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608-23-7062-0017

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1. OVERVIEW
Contractor shall furnish Basic Life Support (BLS), Advance Life Support (ALS). Transport Ambulance Services the beneficiaries of the VA Manchester Healthcare System (VAMHCS). The Contractor shall provide all equipment, personnel, supervision, logistics, and support to provide these transportation services, all services will be provided in accordance with the terms and conditions of this contract and industry accepted quality standards highlighted in the Performance Work Statement (PWS). This contract shall be for a base period of one (1) year with options for four (4) additional one (1) year periods.

The VAMHCS, is located in Manchester, New Hampshire. Services to be provided include transportation to and from VAMHCS, NH Community Based Outpatient Clinics (CBOCS), community hospitals in the state, and longer distances trips outside of NH to other VA medical centers such as, Boston, Bedford, West Roxbury, Jamaica Plain, Leeds, Maine Medical (Togus) and White River Junction. Most trips requested across state lines are to the VA Medical Centers.

The intent is to establish an all inclusive process to the greatest extent possible by establishing a fixed price per trip for routine transports. Base trips are defined as being within a twenty-five (25) mile radius of the pickup point. Pricing is established on a one way, per trip basis with additional line items to cover mileage over the 25-mile radius (26 miles and above). Please see Contract Line Item (CLIN) schedule for further clarification.

Below are the locations of the VAMHCS CBOCs:

Conway CBOC
71 Hobbs St, Third Floor
Conway, NH 03818
Portsmouth CBOC
302 Newmarket Street, Pease Air National Guard Base
Portsmouth, NH 03803
Somersworth CBOC
5 Terrascape Parkway
Somersworth, NH 03878

Tilton CBOC
630 West Main Street, Suite 400
Tilton, NH 03276

TASKING/SPECIFICATIONS

GENERAL: contractor shall furnish twenty-four (24) hour BLS/ALS/SCT Ambulance Service for the beneficiaries of the VAMHCS. Services to be provided seven (7) days a week, nights, and holidays.

NUMBER OF PATIENTS: It is understood and agreed that only one (1) patient will be transported on a trip unless specifically authorized by the VA. An authorized official of VAMHCS may, in the best interest of the patient, allow a relative to accompany him/her at no extra charge to the Government.

WAITING TIME: The Contractor will be reimbursed in accordance with the CUN schedule for wait time more than fifteen (15) minutes from the time the Contractor arrives at the designated location. If the pickup is other than at the VAMHCS, the Contractor will call the Travel Clerk (6:30AM 4:30PM) or the Administrator on Duty (AOD) (after 4:30PM weekdays, weekends and holidays) as soon as they anticipate that a delay may develop for which they expect to claim reimbursement. This call is only for the purpose of verifying arrival time at the pickup point.

COMPLETED TRIP: When ambulance service under the terms of this contract involves pickup of a patient who is to be brought to VAMHCS or another medical facility for hospitalization or treatment, the trip will be considered complete when the patient is delivered by ambulance personnel to the admitting/evaluation unit, a specified ward or unit, or to the location specified at the time the trip is requested.

NON-PICKUP OF PATIENT (DRY RUN): When ambulance service involves a trip to or from VAMHCS or transfer from a community hospital or patient s residence and the patient refuses transport or due to unforeseen circumstances the patient is too unstable for pickup, the Contractor will be reimbursed for the trip at the rates applicable under the schedule portion of the contract.

PROBLEMS IN TRANSPORT: Any adverse events or change to the patient status incurred during the transport of our patients will be immediately reported to 603-624-4336 ext. 3734 (Urgent Care Charge Nurse) or after hours to ext. 6263 to the AOD. All incidents will be recorded in the Patient Incident Reporting System within twenty-four (24) hours of transport.

