36C24225Q0106_1.docx

36C24225Q0106

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.

UEI:

EFT:

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. NOV 2021)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

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

36C24225Q0106 11-19-2024 Tiffany Vazquez-Simon 914-737-4400 202198 12-03-2024 12:00

EST

36C242 Department of Veterans Affairs Network Contracting Office 2 James J. Peters VA Medical Center 130 West Kingsbridge Road Bronx NY 10468-3904 X 621399 $10 Million N/A X Department of Veterans Affairs Albany Stratton VAMC Surgical Department 113 Holland Ave Albany NY 12208 36C242 Department of Veterans Affairs James J. Peters VA Medical Center Network Contracting Office 2 130 West Kingsbridge Road Bronx NY 10468-3904

Tungsten Network https://www.tungsten-network.com/ customer-campaigns/veteransaffairs/

See CONTINUATION Page Albany VA is seeking turnkey intraoperative neuromonitoring technologist services. To include technologist(s), all required equipment and supplies (specialty supplies as needed) as described in the Performance Work Statement.

Estimated period of performance is 12/20/2024-12/29/2025, with the provision for four 12-month options.

Questions must be submitted via email no later than 11/22/24 12:00PM EST to tiffany.vazquez-simon@va.gov.

Quotes and all information requested in section 52.212-1 Instructions to Offerors must be received via email by 12/03/2024 12:00PM EST to tiffany.vazquez-simon@va.gov.

For more information on evaluation factors see section 52.212-2 Evaluation-Commercial Products and Commercial Services.

See CONTINUATION Page x X X Natalie Acevedo Contracting Officer Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C242 Natalie acevedo Department of Veterans Affairs Network Contracting Office 2 James J. Peters VA Medical Center 130 West Kingsbridge Road Bronx NY 10468-3904

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

3. INVOICES: Invoices shall be submitted in arrears:

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

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

B.2 PERFORMANCE WORK STATEMENT

1. GENERAL:

1.1. Services Provided: Electro Neurophysiologic Technologist as Needed. The Contractor shall provide VA and Joint Commission Certified Intraoperative Monitoring Services on site in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and the Albany VA Medical Center (VAMC).

1.1.1. Place of Performance: Contractor shall furnish services at the Albany VA Medical Center, 113 Holland Ave Albany, NY 12208.

1.1.2. Scope: - The Contractor shall provide as needed and case-by-case service that enables Albany VAMC to offer Intraoperative Neuromonitoring (IONM) options for patients under the direct medical care within the operating room. The IONM Contractor must be experienced and available to cover scheduled and emergency cases 24/7/365, within one 1.5 hours of notification for cases scheduled after hours, weekends and holidays. Routine cases must be scheduled by 1:00pm EST on the day immediately preceding the surgery or by 1:00pm EST on Friday if the case will be performed on Monday. Specialized cases require at least 72 hours’ notice and preferably one week.

Services are “technical only” and shall include intraoperative, preoperative, postoperative neurophysiologic monitoring services and evoked potential testing for neurosurgery patients. Contractor shall provide intraoperative neuromonitoring services. Intraoperative monitoring modalities needed include: SSEPS, TcMEP, S-EMG, T-EMG, spinal cord mapping including D-Waves, DNEPs, NMEPs, Cortical, motor, sensory, language mapping, white matter tract and brainstem nuclei mapping, brainstem auditory evoked responses, visual evoked potentials, cranial nerve monitoring, and intraoperative EEG. Specialized cases are procedures requiring advanced IONM techniques or advanced skills including the following: cortical SSEP mapping, direct cortical stimulation mapping of motor cortex, language mapping, brainstem nuclear mapping, cerebral white matter mapping, cases requiring measurement of lateral spread, brachial plexus cases and selective dorsal root rhizotomies.

