25NRW004_-_Exhibits_A-E.pdf

California Department of Veterans Affairs Solicitation Number: 25NRW004 Exhibit A - Scope of Work TBD

TEMPORARY/RELIEF REGISTERED NURSING (RN), CERTIFIED NURSING ASSISTANT (CNA) & LICENSED

VOCATIONAL NURSE (LVN) REGISTRY SERVICES

1. INTRODUCTION

A. Contractor shall provide Temporary Relief Nursing Registry Services, as specified, to California

Department of Veterans Affairs, (CalVet.) Contractor shall provide services at the Veterans Home, (Home), located at 11500 Nimitz Ave., Los Angeles, CA 90049. Contractor shall provide all labor, materials, staff, transportation, license, permits and every other item of expense necessary, unless otherwise stated, to provide services. Services shall be provided at the Home upon request and under the direction of the Contract Manager or designee. For purposes of this Agreement, the State designee must be a civil service employee.

B. Contractor services shall be used to fill temporary vacancies substitute for full-time CalVet employees on extended leave and provide temporary services when appropriate staffing levels cannot be maintained with civil service staff or are not available within civil service.

C. Provider must be able to perform the tasks associated with providing services under the scope of their license. Contractor agrees that all Providers will be required to render health services as stated below and as required by law on an as needed basis. Providers will perform services in accordance with federal and state laws and regulations and CalVet policies and procedures and shall at all times comply with universal safety precautions and maintain CalVet security measures and a safe work environment.

D. Contractor agrees that, unless otherwise stated, all expenses associated with travel to and from the

Veterans Home, lodging, and all training expenses for Providers shall be borne by the Contractor or the Provider, and will not be reimbursed separately by CalVet. Any and all services performed outside the scope of this Agreement will be at the sole risk and expense of the Contractor.

E. Contractor is not authorized to deliver or commence performance of services as described in the

Agreement until written approval has been obtained from CalVet Contract Manager, or Designee, and the Contractor has received a copy of an executed contract from CalVet. For purposes of this Agreement, the State designee must be a civil service employee. Any delivery or performance of service commenced prior to the Contractor obtaining all written approvals shall be considered voluntary on the part of the Contractor.

2. CONTRACTOR’S RESPONSIBILITIES

A. Provide daily shift coverage: within sixty (60) days of the execution of this agreement and subsequently throughout the entire term of this agreement unless and until otherwise specific by CalVet, the contractor shall provide daily shift coverage with providers who meet the requirement specified in Exhibit A-1 service specification.

1. Contractor shall provide daily shift coverage at the following specific days and times:

Position Weekday

(Daytime) Weekdays

(Night-times) Weekend (Daytime)

Weekend (Nighttime)

CNA Seven (7) Three (3) Seven (7) Three (3) LVN One (1) One (1) One (1) One (1) RN One (1) Zero (0) One (1) Zero (0)

2. The following definitions shall apply to Provider shift availability requirements stated herein:

a. "Weekday" shall mean Monday 7:00 a.m. through Friday 7:30 p.m.

b. "Weekend" shall mean Friday 7:00 p.m. through Monday 7:30 a.m.

c. "Daytime" shall mean 7:00 a.m. and 7:30 p.m.

d. "Nighttime" shall mean 7:00 p.m. and 7:30 a.m.

Exhibit A - Scope of Work TBD

3. The daily shift coverage requirement constitutes a good-faith measure of CalVet's current per diem temporary/relief service requests. CalVet reserves the right to adjust, increase, decrease, cancel, or otherwise alter the daily shift coverage requirements, which are dependent upon CalVet's ability to fill staff vacancies, the return to work of CalVet staff from leave, and fluctuations in the resident population.

4. The Contractor shall provide daily shift coverage by qualified Providers by adhering to the following requirements:

a. Immediately upon contract award, and as needed to provide daily shift coverage throughout the term of the agreement, Contractor shall submit qualifications of proposed Providers to the Contract Manager, following the process outlined in Item 6: Submission of Provider Qualifications.

b. The number of Providers that the Contractor submits to the Home for qualification shall be at the discretion and management of the Contractor but shall be sufficient for the Contractor to provide continuous coverage for each of the required daily shifts. Contractor shall be responsible for replacing "call offs" (refer to Item 9: Cancellation).

c. Failure to maintain coverage for each classification as requested by CalVet constitutes grounds for termination of this Agreement.

B. Fulfill New Requests for Services:

1. The Contractor shall also respond to CalVet's requests for Provider services following the process outlined in Item 5: Scheduling Services.

2. Contractor shall be available and fully able to fulfill CalVet's requests for services twenty-four (24) hours a day, seven (7) days per week, including weekends and holidays.

3. Contractor shall consistently provide services for the Home's highly requested service times, which include weekends, evenings, and holidays. Contractor shall be responsible for adjusting its own staffing levels as needed to meet the needs of the Home under this Agreement.

C. Manage Providers:

1. Contractor shall ensure that all Providers assigned to perform services under this agreement have prior, written approval from the Contract Manager, or designee.

2. Contractor shall be responsible for managing Providers including: pre-screening, training, approving work, regulating performance, tracking time, and ensuring Providers meet all contractual requirements.