PATIENT WELFARE AND ABUSE: The Contractor shall be held responsible for patient welfare and all patient and or Government property during transport. Any damaged or lost wheelchairs, walkers, crutches or personal belongings will be replaced by the Contractor at no additional cost to the Government or beneficiary. In the event a patient s condition worsens during transport the Contractor shall transport the patient to the closest facility appropriate for the required care. In the event a patient should expire during transport the Contractor shall return to the VA Medical Center.

NO IDLE POLICY: At no time will the Contractor leave vehicles on VA premises unless a pickup or delivery is in process. Once the patient is secured either by Urgent Care personnel or secured in the transport vehicle, the vehicle will be removed from the Urgent Care exit door to prevent environmental hazards due to exhaust fumes.

3. ORDERING PROCECURES

Requests for transport will be made by telephone by facility Travel Clerk, Urgent Care staff and or AOD. Names and extension of authorized personnel who can place and cancel orders will be furnished by VAMHCS.

If VAMHCS is unable to establish telephone contact with the Contractor for Basic Life Support (BLS) or Advanced Life Support (ALS) service within a reasonable time after receiving a request the VA reserves the right to obtain the service from another service.

When delivering to or picking up a patient at VAMHCS, the ambulance crew will call 20 minutes prior to arrival at 603-624-4366 ext. 3734 or if not available the AOD at ext. 6263.

Ambulance crews shall provide a verbal report to nursing staff. Ambulance run reports will be electronically sent to the VAMHCS Travel Clerk.

Transport of patient belongings will occasionally be required.

4. RESPONSE TIMES

Response time for prescheduled trips: It is expected the Contractor will provide timely transport of patients for all prescheduled trips. At the time of the request the Contractor shall acknowledge their ability to provide the services at the pickup time requested by VAMHCS staff. If the Contractor cannot provide the services for any reason, they will immediately notify the VAMHCS staff so other arrangements can be made.

Response time for unscheduled trips shall be agreed upon a time of the transport request based on patient location. Contractor shall pick up patient no later than 15 minutes after that agreed upon time. If the Contractor cannot provide the services for any reason, they will immediately notify the VAMHCS staff so other arrangements can be made.

Upon request, the Contractor shall furnish to the VAMHCS information detailed in the Contractor s dispatch logs, electronic records or equivalent real time recording system, ambulance sheets, or other materials requested.

For emergent requests for ALS transport from VAMHCS Urgent Care, Medical Center and or CBOC to a local community hospital, should the Contractor determine that they are unable to provide this service with in fifteen (15) minutes, the Contractor will inform VAMHCS of their inability to meet the contractual needs immediately so that the VAMHCS Urgent Care, Medical Center and or CBOC may call 911.

Under no circumstances shall the Contractor transport patients who call for their own transport.

5. GOVERNMENT OWNED EQUIPMENT OR SUPPLIES

Except for intravenous administration pumps, the Contractor shall not be permitted to borrow medical equipment form the VA Medical Center facilities. The Contractor shall provide all medications required while in transport; sheets, blankets, and other equipment and supplies required for use while in transport for direct patient care. An exception will be made for medications which are outside the realm of what is carried in the vehicle and are case-specific to the patient needs. Contractor shall not, under any circumstances exchange supplies, equipment and or medications with VA Medical Centers (except for intravenous administration pumps, as determined by the transporting facility). The prices quoted in the Price/Cost Schedule of this contract shall be inclusive of consumables used in transport. Upon approval by the facility where the patient is located and being transported from, the Contractor will be allowed to transport the intravenous administration pumps that are delivering a fluid or medication to a patient during transfer. The Contractor shall return the pumps to the lending facility within 72 hours of patient delivery.

6. VEHICLES

The Department of Veterans Affairs reserves the right to inspect contractor s equipment and vehicles or require documentation of compliance with contract specifications, State laws, rules and regulations, and guidelines governing passenger and emergency medical transport vehicles. Inspections of contractor vehicles or equipment shall in no way constitute a warranty by the Department of Veterans Affairs that the contractor s vehicles and equipment are properly maintained. Even though the vehicles are owned and operated by subcontractors, the Government reserves the right to inspect.

