Occupational Therapist specializing in driving rehabilitation
Page 15 of 15 Description of Solicitation In accordance with FAR Part 13 this a combined synopsis/solicitation for commercial items prepared in accordance with the format in FAR Subpart 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; quotes are being requested and a written solicitation will not be issued. This Solicitation issued as a Request for Quotation (RFQ) for the following Commercial Items: Occupational therapist specializing in driving rehabilitation. Responses shall be on an all or none basis, no partial submission. The Government reserves the right to make no award at all. NCO21MedicalSharingTeam@va.gov as an alternate contact information should your POC be non-responsive or no longer assigned to NCO 21. Include in subject line, the Contract Number and ATTN: Individual name attempted to contact Respond by: Please see INSTRUCTIONS TO OFFERORS below. Small Business Set-Aside: This solicitation is Set-aside 100% for Small Businesses. Quotations from Large Business offerors will be considered non-responsive, will not be evaluated and will not be eligible for award. NAICS code/Size Standard/PSC or FSC: NAICS code (North American Industrial Classification system: 621340 Size Standard for this NAICS code: $7.5 M PSC/FSC (Product Service Code/Federal Supply Code): Q518 Type of Contract/Award: The type of contract/award the government intends to make/enter into for this solicitation is a single award, firm-fixed price purchase order. Contract Period: October 1, 2019 tu September 30, 2020. Method of Payment: Payment will be made electronically to: Department of Veterans Affairs FMS-VA-2(101), Financial Services Center, PO Box 149971, Austin TX 78714-9971 tough the Tungsten Network Client Services. For help call: 1-866-340-4980, E-mail: va.registration@tungsten-network.com. Provisions and Clauses: All provisions and clauses applicable to this solicitation can be viewed in full text using the following web addresses: https://www.acquisition.gov/browsefar -or- https://www.va.gov/oal/library/vaar/ Services: BASE YEAR: Period of Performance: October 01, 2019 to September 30, 2020 CLIN No. SUB-CLIN Description Qty. Unit Unit Cost Total Annual Cost 0001 None Occupational Therapist Initial clinical and behind the wheel instruction/ evaluation 10 Hours $ $ KEY PERSONNEL None 0001a Occupational Therapist Hourly rate for on the road driving training in instructor s/or patients vehicle for the primary area which is within 40 miles 300 Hours $ $ None 0001b Occupational Therapist Hourly rate for on the road driving training in instructor s/ or patient vehicle located 40 miles outside of primary area 300 Hours $ Total for Base Year $ OPTION YEAR ONE: Period of Performance October 01, 2020 to September 30, 2021 CLIN No. SUB-CLIN Description Qty. Unit Unit Cost Total Annual Cost 1001 None Occupational Therapist Initial clinical and behind the wheel instruction/ evaluation 10 Hours DO NOT PRICE DO NOT PRICE KEY PERSONNEL None 1001a Occupational Therapist Hourly rate for on the road driving training in instructor s/or patients vehicle for the primary area which is within 40 miles 300 $ $ None 1001b Occupational Therapist Hourly rate for on the road driving training in instructor s/ or patient vehicle located 40 miles outside of primary area 300 Total for Option Year One $ OPTION YEAR TWO: Period of Performance: October 01, 2021 to September 30, 2022 CLIN No. SUB-CLIN Description Qty. Unit Unit Cost Total Annual Cost 2001 None Occupational Therapist Initial clinical and behind the wheel instruction/ evaluation 10 Hours DO NOT PRICE DO NOT PRICE KEY PERSONNEL None 2001a Occupational Therapist Hourly rate for on the road driving training in instructor s/or patients vehicle for the primary area which is within 40 miles 300 $ $ None 2001b Occupational Therapist Hourly rate for on the road driving training in instructor s/ or patient vehicle located 40 miles outside of primary area 300 $ $ Total for Option Year Two $ OPTION YEAR THREE: Period of Performance: October 01, 2022 to September 30, 2023 CLIN No. SUB-CLIN Description Qty. Unit Unit Cost Total Annual Cost 3001 None Occupational Therapist Initial clinical and behind the wheel instruction/ evaluation 10 Hours DO NOT PRICE DO NOT PRICE KEY PERSONNEL None 3001a Occupational Therapist Hourly rate for on the road driving training in instructor s/or patients vehicle for the primary area which is within 40 miles 300 Hours $ $ None 3001b Occupational Therapist Hourly rate for on the road driving training in instructor s/ or patient vehicle located 40 miles outside of primary area 300 Hours $ Total for Option Year Tee $ TOTAL FOR BASE YEAR AND ALL OPTION YEARS: $_______________________ Description & Salient Characteristics; The Contractor shall provide the services of a qualified occupational therapist specializing in driving rehabilitation, hereinafter referred to as "contract driving rehabilitation specialist" to perform the requirements of this contract Service will be performed at a location of convenience for the patient. Driving evaluations will be performed in the patient s own car, as long as the car meets the minimum State insurance requirements. Otherwise, a training car will be made available by the contracted driving rehabilitation specialist. Payment for any leave, including sick leave or vacation time, and holiday pay is the responsibility of the Contractor. All costs associated with travel, transportation, lodging or any other miscellaneous expenses related to this work shall be the sole responsibility of the contractor. General Duties: The contract driving rehabilitation specialist shall perform services, which include, but are not limited to the following: The contract driving rehabilitation specialist s primary functions will be skilled care for VA Southern Nevada Healthcare System (VASNHS) veterans who require specialized evaluation, training, and equipment to be successful and safe drivers. The individual driver rehabilitation specialist must possess: Special abilities and technical skills related to the provision of driver rehabilitation services A medical rehabilitation backgrounds Knowledge of residuals of traumatic and non-traumatic disabilities; and Special experience in order to evaluate and determine physical limitations of the Veteran with disabilities and the following modalities; i.e., hand controls, lifts, specialty adaptive driving systems, etc.