3. Contractor shall be responsible for accurately recording all hours worked by its Providers. Contractor shall ensure that each scheduled Provider:

a. Maintains a Contractor-issued timesheet; and

b. Signs in and out in the following three (3) Home locations:

i. Main Entrance;

ii. 2nd Floor Nursing; and

iii. Assigned Unit(s).

4. Contractors shall be solely responsible for directing Providers to ensure that they do not perform services during hours outside of the times agreed upon by CalVet and the Contractor.

Exhibit A - Scope of Work TBD

5. Contractor shall regulate its own Providers so that if any Provider assigned to a shift at the Home becomes unable to perform due to illness, resignation, or factors beyond the Contractor's control, the Contractor has another qualified Provider that can immediately cover the scheduled shift without disruption or delay.

6. Contractor shall require all assigned Provider to comply with the Home's infection control policies and procedures.

7. Contractor shall ensure each Provider follows the Home's security requirements:

a. Providers shall park in the designated employee/visitor lot and shall not park in resident parking.

b. Providers shall adhere to instructions on all of CalVet's posted signage.

c. Providers shall wear a Contractor-issued identification badge above the waist, visible at all times while on-site at the Home. The badge shall include: the name of the Provider, name of the Contractor, and a photo identification.

D. Submit Reports

1. Contractor shall be responsible for maintaining accurate Contractor-issued timesheets for each

Provider, which shall include:

a. Name of Contractor;

b. Name and Title of Provider;

c. Date(s) of Services;

d. Sign-In Time, for each date worked;

e. Sign-Out Time, for each date worked;

f. Break Time(s), as applicable and for each date worked;

g. Total Number of Hours Worked;

h. Signature of Provider; and

i. Signature of CalVet Contract Manager, or designee.

2. Contractor shall submit CalVet-approved timesheets with all invoices.

3. CalVet reserves the right to request that the Contractor provide additional reports and information as needed. Contractor shall respond to requests for reports within CalVet's requested timeframe.

4. Contractor shall submit reports in electronic format via electronic mail as requested by CalVet. If electronic mail is not available, the Contractor and Contract Manager, or designee, shall make arrangements in mutual Agreement.

3. PROVIDER'S QUALIFICATIONS

Provider's qualifications are noted in Exhibit A-1, Service Specification

4. LICENSES, PERMITS, AND CERTIFICATION REQUIREMENTS

Prior to providing services as outlined in this Agreement, Contractor shall ensure that each Provider possess and maintain throughout the term of this Agreement, all licenses, permits, and certification requirements noted in Exhibit A–1, Service Specifications.

The Contractor must have at least 85% of the requested disciplines hired and ready to work within 7-days of awarding the contract.

5. SCHEDULING SERVICES

Exhibit A - Scope of Work TBD

A. CalVet Request for Services:

1. CalVet reserves the right to request services twenty-four (24) hours a day, seven (7) days per week, including weekends and holidays, on an as-needed basis, in accordance with CalVet policies and procedures, to ensure the best qualify of treatment to meet the needs of residents at the Home.

2. To request services, CalVet shall provide the Contractor with:

a. Number of shifts or hours by working title;

b. Date(s) and Time(s) the Home requires of each working title; and

c. Whether the request is for one-time or recurrent services.

3. The initial contact for service request will be by telephone; however, CalVet will make every attempt to follow-up with a facsimile or e-mail.

4. CalVet shall issue requests to Contractor with a good-faith estimate based on the circumstances known to CalVet at the time of the request. It is not a guarantee of business, and requests are subject to change depending on CalVet's ability to fill staff vacancies, the return to work of CalVet staff from leave, and fluctuations in the resident population.

5. CalVet reserves the right to request that services are dispatched and available to the Home starting two (2) hours from the time of the request.

6. CalVet will request services based on the needs of the Home. Durations of services will vary.

Requests will be for a minimum of four (4) hours. In order to meet the Home's needs, CalVet reserves the right to request services that cover a portion of a standard shift or otherwise deviate from the standard working schedules of eight (8) or twelve (12) hours per shift.

7. To request to extend the end time of services in progress, CalVet shall make every attempt to notify the Contractor prior to the end of the Provider's services. The Contract Manager, or designee, shall document the request in writing.

B. Contractor's Response to Requests:

1. Contractor shall have a telephone number and a contact person available to accept and respond to service requests from CalVet by telephone twenty-four (24) hours a day, seven (7) days per week, including weekends and holidays throughout the entire term of this Agreement.

2. Immediately upon receipt of CalVet's request and no later than two (2) hours from receipt of request, Contractor shall provide confirmation of services and submit name(s) and qualifications of available Provider(s) in accordance with Item 6: Submission of Provider Qualifications.

3. Contractor shall also respond to CalVet's request to extend the duration of services in progress immediately and no later than two (2) hours after CalVet's request.

4. Contractor shall dispatch to the Home the requested number of Providers by the requested start time.

5. Contractor shall ensure that all dispatched Providers report to the Contract Manager, or designee, by the scheduled start time. Contractor shall only dispatch Providers whom the Contract Manager, or designee, has deemed qualified.

6. Contractor shall be responsible for replacing any Provider "call-offs" in accordance with Item 10:

Cancellation.

