36C24218Q0300-001.docx

36C24218Q0300

PAGE 1 OF

1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

DUNS:

DUNS+4:

PHONE:

FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Only) 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) 30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

(REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

36C24218Q0300 04-1 -2018

LAWTON, CONSTANCE

315-425-4400X54053 03-31-2019 3pm Department of Veterans Affairs Network Contracting Office 02 1304 Buckley Road Suite 104 Syracuse NY 13212 X 624120 $11 Million X N/A X Department of Veterans Affairs Syracuse Network Contracting Activity 1304 Buckley Road Suite 104 Syracuse NY 13212 Department of Veterans Affairs Network Contracting Office/ATTN 90NCA 1304 Buckley Road Suite 104 Syracuse NY 13212

Y Address invoices as instructed by the VA Medical Center making placement.

As a result of this Request for Quote (RFQ), the Government anticipates awarding multiple Basic Ordering Agreements (BOA) under authority 38 U.S.C. 1720 for Medical Adult Day Health Care Services for eligible veterans of the Department of Veterans Affairs in the following Counties of New York State:

Allegany County (1) Columbia County (1) Cortland County (1) Oneida County (1) Oswego County (1) X X

ONE

Allan Preston Contracting Officer Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINSTRATION DATA (Continuation of SF 1449 Blocks 5-18)

1. Contract Administration: All contract administration matters will be handled by the following individual(s):

a. Contractor _____________________________________________

Address _____________________________________________

City/State/Zip _____________________________________________

Facility Name _____________________________________________

County _____________________________________________

Point of Contact _____________________________________________

Telephone Number _____________________________________________

Fax Number _____________________________________________

Email Address _____________________________________________

TAX ID Number _____________________________________________

DUNS NUMBER _____________________________________________

b. Government:

Allan Preston, Contracting Officer Department of Veterans Affairs

Constance Lawton, Contract Specialist Department of Veterans Affairs Syracuse VA Medical Center 1304 Buckley Road Suite 104 Syracuse, NY 14424

2. GOVERNMENT INVOICE ADDRESS: Address invoices as instructed by the VA Medical Center making placement.

3. INVOICES: Invoices shall be submitted in arrears:

4. CONTRACT MODIFICATIONS: The Contractor is advised that only the Contracting Officer, acting within the scope of the contract and his/her duties and responsibilities and after advice and consultation with the Contracting Officer’s Representative (COR), has the authority to make changes that will affect contract prices, quantity, quality, delivery terms and conditions, or the term of the contract. In no event shall any understanding or agreement, modification, change order, or other matters in deviation from the terms of this contract between Contractor and a person other than the Contracting Officer be effective or binding upon the Government. All such actions must be formalized by the proper contractual document executed by the Contracting Officer.

5. SYSTEM FOR AWARD MANAGEMENT (SAM): Offeror must be registered in the System for Award Management (SAM). SAM includes the functionality of the previous Central Contractor Registration (CCR) and Online Representations and Certifications Applications (ORCA). No contract will be entered into with an unregistered contractor. Internet access allows registration by completing an electronic online registration application at http://www.sam.gov/.

6. CONTRACTING OFFICER’S REPRESENTATIVE: Prior to award, the Contracting Officer will designate the Program Specialist for Primary Care to act as Contracting Officer’s Representative (COR). All work coordination shall be made through the COR. The Contractor shall be provided a copy of the letter of delegation authorizing the COR at the commencement of the term of this agreement. No other person shall be authorized to act in such capacity unless appointed in writing by the Contracting Officer.

7. SOLICITATION/CONTRACT: This solicitation and resulting contract adheres to the format defined in Federal Acquisition Regulation (FAR) Parts 12 and 13. An official copy of the FAR can be obtained at https://www.acquisition.gov/far/ .

8. SECURITY LANGUAGE: The contractor retained to do work for VA under this contract requires the use and transmission of VA Sensitive Personal Information (SPI) and must follow and adhere to the security controls, enhancements, compensating controls, protocols, regulations, and VA directions as the Contracting Officer (CO) shall direct, including, but not limited to those derived from the Federal Information Security Management Act (FISMA), OMB Circular No. A-130 and VA Handbook 6500/6500.6. The contractor must report any data breach according to the protocols and timeframes in HB 6500.