Services are to be conducted in the operating room on a per case basis as determined by the Chief of Surgical Service. The Surgical Chief shall notify the OR Manager or appropriate designee in Surgical Service when monitoring services are needed for a neurosurgical patient. The OR Manager or appropriate designee will contact the Contractor with the request for monitoring. All changes to the proposed monitoring, to include date/time, type of monitoring, etc., will be conveyed by the OR Manager or appropriate designee to the Contractor.

1.2. Period of Performance: Contract will be awarded for a base year with the provision for 4 option years.

1.2.1. ESTIMATED Base Year: 12/20/2024 – 12/19/2025

1.2.2. ESTIMATED Option Year 1: 12/20/2026 – 12/19/2026

1.2.3. ESTIMATED Option Year 2: 12/20/2026 – 12/19/2027

1.2.4. ESTIMATED Option Year 3: 12/20/2027 – 12/19/2028

1.2.5. ESTIMATED Option Year 4: 12/20/2028 – 12/29/2029

1.3. Contract Type: Firm-Fixed Price (FFP), Indefinite-Delivery, Indefinite Quantity (IDIQ)

1.4. Authority: Federal Acquisition Register Subpart 13.5 - Simplified Procedures for Certain Commercial Items.

1.5. Policy/Handbooks: The contractor shall be subject to the following policies, including any subsequent updates during the period of performance:

1.5.1. VHA Handbook 1100.17: National Practitioner Data Bank Reports: https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135

1.5.2. VHA Handbook 1100.18: Reporting And Responding To State Licensing Boards: https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364

1.5.3. VHA Directive 1003.04: VHA Patient Advocacy: https://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=5970

1.5.4. VHA Directive 1088: Communicating Test Results to Providers and Patients: https://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=3148

1.5.5. VHA Directive 1192.01: Seasonal Influenza Prevention Program: https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=8948

1.5.6. VA Directive 1663: Health Care Resources Contracting – Buying: https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2

1.5.7. VHA Directive 1907.01: VHA Health Information Management and Health Records: https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9235

1.5.8. Privacy Act of 1974 (5 U.S.C. 552a) as amended: http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm

1.6. Definitions/Acronyms: Terms used in this contract shall be interpreted as follows unless the context expressly requires a different construction and/or interpretation. In case of a conflict in language between the Definitions and other sections of this contract, the language in this section shall govern.

· IONM: Intraoperative Neuromonitoring.

· CDC: Centers for Disease Control and Prevention

· CEU: Certified Education Unit

· CME: Continuing Medical Education

· Contracting Officer (CO): – The person executing this contract on behalf of the Government with the authority to enter into and administer contracts and make related determinations and findings.

· Contracting Officer’s Representative (COR): – A person appointed by the CO to take necessary action to ensure the Contractor performs in accordance with and adheres to the specifications contained in the contract and to protect the interest of the Government. The COR shall report to the CO promptly any indication of non-compliance in order that appropriate action can be taken.

· COS: Chief of Staff

· CPARS: Contractor Performance Assessment Reporting System

· CPRS: Computerized Patient Recordkeeping System- electronic health record system used by the VA.

· EEG (intraoperative): Electroencephalogram

· DNEPs: Descending neurogenic evoked potential

· FSMB: Federation of State Medical Boards

· HHS: Department of Health and Human Services

· HIPAA: Health Insurance Portability and Accountability Act

· ISO: Information Security Officer

· NMEP: Neurogenic motor evoked potential

· POP: Period of Performance

· PWS: Performance Work Statement

· OR: Operating Room

· EEG: electroencephalogram

· Providers of Care: any providers or servicing individuals who enter the VA under the contract, including onsite technicians.

· QA/QI: Quality Assurance/Quality Improvement

· QM/PI: Quality Management/Performance Improvement

· QASP: Quality Assurance Surveillance Plan

· S-EMG: Stimulus Evoked Electromyograph

· SSEPS: Somatosensory evoked potential

· TcMEP: Transcranial motor evoked potential

· T-EMG: Triggered Electromyograph

· National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers).