The Department of Veterans Affairs reserves the right to restrict the Contractor s use of equipment and vehicles which need repair, unclean, unsafe, damaged on the interior or exterior body, and are not in compliance with contract requirements. The restriction of such equipment and vehicles shall not relieve the Contractor from performing in accordance with the strict intent and meaning of the contract without additional cost to the Government.

Ambulances shall meet all current applicable Federal, State, and local specifications and regulations including, but not limited to licensing, registration, and safety standards by the respective states of service.

Each vehicle shall be equipped at all times when transporting a patient in the performance of this contract with equipment as required by Federal 49 CFR Parts 27, 37, and 38, Transportation for individuals with Disabilities (most current volume), CDC Guidelines, and Local laws, ordinances, codes, rules and regulations.

Each emergency medical care vehicle will have patient compartment facilities, oxygen, suction systems and equipment, environmental climate equipment, communications equipment, and any additional systems, equipment, accessories, and supplies as required by the state in which the vehicle is in operation.

Each ALS vehicle will ALS certified paramedics, patient compartment facilities, oxygen, hear monitor, suction systems, and intravenous IV equipment, environmental climate equipment, communications equipment, and any additional systems, equipment, accessories, and supplies as required by the state in which the vehicle is in operation.

The contractor shall transport patients authorized for transport by the VA, which may include bariatric patients that may require more than one person to lift.

ALS vehicles shall, in conjunction with the above, also provide an on-board EMT-P, perform cardiac monitoring, provide Advance Cardiac Life Support (ACLS) drugs and procedures, and perform advances airway management and medication monitoring and administration. Advanced airway management means the ability to intubate a patient and provide appropriate respiratory care, including emergency cricothyroidotomy.

The Contractor that is providing ambulance services shall provide oxygen when it is requested by authorized VAMC facility personnel or required by the patient s medical condition.

Vehicles shall be clean and maintained in good repair in accordance with manufacturer s instructions and specifications at all times during the performance of this contract and shall contain:
An emergency safety kit (e.eg. bio-hazard spill kit, first aid kit, two flashlights; two sanitary blankets for patient comfort).
Fire suppression equipment
Appropriate road emergency warning equipment (e.g. reflective triangles).
Written emergency procedures.
Protective clothing required for the protection of contractor employees where patient care is expected or as CDC guidance directs, such as:
Gowns
Gloves
Masks, etc.

Failure by the contractor to maintain compliance with any of the provisions prescribed in this section for vehicles used in performance may be considered grounds for default of the contract.

7. PERSONNEL QUALIFCATIONS
(NOTE: ALL PERSONNEL SHALL MEET QUALIFICATIONS AS REGULATED BY New Hampshire Fire Academy and EMS)
EMS - See: Licensing for Emergency Medical Services New Hampshire Fire Academy & EMS (nhfa-ems.com)

8. TRAINING REQUIREMENTS

Emergency Medical Technician-Paramedic (EMT-P) and Emergency Medical Technician Basic (EMT-B) qualifications. In addition to those required by Federal, State, and Local Government.
Have completed training in accordance with the standards published by the Department of Health and Human Services (HHS). Such training programs must also be acceptable under the regulating requirements for local EMS Systems supported by DHHS under PL 93-154.
Shall submit evidence of equivalent training program successfully completed to the COR upon request.
Shall attend (at the expense of the Contractor) all refresher continuing education, or advance training programs as required by the local or state government entity in which service is rendered. In no instance shall this be less frequent than every two (2) years, Such refresher training shall be equivalent to that developed by the Department of Transportation, National Highway Safety Administration.
The Contractor shall provide its employees with certified training for ventilator operations as there may be a need to transport a stable, non-emergent transport for a patient who is on a ventilation system.