7. Contractor shall be responsible for ensuring that all ordered services have prior authorization in accordance with the Home and are mutually agreed upon between the Contract Manager, or

Exhibit A - Scope of Work TBD designee, and the Contractor. Contractor shall be solely responsible for ensuring that Providers do not perform services without approval from the Home and Contractor.

8. Failure to respond to service requests shall be grounds for contract termination

6. SUBMISSION OF PROVIDER QUALIFICATIONS

A. In order to establish a pool of qualified Providers sufficient to meet any and all daily coverage requirements and requests for services, the Contractor shall submit the following documents:

1. Provider's current Resume/Curriculum Vitae, which shall include the following information:

a. All education including name and location of university or college, business, correspondence, trade, or service school; course of study; units completed (semester/quarter); diploma, degree or certificate obtained; and date completed.

b. All relevant work history including classification/job title, job duties performed, "to and from" dates (month and year), and any other information necessary to determine qualifications of Providers.

c. Name of organization for which work was performed.

d. Supervisor name and contact information for each job, if the applicant has provided services to CalVet previously, the Provider must include the name of the specific Home, to and from dates of service, and immediate supervisor's full name and telephone number.

e. At least two (2) professional references and their contact information.

Note: Contact information shall be current with a valid telephone number or e-mail address.

2. Copies of any current and valid license(s), permits, trainings, and/or certification(s) as stated and as required by law. (Refer to Exhibit A-1, Service Specification, for requirements.)

3. Copies of any pre-employment health and background clearance requirements. (Refer to Items 13 and 14 herein).

a. As the Providers' licenses and/or certifications expire, Contractor shall submit the Contract

Manager, or designee, the renewed Provider licenses minimum one (1) month prior to the license expiration date.

b. CalVet reserves the right to reject Provider qualifications. The Contract Manager shall state in writing and submit via electronic mail to the Contractor the reason(s) that the Provider does not meet the stated qualifications, the mission of CalVet/the Home, and/or the minimum required standard of care.

c. Contractor's response to CalVet's service requests shall include Providers for whom the Contractor has already provided copies of the requested documents. If the Contractor has not provided the required qualifications, Contractor may be deemed as non-responsive and the next ranked Contractor(s) will be contacted.

7. OVERTIME

A. Overtime is not permitted under this Agreement.

B. Contractor shall have the sole responsibility of regulating its Provider's overtime.

C. Contractor shall manage Providers and their schedules in order for the Contractor to meet its own legal

Exhibit A - Scope of Work TBD obligations and overtime policies.

D. Contractor shall provide services based on CalVet's request for coverage using its sole discretion for Provider scheduling. Contractor shall appropriately schedule its qualified Providers, including increasing the number of qualified Providers, as necessary, to fulfill services for the requested shift times while avoiding overtime.

E. Contractor shall be responsible for ensuring Providers obtain authorization directly from the Contractor prior to performing services under this agreement.

F. Contractor shall ensure Providers sign out and end services immediately at the end of their scheduled shift time in order to avoid working unauthorized hours.

G. Contractor shall ensure compliance with all federal, state, and local regulations regarding wage laws and provision of overtime for shifts in excess of eight (8) hours.

H. There is no overtime payment permitted under this Agreement.

I. CalVet will compensate the Contractor for services rendered, and which satisfy all terms under this agreement, at the fixed rate as determined by the contract's solicitation in Exhibit 8-1, Rate Sheet. By entering into this agreement, Contractor is acknowledging that any and all services performed under this Agreement shall be compensated at the Exhibit 8-1, Rate Sheet fixed, hourly rate.

J. In the event that Providers perform overtime, which is not authorized under this Agreement, the

Contractor shall be solely responsible for compensating their Providers for any resulting overtime pay rates required by law.

8. BUILDING SECURITY

The Contractor shall ensure each Provider has an identification badge which includes the name of the Provider, Name of. the Contractor (if different), and a photo identification. The badge shall be worn above the waist by the Provider at all times while at the Home. Providers shall sign in and out at the main lobby, as required upon entering the Home. The Contractor/Provider shall follow all requirements indicated by the Home for visitor sign in/out procedures, authorized parking lots, security and reporting. Providers shall wear the Home issued visitor I.D. badge.

9. CANCELLATION

A. Provider Call-Offs:

1. In the event that a Provider "calls off'' from a scheduled assignment, the Contractor shall provide an immediate replacement for CalVet to ensure continuity of services to the Home's residents.

2. If Contractor is unable to replace any and all Provider call off(s), Contractor shall immediately notify the Contract Manager, or designee, at least two (2) hours prior to the start of the scheduled start time. Notification of cancellation shall come from the Contractor. CalVet will not accept any call-offs originating from Providers.

3. Contractor's failure to notify the Contract Manager, or designee, of a Provider call off/cancellation is detrimental to the Home's continuity of services and shall be grounds for immediate contract termination.

4. Contractor's inability to find a qualified replacement for scheduled assignments on more than three

(3) occasions shall be grounds for contract termination.

B. CalVet Cancellations:

Exhibit A - Scope of Work TBD

1. CalVet may cancel or change assignments by telephone up to two (2) hours before a Provider's scheduled reporting time without incurring any liability to pay Contractor.

