must be maintained and made available for inspection upon request. Escort/Caregivers - The VA reserves the right to send an escort, such as a relative, caregiver, or VA staff to accompany a beneficiary when the VA determines that the escort/caregiver is in the best interest of the beneficiary receiving travel services. The contractor will be notified in advance if a scheduled transport patient requires an escort/caregiver. An escort/caregiver is defined as an individual, not employed by the Contractor, who provides direct care to the patient being transported via special mode. Adequate seating must be provided for escort/caregivers, with appropriate safety equipment. There shall be no additional charge for escorts/caregivers. The VA will be the sole judge in determining when an escort/caregiver is required. The Contractor shall only be required to transport the escort/caregiver that accompanies a patient and shall not be required to return the escort/caregiver that does not accompany a patient to the point of origin, except when specifically authorized. Insurance - IAW clause 852.237-71, the following minimum coverage shall apply to this contract. Worker's compensation and employer's liability (OWCP) - Contractors are required to comply with applicable Federal and State worker's compensation and occupational disease statutes. If occupational diseases are not commensurable under those statutes, they are covered under the employer's liability section of the insurance policy, except when contract operations are so commingled with a Contractor's commercial operations that it would not be practical to require this coverage. The Contractor shall hold Employer's liability coverage of at least $100,000. General Liability (covers liability exposures, such as lawsuits, property or personal injury on the premise of a business): $500,000 per occurrence. Automobile Liability: $200,000 per person, $500,000 per occurrence for bodily injury and $20,000 per occurrence for property damage. The contractor shall provide proof of liability insurance, as listed above, prior to commencement of work. Treatment/Mistreatment of Patients in Route - Any substantiated mistreatment of patients in the performance of this contract may be cause for termination of the contract, or discontinuance of further placement of orders. The VA reserves the right to request driver removal from transporting VA patients if mistreatment is substantiated. Drivers must be courteous and considerate of all patients they are transporting. Orders - Requests for services will be made by telephone/fax from the VA VTS Coordinator, his designee or the Administrative Officer of the Day (AOD): "Each request will have an identified VA authorization number associated with the trip request. "If the Contractor's place of business is located beyond the local telephone call zone of the hospital, the Contractor agrees to accept telephone orders for service on a collect call basis or provide toll free numbers. "When transporting patient(s) leaving the hospital, the Contractor will be required, if necessary, to transport a maximum of three (3) items (boxes or luggage) of the patient's personal effects at no additional cost to the VA. "Drivers shall return patients in the order that they are called in. Drivers shall not skip departing patients to cover a longer distance versus a shorter distance. Only with the approval of the Supervisor - Travel Unit will this be authorized. Repeated instances of skipping may lead to termination of the contract or discontinuance of further order placement. "Invoices for payment shall include a copy of the trip ticket and the VA authorization number to ensure payments. The Department of Veterans Affairs reserves the right to use station vehicles/drivers prior to using those of the Contractor. Origin and Destination - Patients may be transported to or from any designated location within the defined service area, encompassing the Western Washington, to include county-to-county transports and within county transports for wheelchair ambulatory patients. All transports will be between VA facilities or between the VA facility and a facility that provides care under VA auspices (i.e. Contract Nursing Home, Community Outpatient Clinics), and/or between the home of the beneficiary receiving travel services and the VA facility. The VA staff will specify the points of origin and the destination of every trip. Substitution of Beneficiary - The VA reserves the right to substitute the beneficiary requiring services at any time during the performance of this contract, to prevent delays, cancellations, or no-shows. There shall be no additional charge to the VA when such changes occur. Trip Documentation - The Contractor shall document each transport with an appropriate document that specifies the date, patient name, time of pick up, destination, time of drop off and any notes regarding issues particular to the specific transport, including recording oxygen, cardiac monitoring, and other services provided. The Contractor shall include a copy of this form with all invoices and also provide the trip documentation form upon request by the VA. These forms will serve as documentation of the transport and will be a source document for reconciliation of the Contractor's requests for payment. Response Time - Between