If the contractor retained to do work for VA under this contract requires access, use, etc., of VA SPI as aforesaid, and if an actionable data breach occurs because of the contractor’s acts, omissions, or negligence in following the VA-directed security controls, enhancements, compensating controls, protocols, and/or measures, including, but not limited to the sources above, the contractor is further subject to the statutory requirement to assess liquidated damages under 38 U.S.C. §5725 in the event of a breach of Sensitive Personal Information (SPI)/ Personally Identifiable Information (PII). Said liquidated damages shall be assessed at $37.50 per affected Veteran or beneficiary. A breach in this context includes the unauthorized acquisition, access, use, or disclosure of VA SPI which compromises not only the information’s security or privacy but that of the Veteran or beneficiary as well as the potential exposure or wrongful disclosure of such information as a result of a failure to follow proper data security controls and protocols.

a. VA Handbook 6500 requires the following statement on fax sheets be included:

This fax is intended only for the use of the person or office to which it is addressed and may contain information that is privileged, confidential, or protected by law. All others are hereby notified that the receipt of this fax does not waive any applicable privilege or exemption for disclosure and that any dissemination, distribution, or copying of this communication is prohibited. If you have received this fax in error, please notify this office immediately at the telephone number listed above.

b. If facsimile transmission is used to transmit orders or other necessary patient information to the Contractor, the fax location shall be secure and only accessible by those individuals who will be involved in the care of or administration of the referred veteran.

c. The VA may use the United States Post Office to send the start orders or other information as required.

d. The Contractor shall submit invoices or any document containing personally identifiable information via the United States Post Office or fax transmission to the program office as instructed by the Contracting Officers Representative.

e. E-mailing any personally identifiable patient information or protected health information is strictly prohibited.

9. PRIVACY AND CONFIDENTIALITY: Contractors to the Department of Veterans Affairs may be exposed to sensitive information. Information may be overheard, seen on documents or electronic devices, or observed that could potentially violate the privacy and confidentiality of our Veterans, employees, volunteers and their families. Regulations such as, but not limited to the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Freedom of Information (FOIA) and Privacy Act of 1974 have been enacted to protect sensitive information from being improperly disclosed. Information should not be divulged or released to anyone unless specifically authorized by this contracts or its attached documents accordance with the contracted services. Failure to comply with applicable statutes and regulation can result in the termination of this contract and civil and criminal penalties, including fines and imprisonment. All suspected or actual breeches of privacy and confidentiality should be reported immediately to the Contracting Officer, Contracting Officer’s Representative (COR) or the Facility Privacy Officer.

10. MULTIPLE AWARDS/AWARD WITHOUT DISCUSSIONS: As stated in 52.212-1(g), each offer should contain the best terms from a price and technical standpoint, as the Government intends to evaluate offers and make awards to Offerors without holding discussions.

The Government intends to enter into multiple fixed-price, Basic Ordering Agreements (BOA) for the required services. The Government may issue additional solicitations for this same requirement until it believes that sufficient capacity to meet the needs of veterans is available under the BOAs placed in response to such solicitations.

11. TECHNICAL INQUIRIES: Direct all technical inquiries in writing to Contract Specialist, Constance.Lawton@va.gov. ALL inquiries must be in writing.

12. PROPOSAL DELIVERY: Offers shall be submitted electronically to Constance Lawton at Constance.Lawton@va.gov. Faxed offers will not be accepted. Mailed offers will not be accepted.

a. PROPOSAL CHECKLIST:

· Complete blocks 17a and b and 30a through 30c on page 1 (Standard Form (SF) 1449)

· Complete Section B.1.1(a) Contract Administration data for Contractor

· Offeror must be registered (and active) in the System for Award Management (SAM). Instructions can be found in Section B.1.5

· Complete Section B.1.15 Acknowledgement of Amendments (page 15). Return amendment(s) (if applicable) signed by the same official that signed the SF 1449 (box 30a).

· Complete B.2.6 Schedule of Prices and Description of Services. Base year: Follow all pricing instructions (page 9).