2. If CalVet cancels or changes a requested assignment for any reason, including emergency security situations, less than two (2) hours before the scheduled shift, CalVet shall compensate the Contractors for four (4) hours of registry time or, at the State's discretion, find suitable tasks (based on licensure) for the scheduled Provider for four (4) hours with no liability

10. INDEPENDENT CONTRACTOR STATUS

A. The Contractor/Providers shall be considered “Independent Contractors” in relation to CalVet and the

State. Therefore, the Contractor/Providers shall not be considered employee(s) of the Home and shall not be entitled to any employee benefits from the CalVet or the State including, but not limited to, the following:

1. Premium Pay, Overtime Pay, or Holiday Pay

2. Medical Insurance

3. Vacation or Sick Leave

4. Worker’s Compensation

5. Other employee benefits

Note: It is the Contractor’s responsibility to rotate providers if necessary to avoid overtime hours.

11. ORIENTATION/TRAINING

A. Contractor shall ensure that, prior to reporting for work at the Home, all Providers complete all required orientation and training to become familiar with the operations of the Home, its medical facilities, Title 22 of the California Code of Regulations, Title 42 of the Code of Federal Regulations, and any other laws or bylaws that may apply to the Home.

B. The Home shall provide orientation training as determined by the Contract Manager, or designee, towards

Home processes. Payment for orientation training shall be given after the Provider completes a minimum of one (1) shift. Payment for orientation training shall be based on hourly rates listed in Exhibit 8-1, Rate Sheet.

C. To maintain continuity of services and ensure safety for all workers, Contractor shall make available to the Home only those Providers who have completed the required orientation and training.

12. HEALTH CLEARANCE

A. Contractor shall be responsible for financing and obtaining required initial and annual health clearance for all Providers assigned to the Home (Refer to Exhibit A-1 - Service Specification, Item 1, D).

B. As part of compliance with OSHA Regulation 1910.1030-Bloodborne Pathogens, the Home will extend the Hepatitis B vaccine series offer to requesting Contractor staff.

C. Contractor's failure to comply with the Home's infection control policies for any Provider shall result in immediate Provider suspension and may be grounds for contract termination. The Home's suspension of a Provider will remain in effect until a medical clearance is provided and approved by CalVet.

D. During times of pandemic (such as COVID-19) or other instances of widespread viral or bacterial infections, additional precautionary infection control steps may be implemented and required by the Home.

These may include, but are not limited to: wearing CalVet approved masks and/or face shields, extra or

Exhibit A - Scope of Work TBD special cleanings, social distancing, partitions, adjusted hours and obtaining additional clearance certifications that may be required by local, state or federal health authorities.

E. Providers shall comply with the Home’s COVID-19 Mitigation Plan and follow all current COVID-19 guideline for precautions.

13. BACKGROUND CLEARANCE

A. Contractor shall be responsible for financing and obtaining criminal offense background clearance with fingerprinting for Providers assigned to the Home prior to assignment (Refer to Exhibit A-1 - Service Specification, Item 1, E).

14. FAILURE TO PERFORM

A. Contractor's Providers shall be required to meet CalVet's mission and the Home's policies and standards of care for residents.

B. CalVet shall routinely evaluate the work performance of the Contractor and Provider(s) to determine whether services meet contractual obligations and CalVet standards, policies, and procedures.

C. In order to ensure quality of services for the Home's residents, any Provider failing to uphold CalVet standards shall not be permitted to perform services.

1. For Providers whose performance does not meet CalVet's minimum standards, CalVet shall notify the

Contractor in writing and recommend training for improvement, at the expense of the Contractor.

Providers whom CalVet deems deficient in meeting minimum standards shall not be permitted to perform services until the Contractor provides the required training for the Provider, submits proof of training to CalVet, and receives written confirmation from the Contract Manager, or designee.

2. Any and all Provider(s) who continue(s) to fail to meet the minimum qualifications after completing the required Contractor-sponsored training shall not be permitted to perform services at the Home. After determining that the Provider is unable to satisfactorily perform the duties necessary to provide safe and efficient patient care, the Contract Manager, or designee, shall state in writing the reason(s) the Providers does not meet minimum qualifications and submit to the Contractor with notification that the individual is not to return: "Do Not Return" (DNR).

3. After notification of failure to meet minimum qualifications has been provided, CalVet shall not pay the

Contractor for additional hours worked by the Provider identified as DNR.

D. Contractor shall be able to provide a minimum number of Providers approved by CalVet within 60 days from the execution of the Agreement. Failure to do so may result in terminating the Agreement, at the discretion of the Contract Manager.

E. Failure to provide services on three (3) or more occasions may result in termination of the Agreement.

15. TRANSITION OF SERVICES

A. In the event the Contractor has an agreement from a prior bid for the same services in this Agreement, the State shall pay for services using rate(s) in the prior agreement for the period of time up to and including the term end date of that Agreement.

B. The transition period is defined as the time when the new Agreement(s) with new Contractor(s) are approved by the DGS/Office of Legal Services (DGS/OLS) and/or the Home must begin transition activities such as canvassing the Contractors on new Agreement and providing orientation training to the new Contractor's Providers to ensure there is not a break in services. During the transition period, providers working from prior agreements may continue to provide services based on the Home(s) needs up to the

Exhibit A - Scope of Work TBD expiration/termination date of the prior Agreement(s).