\ The individual driver rehabilitation specialist must maintain a current knowledge of: Technological advances in adaptive equipment and high-tech driving systems; Changes in automotive design; and Other factors which may influence an individual s capacity to safely operate a motor vehicle. The Contractor and its personnel are expected to comply with all mandated standards and requirements. The Contractor is responsible for completing all mandatory training per VASNHS policy. The contractor must provide documented evidence of completion annually. If contractor fails to comply, suspension or termination of all physical and/or electronic access privileges and removal from contract until such time as the training is complete. Functions: Clinical: Provide accurate reports for all evaluation and training. Report requirements: Interview: Driving History Current needs/goals Usual driving conditions Medical history Clinical Evaluation includes: Vision. Portable vision devices provide an evaluation of certain vision factors necessary to perform a safe driving task. Equipment must be available to measure the following: visual acuity, color perception, field of vision, depth perception, glare recovery, and night vision Reaction Time. A device is used to measure reaction time from acceleration to braking. Cognitive and Perceptional Screening. In screening of basic cognitive and perceptional motor materials, identification and/or verification of a potential problem must be referred to the appropriate professional for a more in-depth evaluation. Neuromotor Assessment. This is a physical assessment of range of motion, strength, sensation, coordination, and endurance. Automobile Accessibility. Transfer in/out of vehicle and stowing of mobility aides (wheelchair, walker, etc.). Operation of equipment (headlights, turn signals, gear selector, etc.). Behind-the-Wheel Assessment Basic state driving laws Maneuverability in various types of traffic environments. Driving behaviors such as: anxiety, confusion, distractibility, impulsivity. Mental fatigue Access: Contractor to contact patient within reasonable time frame (30 days of initial consult) or document justification of inability to reach patient. Patient contact information to be released to contractor via release of information signed by veteran. Failure to comply with reasonable time frame will result in decrease in compensation rate for initial evaluation by 10% of negotiated cost. Administrative: Documentation of Clinical Chart. The patient s progress must be documented in the medical record via scanned reports from the driving rehabilitation specialist from time of initial evaluation and/or assessment until completion of the driver rehabilitation training. The provider will fax or mail records to administrative contract officer representative to have documents scanned into Vista Imaging. The provider will not physically enter records into VA computer database. Documentation must follow local medical facility policy and be in compliance with appropriate accreditation standards (i.e., the Joint Commission and the Commission on the Accreditation of Rehabilitation Facilities (CARF). The VA will provide the contract driving rehabilitation specialist with all adaptive equipment necessary for driving rehabilitation evaluation and training. Organizational Relationship The contract driving rehabilitation therapist will perform services under the oversight of the VA Chief, Optometry service or his/her designee. Routine work shall be performed with a minimum of supervision and the contract driving rehabilitation therapist will be required to perform duties on their own initiative. The contract driving rehabilitation therapist shall act in a thoroughly professional manner at all times. They shall work in harmony with other members of VA Staff where they are working. Tact and courtesy are mandatory when interacting with patients and staff. Work days/hours Work days/hours: The Contractor shall provide driving rehabilitation therapist shall provide services on a per patient bases as need arises. The contract driving rehabilitation therapist shall not be required to provide on-call or stand-by services. The contract driving rehabilitation therapist shall not be required to provide services on the following federal holidays: New Year's Day, Martin Luther King Day, President's Day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans Day, Thanksgiving Day, Cistmas Day and any other day specifically declared by the President of the United States to be a Federal Holiday. The contractor will not be required to work weekends. Services The services specified herein may be changed by written modification to this contract. The VA Contracting Officer will prepare the modification. Other personnel and equipment necessary for the operation of the services contracted for will be provided by the VA at levels compatible with the safety of patients, staff, and quality medical care programming. The services to be performed shall be performed in accordance with VA policies and procedures. Qualifications Prior to performing any work under this contract, the qualifications of the contract driving rehabilitation specialist must be submitted to the VA Chief, Optometry service or his/her designee for approval. In order to perform the services covered by this contract the contractor shall have a minimum of a Baccalaureate Degree in occupational therapy. The contractor shall also be certified as a driving rehabilitation therapist, hand therapist, and a licensed driving instructor with their own driving school. Updated licensing, registration, and certification must be provided as they are renewed yearly. Failure to comply will result in termination of the contract. Appropriate referrals need to be initiated by the driver rehabilitation specialist to other services for more detailed evaluations as indicated (i.e. cognitive assessment, neuro-sensory evaluation, visual examination, etc.). Additional university credentials, State certification and/or successful completion of the National Driver Rehabilitation Specialist Examination sponsored by Association for Driver Rehabilitation Specialists (ADED) , formerly known as the Association for Driver Educators for the Disabled, is encouraged. Qualifications shall be subject to review by the VA Chief of Staff and approval by the VA Facility Director. The contractor's personnel shall be responsible and able to show evidence of reliability, ability and experience. Verified references of ability and qualifications may be accepted by the Contracting Officer to satisfy these requirements. Before commencing work under this contract, the Contractor, shall provide, and thereafter maintain for the duration of the contract, Liability Insurance in conformance with applicable Nevada State requirements for the service contemplated. Evidence of insurance will not be waived. Emergency Health Services The VA will not render emergency health services to the contract driving rehabilitation specialist for an incapacitating injury or otherwise serious illness