· Veterans’ Health Administration (VHA): The central office for administration of the VA medical centers through throughout the United States. The VHA is located in Washington, D.C.

· Veterans Integrated Services Network (VISN): The regional oversight for the VA medical centers.

· VISTA (Veterans Integrated Systems Technology Architecture): A PC based system that will capture and store clinical imagery, scanned documents and other non-textual data files and integrates them into patient’s medical record and with the hospital information system.

· Veterans Affairs Medical Center (VAMC): Unless identified with the name of a different VA Medical Center, for purposes of this contract, this term shall mean the Albany VA Medical Center, in Albany, NY.

2. QUALIFICATIONS:

2.1. Staff/Facility:

2.1.1. Board Certification:

2.1.1.1. The contractor shall provide Electro Neurophysiologic Technologists who perform on-site IONM services who is accredited through the American Board of Registered Electro Neurophysiologic Technologist (http://www.abret.org). This technical certification is intended for technologists who work under supervision by a Neurophysiologist or Neurologist. All continuing education courses required for maintaining certification must be kept up to date at all times. Documentation verifying current certification shall be provided by the Contractor to the VA Contracting Officer Representative (COR) within the first thirty (30) days of contract award and shall provide on an annual basis for each year of contract performance.

2.1.1.2. On-site providers shall be certified in Basic Life Support (BLS). All continuing education courses required for maintaining certification must be kept up to date at all times. Documentation verifying current certification shall be provided by the Contractor to the VA COR on an annual basis for each year of contract performance.

2.1.2. Technical Proficiency: The Contractor must be capable of providing real-time data; in addition, the Contractor will offer the most recent technology and hardware. The Contractor will work closely with the surgeons, nursing staff, schedulers, Clinical Engineering, and Sterilization and Processing Service. It is the responsibility of the Contractor to provide a surgical system that has the ability to function with the current power (electrical) supply. The Contractor shall provide scheduled services throughout the contract period. In the event of the absence of contractor’s personnel for any reason, the contractor shall bear the responsibility of providing replacement personnel to provide the scheduled services without any additional cost to the government. All and any replacement personnel must meet the technical requirements prior to providing care to Albany VAMC patients. Finally, the Contractor will provide a complete Quality Assurance program that monitors, track any successes or complications. Reports are due to the COR no later than the 10th of each month following the end of the quarter.

2.1.2.1. The contractor shall provide Electro Neurophysiologic Technologists who perform on-site IONM services. Intraoperative monitoring modalities needed include: SSEPS, TcMEP, S-EMG, T-EMG, spinal cord mapping including D-Waves, DNEPs, NMEPs, Cortical, motor, sensory, language mapping, white matter tract and brainstem nuclei mapping, brainstem auditory evoked responses, visual evoked potentials, cranial nerve monitoring, and intraoperative EEG.

2.1.2.2. Electro Neurophysiologic Technologist shall be technically proficient in the skills necessary to fulfill the Government’s requirements, including the ability to speak, understand, read and write English fluently. Contractor shall provide documents upon request of the COR to verify current and ongoing competency and skills upon completion. Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all Electro Neurophysiologic Technologists. Electro Neurophysiologic Technologists shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern staff behavior.

2.1.2.3. The Electro Neurophysiologic Technologist will be responsible to test equipment prior to use and to make any adjustments in the equipment settings that are required. The Electro Neurophysiologic Technologist will select predetermined electrode combinations as well as non-standard assortments as necessary. The Electro Neurophysiologic Technologist will obtain standard recordings and report on-going status of patient’s nervous system to the surgeon.

2.1.2.4. The Electro Neurophysiologic Technologist must be capable of recognizing artifacts in the data, differentiate them from evoked potential patterns, and take appropriate steps to eliminate them. They will obtain patient medical information when requested and will translate test results from computer files to a hard copy report for VA Neurologist’s interpretation.