9. CONTRACT ADMINISTRATION
The Contractor shall contact the Contracting Officer on all matters pertaining to administration. Only the Contracting Officer is authorized to make commitments to issue changes that will affect the price, quantity, quality, or delivery terms of this contract.

10. EVIDENCE OF INSURANCE COVERAGE
Before award of the 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, shall not be effective unless a 30 day written notice of cancellation or change is furnished the Contracting Officer.

11. LICENSES
The Contractor shall obtain all necessary licenses and or permits required to perform this work. The Contractor shall take all precautions necessary to protect persons and property from injury or damage during the performance of this contract. The Contractor shall be responsible for any injury to themselves, their employees, or others, as well as for any damage to personal or public property that occurs during the performance of this contract that is caused by their, or their employee s actions and or negligence. The Contractor shall maintain personal liability, automobile liability, and property damage insurance, as prescribed by the laws of the states, and in accordance with VMR 852.228-71 INDEMNIFICATON AND INSURANCE and 852.237-7 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE. Evidence of coverage shall be submitted to the Contracting Officer before commencing work under this contract (copy of Certificate of Insurance), and it shall not be changed or cancelled without thirty calendar days prior written notice to the Contracting Officer.

12. INVOICING
The Contractor shall coordinate billing arrangements with the COR monthly. Billing documents shall include a report that (e.g. spreadsheet) shall contain the contract number, date , departure and arrival times, patient s name, origin and destination addresses, and any mileage greater than twenty-five (25) miles per trip leg. The COR will review the report and once all information is determined to be accurate the invoice will be approved by the COR for payment submission in accordance with VMR Clause 852.232-72 Electronic Submission of Payment Requests. Invoices shall be submitted monthly in arrears. At no time will the Contractor invoice a Veteran direct.
13. SERVICE CONTRACT ACT OF 1965
The solicitation and subsequent contact include. Service Contract Labor Standards (SCLS). The Offeror and resultant contract awardee, by signing the offer and contract, is acknowledging they have reviewed the clause and will fully comply throughout the contract period. It is the responsibility of the Contractor to determine and pay the appropriate prevailing wage rate and fringe benefits for the location. The Government will not be held responsible for any mistakes in applying the SCLS.
VA reminds contractors of the Department of Labor Regulations which implement the SCLS and which read at 29 CFR § 4.155:
Employee coverage does not depend on form of employment contract. The Act, in section 8(b), makes it plain that the coverage of service employees depends on whether their work for the contractor or subcontractor on a covered contract is that of a service employee as defined in section 8(b) and not on any contractual relationship that may be alleged to exist between the contractor or subcontractor and such persons. In other words, any person, except those discussed in §4.156 below, who performs work called for by a contract or that portion of a contract subject to the Act is, per se, a service employee.
Thus, for example, a person's status as an "owner-operator" or an "independent contractor" is immaterial in determining coverage under the Act and all such persons performing the work of service employees must be compensated in accordance with the Act's requirements.
It is the Contractor's responsibility to obtain the correct wage information. Wage Determinations are available from the Department of Labor at beta.SAM.gov
14. HIPAA COMPLIANCE
As a covered entity, the department of Veterans Affairs (VA) is required by law to obtain satisfactory assurance of a Business Associate Agreement (BAA) and that the BAA appropriately safeguards protected health information it receives or creates on behalf of the covered entity. Contractors must adhere to the provisions of Public Law 104-191, Health Insurance Portability and Accountability Act of 1996 (HIPAA) to include the Administrative Simplification Provisions of the law and associated rules and regulations published by HHS. The Contractor shall comply with all HIPPA related rules and regulations to include Electronic Transactions, the Standards for Privacy of Individually Identifiable Health Information, and the Security Standards. This includes both the Privacy and Security Rules published by HHS. As required by HIPAA, HHS has promulgated rules governing the use and disclosure of protected health information by covered entities. The covered entity component of the Department Veterans Affairs is the VHA. In accordance with HIPAA, the Contractor will be required to enter into a BAA with VHA.
Business associates must follow VHA privacy policies and practices as defined in the BAA. All contractors and business associates must receive privacy training annually. For contractors and business associates who do not have access to VHA computer systems, this requirement is met by completing the VHA National Privacy Policy training, or other VHA approved primacy training or Contractor furnished training that meets the requirements of HHS Standards for Primacy of Individually Identifiable Health Information as determined by VHA. For contractors and business associates who are granted access to VHA computer systems, this requirement is met by completing VHA National Privacy Policy training or other VHA approved privacy training. Proof of training is required.
Any violation of HIPAA will be reported to the Contracting Officer in writing within twenty-four (24) hours of the Contractor s discovery of an occurrence. Included in the report will be a description of the occurrence, patient names (if known), location, date and time. A copy of any filed police report will be provided by the Contractor to the Contracting Officer within twenty-four hours of completion.
16. CONTRACTOR S QUALITY CONTROL PROGRAM (QCP)
The contractor shall establish and maintain quality control program to ensure all contract requirements are met. The Contractor's QCP shall include the following or have incorporated into during performance of the contract, at a minimum:
An inspection plan covering all services required by this contract. The inspection plan must specify the areas to be inspected on either a scheduled or unscheduled basis and how often inspections will be accomplished and documented, and the title of the individual(s) who will perform the inspections.