· Complete E.2 52.209-11 Representation By Corporations Regarding Delinquent Tax Liability Or A Felony Conviction Under Any Federal Law (page 104)

· Complete E.10: 52.212-3 – Offeror’s Representations and Certifications – Commercial Items (pages 110-126)

· Provide evidence of the following:

· Offeror’s State license and/or certificate to operate

· Medical Liability Insurance

· Copy of the State survey (SSA 2567), any deficiencies, corrective action plans and concurrence

· Facilities are fully sprinkled

· A copy of your current NYS Medicaid per diem rate

· NYS transportation rate (if applicable)

· Provide the facility’s private rates per diem

· NOTE: Offeror must ensure that their registration with the System for Award Management (SAM; http://www.sam.gov) is valid and active and that Representations and Certifications section has been completed. If assistance is needed with this step, please contact:

Anna Vulaj Fitzsimmons, ACAS Business Development Manager Rochester Procurement Technical Assistance Center (PTAC) 50 W. Main Street, Ste. 8100 Rochester, NY 14614 P: (585) 753-2017

13. LIMITATIONS ON SUBCONTRACTING-- MONITORING AND COMPLIANCE (JUN 2011): This solicitation includes FAR 52.219-4 Notice of Price Evaluation Preference for HubZone Small Business Concerns. Accordingly, any contract resulting from this solicitation will include this clause. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) retained by VA to assist in assessing the contractor's compliance with the limitations on subcontracting or percentage of work performance requirements specified in the clause. To that end, the support contractor(s) may require access to contractor's offices where the contractor's business records or other proprietary data are retained and to review such business records regarding the contractor's compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor's compliance with the limitations on subcontracting or percentage of work performance requirement.

14. SUBCONTRACTING COMMITMENTS--MONITORING AND COMPLIANCE (JUN 2011): This solicitation includes VAAR 852.215-70, Service-Disabled Veteran-Owned and Veteran-Owned Small Business Evaluation Factors, and VAAR 852.215-71, Evaluation Factor Commitments. Accordingly, any contract resulting from this solicitation will include these clauses. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) to assist in assessing contractor compliance with the subcontracting commitments incorporated into the contract. To that end, the support contractor(s) may require access to the contractor's business records or other proprietary data to review such business records regarding contract compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor compliance with the subcontracting commitments.

15. ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

B.2 SCHEDULE OF PRICES AND DESCRIPTION OF SERVICES:

1. Provide rates for the medical adult day health care services for beneficiaries of the VA Healthcare Network Upstate New York in accordance with all the terms, conditions and provisions of the solicitation.

2. This is a basic ordering agreement for a base period of (dates TBD upon award) plus four (4) option periods, in accordance with Federal Acquisition Regulation (FAR) 16.7. A contract is formed, in accordance with the terms and conditions of this agreement, when the Department of Veterans Affairs (VA) agrees to place a VA beneficiary in the adult day care program and the provider (contractor) agrees to accept the placement. Upon acceptance of a VA beneficiary in the program, all terms and conditions of this agreement shall apply during such time as the participant remains in the program at the expense of VA. Contract award shall be for one (1) year period and for four (4) additional one (1) year extensions to be determined by the feasibility and cost effectiveness of this alternative long term care program within the Department of Veteran Affairs.

3. Upon acceptance of a VA beneficiary in the program, the contractor shall furnish all supplies and services herein described, at the rate(s) specified. VA is obligated only to the extent authorized placements of VA beneficiaries are made under this agreement.

4. A work week as used in the description above is defined at Monday through Friday.

5. Transportation:

a. The Contractor is responsible to ensure that any transportation services provided pursuant to this Basic Ordering Agreement comply with all pertinent provisions of Federal, State and local statues, rules and regulations.

b. Transportation is defined as either a one way or round trip to/from the Veterans residence and the Adult Day Care facility.

6. Price Schedule for Medical Adult Day Health Care Services:

Base Year: (dates TBD upon award)

Additional Services Offered (if applicable):

(½ of the Round Trip transportation)

Option Year 1: (dates TBD upon award)

2019 NYS Medicaid Rate

Additional Services Offered (if applicable):

Option Year 2: (dates TBD upon award)

2020 NYS Medicaid Rate

Additional Services Offered (if applicable):

Option Year 3: (dates TBD upon award)

2021 NYS Medicaid Rate

Additional Services Offered (if applicable):

Option Year 4: (dates TBD upon award)

2022 NYS Medicaid Rate

Additional Services Offered (if applicable):

Award Policy: The VA reserves the right to award contract on the basis of need, and not solely based on price. The VA may award multiple contracts as determined in the best interest of the Government.