2.1.2.5. Contractor’s personnel shall be capable of providing technical and professional direction during surgical procedure and notify the attending surgeon immediately in the event possible damage may occur to the patient.

2.1.2.6. Neurophysiologic Technologists are requested to provide a list of all clients served in the past 12 months to permit Albany VA Medical Center to contact any reference of our choosing to verify technical capabilities.

2.1.3. Training (BLS, EHR and VA MANDATORY): Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the contractor’s Neurophysiologic Technologist(s) as required by the VA. Other training may become required. VA will communicate any changes to the training requirement to the contractor.

2.1.4. Standard Personnel Testing (PPD, etc.): Contractor shall provide proof of the following tests for providers of care entering the facility within five (5) calendar days after contract award and prior to the first duty shift to the COR and Contracting Officer. Tests shall be current within the past year.

2.1.4.1. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative reaction to PPD testing for all contractor’s providers of care. A negative chest radiographic report for active tuberculosis shall be provided in cases of positive PPD results. The PPD test shall be repeated annually.

2.1.4.2. RUBELLA TESTING: Contractor shall provide proof of immunization for all contract providers of care for measles, mumps, rubella or a rubella titer of 1.8 or greater. If the titer is less than 1.8, a rubella immunization shall be administered with follow-up documentation to the COR.

2.1.4.3. VARICELLA: Contractors shall provide proof of immunity for all Contractors.

2.1.4.4. ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of Tdap vaccination for all Contractors.

2.1.4.5. INFLUENZA: Contractors shall provide proof that all contractor personnel have received the annual Influenza vaccine unless it is contraindicated. If the contractor personnel has a medical contradiction to the vaccine, they shall be required to wear a mask during the Influenza season. {This is applicable to all health care workers}.

2.1.4.6. OSHA Regulation Concerning Occupational Exposure to Bloodborne Pathogens: Contractor shall provide generic self-study training for all contractor’s providers of care; provide their own Hepatitis B vaccination series at no cost to the VA if they elect to receive it; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident. Albany VAMC shall notify the contractor of any significant communicable disease exposures as appropriate. Contractor shall adhere to current CDC/HICPAC Guideline for Infection Control in health care personnel ( as published in American Journal for Infection Control- AJIC 1998; 26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf) for disease control. Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.

2.1.4.7. Albany VAMC shall notify the contractor of any significant communicable disease exposures as appropriate. Contractor shall adhere to current CDC/HICPAC Guideline for Infection Control in health care personnel (as published in American Journal for Infection Control- AJIC 1998; 26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf) for disease control. Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.

2.1.5. Conflict of Interest: The Contractor and all contractor’s Neurophysiologic Technologists are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of quote and during the entirety of contract performance. At the time of quote, the contractor shall provide a statement which describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided. The contractor shall also provide statements containing the same information for any identified consultants or subcontractors who shall provide services. The contractor must also provide relevant facts that show how it’s organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest. These statements shall be in response to the VAAR provision 852.209-70 Organizational Conflicts of Interest (Jan 2008) and fully outlined in response to the subject attachment in Section D of the solicitation document.

2.1.6. Citizenship related Requirements;

2.1.6.1. The contractor certifies that the contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to Department of Veterans Affairs patient referrals;

2.1.6.2. While performing services for the Department of Veterans Affairs, the Contractor shall not knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States. Additionally, the Contractor is required to comply with all “E-Verify” requirements consistent with “Executive Order 12989” and any related pertinent Amendments, as well as applicable Federal Acquisition Regulations.

2.1.6.3. If the contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the Department of Veterans Affairs may, at its discretion, require that the foreign national who failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor, shall be prohibited from working at the contractor’s place of business that services Department of Veterans Affairs patient referrals; or other place where the contractor provides services to veterans who have been referred by the Department of Veterans Affairs; and shall form the basis for termination of this contract for breach.