the hours of 7:00 a.m. PST and 4:00 p.m. PST, Monday through Friday (excluding Government holidays), the Contractor's vehicles shall respond within 30-minutes after receiving a request or order. All other times the Contractor's vehicle must respond within forty-five (45) minutes after receiving a request or order. If the Contractor fails to furnish service within the required response times, the VA reserves the right to obtain this service from another source and to charge the Contractor with any excess cost which may result, and will be deducted from their monthly invoice. The VA will be the sole judge in determining when to order service from another source. Repeated failure to meet required response time may result in termination of the contract, or discontinuance of further orders. Response time will be calculated from the Contractor's receipt of the telephonic request for service. No Show Rate - No show is defined as the case in point where the beneficiary receiving services does not present at the time of transport or declines to go with the contracted service. Cancellation - At the time of the request, Contractor shall acknowledge their ability to provide the service within the requested response time. If the Contractor cannot provide the services for any reason, they must notify the VA staff person requesting the service of their inability to provide the service. (All companies utilized as subcontractors are subject to the approval of the VA and the Contractor must provide a list of such subcontractors to the VA). In the case when a subcontractor is utilized, they must meet all response times and all other requirements of this contract. The Contractor shall not charge the VA a cancellation fee when cancellations are made prior to the special mode transportation dispatch. Safety Requirements - In order to protect the lives and health of patients, the Contractor shall take such safety precautions as the Contracting Officer, or his designate, may determine to be reasonably necessary. The Contracting Officer, or his designate, will notify the Contractor of any safety non-compliance and the action to be taken. The Contractor shall, after receipt of such notice, immediately correct the conditions to which attention has been directed. If the Contractor fails or refuses to comply promptly, the Contracting Officer may issue an order stopping all or any part of the work and discontinuance of further order placement. Change in Patient Condition upon Arrival or in Route - Upon arrival at the patient pick-up point, if the contractor determines the condition of the patient scheduled for pick-up is different than what was stated on the travel request, the contractor shall notify the VA VTS Coordinator or Administrative Officer of the Day (AOD) for further instruction. While in route if the patient's condition changes to where emergency care is required, the contractor shall take the patient to the nearest Emergency Room for treatment and notify the VA VTS Coordinator during regular duty hours and the AOD during irregular duty hours. Infection Control - Contractor employees shall receive ongoing training on universal precautions and infection control as appropriate to their duties. Contractor drivers and attendants shall use universal precautionary measures at all times for the prevention and control of the spread of infectious agents to all persons. The Contractor shall delay using drivers and/or attendants who have the cold, flu, chickenpox, measles, or have been around someone who is sick on trips until well or no longer symptomatic. Disposal of Hazardous Waste - Contractor employees shall be trained on how to handle bio-hazardous waste during transport and how to properly dispose of bio-hazardous waste in designated containers, including how to dispose in designated containers when onsite at James A. Haley Veterans Hospital. The Contractor shall not dispose of any bio-hazardous materials at any location on the medical facility premises except as specified by the Contracting Officer. 4.0 CERTIFICATIONS The Contractor shall maintain documentation that they meet all competency and training requirements of Federal, State, County or City codes regarding operation of this type of service. This documentation shall be made available to the VA immediately upon request for the duration of this contract. Throughout the life of the contract, the Contractor must be licensed to perform this service. In the event the license lapses or expires, this could be cause for termination of the contract or discontinuance of further ordering. The Contractor employees shall possess current and valid licenses/certifications, and must possess these current and valid licenses/certifications before they can begin work on this contract. Copies of these licenses/certifications and/or other credentials shall be provided to the VA upon request at any time for the duration of this contract. The Contractor shall ensure that its employees receive the training required to do their jobs in a manner that is consistent with terms or conditions specified: "All Contractor personnel shall have ongoing documented training to maintain their appropriate levels of competency, including HIPAA training. "Records and certifications shall be maintained by the Contractor and available for VA inspection upon request