occurring while on duty. All services, to include wages earned during period of initial medical evaluation provided by the VA, will be reimbursed by the Contractor. The Contractor will furnish the VA with the necessary injury/illness form(s) for reporting purposes. The VA for statistical and/or billing purposes will retain a copy of the complete form(s). Patient Safety Patient safety incidents must be reported using Patient Safety Report. All incidents must be reported within 24 hours. Personnel Policy The Contractor shall be responsible for protecting the personnel furnishing services under this contract. To carry out this responsibility, the Contractor shall provide the following: Worker s Compensation, Professional liability insurance, income tax withholding, and Social Security payments. The Contractor shall verify, and document, that all employees who provide patient care services at the VA Outpatient Clinic have the following before they provide any service related to this contract: (1) Health examinations including annual TB skin test result, (2) Either has received the Hepatitis 8 vaccine series, or is immune as a result of acquired infection, or haw been offered and refused the vaccinations. (3) Received measles-mumps-rubella (MMR) vaccine. Combined vaccine (MMR) is the vaccine of choice if individuals are likely to be susceptible to more than one of the tee diseases and is required for all persons born after 1956. (4) A negative PPD within the last year, or, if a known reactor, a negative chest X-Ray within the past year. (5) A history of varicella (chicken pox) or, if unknown, results of a varicella antibody test. If non-immune, must be vaccinated with Varivax (Chicken pox). (6) Received training In Universal Precautions and Blood Borne Pathogens, Hazardous Material Management, and Life Safety Management (fire preparedness). (7) Successfully completed cardiopulmonary resuscitation (CPR) training. Identification, Parking, Smoking and VA Regulations The contract driving rehabilitation therapist shall wear visible identification, provided by the Contractor, at all times while on the premises of the VA Southern Nevada Healthcare System. It is the responsibility of the Contractor's personnel to park in the appropriate designated parking areas. Information on parking is available from the VA Police and Security Service. The VA Southern Nevada Healthcare System will not invalidate or make reimbursement for parking violations of the Contractor under any conditions. Smoking is prohibited inside any buildings at the VA Southern Nevada Healthcare System. Possession of weapons is prohibited. Enclosed containers, including tool kits, shall be subject to search. Violations of VA regulations may result in citation answerable in the United States (Federal) District Court, not a local district, state, or municipal court. Standard Precautions By signing this instrument, the Contractor certifies that all Contractor's employees assigned to work for the VA are current in standard Precautions and are aware of pertinent OSHA and standard Precautions Regulations. Special Contract Requirements Contractors, contractor personnel, subcontractors, and subcontractor personnel shall be subject to the same Federal laws, regulations, standards, and VA Directives and Handbooks as VA and VA personnel regarding information and information system security. 1.d DELIVERY Needed: Delivery Terms: 10/01/2019 tough 09/30/2023 Deliver to: Department of Veteran Affairs VA Sierra Pacific Network (VISN 21) 6900 North Pecos Road North Las Vegas, NV 89086 2. INSTRUCTIONS TO OFFERORS The Provision FAR 52.212-1, Instructions to Offerors Commercial Items (Jan 2017) applies to this acquisition. Addendum to 52.212-1 Instructions to Offerors Commercial Items: Respond by: Offerors are to email complete offers to Bruce.Lundvall@va.gov, 916-923-4549 Offers must be received no later than 12:00, Sept 17, 2019 Please include in the subject line: Solicitation 36C26119Q0971 Occupation Therapist qualified in driving rehabilitation. Past Performance. Provide no more than tee (3) references within tee (3) years showing experience in providing the services required. Technical. Provide staffing plan to include staffing information, experience of staff, licenses, certifications and documentation to demonstrate capability in providing the services required. Price. The Contractor must complete price schedule in the solicitation in its entirety to include unit and total prices for all ordering periods. SOLICITATION PROVISIONS BY REFERENCE: 52.209-7 Information Regarding Responsibility 52.252-1 Solicitation Provisions Incorporated by Reference 852.233-70 Protest Content/Alternative Dispute Resolution 852.233-71 Alternate Protest Procedure 852.270-1 Representatives of contracting officers 852.252-70 Solicitation Provisions or Clauses Incorporated by Reference 852.273-74 Award without Exchanges (End of Provision 52.212-1) 3. EVALUATION OF OFFERS The Provision FAR 52.212-2, Evaluation Commercial Items (Oct 2014) applies to this acquisition and the following two lines are to be used and inserted into paragraph (a) of the that provision: Past Performance (References, Experience) Technical Capability License/Certifications Occupational Therapist License (license to practice in Nevada) Graduation from a degree program in occupational therapy approved by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations to include an internship (supervised fieldwork experience required by the educational institution). The ACOTE is the only accreditation agency recognized by the United States Department of Education (USDE) and the Council for Higher Education Accreditation (CHEA). Certification/Examination: Possession of written documentation that the individual has passed the entry-level certification examination for OTs which is administered by the National Board for Certification in Occupation Therapy (NBCOT) Certified hand therapist Certified by the Hand Therapy Certification Commission, Inc., Definition: An occupational therapist or physical therapist who has a minimum of five years of clinical experience, including 4,000 hours or more in direct practice in hand therapy. In addition, the Certified Hand Therapist has successfully passed a comprehensive test of advanced clinical skills and theory in upper quarter rehabilitation. Because of changes in the profession, every CHT is required to demonstrate continued professional development and competency by recertifying every five years. Certified driving rehabilitation therapist Pass the certification exam tough The Association for Driving Rehabilitation Specialists and/or meet the requirements below: An undergraduate degree or higher in a health-related area of study with 1-year full time experience in