Attachment G - Representative Task Order ICSP - Centralized Staffing_7 (Updated for Amendment 1).docx

ATTACHMENT G: REPRESENTATIVE TASK ORDER ICSP

PERFORMANCE WORK STATEMENT

Centralized Critical Staffing and Program Support of 21 Facilities (across 18 VISN)

1. General: The purpose of this Representative Task Order (TO) is to support the critical staffing needs within the 18 VISNs of the Department of Veterans Affairs (VA). The Labor Categories (LCATs) identified below have been identified by the VA, Veterans Health Administration (VHA) as areas with significant critical staffing shortages. This TO is for the VITAL to identify its capability to provide staffing towards shortages at different Veteran Integrated Service Networks (VISNs) throughout the United States and its territories. The support will vary between VISNs, health care facilities, VA Medical Centers (VAMCs) and Community Based Outpatient Clinics (CBOCs). Requests will also vary in the size of the Veteran community as some will be for rural areas and others for urban areas. It is the VITAL’s responsibility to utilize their partners to identify staff, provide resumes of specified LCATs, and build a robust team.

2. Staffing Scenario: VHA has identified the need to provide national temporary staffing support, starting with one facility with the highest priority staffing needs within the 18 Veteran Integrated Service Networks (VISN) at 21 facilities. VHA requests that contractors provide up to three (3) resumes for the six (6) identified labor category positions across the 21 sites in the representative task order. This is the number of labor categories requested multiplied by number of sites multiplied by number of resumes for a total of up to 378 resumes. One (1) resume for the Primary Care Physician, chosen by the vendor, shall include a fully completed credentialing package ready for review by a facility Medical Staff Committee.

3. Labor Categories: The VA has staffing shortages in the 6 LCATs below. The ability to recruit and source qualified candidates will be assessed by VITALs providing up to 3 candidates for up to 6 representative labor categories across all 21 facilities for a national staffing initiative. The VIT will be assessed by determining whether each candidate meets required qualifications. Proposed candidates local (within 50 miles) of the site of service are preferred.

1. Human Resource Specialist Sr.

2. Medical Support Assistant

3. Primary Care Physician

4. Social Worker (Mental Health Counselor)

5. Practical Nurse

6. Diagnostic Radiologic Technician

4. Staffing Deliverables

a. Up to three (3) resumes per LCAT at each of the 21 facilities (up to a total of 378)

b. One (1) credentialing package of one of the identified Primary Care Physicians.

5. Locations: The Contractors should use the following 18 locations, one from each VHA VISN, that have been selected for this Sample Task Order (DO NOT CONTACT THE FACILITIES; this is a representative task order for evaluation purposes only).

Manchester, NH 03104

Syracuse, NY 13210

St. Clairsville, OH 43950

Baltimore, MD 21201

Fayetteville, NC 28301

Tuscaloosa, AL 35404

Orlando, FL 32827

San Juan, PR 00921-3201

Bowling Green, KY 42101

Marion, IN 46953-4589

Danville, IL 61832-5198

Dodge City, KS 67843

Jackson, MS 39216

El Paso, TX 79936

Fort Harrison, MT 59636

Aurora, CO 80045

White City, OR 97503

Anchorage, AK 99504

Honolulu, HI 96819-1522

Los Angeles, CA 90073

Rapid City, SD 57701

6. Program Support: This massive temporary staffing initiative scenario will require significant contractor program support. Expert levels of management and coordination of multiple concurrent critical staffing LCATs at the 21 facilities throughout the 18 VISNs will be required. Identify your approach to project management, change management, and communications to ensure the success of the national initiative. The contractor shall provide an associated Program Management Plan (PMP). The PMP should detail the contractor’s approach, timeline, staffing, and tools to be used in execution of the initiative. The PMP should take the form of both a narrative and graphic format that displays the approach, the overall management of the task, and requirements engagement, i.e., schedule, milestones, risks and resource support.

7. Program Support Deliverables/PMP

a. The contractor’s approach/ task management (to include Work Breakdown Structure),

b. Timeline (relative),

c. Staffing/onboarding plan,

d. Requirements engagement (i.e., schedule, milestones, risks and resource support)

e. Risk management plan,

f. Change management plan,

g. Communications plan,

h. Quality assurance plan,

i. Tools to be used in execution of the initiative.

8. Labor Category Description and Education, Experience, and Certification Requirements

Human Resource Specialist Sr.

College Degree is preferred

Medical Support Assistant

HS/GED

Primary Care Physician

2 years of clinical practice, after residency training Current, active, full and unrestricted license or registration as a physician; Board certified in Internal Medicine, Family Medicine, or Preventive Medicine

9. Credentialing Package Requirements (Modified for Evaluation Purposes Only)

a. Personal Information (Name, Address, Contact Information)

b. NPI and Taxonomy

c. Professional Education (Schools, Dates of Attendance, Degrees Conferred)

d. Professional Training (Internship, Residency, Fellowship; Institutions, Dates, Completed)

e. Licensure (License Type, License Number, State, Issue Date, Expiration Date)

f. Certifications (Specialty, CDS, DEA, ECFMG; Issue Dates, Expiration Dates)

g. Work History (Organizations, Job Titles, Dates; include Prior Clinical Privileges)

h. References/Peer Review (provide Four (4) Support Letters)

i. Attestation (Provide statement signed by provider affirming that they have never been or are in the process of being – either on a voluntary or involuntary basis – denied, revoked, suspended, reduced, limited, placed on probation, not renewed, withdrawn, or relinquished clinical privileges while under investigation or for disciplinary reasons.)

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