Ambulance and Ambulette Services

Ohio Department of Veterans Services

OHIO VETERANS HOMES

“Serving Those Who Served”

Mike DeWine, Governor | Deborah Ashenhurst, Director | Terrence Holecek, Superintendent

Solicitation Page

Executive Summary

The Ohio Department of Veteran Services (DVS), The Ohio Veterans Home-Georgetown (OVH-G) is seeking contractors for Ambulance and Ambulette services to and from OVH-G to doctor appointments and hospital visits.

Scope of Work

ALL work must comply with ADA and OSHAA standards and all federal, state, and local regulations.

1. Permits and licenses of any nature, necessary for any and all work, shall be secured and paid for by the contractor.

2. All work shall be performed by qualified personnel. Qualifications shall be presented upon request.

3. Contractor shall make available Basic or Advance level life support transportation to and from facilities, twenty-four (24) hours per day, seven (7) days a week.

4. Contractor’s ambulance/ambulette services shall, be available twenty-four (24) hours per day, seven (7) days per week. In the event that an ambulance is not available for immediate dispatch, contractors dispatch will advise OVH-G of the situation and the estimated time of arrival (ETA).

5. Contractor shall have available wheelchair accessible transportation and regular and bariatric stretcher transportation.

6. Contractor shall provide OVH-G a process for long appoints or scheduled procedures.

7. Contractor will be responsible for the following transports when requested by OVH-G:

a. Transports to and from hospitals, doctor appointments, etc. outside of a 50-mile radius from 2003 Veterans Blvd, Georgetown, OH 45121.

b. Transports to and from hospitals, doctor appointments, etc. within the 50-mile radius of OVH-G is unable to do transport.

c. Transports requiring a stretcher regardless of them being in or out of 50-mile radius.

8. Contractor shall ensure that all services required are provided by qualified and appropriately licensed and/or certified personnel and in accordance with all applicable laws. Contractor shall comply fully with Title VII of the Civil Rights Act of 1964; sections 504 of the Rehabilitation Act of 1973; and the Age Discrimination Act of 1975; and shall render service to Ohio Veterans Home patients without discrimination due to gender, race, religion, color, national origin, handicapping condition, or age.

9. Contractor shall comply with all plans of correction and other regulatory requirements necessary of OVH- G’s certification, licensure, OSHA and/or other applicable regulatory compliance.

10. Contractor shall certify that it and its employees and agents comply with, are not under investigation for violations of, an have never been convicted of or sanctioned for violations of any Federal and State laws governing the Medicare and Medicaid regulations.

11. All medical transportation vehicles will be equipped to meet all state and local guidelines issued by the Ohio Medical Transportation Board.

12. Contractor will complete a report of all medical treatment performed on any patient transported to or from OVH-G, which will be provided to the receiving facility on each transportation completed. The report will contain at minimum such information required by State and local guidelines.

13. Contractor will bill for any transports made at the request of OVH-G as requested to do so by insurance regulations or laws.

14. Payment to contractor for Ambulance and Ambulette services covered by a resident’s insurance carrier will be the responsibility of the Contractor.

15. Payment to the contractor for Ambulance/Ambulette services NOT covered by the resident’s insurance carrier will be the responsibility of the resident and will be payable to the Contractor at the contractor’s rates at the time the service was rendered.

16. Payment for the Ambulance/Ambulette service which is the responsibility of OVH-G (residents with a service connected disability of 70% or greater) shall be made to the Contractors at the rate for the Ambulance/Ambulette in effect at the time the service was rendered.

17. Contractor shall agree to supply in-services to OVH-G whenever necessary to insure Medicare and Medicaid compliance.

18. Contractor is at all times an independent contractor and not an agent or employee of OVH-G. No Act of commission or omission by either party shall make the other a principal agent or employee of the other.

19. Contractor shall maintain comprehensive public liability, medical/professional liability, and motor vehicle insurance against all claims for damage or loss of property, and for bodily injury, including death minimum limits as prescribed by the State of Ohio. Contractor agrees to maintain insurance coverage with carriers in limits mandated by law for workers compensation, occupational disease and employer liability. Contractor will provide proof of same upon request from OVH-G within a reasonable amount of time.

20. Due to the increased staffing, equipment, and supply requirements by Contractor, in performance of the agreement, OVH-G will place first call for any and all non-emergency medical transport to Contractor. In the event that timely and suitable transportation arrangements are not attainable through Contractor, or in the event that the resident requests a different ambulance service, OVH-G shall make arrangements with any ambulance supplier that they deem advisable for said patient. This contract is not be considered exclusive.