degree area of study and an additional 1-year full time experience in the field of Driver Rehabilitation. Four-year undergraduate degree or higher with a major or minor in Traffic Safety and/or a Driver and Traffic Safety Endorsement with 1-year full time experience in Traffic Safety and an additional 2 years of full-time experience in the field of Driver Rehabilitation. Two-year degree in a health-related area of study with 1-year experience in degree area of study and an additional 3 years full time experience in the field of Driver Rehabilitation. Five years of full-time work experience in the field of Driver Rehabilitation. Certified driving instructor with driving school Listed as a certified professional drive school tough the Nevada State Department of Motor Vehicles website. Accessibility (Local contractor) Within 100 miles of Las Vegas, Nevada Within Southern Nevada due to differing state DMV regulations for bioptic driving Training Car Availability for patients without access to their own vehicle Training car must have: Anti-glare window tinting Cross over bar Cushions for seating options Driving School brake EZ Handle for entry and exit Footrest Four-way power seat GPS Left foot accelerator Menox hand controls, right side MPS Right angle, left sided hand controls Pedal extensions Pedal guard Reverse alarm Seatbelt extender Spinner knob attachment left Spinner knob attachment, right Liability Coverage Meet the demands of the Department of Motor Vehicles in terms of bond and insurance for a professional driving school. Price (End of Provision 52.212-2) 4. OFFEROR REPRESENTATION AND CERTIFICATIONS The Provision 52.212-3, Offeror Representation and Certifications Commercial Items applies to this acquisition. The Offeror shall complete only paragraph (b) of this provision if the Offeror has completed the annual representations and certification electronically via the System for Award Management (SAM) Web site located at https://www.sam.gov/portal. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) tough (u) of this provision. (End of Provision 52.212-3) 5. TERMS & CONDITIONS The Clause 52.212-4, Contract Terms and Conditions Commercial Items (Jan 2017), applies to this acquisition. Addendum to FAR 52.212-4, Contract Terms and Conditions - Commercial Items (Jan 2017): 52.252-2 Clauses Incorporated by Reference (FEB 1998) 52.232-40 Providing Accelerated Payments to Small Business Subcontractors (DEC 2013) 52.217-8 Option to Extend Services 52.217-9 Option to Extend the Term of the Contract 52.224-1 Privacy Act Notification 52.224-2 Privacy Act 52.232-18 Availability of Funds 52.232-40 Providing Accelerated Payments to Small Business Subcontractors. 52.237-3 Continuity of Services 852.203-70A Commercial advertising (Jan 2008) 852.219-74A Limitations on Subcontracting 852.232-72 Electronic Submission of Payment Requests 852.237-70 Contractor responsibilities 852.237-7 Indemnification and Medical Lability Insurance 852.271-70 Nondiscrimination in services provided to beneficiaries (End of Clause 52.212-4) 6. CONTRACT TERMS & CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR EXECUTIVE ORDERS The Clause 52.212-5, Contract Terms and Conditions Required to Implement Statutes or Executive Orders Commercial Items applies to this acquisition. The FAR clauses listed below are the clauses chosen from paragraph (b) of this provision that apply to this acquisition and are incorporated by reference: 52.204 10, Reporting Executive Compensation and First-Tier Subcontract Awards (Oct 2018) (Pub. L. 109 282) (31 U.S.C. 6101 note). 52.209-6, Protecting the Government's Interest When Subcontracting with Contractors Debarred, Suspended, or Proposed for Debarment. (OCT 2015) (31 U.S.C. 6101 note). 52.219-6, Notice of Total Small Business Set-Aside (NOV 2011) (15 U.S.C. 644). 52.219-28, Post Award Small Business Program Representation (Jul 2013) (15 U.S.C 632(a)(2)). 52.222-3, Convict Labor (June 2003) (E.O. 11755). 52.222-21, Prohibition of Segregated Facilities (APR 2015). 52.222 26, Equal Opportunity (SEP 2016) (E.O. 11246). 52.222-36, Equal Opportunity for Workers with Disabilities (JUL 2014) (29 U.S.C. 793). 52.222-40, Notification of Employee Rights Under the National Labor Relations Act (DEC 2010) (E.O. 13496). 52.222-50, Combating Trafficking in Persons (JAN 2019) (22 U.S.C. chapter 78 and E.O. 13627). 52.223-18, Encouraging Contractor Policies to Ban Text Messaging While Driving (AUG 2011) 52.224-3, Privacy Training (JAN 2017) (5 U.S.C. 552a). 52.225-13, Restrictions on Certain Foreign Purchases (JUN 2008) (E.O.'s, proclamations, and statutes administered by the Office of Foreign Assets Control of the Department of the Treasury). 52.232-33, Payment by Electronic Funds Transfer System for Award Management (Oct 2018) (31 U.S.C. 3332). 52.232-34, Payment by Electronic Funds Transfer Other than System for Award Management (Jul 2013) (31 U.S.C. 3332). 52.222-41, Service Contract Labor Standards (AUG 2018) (41 U.S.C. chapter 67). 52.222-42, Statement of Equivalent Rates for Federal Hires (MAY 2014) (29 U.S.C. 206 and 41 U.S.C. chapter 67). Employee Class: Monetary Wage-Fringe Benefits: 12012 $15.00 . (End Clause 52.212-5) end solicitation** 36C26119Q0971 Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 21
9/10/19, 10:32 AM Late ADR for Optometry VA262-14-D-0112 VA261-17-J-1636 36C261-19-AP-5249
Occupational Therapist Statement of Work General: The VA Southern Nevada Healthcare System has a need for a contracted occupational therapist specializing in driving rehabilitation. Contract Period: 1 October 2019 to 30 September 2020 Occupational therapist services shall be provided in accordance with the terms and conditions of this contract. The price shall include all necessary travel time, mileage charges and per diem to and from the contractor s place of business or residence. Occupational therapist services: Scope of Services The Contractor shall provide the services of a qualified occupational therapist specializing in driving rehabilitation, hereinafter referred to as "contract driving rehabilitation specialist" to perform the requirements of this contract Service will be performed at a location of convenience for the patient. Driving evaluations will be performed in the patient s own car, as long as the car meets the minimum State insurance requirements. Otherwise, a training car will be made available by the contracted driving rehabilitation specialist. Payment for any leave, including sick leave or vacation time, and holiday pay is the responsibility of the Contractor. All costs associated with travel, transportation, lodging or any other miscellaneous expenses related to this work shall be the sole responsibility of the contractor. General Duties: The contract driving rehabilitation specialist shall perform services, which include, but are not limited to the following: The contract driving rehabilitation specialist s primary functions will be skilled care for VA Southern Nevada Healthcare System (VASNHS) veterans who require specialized evaluation, training, and equipment to be successful and safe drivers. The individual driver rehabilitation specialist must possess: Special abilities and technical skills related to the provision of driver rehabilitation services A medical rehabilitation background Knowledge of residuals of traumatic and non-traumatic disabilities; and Special experience in order to evaluate and determine physical limitations of the Veteran with disabilities and the following modalities; i.e., hand controls, lifts, specialty adaptive driving systems, etc.