C. The overlapping term allows Contractors on the new Agreement to invoice for orientation training under the conditions allowed in the agreement and at the rates provided in Exhibit B-1. In the events Contractor has multiple contracts in place, providers attending orientations will be paid at the rates given in the new agreement for canvases resulting from the new Agreement.

16. CONTACT INFORMATION

A. The project representatives during the term of this Agreement will be:

1. CalVet Representative/Contract Manager:

Veterans Home of California - West Los Angeles Director of Nursing 11500 Nimitz Avenue Los Angeles, CA 90049 Phone:

Fax:

Email:

2. Contractor Representative:

TBD

B. Contract Representatives, addresses, and phone/fax numbers may be changed by issuing a 20-day prior written notification and shall not require a formal amendment to this Agreement. The notifying party shall provide complete contact information for the replacement Contract Representative including, name, title, mailing address, phone/fax numbers, and email address. All other changes require a formal written amendment to this Agreement.

Exhibit A-1 – Service Specification

TEMPORARY/RELIEF REGISTERED NURSE (RN), LICENCED VOCATIONAL NURSE (LVN),

AND CERTIFIED NURSING ASSISTANT (CNA) REGISTRY SERVICES

1. PROVIDER’S QUALIFICATIONS

A. Providers assigned to CalVet must have the minimum experience/education outlined below:

1. Registered Nurse (RN):

a. Minimum of six (6) months of experience within the last three (3) years performing services similar in scope to those defined herein, in a public or private institution.

Internship does not count towards the required experience.

b. Clinical competencies must be current and provided to the Home prior to the staff being assigned.

c. Minimum of 6 months of experience working with an electronic medication Administration Record System and an electronic medical records system.

d. Intermediate MS Office skills (Word, Excel, Outlook).

2. Licensed Vocational Nurse (LVN)

a. Minimum of six (6) months of experience within the last three (3) years rendering direct patient care in public or private institution.

c. Minimum of 6 months of experience working with an electronic medication Administration Record System and an electronic medical records system.

d. Intermediate MS Office skills (Word, Excel, Outlook).

3. Certified Nursing Assistant (CNA):

a. Minimum of six (6) months of experience within the last three (3) years rendering direct patient care in public or private institution.

c. Minimum of 6 months of experience working with an electronic medical records system.

d. Basic MS Office skills (Word, Excel, Outlook).

B. All Providers must have the required licenses, permits, and/or certifications noted herein. (Refer to Exhibit A-1, Item 2: Licenses, Permits, and Certification Requirements.)

C. Resident health care is of paramount importance. Accuracy in communications is critical to ensure timely, correct care is provided. Therefore, any Provider(s) providing services through this Agreement must be proficient in the English language and be able to communicate effectively with CalVet. This includes an ability to communicate verbally and in writing, including use of electronic tools.

D. Health Clearance: Initial and annual health clearance to include tuberculosis (TB) screening and

Hepatitis B vaccine series offer (initial only) is required by Home policy of all state employees and contract providers in order to meet state facility licensure requirements.

a. Contractor shall submit proof of required health screening to the Home’s Contract Manager, or designee, and Ambulatory Care Clinic in order to indicate the individual is cleared to perform their duties and is free of communicable disease.

i. Contractor shall provide proof that Providers have cleared Initial TB screening, which may include, but is not limited to, 2-step TST/PPD testing and/or X-ray, and TB questionnaire.

ii. Contractor shall provide proof of each active Provider’s annual TB screening, which may include, but is not limited to, 1-step TST/PPD testing and/or X-ray, and TB questionnaire.

b. The health clearance process must be completed for each Provider prior to initiation of services and within the required timeframe stipulated by the Home for the annual requirement.

E. Background Clearance: Home policy requires that Contractors/Providers obtain background clearance with Livescan fingerprinting prior to assignment to the Home in order to meet state facility licensure requirements:

a. Contractor shall submit criminal offense record background check number with each Provider’s application when submitting the qualifications of Providers to CalVet.

b. The Contractor and Contract Manager shall ensure that the Home’s Personnel Office receives the Live-Scan results prior to approving assignment to the Home.

F. Any Staff(s) who fails to meet the minimum qualifications, shall not be permitted to perform services. The Home’s Administrator, Contract Manager, or designee, shall state in writing the reason(s) the Provider does not meet minimum qualifications. After notification of failure to meet minimum qualifications has been provided, CalVet shall not pay the Contractor for additional hours worked by the Provider identified as not meeting the minimum qualifications.

2. LICENSES, PERMITS, AND CERTIFICATION REQUIREMENTS

Prior to providing services as outlined in this Agreement, Contractor shall:

A. Ensure that each Provider shall possess and maintain all current and valid licenses, permits, and certifications throughout the term of this Agreement for each classification noted below:

1. Valid license/certification as follows:

a. RN - valid license as RN issued by the California Board of Registered Nursing

b. LVN - valid license as LVN issued by the California State Board of Vocational Nurse Examiners

c. CNA - Current Nursing Assistant Certificate issued by the State of California in order to perform services in the State of California

2. Current Healthcare Staff Basic Life Support (BLS) certification from an American Heart Association or American Red Cross

B. Provide evidence of clinical competency consistent with current Department of Public Health

Services’ standards.