21. Contractor will treat and transport any and all patients regardless of race, creed, national origin, or ability to pay as deemed medically necessary by OVH-G. Insurance screening will not be done prior to any transport of any patient from OVH-G. Contractor has in place a written equal employment opportunity policy and wil maintain this policy at all times.

22. Contractor shall agree to maintain the confidentiality of information contained to the medical records of OVH-G’s residents, except for release of such records to authorities. Contractor shall agree no to disclose such information without written consent of the individual authorized to release such records. The termination of this agreement shall have no effect on the obligation contained in this clause.

23. Contractor shall attest that it will preform and maintain evidence of:

a. Criminal background checks for all employees in accordance with Ohio law.

b. History, physical, and other health records in accordance with Ohio law.

c. Appropriate credentials and/or certifications Ambulance/Ambulette staff.

OVH-G Responsibilities

1. OVH-G shall information Contractor of the pay source of any resident transported by contractor upon request.

2. OVH-G shall provide such certification of medical necessity for transport as needed for billing purposes when necessary. OVH-G will only order medically necessary levels of transportation from Contractor.

3. OVH-G will send appropriate OVH staff on Contractor’s Ambulance/Ambulette service in events where OVH-G attending physician feels that a patient’s condition would warrants this.

Invoice Requirements

1. The Contractor, authorized to submit invoices, must submit an original invoice to the office designated in the purchase order. The contractor will only be compensated for the Deliverable accepted by the State. To be a proper invoice must include:

a. The purchase order number authorizing the delivery of supplies or services;

b. State of Ohio Contract Number (in applicable);

c. Agency Name;

d. Agency Billing address;

e. Deliver location of supplies or services;

f. Contractor Name;

g. Contractor Address;

h. Contractor’s Unique Invoice Number;

i. Date that services were provided, including cost;

j. Clear statement of total payment expected.

2. For billing purposes, the vendor will provide OVH-G with an activity log for each month’s services within two

(2) business days of the end of the month.

Payment

1. The Contractor shall invoice private pay residents, Medicaid, Medicare, and any other third party payors in accordance with the specific needs of OVH-G and applicable federal and state statutes and regulations.

2. Contractors shall invoice OVH-G for residents identified by OVH-G as residents who have a service connected disability of 70% or greater.

3. Contractor shall invoice OVH-G for residents identified by OVH-G as recipients of skilled nursing care under Medicare Part A.

4. The mobilization fee, if any must be specified in the proposal. The vendor agrees to charge only one (1) mobilization fee per visit, regardless of the number of services provided during that visit.

Bid Submission

1. Contractor shall submit all bids on the Cost Summary Form (see below).

2. Contractor shall fill out and return the following Forms with its bid.

a. Affirmation and Disclosure Form.

b. Certification Statement

c. Business Associate Agreement.

d. Subcontractor Identification Form.(if applicable)

Cost Summary

The Ohio Veterans Home Georgetown averages five (5) non-emergency transports a month at varying service levels.

Please fill out the grid line item in Ohio Buys for each service provided.

Services	Estimated Monthly Usage*
ALS 1	2
ALS 2	1
BLS 1	1
ALS/BLS Mileage	135
Ambulette – Wheelchair	1
Ambulette – Wheelchair Mileage	45

**Estimated Monthly usage is for evaluation purposes only and is not a guarantee of actual usage.

The accuracy of the Offer is the sole responsibility of the contractor. No changes in the Offer shall be allowed after the date and time that the Offers are due.

All solicitations/proposals are to be submitted in OhioBuys. Offers after the close date in OhioBuys will not be accepted. DVS will apply the Preference Program as required by ORC 9.318, ORC 125.11 and OAC 123:5-1-16.

Term of Contract

1. Any subsequent agreements or contracts arising from this solicitation shall begin on July 1, 2025 and the term of the contract shall be until June 30, 2026, unless it is terminated earlier.

2. Subject to mutual agreement, the period covered by the ensuing contract under the same terms and conditions stated herein can be extended for three (3) additional years in one (1) year increments.

3. Terms and conditions may be added, modified, and deleted upon mutual agreement between agents of DVS and the Contractor provided that such terms and conditions remain within the scope and original intent of the Solicitation. Said terms and conditions may include, but are not limited to, additions or deletions of service levels and/or commodities and/or increases or decreases in the time limits for an existing contract. Any and all modifications must be expressed in writing through a Memorandum of Understanding and executed by authorized agents of DVS and the Contractor prior to the enactment of such modifications.

4. Rates may only be re-negotiated if the original contract is extended and will be in effect for the term of the extension. All item price changes shall be approved by DVS in writing prior to going into effect. DVS reserves the right to refuse position hourly rates changes.

5. Contractor will be required to enter into a DVS Agreement/Contract.