Adult Day Services are provided in the following Counties: Allegany, Columbia, Cortland, Oneida, and Oswego

B.3 PERFORMANCE WORK STATEMENT (PWS)

PART 1

GENERAL INFORMATION

GENERAL INFORMATION: This is a non-personnel services agreement to provide contracted Medical Adult Day Health Care Program Services.

1.1. Description of Services/Introduction: The Contractor shall provide Medical Adult Day Health Care Program Services to eligible beneficiaries for whom such care is specifically authorized by the Veterans Affairs Medical Centers (VA) in New York State. The Contractor shall provide all necessary personnel, equipment, transportation, and supplies associated with the full range of Medical Adult Day Health Care Program Services in performing the requirements of this agreement within the terms, conditions, and provisions of this agreement. The patients to be cared for under this agreement will receive these services as a substitute for institutionalization.

1.2. Background: Beneficiaries to be cared for under this agreement, as referred by the VA staff, Geriatrics and Extended Care Service Line or his/her designee, shall receive the service as a substitute for nursing home care. The purpose of providing Medical Adult Day Health Care Program Services is to:

1.2.1. Enable functionally impaired individuals to reside in supportive home environments rather than in nursing home care facilities;

1.2.2. Facilitate the return of Veterans to their home and coordinate long term care by reducing readmissions to hospitals and nursing homes;

1.2.3. Maintain the Veteran at the highest level of functioning possible;

1.2.4. Improve the quality of life for the participants; and

1.2.5. Provide support for the family and other caregivers of Veterans.

1.3. Term of Agreement: This agreement is effective for a 1-year base period plus (4) 1-year option periods of from the effective date.

1.3.1. To the extent that this contract is so terminated, the VA will be liable only for payment provisions of this contract for services rendered prior to the effective date of termination.

1.3.2. Termination of Beneficiary Services: The VA reserves the right to remove any or all VA beneficiaries from the Medical Adult Day Health Care Program Services program at any time, when it is determined to be in the best interest of the VA or the beneficiary.

1.4. Quality Control: The contractor shall develop and maintain an effective quality control program to ensure services are performed in accordance with this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The contractor’s quality control program is the means by which he assures himself that his work complies with the requirement of the contract.

1.5. Quality Assurance: The Government will periodically evaluate the contractor’s performance under this contract. Contractor shall provide the Government unrestricted access to facilities and records required to evaluate Contractor’s performance under this contract.

1.6. (QASP Indicator #1) Contractors must have and maintain, for the life of the contract, current State Licensure to meet the requirements of this contract.

1.7. Place of Performance: The work to be performed under this agreement shall be performed at the contractor facility in any of these counties: Allegany, Columbia, Cortland, Oneida, and Oswego.

1.8. Post Award Conference/Periodic Progress Meetings: The Contractor shall attend any post award conference convened by the contracting activity or contract administration office. The CO, Contracting Officers Representative (COR), Alternate Contracting Officer's Representative (ACOR), and other Government personnel, as appropriate, may meet periodically with the contractor to review the contractor's performance. At these meetings the CO will apprise the contractor of how the Government views the contractor's performance and the contractor will apprise the Government of problems, if any, being experienced. Appropriate action shall be taken to resolve outstanding issues. All meetings described herein shall be at no additional cost to the Government.

1.9. Contracting Officer Representative (COR): The COR (and if applicable ACOR) will be identified by a separate letter. The COR monitors all technical aspects of the contract and assists in contract administration. The COR is authorized to perform the following functions:

· monitor Contractor’s performance of the technical requirements of the contract

· perform inspections necessary in connection with contract performance

· maintain written and oral communications with the Contractor concerning technical aspects of the contract

· issue written interpretations of technical requirements, including Government specifications

· monitor Contractor's performance and notifies both the CO and Contractor of any deficiencies

· COR is not authorized to change any of the terms and conditions of this contract

1.10. Key Personnel: The Contractor shall utilize the personnel named in its proposal to perform the services required under this agreement. In the event that any of the personnel named in the proposal are unable to perform the duties of this contract, for any reason such as death, illness, or resignation from the Contractor’s employ, the Contractor shall promptly submit to the CO and COR, in writing, a detailed explanation of the circumstances necessitating the substitution within one business day of the personnel change event.