C. Provide to CalVet proof of state and federally-mandated training for healthcare providers.

D. Provide Employment Eligibility Verification (I-9) form.

E. Provide copies of any required license(s), permits, and/or certification(s) for each Provider to the Home’s Contract Manager, or designee, to be kept on file at the Home throughout the term of this Agreement. Contractor shall ensure that all required licenses, permits, certifications, and any other requirements outlined herein are current and in effect at all times during the term of this Agreement.

F. Provide current/renewed license(s), permit(s) and/or certification(s) to CalVet not less than thirty

(30) calendar days prior to their expiration. If, during the course of this Agreement, any of the licenses and/or requirements are found to be inactive or not in compliance, CalVet may withhold payment for services rendered during the expiration period and/or immediately terminate this

G. Assume responsibility for verifying, through the appropriate licensing boards, that no current or unresolved adverse actions have been taken by the State licensing authorities against any Staff(s) assigned to CalVet, and that all licenses are active and void of misconduct. CalVet may, at its discretion, verify the current status of Staff(s) assigned.

Note: Contractor is recommended to be Joint Commission of the Accreditation of Healthcare Organizations (JCAHO) certified but this certification is not required.

3. PROVIDER’S RESPONSIBILITIES

Under the direction of the Home’s SNF Administrator, Contract Manager, or designee, Providers shall provide services as permitted within the scope of practice for RN, LVN, and CNA Services in accordance with CalVet/Home policies and procedures.

A. Duties/Responsibilities shall include, but are not limited to:

1. RN:

a. Plan and implement nursing care. This includes administration of medication, therapeutic agents, treatments, disease prevention, physicians’ orders, as well as obtaining specimens for diagnostic testing.

b. Participate as a member of the interdisciplinary team in developing multi-disciplinary treatment efforts; complete assigned weekly summaries, formulate care plans, assist physicians with rounds; note and institute physician orders;

c. Provide observation, ongoing patient assessments, and therapeutic intervention consistent with the patient physical and psychological status; evaluate effectiveness of patient treatment regimens and record progress;

d. Document all nursing activities in medical records, including an initial nursing assessment, treatment interventions, and patient education;

e. Ensure that staff utilizes optimum standards of resident care and that staff members observe safety and Infection Control Precautions and regulations at all times;

2. LVN:

a. Organize, provide, and maintain necessary health care services consistent with CalVet policies and procedures;

b. Plan and implement nursing care. This includes administration of medication, therapeutic agents, treatments, disease prevention, physicians’ orders, as well as obtaining specimens for diagnostic testing.

c. Participate as a member of the interdisciplinary team in developing multi-disciplinary treatment efforts; complete assigned weekly summaries, update care plans, assist physicians with rounds; note and institute physician orders;

d. Collect information regarding patient status and report the results to the Primary Care Staff (PCP) or RN in a timely manner;

e. Provide Resident education and accurately document care in the approved format;

f. Assist mental health professionals by contributing to the treatment planning process and the formal evaluation of Resident progress by monitoring and recording observed patient behavior;

g. Document in the Resident’s health record the nursing care and treatment provided and the Resident’s response to facilitate the continuity of care and communicate to other health care Staff

h. Ensure that staff utilizes optimum standards of resident care and that staff members observe safety and Infection Control Precautions and regulations at all times.

3. CNA:

a. Provide care and tend to physical needs of the patients according to the patient care plan;

b. Perform and document rounds of patient receiving care and report changes in patient condition to the Nurse;

c. Obtain specimens for diagnostic testing;

d. Complete all required documentation of patient care, provide written and/or oral reports;

e. Clean, maintain, and check equipment;

f. Document care provided in accordance with Minimum Dataset (MDS) standards;

g. Escort residents to appointments as need via available CalVet bus transportation or by walking to appointments that are within the facility or nearby.

B. Providers shall wear an identification badge which includes the name of the Contractor, the Staff’s name, and a photo ID as supplied by the contractor. This badge shall be worn at all times, above the waist while on grounds of the Home.

C. Providers shall adhere to mandated break times as required by state and federal law and in accordance with the operations and policies of the Home. At intervals required by law of qualifying shifts and at times mutually agreed upon by the Provider and supervising nurse, the Provider shall take the following breaks:

a. Two (2), fifteen (15) minute breaks that shall be paid; and

b. One (1), thirty (30) minute break that shall be unpaid.

D. Providers shall ensure resident medical record information is maintained as “CONFIDENTIAL” and shall be held in trust and confidence. Information shall be used only for the purposes contemplated under this contract.

E. If a lack of equipment and/or supplies creates a limitation to services requested, the Provider shall make a recommendation to the Administrator, Contract Manager, or designee, identifying equipment or supplies necessary for treatment. CalVet shall not reimburse Contractor or Contractor’s Providers for any equipment or supplies.

Providers shall perform their assigned tasks, functions, and responsibilities in a professional, ethical, and diligent manner in accordance with state and federal laws, regulations, rules, and policies as well as Home medical standards, policies, and procedures which include compliance with the requirements of Title 22, California Code o

Exhibit B - Budget Detail and Payment Provisions Contractor Name: TBD

1. STANDARD BUDGET DETAIL AND PAYMENT PROVISIONS

A. Invoicing and Payment

1. For services satisfactorily rendered, and upon receipt and approval of the invoices, the State agrees to compensate the Contractor for services rendered in accordance with the rates in Exhibit B-1.