for the duration of this contract. "All drivers must meet DOT requirements and hold current CPR certifications. Contractor employees shall be trained on the appropriate handling of Mental Health and other special populations. "All personnel must meet the State of Washington Regulations for licensing and certification stipulations. The Contractor shall be required to meet the regulations of the Washington Public Transportation Commission and comply with the Washington State Motor Vehicle Regulations. Drivers shall be trained in the correct use of the special equipment herein, and shall insure that such equipment is in good repair, and that each passenger is properly secured in place by latching and restraining devices before the vehicle is placed in motion and throughout the transportation performed. The Contractor shall provide vehicles under this contract, be licensed and meet minimum vehicle operational and safety standards as mandated by the State of Washington. The Contractor shall provide vehicles that meet the following criteria: "Equipment shall be cleaned to meet customer expectations. "All lights shall function properly. "All vehicles shall contain functioning air conditioning and heating systems. "All equipment in the patient area shall be adequately secured. "All vehicles shall contain seatbelts, rear view and side view mirrors. "A no-smoking policy shall be applied with visible signage posted. "Vehicles shall be inspected for cleanliness prior to each pick-up and kept clean and in good mechanical and body condition. "All vehicles shall contain functioning, primary and back-up, two-way communication between the transport vehicle and the contractor's dispatch location. The VA reserves the right to inspect any and all vehicles during the performance of this contract. 5.0 QUALITY CONTROL PROGRAM (QCP) The Contractor shall establish and maintain a complete QCP to assure the requirements of this contract are provided as specified, during the life of the contract. The Contractor's QCP shall include the following: "An inspection plan covering all services required by this contract. The inspection plan must specify the type of inspections (i.e. scheduled, unscheduled), areas for inspection, frequency of inspections and documentation of inspections, and who will conduct the inspections, with his or her title specified. "On-site records of all inspections conducted by the Contractor. The inspection records must note findings and necessary corrective action taken, the timeframe, and follow-up responsibility/issues. The VA reserves the right to request copies of any and/or each inspection. "Internal procedures for updating medical service protocols. The Contractor shall have established internal procedures for updating medical service protocols that have been revised, requires changes and/or incorporation of new protocols since licensing. The changes to processes, equipment, and/or protocol that may affect performance of contract must be communicated in writing to the Contracting Office. "Methods for identifying and preventing deficiencies. The Contractor shall have quality improvement mechanisms in place that allows the business to evaluate the quality of services performed by using established methods for identifying and preventing deficiencies before the level of performance becomes unacceptable. Specific organizational monitoring functions and areas must be identified with levels of responsibility associated, noting intermediate supervisory responsibility and overall management responsibility for ensuring total acceptable performance. Proposed Performance Measures Metric Name Measurement LevelFrequency Method (Discussion) Cost Modality of Transport; VTS Proof of Concept Site Monthly The costs associated with: "Depreciation "Maintenance/Upkeep "Fuel "Insurance/Other "Labor Cost per Patient MileModality of Transport; VTS Proof of Concept Site MonthlyTotal costs divided by total patients carried (to/from) multiplied by total patient miles traveled Unique Patients Modality of Transport; VTS Proof of Concept Site; System WideWeeklyCount of unique patients utilizing VTS Patients Modality of Transport; VTS Proof of Concept Site; System Wide WeeklyCount of patients utilizing VTS (includes repeat users) Average Trips per Month per Patient Modality of Transport; VTS Proof of Concept Site; System WideMonthlyAverage number of trips per patient measured on monthly basis Miles Traveled Modality of Transport; VTS Proof of Concept Site; System WideMonthly Aggregation of total miles traveled Average Length of Trip VTS Proof of Concept Site; System WideMonthlyAverage duration per trip (may be very difficult) Overall SatisfactionModality of Transport; VTS Proof of Concept Site; System WideMonthly Patient Satisfaction Postcard on VTS vehicle Satisfaction with Dependability Modality of Transport; VTS Proof of Concept Site; System WideMonthly Patient Satisfaction Postcard on VTS vehicle Satisfaction with Cleanliness and Comfort Modality of Transport; VTS Proof of Concept Site; System WideMonthlyPatient Satisfaction Postcard on VTS vehicle Satisfaction with Driver Modality of Transport; VTS Proof of Concept Site; System WideMonthlyPatient Satisfaction Postcard on VTS vehicle Likelihood to Continue UseModality of Transport; VTS Proof of Concept Site; System WideMonthlyPatient