1.10.1. Program Manager-The Contractor shall appoint a Program Manager at each Medical Adult Day Health Care facility covered by this agreement who shall be the Contractor’s authorized representative for technical and administrative performance of all services required at that Medical Adult Day Health Care Program facility. The Contractor shall accept or reject beneficiaries within 1 week of referral. Once the beneficiary is accepted for placement, the beneficiary will be admitted to the adult day care on the next business day or at the beneficiary’s convenience not to exceed one week from referral. If this time frame is exceeded, the contractor will notify the VA COR.

1.11. Special Qualifications: The contractor shall ensure all employees possess and maintain current professional certification as described below during the execution of this agreement. Contractor shall ensure the following staff performing services under this contract have the following qualifications and meet the following staffing ratios: direct service staff to clients shall be at least one staff person for every six beneficiaries during provision of all covered services except during facility provided transportation.

1.12. HIPAA Compliance. HIPAA compliance is required. The Contractor must adhere to the provisions of Public Law 104-191, Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the National Standards to Protect the Privacy and Security of Protected Health Information (PHI). As required by HIPAA, the Department of Health and Human Services (HHS) has promulgated rules governing the security and use and disclosure of protected health information by covered entities, including the Department of Veterans Affairs (VA).

PART 2

2. DEFINITIONS AND ACRONYMS:

2.1. DEFINITIONS:

2.1.1. ADMINISTRATIVE DISCHARGE. When the Veteran has been transferred to an alternate level of care with concurrence from the COR for medical, mental health, or substance abuse treatment to better meet the Veteran’s clinical needs.

2.1.2. CONTRACTOR. A supplier or vendor awarded a contract to provide specific supplies or service to the government. The term used in this contract refers to the prime.

2.1.3. CONTRACTING OFFICER (CO). A person with authority to enter into, administer, and or terminate contracts, and make related determinations and findings on behalf of the government. Note: The only individual who can legally bind the government.

2.1.4. CONTRACTING OFFICER'S REPRESENTATIVE (COR). An employee of the U.S. Government appointed by the contracting officer to administer the contract. Such appointment shall be in writing and shall state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract.

2.1.5. DELIVERABLE. Anything that can be physically delivered, but may include non-manufactured things such as meeting minutes or reports.

2.1.6. FUNCTIONALLY IMPAIRED. Needing the assistance of another person in at least one of the following activities of daily living: toileting, mobility, transferring, eating; or needing supervision due to cognitive and/or psycho-social impairment.

2.1.7. KEY PERSONNEL. Contractor personnel that are evaluated in a source selection process and that may be required to be used in the performance of a contract by the Key Personnel listed in the PWS. When key personnel are used as an evaluation factor in best value procurement, an offer can be rejected if it does not have a firm commitment from the persons that are listed in the proposal.

2.1.8. QUALITY ASSURANCE (QA). The government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.

2.1.9. QUALITY ASSURANCE SURVEILLANCE PLAN (QASP). An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance.

2.1.10. QUALITY CONTROL (QC). All necessary measures taken by the Contractor to assure that the quality of an end product or service shall meet contract requirements.

2.1.11. MEDICAL ADULT DAY HEALTH CARE PROGRAM. A structured, comprehensive program which provides functionally impaired individuals with socialization, supervision, monitoring, personal care, and nutrition services in a protective setting during any part of the day, but less than a 24-hour period. Additional services may include maintenance and enhancement of daily living skills, transportation, caregiver assistance, along with case management coordination and assistance.

2.1.12. SUBCONTRACTOR. One that enters into a contract with a prime contractor. The Government does not have privity of contract with the subcontractor.

2.1.13. WORK DAY. The number of hours per day the Contractor provides services in accordance with the contract.

2.2. ACRONYMS:

PART 3

3. GOVERNMENT ROLES AND RESPONSIBILITIES:

3.1. VA will assign a VA social worker and/or RN to each veteran referred for Medical Adult Day Health Care Program Services for oversight requirement purposes.