2. Invoices shall include the Agreement Number and shall be submitted in not more frequently than monthly in arrears to:

Original Invoice Approval Copy Department of Veterans Affairs CalVet Accounting Office 1227 “O” Street Room 402 Sacramento, CA 95814 APInvoices@calvet.ca.gov

Veterans Home of California – West Los Angeles Attn: TBD 11500 Nimitz Ave.

Los Angeles, CA 90049

B. Budget Contingency Clause

1. It is mutually agreed that if the Budget Act of the current year and/or any subsequent years covered under this Agreement does not appropriate sufficient funds for the program, this Agreement shall be of no further form and effect. In this event, the State shall have no liability to pay any funds whatsoever to Contractor or to furnish any other considerations under this Agreement and Contractor shall not be obligated to perform any provisions of this Agreement.

2. If funding for any fiscal year is reduced or deleted by the Budget Act for purposes of this program, the State shall have the option to either cancel this Agreement with no liability occurring to the State, or offer an Agreement amendment to Contractor to reflect the reduced amount.

C. Prompt Payment Clause

Payment will be made in accordance with, and within the time specified in, Government Code, Chapter 4.5, commencing with Section 927.

2. SPECIAL BUDGET DETAIL AND PAYMENT PROVISIONS

Submissions of Invoices/Claims

1. All invoices/claims must be completed thoroughly and legibly, with all applicable fields completed.

Invoices/claims that are submitted to the appropriate location but have been altered, or are inaccurate, or do not provide all necessary information will not be accepted and will be returned to the Contractor for correction.

2. Any changes to this provision relating to the invoice/claim submittal process, including but not limited to an address, form, or process change, shall be an administrative change managed through the appropriate designated CalVet office and shall not require a contract amendment.

3. Contractor shall submit monthly invoices to the CalVet Contract Manager for approval and processing. Invoices/claims submitted shall include the following information in order to be considered complete and acceptable for processing, or the invoice/claim will be returned:

a) Contractor’s Company name exactly as it appears on the Payee Data Record (STD.204)

b) Contractor’s Company address, phone number and e-mail

c) Date of invoice/claim

d) Invoice/claim number

e) CalVet location where services were performed

Exhibit B - Budget Detail and Payment Provisions Contractor Name: TBD

f) Contract/Agreement Number

g) Date(s) of Service

h) Total dollar amount being billed

i) First and Last name of Contractor or Provider performing services, if applicable

j) Contractor’s or Provider’s Classification, whichever is applicable

k) When applicable, Contractors shall include the following information on the invoice/claim submitted for hourly reimbursement:

1. Hourly Rate

2. Time in and time out

3. Total hours worked

4. Any other information or documentation reasonably required to verify and substantiate the provision of services and the charges for such services.

3. CONTRACTOR OVERPAYMENTS

1. If the State determines that an overpayment has been made to the Contractor, the State will seek recovery immediately upon discovery of the overpayment by: (a) calling the Contractor’s accounting office to request a refund of the overpayment amount, or (b) offsetting subsequent Contractor payments by the amount of the overpayment if Contractor repayment or credit is not received within thirty (30) days from the date of notice.

2. If Contractor discovers it has received an overpayment, Contractor must notify the State and refund the overpayment immediately.

California Department of Veterans Affairs Solicitation Number: 25NRWS004 Exhibit B-1 - Rate Sheet Contractor Name: TBD

RATE SHEET

The Contractor must be able to provide services listed below. Subcontractors may be used to comply with this requirement. Subcontractor Agreements may be used to comply with this requirement. Subcontractor(s) information must be identified on Bidder Declaration (GSPD-05-105). If additional Subcontractors are added during the term of the Agreement, an updated GSPD-05-105 must be submitted.

The rate listed below is in effect for the term of the Agreement, including any extension of the term through a formal amendment.

Description of Service Hourly Rate

A. Certified Nursing Assistant-Day Shift (7:00AM-7:30PM)

B. Certified Nursing Assistant-Night Shift (7:00PM-7:30AM )

C. Licensed Vocational Nurse - Day Shift (7:00AM-7:30 PM)

D. Licensed Vocational Nurse - Night Shift (7:00 PM-7:30 AM)

E. Registered Nurse- Day Shift

(7:00AM-7:30PM)

F. Registered Nurse- Night Shift

(7:00 PM-7:30AM)

Exhibit D – Special Terms and Conditions TBD

1. EXCISE TAX

The State of California is exempt from Federal Excise Taxes, and no payment will be made for any taxes levied on employees' wages. The State will pay for any applicable State of California or local sales or use taxes on the services rendered or equipment or parts supplied pursuant to this Contract. California may pay any applicable sales or use tax imposed by another state.

2. STATUTORY AND REGULATORY PROVISIONS

A. This Contract shall be governed and construed in accordance with all applicable statutory and regulatory provisions including, but not limited to:

1) Title XVIII of the Federal Social Security Act

2) Title XIX of the Federal Social Security Act

3) Chapters 7 and 8 (commencing with Section 14000), Part 3, Division 9, Welfare and Institutions Code

4) Division 3, Title 22, California Code of Regulations (CCR)

5) Health and Safety Code Section 1340 et seq.