2.1.6.4. This certification concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under 18 U.S.C. 1001.

2.1.6.5. The contractor agrees to obtain a similar certification from its subcontractors. The certification shall be made as part of the Contractors response to the RFQ using the subject attachment in Section D of the solicitation document.

2.1.6.6. Annual Office of Inspector General (OIG) Statement; In accordance with HIPAA and the Balanced Budget Act (BBA) of 1977, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) has established a list of parties and entities excluded from Federal health care programs. Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs.

2.1.6.7. Therefore, contractor shall review the HHS OIG List of Excluded Individuals/Entities on the HHS OIG web site at http://oig.hhs.gov/exclusions/index.asp to ensure that the proposed contractor’s providers of care are not listed. Contractor should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty (CMP) for each item or service furnished during a period that the person was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMP’s may also be imposed against the contractor that employ or enter into contracts with excluded individuals to provide items or services to Federal program beneficiaries.

2.1.6.8. By submitting their quote, the contractor certifies that the HHS OIG List of Excluded Individuals/Entities has been reviewed and that the contractors are and/or firm is not listed as of the date the offer/bid was signed.

2.2. Professional Performance: The qualifications of contractor personnel are subject to review by VA Medical Center COS or his/her clinical designee and approval by the Medical Center Director as provided in VHA Handbook 1100.19. Professional performance monitoring and review of all personnel covered by this contract for quality purposes will be provided by the Albany VAMC COS and/or the Chief of the Service or his designee. A COR may be appointed, however, only the CO is authorized to consider any contract modification request and/or make changes to the contract during the administration of the resultant contract.

2.3. Non-Personal Healthcare Services: The parties agree that the contractor and all contractor’s Electro Neurophysiologic Technologist shall not be considered VA employees for any purpose.

2.4. Indemnification: The contractor shall be liable for, and shall indemnify and hold harmless the Government against, all actions or claims for loss of or damage to property or the injury or death of persons, arising out of or resulting from the fault, negligence, or act or omission of the contractor, its agents, or employees.

2.5. Inherent Government Functions: Contractor and contractor’s Electro Neurophysiologic Technologist’s shall not perform inherently governmental functions. This includes, but is not limited to, determination of agency policy, determination of Federal program priorities for budget requests, direction and control of government employees (outside a clinical context), selection or non-selection of individuals for Federal Government employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for Federal employees, approving any contractual documents, approval of Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy.

2.6. No Employee status; The contractor shall be responsible for protecting contractor’s Neurophysiologic Technologists furnishing services. To carry out this responsibility, the contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract:

· Workers’ compensation

· Professional liability insurance

· Health examinations

· Income tax withholding, and

· Social security payments.

2.7. Tort Liability: The Federal Tort Claims Act does not cover contractor or contractor’s Neurophysiologic Technologists. When a contractor or contractor’s Neurophysiologic Technologists have been identified as a provider in a tort claim, the contractor shall be responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a contractor’s (or contractor’s Neurophysiologic Technologists) action or non-action shall be the responsibility of the contractor and/or insurance carrier.

2.8. Liability and Insurance Requirements:

2.8.1. The Contractor shall provide insurance coverage in accordance with Federal Acquisition Regulation (FAR) Clause 52.228-5, Insurance – Work On a Government Installation (Jan 1997), VA Acquisition Regulation (VAAR) Clause 852.237-7, Indemnification and Medical Liability Insurance (Jan 2008), and Supplemental Insurance Requirements incorporated herein under the Clauses Section.

2.8.2. Before commencing work under the contract, the Contractor shall furnish to the Contracting Officer a certificate of insurance indicating the coverage outlined herein or in FAR Clause 52.228-5 and VAAR Clause 852.237-7 containing an endorsement to the effect that cancellation of, or any material change in the policies which adversely affect the interests of the Government in such insurance shall not be effective unless a 30-day advance written notice of cancellation or change is furnished the Government.