On-site records of all inspections conducted by the Contractor noting necessary corrective action taken. The Government reserves the right to request copies of any and/or each inspection.

The methods for identifying and preventing deficiencies in the quality of service performed, before the level of performance becomes unacceptable and organizational functions noting intermediate supervisory responsibilities and overall management responsibilities for ensuring total acceptable performance.

The contractor shall maintain on-site records of all vehicle maintenance and repairs performed on vehicles used in the performance of this contract. The contractor shall institute methods to identify and prevent vehicle breakdowns, with detailed procedure for alternative transportation of patients in the event of mechanical breakdown of vehicle.

The contractor shall maintain on-site records documenting satisfactory background checks, physical capabilities, certifications and ongoing training of each employee performing services under this contract.

The contractor shall have methods of identifying and preventing communication breakdowns and provide a detailed procedure for alternative communications in the event of electronic and mechanical breakdown.

The contractor shall maintain on-site records of any complaints or problems with procedures taken to allow for corrections and/or elimination before effects caused interruption of contract performance.

The contractor shall participate in quarterly scheduled and/or unscheduled conference calls with the VA representatives to provide a report of on-going operational issues.

The contractor shall have a system that verifies the licenses and driving records of individuals operating the vehicles. The contractor shall make this information available for review by the VA upon request.

17. PERFORMANCE STANDARD
Contractor must maintain a 99% satisfaction rate per 100 scheduled trips to be considered as providing acceptable performance. Acceptable performance is considered as having no more than one (1) valid complaint per 100 scheduled trips. The validity of any complaint shall be determined by the COR before being marked against contractor performance. Valid complaints in excess of 1% per quarter may be grounds for termination. Performance tracking will be monitored by the COR on a quarterly basis.

18. COVID-19 TESTING
Contractor shall be responsible for ensuring that employees (including employees who have
been vaccinated) are routinely tested for COVID-19 and take every precaution necessary to
prevent COVID-19 positive contact with VA patients. The Government reserves the right to request
of or review current procedures at any time.

19. TUBERCULOSIS TESTING

Contractor must provide evidence of negative PPD test within fourteen (14) calendar days prior to an employee with direct patient contact beginning service and annually thereafter.

Contractor must provide medical evidence that employee is disease free for those employees having a positive PPD.

In no circumstance will an employee or driver be allowed to begin duty without prior submission of the required testing certification.

20. HEPATITIS B VACCINATION
The employer shall make available the Hepatitis B vaccine and vaccination series within ten (10) days of employment to all contract employees who have direct patient contact and follow-up to all contract employees who have an exposure incident.