6) All applicable Federal provisions which regulate the administration of health care programs and budget revisions, as contained in the Code of Federal Regulations (CFR), Title 42, and Title 45, Part 74, Title 42 United States Code, Sections 1395 et seq. and 1396 et seq.

7) Sub-chapter 13 (commencing with Section 6800), Chapter 4, Part 1, Title 17, CCR; and

8) All other applicable laws and regulations.

B. Any provision of this Contract in conflict with the applicable laws and regulations is hereby amended to conform to the provisions of those laws and regulations. Such amendment of the Contract shall be effective on the effective date of the statutes or regulations necessitating it, and shall be binding on the parties even though the amendment may not have been reduced to writing and formally agreed upon and executed by the parties. If, due to amendment in laws of regulations, Contractor is unable or unwilling to comply with the provisions of the amendment(s), State or Contractor may terminate this Contract in accordance with the Termination provision of this Contract.

3. EXAMINATION AND AUDIT

A. Contractor shall allow the State and its related entities, the Comptroller General of the United States, Department of Justice (DOJ), and the Bureau of Medi-Cal Fraud, or their duly authorized representatives, to inspect or otherwise evaluate the quality, appropriateness, and timeliness of services performed under this Contract, and to inspect, evaluate, and audit any and all books, records, and facilities maintained by the Contractor and Subcontractors pertaining to services under this Contract at any time during normal business hours.

B. Contractor shall be subject to the examination and audit of the State Auditor for a period of three (3) years after final payment under this Contract in accordance with Government Code, Section 85467.7. The examination and audit shall be confined to those matters directly connected with the performance of the contract, including, but not limited to, the costs of administering the Contract.

C. Books and records include, but are not limited to, all physical records originated or prepared pursuant to the performance under this Contract, including working papers, reports, financial records, and books of account, Medical Records, prescriptions files, Subcontracts, and any other documentation pertaining to medical and non-medical services for residents of the Home. Upon request, at any time during the term of this Contract, the Contractor shall furnish any record or copy.

4. RESOLUTION OF DISPUTES

A. The Contractor may dispute and appeal a decision or action by the State arising out of the Interpretation or administration of this Contract. A written dispute notice shall be submitted to the Contract Manager within thirty (30) calendar days from the date the Contractor receives notice of the decision or action in dispute.

The Contractor’s dispute notice shall state the following, based on the most accurate information available to the Contractor:

1) That it is a dispute pursuant to this Section.

2) The date, nature, and circumstances of the conduct, which is the subject of dispute.

3) The names, telephone numbers, function, and activity of each contractor, subcontractor, State official, or employee involved in or knowledgeable about the conduct.

4) The identification of any documents and the substance of any oral communications involved in the conduct. Copies of all identified documents shall be attached.

5) The reason why the Contractor is disputing the conduct.

6) The cost impact to the Contractor directly attributable to the alleged conduct, if any.

7) The Contractor’s desired remedy.

B. The State and the Contractor agree to try to resolve all contractual issues by negotiation and mutual agreement at the Contract Manager level. The parties recognize that the implementation of this policy depends on open-mindedness, and the need for both sides to present adequate supporting information on matters in question. The Contract Manager, in a written decision stating the factual basis for the decision, will decide any disputes concerning performance of this Contract. Before issuance of the Contract Manager’s decision, informal discussions between the parties by the individuals who have not participated substantially in the matter in dispute will be considered by the parties in efforts to reach mutual agreement.

C. The Contract Manager will render a decision or request additional substantiating documentation from the

Contractor within thirty (30) days of receipt of the Contractor’s appeal. A copy of the decision will be provided to the Contractor. The decision shall be final and conclusive unless, within thirty (30) days from the date of the decision, the Contractor files a written appeal addressed to the Undersecretary, California Department of Veterans Affairs.

D. The Undersecretary’s decision shall be final and conclusive unless the decision is arbitrary, capricious, grossly erroneous or if any determination of fact is unsupported by substantiating evidence. The Undersecretary’s decision will be in writing and may encompass facts, interpretations of the Contract, and determination or application of law. The Contractor may, prior to the Undersecretary’s decision, present oral or documentary evidence, and arguments in support of the Contractor’s appeal. The decision will either:

1) Find in favor of the Contractor, in which case the Undersecretary may:

a) Countermand the earlier conduct which caused the Contractor to file a dispute; or

b) Reaffirm the conduct and, if there is a cost impact sufficient to constitute a change in obligations pursuant to the payment provisions, direct the State to comply with that Section.

2) Deny the Contractor’s dispute and, where necessary, direct the manner of future performance; or

3) Request additional substantiating documentation in the event the information in the Contractor’s dispute or appeal is inadequate to permit a decision to be made under paragraphs (1) or (2) above, advise the Contractor as to what additional information is required, and establish how that information will be furnished. The Contractor shall have thirty (30) days to respond to the Undersecretary’s request for further information. Upon receipt of this additional requested information, the

Undersecretary will have thirty (30) days to respond with a decision. Failure to supply additional information required by the Undersecretary within the time period specified above shall constitute waiver by the Contractor of all claims.

E. Attorney’s fees and costs for any dispute or subsequent trial shall be borne by the respective parties.

Both parties waive trial by jury, and any trial in…