2.9. Key Personnel:

2.9.1. Technical Personnel Required: The contractor shall provide contracted Electro Neurophysiologic Technologists who are competent, qualified per this Performance Work Statement and adequately trained to perform assigned duties.

2.9.2. At all times during procedures in the operating room, the ratio of contracted staff to patient will be at a minimum 1 to 1, which will be established, and may be revised, as deemed appropriate for patient care, by the Chief of Staff.

2.9.3. Personnel Substitutions: During the first ninety (90) calendar days of performance, the contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death or termination of employment. The contractor shall notify the CO, in writing, within three (3) calendar day(s) after the occurrence of any of these events and provide the information required below. After 90 days, the contractor shall submit the information required below to the CO at least 30 calendar days prior to making any permanent substitutions.

2.9.3.1. The contractor shall provide a detailed explanation of the circumstances necessitating the proposed substitutions, complete resumes for the proposed substitutes, and any additional information requested by the CO. Proposed substitutes shall have comparable qualifications to those of the persons being replaced. The CO will notify the Contractor within ten (10) calendar days after receipt of all required information of the decision on the proposed substitutes. The contract will be modified to reflect any approved changes of key personnel.

2.9.3.2. For temporary substitutions where the key person shall not be reporting to work for three consecutive workdays or more, the contractor shall provide a qualified replacement for the key person. The substitute shall have comparable qualifications to the key person. Any period exceeding two weeks will require the procedure as stated above.

2.9.3.3. The Government reserves the right to refuse acceptance of any contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. Should the VA COS or designee show documented clinical problems or continual unprofessional behavior/actions with any Contractor’s Neurophysiologic Technologist(s), s/he may request, without cause, immediate replacement of said Contractor’s Neurophysiologic Technologist(s). The CO and COR shall deal with issues raised concerning Contractor’s Neurologists (s) conduct. The final arbiter on questions of acceptability is the CO.

2.9.3.4. Contingency Plan: Because continuity of care is an essential part of Albany VAMC’s medical services, The contractor shall have a contingency plan in place to be utilized if the contractor’s Neurophysiologic Technologist(s) leave contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract.

3. HOURS OF OPERATION:

3.1. VA Business Hours; Normal hours of operations are 7:00 am – 5:00 pm, Monday through Friday. The operating room is open 24 hours/day and a contractor shall be available for procedures 365 days/year, 24/7.

3.1.1. Contractor’s services shall be available and present for all hours of possible scheduled operations, which will be established, and may be revised, as deemed appropriate for patient care by the Chief of Staff. Currently normal operating room hours are 7:00 am – 5:00 pm, Monday through Friday.

3.1.1.1. Routine cases must be scheduled by VA by 1:00 p.m. Eastern Time on the day immediately preceding the surgery or by 1:00 p.m. Eastern Time on Friday if the case will be performed on Monday.

3.1.1.2. During normal business hours of operation, contracted staff shall be onsite and ready to perform services 45 minutes prior to the start of surgery. Equipment and technicians shall be cleared through biomed and SPS 45 minutes prior to surgical procedure.

3.1.2. Contracted personnel shall be available for procedures outside of normal hours of operations, including evenings, weekends and holidays.

3.1.2.1. VA will provide notice of at least 1.5 hrs. for cases scheduled after hours, weekends, and holidays

3.1.2.2. Outside of normal business hours, contracted staff should report to the operating room within 60 minutes of being called for surgery.

3.1.3. Contractor personnel shall be available for Specialty Procedures

3.1.3.1. Specialized cases require the VA to provide least seventy two (72) hours’ notice and preferably one week. Specialized cases are procedures using the Cascade system requiring advanced IONM techniques or advanced skills including the following: cortical SSEP mapping, direct cortical stimulation mapping of motor cortex, language mapping, brainstem nuclear mapping, cerebral white matter mapping, cases requiring measurement of lateral spread, brachial plexus cases and selective dorsal root rhizotomies.