3.2. VA will periodically and/or annually inspect Contractor’s Program and Facility. There will be an inspection prior to award and during the term of the agreement. The VA shall have the right to inspect the Contractor’s facility/program by an authorized representative(s) to determine whether acceptable standards are maintained and that adequate care is being rendered. All inspections may be carried out by an interdisciplinary team that may consist of a VA Social Worker, VA Registered Nurse, VA dietician, VA Fire Safety Specialist and the VA COR. If deficiencies are noted during any inspection, the Contractor will be advised of the inspection team’s findings and given a reasonable time to take corrective action. Any deficiencies shall be documented by the team and MUST be corrected within the timeframe specified by the inspection team. The Contractor will notify the COR when correction(s) have been made.

3.3. VA agrees that a duly authorized representative of the VA will provide followup supervision visits to veterans placed in the facility to assure that there is continuity of care. It is understood that these visits do not substitute for nor relieve the contractor in any way of the responsibility for care of the veteran.

3.4. VA may evaluate the quality of professional and administrative services provided, but retains no control over the medical/professional aspects of services rendered.

3.5. VA authorizations must be initiated by and confirmed by the authorized Contracting Officer’s Representative (COR) of which a copy of the authorization will be provided to the Contractor.

3.6. VA payments under this Basic Ordering Agreement will constitute the total cost of Medical Adult Day Health Care Program Services. No additional charges will be billed to the beneficiary or his/her family, whether by the Contractor or any third party furnishing services or supplies required for such care, unless and until specific prior authorization, in writing, is obtained from the VA. Claim submission instructions will be provided upon contract award.

3.7. VA beneficiaries will be provided Medical Adult Day Health Care at the expense of the VA for a period not in excess of that stated in the care plan approved by the VA unless an extension of the authorization is provided, in writing, by the placing VA facility.

3.8. Absences of the VA beneficiary from the program will not be reimbursed.

PART 4

4. CONTRACTOR FURNISHED ITEMS AND RESPONSIBILITIES:

4.1. Contractor shall furnish all supplies, equipment, facilities and services required to perform work under this agreement.

4.2. Contractor shall provide Medical Adult Day Health Care Program Services and Documentation of Services described in the Performance Work Statement.

4.3. Contractor’s program must include the assessment of a proposed participant’s physical and mental condition shall be completed prior to the admission of each new participant to determine appropriateness of the program offered. Reassessment shall be done at least annually. A written care plan shall be developed for each participant and revised as needed to tailor the services provided to the specific needs of the individual. Each plan shall include the participant’s strengths and needs based on the results of the functional assessment, goals and objectives of care, activities to achieve goals and any recommendations for therapy or referrals for other services.

4.4. Contractor’s program must include ongoing case management to coordinate Adult Day Care with other long term care services needed by the participants as well as monitoring of continued need for adult day care and arranging for discharge from the program when there is need for another level of care.

4.5. Contractor’s program shall provide a balance of activities to meet the participants’

and large group activities (both recreational and therapeutic), (ii) individualized activities (both recreational and therapeutic), (iii) active and spectator participation, (iv) inter- generational experiences, (v) involvement in the larger community, and (vi) volunteer service to individuals and to the program. These services and activities may include arts and crafts, music, TV and radio stimulation, physical exercise, books and magazines, games, field trips, and other commercially appropriate activities.

4.9 Contractor shall not maintain nor provide dual or segregated beneficiaries facilities which are segregated on the basis of race, creed, color or national origin. The Contractor shall neither require such segregated use by written or oral policies nor tolerate such use by local custom. The term "facilities" shall include but not be limited to rooms, wards, sections, eating areas, drinking fountains, and entrances, and other like areas.

4.10 Contractor shall accept referral of and shall provide all services specified in this contract for any person determined eligible by the VA, regardless of the race, color, religion, sex or national origin of the person for whom such services are ordered. The contractor shall not use subcontracting as a means of circumventing this provision.

4.11 Contractor retains the right to refuse and accept any patient when it is anticipated that the cost of care or services required would exceed the scope of the contract, or placement is determined unsafe due to the level of care needed by the Veteran.