\ The individual driver rehabilitation specialist must maintain a current knowledge of: Technological advances in adaptive equipment and high-tech driving systems; Changes in automotive design; and Other factors which may influence an individual s capacity to safely operate a motor vehicle. The Contractor and its personnel are expected to comply with all mandated standards and requirements. The Contractor is responsible for completing all mandatory training per VASNHS policy. The contractor must provide documented evidence of completion annually. If contractor fails to comply, suspension or termination of all physical and/or electronic access privileges and removal from contract until such time as the training is complete. Functions: Clinical: Provide accurate reports for all evaluation and training. Report requirements: Interview: Driving History Current needs/goals Usual driving conditions Medical history Clinical Evaluation includes: Vision. Portable vision devices provide an evaluation of certain vision factors necessary to perform a safe driving task. Equipment must be available to measure the following: visual acuity, color perception, field of vision, depth perception, glare recovery, and night vision Reaction Time. A device is used to measure reaction time from acceleration to braking. Cognitive and Perceptional Screening. In screening of basic cognitive and perceptional motor materials, identification and/or verification of a potential problem must be referred to the appropriate professional for a more in-depth evaluation. Neuromotor Assessment. This is a physical assessment of range of motion, strength, sensation, coordination, and endurance. Automobile Accessibility. Transfer in/out of vehicle and stowing of mobility aides (wheelchair, walker, etc). Operation of equipment (headlights, turn signals, gear selector, etc). Behind-the-Wheel Assessment Basic state driving laws Maneuverability in various types of traffic environments. Driving behaviors such as: anxiety, confusion, distractibility, impulsivity. Mental fatigue Access: Contractor to contact patient within reasonable time frame (30 days of initial consult) or document justification of inability to reach patient. Patient contact information to be released to contractor via release of information signed by veteran. Failure to comply with reasonable time frame will result in decrease in compensation rate for initial evaluation by 10% of negotiated cost. Administrative: Documentation of Clinical Chart. The patient s progress must be documented in the medical record via scanned reports from the driving rehabilitation specialist from time of initial evaluation and/or assessment until completion of the driver rehabilitation training. The provider will fax or mail records to administrative contract officer representative to have documents scanned into Vista Imaging. The provider will not physically enter records into VA computer database. Documentation must follow local medical facility policy and be in compliance with appropriate accreditation standards (i.e., the Joint Commission and the Commission on the Accreditation of Rehabilitation Facilities (CARF). The VA will provide the contract driving rehabilitation specialist with all adaptive equipment necessary for driving rehabilitation evaluation and training. Organizational Relationship The contract driving rehabilitation therapist will perform services under the oversight of the VA Chief, Optometry service or his/her designee. Routine work shall be performed with a minimum of supervision and the contract driving rehabilitation therapist will be required to perform duties on their own initiative. The contract driving rehabilitation therapist shall act in a thoroughly professional manner at all times. They shall work in harmony with other members of VA Staff where they are working. Tact and courtesy are mandatory when interacting with patients and staff. Work days/hours Work days/hours: The Contractor shall provide driving rehabilitation therapist shall provide services on a per patient bases as need arises. The contract driving rehabilitation therapist shall not be required to provide on-call or stand-by services. The contract driving rehabilitation therapist shall not be required to provide services on the following federal holidays: New Year's Day, Martin Luther King Day, President's Day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans Day, Thanksgiving Day, Cistmas Day and any other day specifically declared by the President of the United States to be a Federal Holiday. The contractor will not be required to work weekends. Services The services specified herein may be changed by written modification to this contract. The VA Contracting Officer will prepare the modification. Other personnel and equipment necessary for the operation of the services contracted for will be provided by the VA at levels compatible with the safety of patients, staff, and quality medical care programming. The services to be performed shall be performed in accordance with VA policies and procedures. Qualifications Prior to performing any work under this contract the qualifications of the contract driving rehabilitation specialist must be submitted to the VA Chief, Optometry service or his/her designee for approval. In order to perform the services covered by this contract the contractor shall have a minimum of a Baccalaureate Degree in occupational therapy. The contractor shall also be certified as a driving rehabilitation therapist, hand therapist, and a licensed driving instructor with their own driving school. Updated licensing, registration, and certification must be provided as they are renewed yearly. Failure to comply will result in termination of the contract. Appropriate referrals need to be initiated by the driver rehabilitation specialist to other services for more detailed evaluations as indicated (i.e. cognitive assessment, neuro-sensory evaluation, visual examination, etc.). Additional