Contractor shall bear all costs associated with vaccinations.

VA Form 10-5549c, Information about Hepatitis B Vaccine (Recombinant), Consent Form, or VA Form 10- 5549d. Hepatitis B Vaccine Declination (Mandatory) (Attachment B) shall be submitted to the Contracting Officer within thirty (30) days of waiver, or completion of the first in the series of the Hepatitis B Vaccine, and at completion of the vaccination series. These forms shall be provided to the contractor upon award of the contract.

21. JOINT COMMISSION FOR ACCREDITATION OF HEALTH CARE ORGANIZATIONS COMPETENCY REQUIREMENTS
The contractor shall be responsible to ensure that his/her employees coming to the work site shall receive the information required to perform their duties.

Contractor shall attend a pre-work orientation meeting prior to the commencement of work onsite. The VA shall schedule this meeting and it shall include discussion of the following topics: Fire and Safety, Infection Control and Disaster procedures.

Contractor shall be responsible to ensure his/her employees who are providing work on this contract are fully trained and completely competent to perform the required work.

22. INFECTION CONTROL COMPLIANCE

A. Contractor shall provide written certification of training to employees used in performance of this contract and Contractor compliance with the Blood borne Pathogens Standards. 29 CFR Part 1910.1030 (copy available on request). Certification must be received by the Contracting Officer prior to employee being assigned for duty.

B. The infection control compliance requirements apply to Contractor employees providing services during any absence from duty of scheduled employees for any reason.

C. In no circumstance will an employee be allowed to begin duty without prior submission of the required training certification. 29 CFR part 1910.1030 is OSHA's standard requiring employers to:

Develop written exposure-control plans;
Train all employees on occupational risks;
Maintain records on employee training;
Use warning labels;
Implement proper work methods including "Universal Precautions", (e.g. proper care and disposal of personal protective equipment such as the use and disposal of latex gloves);
Offer Hepatitis B Vaccine (HBV) to employees;
Provide medical evaluations following employee's exposure incident; and,
Supply personal protective clothing and equipment

23. CONTRACTING WITH PARTIES LISTED ON THE OIG LIST OF EXCLUDED INDIVIDUALS/ENTITIES

In accordance with The Health Insurance Portability and Accountability Act (HIPAA), Sections 1128 and 1128A of the Social Security Act and the Balanced Budget Act (BBA) of 1977, the Office of Inspector General has established a list of parties and entities excluded from Federal health care programs. Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs.

On a monthly basis the Contractor shall review the OIG List of Excluded Individuals/Entities on the OIG web site at www.hhs.gov/oig to ensure that any Contractor Employees or Subcontractors are not excluded. The Contractor should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty (CMP) of $10,000 for each item or service furnished during a period that the person or entity was excluded and may also be subject to treble damages for the amount claimed for each item or service. Damages may also be imposed against health care providers and entities that employ or enter into contracts with excluded individuals or entities to provide items or services to Federal program beneficiaries.

By performing services under this contract the Contractor certifies that they have reviewed the OIG List of Excluded Individuals/Entities and that no Contractor Employees or Subcontractors used in the performance of this contract are listed as excluded individuals or entities.