Satisfaction Postcard on VTS vehicle Helped Make Appointment Modality of Transport; VTS Proof of Concept Site; System WideMonthlyPatient Satisfaction Postcard on VTS vehicle Missed Appointment PercentModality of Transport; VTS Proof of Concept Site; System WideMonthlyVista measure (?) "On-site competency records of each employee. The Contractor shall have employee records available on-site that identifies the character, physical capabilities, certifications, and ongoing training records of each employee performing services under this contract. "A logor trip ticket to account for all requests for service. The Contractor shall use a log or trip ticket to account for all requests for services. The log shall indicate the date and time of service call, name of beneficiary requiring service, type of transportation requested, designated pick-up and delivery points, actual time of arrival at pick-up and delivery points and actual waiting time at pick-up and delivery points, if waiting charges are claimed. The trip ticket shall also contain a patient trip evaluation section, which should be completed for ongoing monitoring of customer comments. "On site records for tracking of customer complaints and actions taken. The Contractor shall keep onsite records for tracking customer complaints or problems with the procedures or initiatives implemented for correction and/or elimination of the problem before negative effects caused interruption of performance on contract. "Drug Testing Policy - The contractor shall have internal policies and procedures for addressing drug and alcohol abuse. Incident Reporting: The contractor shall report any patient incident initially on a signed incident report within two (2) hours of the incident to the VA VTS Coordinator or AOD. An assessment of the incident and a signed vender response to the incident to include training and process changes shall be submitted to the travel supervisor within five (5) days from the date of the incident. A signed final analysis to include Education, Training, and Process changes to prevent future incidents shall be submitted within thirty (30) days to the VA VTS Coordinator. Contractor Personnel Security Requirements (applies to contractor drivers and attendants): Position Sensitivity - The position sensitivity has been designated as Low Risk. Background Investigation - The level of background investigation commensurate with the required level of access is National Agency Check with Written Inquiries. 6.0 CONTRACTOR RESPONSIBILITIES a.The contractor shall bear the expense of obtaining background investigations. If the investigation is conducted by the Office of Personnel Management (OPM), the contractor shall reimburse VA within 30 days. Currently the maximum cost of a National Agency Check with Written Inquiries is $100.00 during the effective period of the contract if this cost increases; the contractor will be entitled to an equitable adjustment in the contract price. b.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: (1) Standard Form 85P, Questionnaire for Public Trust Positions (2) Standard Form 85P-S, Supplemental Questionnaire for Selected Positions (3) FD 258, U.S. Department of Justice Fingerprint Applicant Chart (4) VA Form 0710, Authority for Release of Information Form (5) Optional Form 306, Declaration for Federal Employment (6) Optional Form 612, Optional Application for Federal Employment c.The contractor, when notified of an unfavorable determination by the Government, shall withdraw the employee from consideration from working under the contract. d.Failure to comply with the contractor personnel security requirements may result in termination of the contract for default cause. 7.0 GOVERNMENT RESPONSIBILITIES a.The VA Office of Security and Law Enforcement 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 Office of Security and Law Enforcement 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 Office of Personnel Management (OPM) 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 OPM. e.The contracting officer will ensure that the contractor provides evidence that investigations have been completed or are in the process of being requested. 8.0 CONTRACT DEFINITIONS/ACRONYMS Ambulatory Patient - A non-emergency VA beneficiary who does not require the use of an ambulance, who can utilize normal forms of transportation such as taxi or hired car, or vehicle equipped with a wheelchair lift. Wheelchair Patient - A non-emergency VA beneficiary confined to a wheelchair or scooter, using a wheelchair or scooter for mobility or with mobility impairments, whose handicap prevents use of normal modes of transportation, or lift equipped, such as car, van, or taxi. Attendant/Escort - A non-medical attendant may be required to assist with transportation, when deemed necessary by a VA physician or VA VTS Coordinator. An escort is a non-medical attendant which can be a care giver, family member or VA employee to accompany the patient. VTS Coordinator -Veterans Transportation Service Coordinator AOD - Administrative Officer of the Day
 

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File Name: VA-260-11-RQ-0572 VA-260-11-RQ-0572.doc (https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=178516&FileName=VA-260-11-RQ-0572-000.doc)

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