university credentials, State certification and/or successful completion of the National Driver Rehabilitation Specialist Examination sponsored by Association for Driver Rehabilitation Specialists (ADED) , formerly known as the Association for Driver Educators for the Disabled, is encouraged. Qualifications shall be subject to review by the VA Chief of Staff and approval by the VA Facility Director. The contractor's personnel shall be responsible and able to show evidence of reliability, ability and experience. Verified references of ability and qualifications may be accepted by the Contracting Officer to satisfy these requirements. Before commencing work under this contract, the Contractor, shall provide, and thereafter maintain for the duration of the contract, Liability Insurance in conformance with applicable Nevada State requirements for the service contemplated. Evidence of insurance will not be waived. Payment Within 30 days of the end of each month services were provided, as described above, the contractor shall provide itemized invoicing All payments made under the contract will be made monthly, in arrears. No advance payments will be authorized. A recordkeeping system of contractor s hours worked shall be established. The payments for any leave, including sick leave or vacation time, are the responsibility of the contractor. Emergency Health Services The VA will not render emergency health services to the contract driving rehabilitation specialist for an incapacitating injury or otherwise serious illness occurring while on duty. All services, to include wages earned during period of initial medical evaluation provided by the VA, will be reimbursed by the Contractor. The Contractor will furnish the VA with the necessary injury/illness form(s) for reporting purposes. The VA for statistical and/or billing purposes will retain a copy of the complete form(s). Patient Safety Patient safety incidents must be reported using Patient Safety Report. All incidents must be reported within 24 hours. Personnel Policy The Contractor shall be responsible for protecting the personnel furnishing services under this contract. To carry out this responsibility, the Contractor shall provide the following: Worker s Compensation, Professional liability insurance, income tax withholding, and Social Security payments. The Contractor shall verify, and document, that all employees who provide patient care services at the VA Outpatient Clinic have the following before they provide any service related to this contract: (1) Health examinations including annual TB skin test result, (2) Either has received the Hepatitis 8 vaccine series, or is immune as a result of acquired infection, or haw been offered and refused the vaccinations. (3) Received measles-mumps-rubella (MMR) vaccine. Combined vaccine (MMR) is the vaccine of choice if individuals are likely to be susceptible to more than one of the tee diseases and is required for all persons born after 1956. (4) A negative PPD within the last year, or, if a known reactor, a negative chest X-Ray within the past year. (5) A history of varicella (chicken pox) or, if unknown, results of a varicella antibody test. If non-immune, must be vaccinated with Varivax (Chicken pox). (6) Received training In Universal Precautions and Blood Borne Pathogens, Hazardous Material Management, and Life Safety Management (fire preparedness). (7) Successfully completed cardiopulmonary resuscitation (CPR) training. Identification, Parking, Smoking and VA Regulations The contract driving rehabilitation therapist shall wear visible identification, provided by the Contractor, at all times while on the premises of the VA Southern Nevada Healthcare System. It is the responsibility of the Contractor's personnel to park in the appropriate designated parking areas. Information on parking is available from the VA Police and Security Service. The VA Southern Nevada Healthcare System will not invalidate or make reimbursement for parking violations of the Contractor under any conditions. Smoking is prohibited inside any buildings at the VA Southern Nevada Healthcare System. Possession of weapons is prohibited. Enclosed containers, including tool kits, shall be subject to search. Violations of VA regulations may result in citation answerable in the United States (Federal) District Court, not a local district, state, or municipal court. Standard Precautions By signing this instrument, the Contractor certifies that all Contractor's employees assigned to work for the VA are current in standard Precautions and are aware of pertinent OSHA and standard Precautions Regulations. Special Contract Requirements Contractors, contractor personnel, subcontractors, and subcontractor personnel shall be subject to the same Federal laws, regulations, standards, and VA Directives and Handbooks as VA and VA personnel regarding information and information system security. ACCESS TO VA INFORMATION AND VA INFORMATION SYSTEMS A contractor/subcontrator shall request logical (technical) or physical access to VA information and VA information systems for their employees, subcontractors, and affiliates only to the extent necessary to perform the services specified in the contract, agreement, or task order. All contractors, subcontractors, and third-party servicers and associates working with VA information are subject to the same investigative requirements as those of VA appointees or employees who have access to the same types of information. The level and process of background security investigations for contractors must be in accordance with VA Directive and Handbook 0710, Personnel Suitability and Security Program. The Office for Operations, Security, and Preparedness is responsible for these policies and procedures. Custom software development and outsourced operations must be located in the U.S. to the maximum extent practical. If such services are proposed to be performed abroad and are not disallowed by other VA policy or mandates, the contractor/subcontractor must state where all non-U.S. services are provided and detail a security plan, deemed to be acceptable by VA, specifically to address mitigation of the resulting problems of communication, control, data protection, and so forth. Location within the U.S. may be an evaluation factor. The contractor or subcontractor must notify the Contracting Officer immediately when an employee working on a VA system or with access to VA information is reassigned or leaves the contractor or subcontractor s employ. A The Contracting Officer must also be notified immediately by the contractor or subcontractor prior to an unfriendly termination. VA INFORMATION CUSTODIAL LANGUAGE Information made available to the contractor or subcontractor by VA for the