24. CONTRACT DEFINITIONS AND ACRONYMS

Advanced Life Support (ALS) -ALS shall be provided by ambulance vehicles containing at a minimum an on-board EMT-P, cardiac monitoring, Advanced Cardiac Life Support (ACLS) drugs and procedures, advanced airway management and medication monitoring and administration. Ambulances for ALS services shall be staffed, certified and licensed in accordance with current laws and regulations governing the certification and licensure of private ambulances by the respective states of service, and all ALS services shall be in accordance with current laws and regulations by the respective states of service.
Base Rate - The Base Rate shall constitute full compensation for one-way trips which do not exceed the "Mileage Threshold" as shown in Section B for the VAMC. Patient loaded miles only.
Basic Life Support (BLS) - BLS is defined as services required for non-critical patient care in which patient requires an ambulance, which has been staffed, certified, and licensed in accordance with current laws and regulations governing the certification and licensure of private ambulances by the respective states of service, and all BLS services shall be in accordance with current laws and regulations by the respective states of service. The ambulance at a minimum shall be staffed with a vehicle operator and an Emergency Medical Technician (EMT) - Basic Ambulance, and with basic airway management and IV's at KVO (keep vein open) without additives.
Beneficiary - Veterans and other members determined to be eligible for benefits by the VA.
Contracting Officer (CO) - VA official with the authority to enter, administer and/or terminate contracts
and make related determinations and findings.

Contracting Officer's Representative (COR) - VA official responsible for providing contract oversight and technical guidance to the Contracting Officer. Responsibilities include certification of invoices, placing orders for service, providing technical guidance, overseeing technical aspects of the contract. All administrative functions remain with the Contracting Officer.
Contractor - The term "Contractor" as used herein refers to both the prime Contractor and his/her employees, and any subcontractors and their employees. The Contractor shall be responsible for assuring that their subcontractors comply with all terms, conditions and provisions of this contract.
Mileage Rate - This is the rate paid for each mile driven with patient in transit ("patient loaded miles") AFTER patient pick up, either from an appointment or from patient's original point of origin. This rate is in addition to the BASE RATES for each type of trip stated in the Schedule.
Medical Administrative Assistant (MAA) - VA official that works in the admissions area during evenings, and monitors hospital activities during other than normal working hours. This person acts as hospital administrator during off-hours.
Quality Assurance - Those actions taken by the Government to assure services meet the requirements of this contract.
Quality Assurance Surveillance Plan - An organized written document used for quality assurance surveillance. The document contains specific methods for performing surveillance of the Contractor's continuous performance.
Quality Control - Those actions taken by the Contractor to control the production of goods or services so they will meet the requirements of a contract.
Rate - Rate is defined as the rate paid for one-way transportation from a designated pick up point to a designated delivery point. This rate will be paid for all authorized one-way trips ordered under this contract action.
Rural Area - The Census Bureau defines rural as any population, housing, or territory NOT in an urban area. Thus, having a population under 2,500 inhabitants.
Scheduled Trip(s) - The term "Scheduled Trip" as used in this contract refers to those trips in which the Contractor has been given advance notice (advance notice is defined as a notice given by 1:00 p.m. the prior business day) of required services and a specific pick-up time and location.
Specialty Care Transport- SCT is defined as services required for critically ill patient care in which patient requires an ambulance, which has been staffed, certified, and licensed in accordance with current laws and regulations governing the certification and licensure of private ambulances by the respective states of service, and all CCT services shall be in accordance with current laws and regulations by the respective states of service. The ambulance at a minimum shall be staffed with a vehicle operator and a Paramedic lnter-facility Transfer (PIFT) - and with advanced life support airway-endotracheal intubation; Magill forceps for foreign body airway obstruction; drug and medication administration as approved by the Board and as allowed by Maine EMS protocol; and other techniques and practices approved and published by the Board.
Unscheduled Trips(s) - The term "Unscheduled Trip" as used in this contract refers to those trips required on an as needed basis and advance notice is not given.
Urban Area - The Bureau of the Census defines urban as comprising all territory, population, and housing units located in urbanized areas and in places of 2,500 or more inhabitants.
Vehicle(s) - The term "Vehicle(s)" as used in this contract refers to all modes of transportation provided under the requirements of this contract, unless a specific mode of transportation is identified.
Waiting - Waiting as used in this contract is defined as the time required and verified by authorized medical facility personnel.
Waiting Grace Period - The waiting grace period is defined as fifteen (15) minutes prior to the start of the "Waiting Time" which begins fifteen minutes following the Contractor's arrival at the location of patient pick up. This grace period is free of charge to the VA.

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