4.11.1 Contractor shall notify the COR within 24 hours.

4.12 (QASP Indicator #2) Contractor shall make all medical records and administrative records concerning the patient’s care concerning the beneficiary's care in the Medical Adult Day Health Care Program readily accessible to the VA. Upon discharge or death of the beneficiaries, the contractor shall retain all medical records for a period of at least three years following termination of care. The contractor shall maintain beneficiaries’ records in conformance with the Privacy Act of 1974 (5 U.S.C. 552a). The Contractor shall maintain a medical record for each beneficiary that includes at a minimum the following:

4.12.1 Admission record, including assessment and diagnosis;

4.12.2 Physician orders as required by state licensing requirements;

4.12.3 Treatment plan;

4.12.4 Progress notes from nursing, dietary, and activity disciplines of beneficiary response to Medical Adult Day Health Care Program Services;

4.12.5 Periodic evaluations;

4.12.6 Discharge Summaries;

4.12.7 Other usual and customary information pertinent to beneficiary care

4.12.8 Nursing assessment;

4.12.9 Documentation whether or not individual beneficiary has executed an advance directive;

4.12.10 Activity participation log

4.13 Contractor shall forward all clinical concerns regarding this agreement to the COR.

4.14 Contractor will notify the VA COR immediately when a medical emergency requiring hospitalization or re-hospitalization occurs. Beneficiaries will be admitted to the appropriate VA. When admission is not feasible because of the nature of the emergency, hospitalization in a non-federal hospital may be accomplished provided VA authorization is obtained. If such hospitalization is required, it is agreed that admission to the hospital will be accomplished promptly.

4.15 Contractor shall allow reasonable visitation rights to family and to other persons who have a care-giving or significant relationship to the beneficiary while the beneficiary is attending Medical Adult Day Health Care Program.

4.16 Contractor shall provide the following documentation for each Veteran for the duration of the agreement.

4.16.1 Telephone contact, with written notification to follow, will be made regarding any beneficiary on contract who experiences a sentinel event, death, major change in condition or reports abuse. Telephone contact will be made to the COR for Adult Day Program Services or the Administrative Officer (AO) of the Day at the VA during non-business hours.

4.16.2 Any complaint made against the Medical Adult Day Health Care Program by the beneficiary or his/her family will be forwarded to the COR or Contracting Officer within ten days of the complaint.

4.17 Contractor shall report all patient safety incidents to the authorizing VA and COR within 24 hours of incident.

4.18 Contractor shall provide safety and supervision for wandering/ambulating, and/or behavioral supervision for combativeness, agitation, aggression, and/or withdrawal.

4.19 Contractor may provide physical assistance/ human help or lifting for transferring in order to accomplish personal care, transportation if available, safety, and/or incontinence care.

4.20 Contractor may provide handicapped accessible transportation to/from beneficiary’s or caretaker’s home or assist the Veteran in securing community resources. If the facility employs a driver, the driver shall operate the facility’s vehicle in a safe manner; maintain adult cardiopulmonary resuscitation (CPR) certification; and be capable of assisting individuals to board/exit the vehicle.

4.21 Contractor shall provide certification that its facility is in compliance with all applicable fire code laws and that there are not any recommendations by fire officials that have not been resolved. Furthermore, the contractor will provide sufficient staff to assist beneficiaries in the event of fire or other emergency.

4.22 Contractor shall provide at a minimum quarterly reports to the COR on the attendance, functional and psycho-social status of the veterans receiving care under the contract upon request. In addition, Contractor shall provide a monthly invoice for each the beneficiaries receiving care under the contract.

4.23 Contractor to provide timely reports to COR for the following incidents:

4.23.1 Patient complaints within 48 hours of complaint.

4.23.2 Patient safety within 24 hours of incident.

4.24 The institution shall have the capability (including sufficient qualified staff) to provide:

a. Medical services including a Medical Director, at least on a consulting basis, and the provision of direct patient care;

b. Services of a registered nurse;

c. Medical Service provided by a qualified medical worker;

d. Rehabilitation services including occupational, physical and speech therapy;

e. Assistance for daily living including bathing, feeding, toileting, ambulating and transferring;

f. Case management;

g. Nutrition services including counseling, regular meals and special diets;

h. Recreation therapy:

i. The maintenance of individual client records. These records shall include a treatment plan, periodic re-evaluations, progress notes, discharge summaries, and other usual and customary information normally included in a client record.

PART 5

5 TERMS AND CONDITIONS:

5.3 Termination of Services: VA reserves the right to remove any or all VA patients from the Medical Adult Day Health Care Program at any time, when it is determined to be in the best interest of VA or the patients, without additional costs to the Government.

5.4 Extension of Agreement: This agreement may be extended for four one-year periods at