performance or administration of this contract or information developed by the contractor/subcontractor in performance or administration of the contract shall be used only for those purposes and shall not be used in any other way without the prior written agreement of the VA. This clause expressly limits the contractor/subcontractor's rights to use data as described in Rights in Data - General, FAR 52.227-14(d) (1). VA information should not be co-mingled, if possible, with any other data on the contractors/subcontractor s information systems or media storage systems in order to ensure VA requirements related to data protection and media sanitization can be met. If co-mingling must be allowed to meet the requirements of the business need, the contractor must ensure that VA s information is returned to the VA or destroyed in accordance with VA s sanitization requirements. A VA reserves the right to conduct onsite inspections of contractor and subcontractor IT resources to ensure data security controls, separation of data and job duties, and destruction/media sanitization procedures are in compliance with VA directive requirements. Prior to termination or completion of this contract, contractor/subcontractor must not destroy information received from VA, or gathered/created by the contractor in the course of performing this contract without prior written approval by the VA. Any data destruction done on behalf of VA by a contractor/subcontractor must be done in accordance with National Archives and Records Administration (NARA) requirements as outlined in VA Directive 6300, Records and Information Management and its Handbook 6300.1 Records Management Procedures, applicable VA Records Control Schedules, and VA Handbook 6500.1, Electronic Media Sanitization. A Self-certification by the contractor that the data destruction requirements above have been met must be sent to the VA Contracting Officer within 30 days of termination of the contract. The contractor/subcontractor must receive, gather, store, back up, maintain, use, disclose and dispose of VA information only in compliance with the terms of the contract and applicable Federal and VA information confidentiality and security laws, regulations and policies. A If Federal or VA information confidentiality and security laws, regulations and policies become applicable to the VA information or information systems after execution of the contract, or if NIST issues or updates applicable FIPS or Special Publications (SP) after execution of this contract, the parties agree to negotiate in good faith to implement the information confidentiality and security laws, regulations and policies in this contract. The contractor/subcontractor shall not make copies of VA information except as authorized and necessary to perform the terms of the agreement or to preserve electronic information stored on contractor/subcontractor electronic storage media for restoration in case any electronic equipment or data used by the contractor/subcontractor needs to be restored to an operating state. A If copies are made for restoration purposes, after the restoration is complete, the copies must be appropriately destroyed. If VA determines that the contractor has violated any of the information confidentiality, privacy, and security provisions of the contract, it shall be sufficient grounds for VA to withhold payment to the contractor or third party or terminate the contract for default or terminate for cause under Federal Acquisition Regulation (FAR) part 12. If a VHA contract is terminated for cause, the associated BAA must also be terminated and appropriate actions taken in accordance with VHA Handbook 1600.01, Business Associate Agreements. A Absent an agreement to use or disclose protected health information, there is no business associate relationship. The contractor/subcontractor must store, transport, or transmit VA sensitive information in an encrypted form, using VA-approved encryption tools that are, at a minimum, FIPS 140-2 validated. The contractor/subcontractor s firewall and Web services security controls, if applicable, shall meet or exceed VA s minimum requirements. VA Configuration Guidelines are available upon request. Except for uses and disclosures of VA information authorized by this contract for performance of the contract, the contractor/subcontractor may use and disclose VA information only in two other situations: (i) in response to a qualifying order of a court of competent jurisdiction, or (ii) with VA s prior written approval. A The contractor/subcontractor must refer all requests for, demands for production of, or inquiries about, VA information and information systems to the VA contracting officer for response. Notwithstanding the provision above, the contractor/subcontractor shall not release VA records protected by Title 38 U.S.C. 5705, confidentiality of medical quality assurance records and/or Title 38 U.S.C. 7332, confidentiality of certain health records pertaining to drug addiction, sickle cell anemia, alcoholism or alcohol abuse, or infection with human immunodeficiency virus. A If the contractor/subcontractor is in receipt of a court order or other requests for the above mentioned information, that contractor/subcontractor shall immediately refer such court orders or other requests to the VA contracting officer for response. For service that involves the storage, generating, transmitting, or exchanging of VA sensitive information but does not require C & A or an MOU-ISA for system interconnection, the contractor/subcontractor must complete a Contractor Security Control Assessment (CSCA) on a yearly basis and provide it to the COR. SECURITY INCIDENT INVESTIGATION The term security incident means an event that has, or could have, resulted in unauthorized access to, loss or damage to VA assets, or sensitive information, or an action that breaches VA security procedures. The contractor/subcontractor shall immediately notify the COR and simultaneously, the designated ISO and Privacy Officer for the contract of any known or suspected security/privacy incidents, or any unauthorized disclosure of sensitive information, including that contained in system(s) to which the contractor/subcontractor has access. To the extent known by the contractor/subcontractor, the contractor/subcontractor s notice to VA shall identify the information involved, the circumstances surrounding the incident (including to whom, how, when, and where the VA information or assets were placed at risk or compromised), and any other information that the contractor/subcontractor considers relevant. With respect to unsecured protected health information, the business associate is deemed to have discovered a data breach when the business associate knew or should have known of a breach of such information. Upon discovery, the business associate must notify the covered entity of the breach. A Notifications need to be made in accordance with the executed business associate agreement. In instances of theft or break-in or other criminal activity, the contractor/subcontractor must concurrently report the incident to the appropriate law enforcement entity (or entities) of jurisdiction, including the VA OIG and Security and Law Enforcement. The contractor, its employees, and its subcontractors and their employees shall cooperate with VA and any law enforcement authority responsible for the investigation and prosecution of any possible criminal law violation(s) associated with any incident. The contractor/subcontractor shall cooperate with VA in any civil litigation to recover VA information, obtain monetary or other A compensation from a third party for damages arising from any incident, or obtain injunctive relief against any third party arising from, or related to, the incident. LIQUIDATED DAMAGES FOR DATA BREACH Consistent with the requirements of 38 U.S.C. A5725, a contract may require access to sensitive personal information. If so, the contractor is liable to VA for liquidated damages in the event of a data breach or privacy incident involving any SPI the contractor/subcontractor processes or maintains under this contract. The contractor/subcontractor shall provide notice to VA of a security incident as set forth in the Security Incident Investigation section above. A Upon such notification, VA must secure from a non-Department entity or the VA Office of Inspector General an independent risk analysis of the data breach to determine the level of risk associated with the data breach for the potential misuse of any sensitive personal information involved in the data breach. The term 'data breach' means the loss, theft, or other unauthorized access, or any access other than that incidental to the scope of employment, to data containing sensitive personal information, in electronic or printed form, that results in the potential compromise of the confidentiality or integrity of the data.A A Contractor shall fully cooperate with the entity performing the risk analysis. A Failure to cooperate may be deemed a material breach and grounds for contract termination. Each risk analysis shall address all relevant information concerning the data breach, including the following: Nature of the event (loss, theft, unauthorized access); Description of the event, including: (a) date of occurrence; (b) data elements involved, including any PII, such as full name, social security number, date of birth, home address, account number, disability code; (3) Number of individuals affected or potentially affected; (4) Names of individuals or groups affected or potentially affected; (5) Ease of logical data access to the lost, stolen or improperly accessed data in light of the degree of protection for the data, e.g., unencrypted, plain text; (6) Amount of time the data has been out of VA control; (7) The likelihood that the sensitive personal information will or has been compromised (made accessible to and usable by unauthorized persons); (8) Known misuses of data containing sensitive personal information, if any; (9) Assessment of the potential harm to the affected individuals; (10) Data breach analysis as outlined in 6500.2 Handbook, Management of Security and Privacy Incidents, as appropriate; and (11) Whether credit protection services may assist record subjects in avoiding or mitigating the results of identity theft based on the sensitive personal information that may have been compromised. Based on the determinations of the independent risk analysis, the contractor shall be responsible for paying to the VA liquidated damages in the amount of $37.50 per affected individual to cover the cost of providing credit protection services to affected individuals consisting of the following: Notification; One year of credit monitoring services consisting of automatic daily monitoring of at least 3 relevant credit bureau reports; Data breach analysis; Fraud resolution services, including writing dispute letters, initiating fraud alerts and credit freezes, to assist affected individuals to bring matters to resolution; One year of identity theft insurance with $20,000.00 coverage at $0 deductible; and Necessary legal expenses the subjects may incur to repair falsified or damaged credit records, histories, or financial affairs. TRAINING All contractor employees and subcontractor employees requiring access to VA information and VA information systems shall complete the following before being granted access to VA information and its systems: Sign and acknowledge (either manually or electronically) understanding of and responsibilities for compliance with the Contractor Rules of Behavior, Appendix E relating to access to VA information and information systems; Successfully complete the VA Cyber Security Awareness and Rules of Behavior training and annually complete required security training; Successfully complete the appropriate VA privacy training and annually complete required privacy training; and Successfully complete any additional cyber security or privacy training, as required for VA personnel with equivalent information system access [to be defined by the VA program official and provided to the contracting officer for inclusion in the solicitation document e.g., any role-based information security training required in accordance with NIST Special Publication 800-16, Information Technology Security Training Requirements.] The contractor shall provide to the contracting officer and/or the COR a copy of the training certificates and certification of signing the Contractor Rules of Behavior for each applicable employee within 1 week of the initiation of the contract and annually thereafter, as required. Failure to complete the mandatory annual training and sign the Rules of Behavior annually, within the timeframe required, is grounds for suspension or termination of all physical or electronic access privileges and removal from work on the contract until such time as the training and documents are complete. Quality Assurance The administrative COR for this contract, reserves the right to conduct competency assessment checks of contract driving rehabilitation therapist to include demonstration of age-related competencies and other pertinent position-specific competencies as well as ongoing competency assessments. Monthly audits (if services are provided that month) of one patient will be performed to ensure hours billed match hours received by the patient. 36C26119Q0971 Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 21
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