3.2. Federal Holidays; The following holidays are observed by the Department of Veterans Affairs:

· New Year’s Day

· President’s Day

· Martin Luther King’s Birthday

· Memorial Day

· Juneteenth

· Independence Day

· Labor Day

· Columbus Day

· Veterans Day

· Thanksgiving

· Christmas

· Any day specifically declared by the President of the United States to be a national holiday.

3.3. Cancellations: Contractor will not cancel service for any reason.

3.3.1. Unless a state of emergency has been declared or clinics are otherwise cancelled by the Albany VAMC, the contractor shall be responsible for providing services.

4. TECHNOLOGIST RESPONSIBILITIES:

4.1. The Contractor shall furnish “technical only” services, not including any professional oversight via Contractor MD/DO Neurologists. The Contractor shall furnish all supplies, accessories, equipment, consumables, transportation, delivery, training, and services. The Contractor shall provide 24/7 onsite case coverage and scheduling 365 days/year by Key Personnel who are cleared to perform services after submitting to a background check and fingerprinting. Electro Neurophysiologic Technologists must be available for onsite coverage before and during surgery. Contractor shall coordinate provision of services with the attending surgeon or designee. Contractor shall complete all administrative tasks and required documentation immediately following the procedures.

4.2. Intraoperative Neuromonitoring (neurophysiology) services: The Electro Neurophysiologic Technologist shall be under direction of the OR Surgeons and shall perform multiple modality evoked potentials on patients in the operating room at the Albany VAMC. Procedures may include stimulate screws and stimulate nerves. The Electro Neurophysiologic Technologist will be responsible for setting up all necessary OR equipment and supplies necessary for neurophysiological intraoperative monitoring and the placement of suitable electrodes on predetermined measured positions on the patient’s body. Contractor must accurately apply all recording and stimulating electrodes. Once connected to the machine in the operating room, data can be interpreted by the neurophysiologist (in-house) or remotely where the data is transmitted using a secure HIPAA compliant internet connection.

4.2.1. Intraoperative monitoring modalities needed include: SSEPS, TcMEP, S-EMG, T-EMG, spinal cord mapping including D-Waves, DNEPs, NMEPs, Cortical, motor, sensory, language mapping, white matter tract and brainstem nuclei mapping, brainstem auditory evoked responses, visual evoked potentials, cranial nerve monitoring, and intraoperative EEG. Specialized cases are procedures requiring advanced IONM techniques or advanced skills including the following: cortical SSEP mapping, direct cortical stimulation mapping of motor cortex, language mapping, brainstem nuclear mapping, cerebral white matter mapping, cases requiring measurement of lateral spread, brachial plexus cases and selective dorsal root rhizotomies.

4.3. Contractors must comply with appropriate and applicable policies, procedures and regulations of the Albany VAMC as well as with centers for Medicare and Medicaid services (CMS) requirements and complete medical record deficiencies within policy guidelines. Services must meet Joint Commission clinical quality standards for intraoperative monitoring and be FPIS compliant. Quality reports required for quality assurance need to be JHACO certified.

4.4. The Contractor establish communication protocols with the surgical team to report monitoring activity. The Neuromonitoring team will provide all resources required to ensure a smooth transition in accordance with the contract requirements.

4.5. Contractor shall interpret the intraoperative monitoring recording and make recommendations regarding action or consequence to the attending Neurosurgeon. The Electro Neurophysiologic Technologist will recognize artifacts in the data differentiate them from evoked potential patterns and take appropriate steps to eliminate them. They will obtain patient medical information when requested and will translate test results from computer files to a hard copy report for VA Neurophysiologic Technologist’s interpretation.

4.5.1. Contractor must be proven capable of identifying monitored waveforms and any variation from baseline.

4.5.2. Contractor must demonstrate an understanding of anesthetic techniques and physiologic changes that can affect the waveforms being monitored.

4.6. The Electro Neurophysiologic Technologist staff will be responsible for removing electrodes post procedure and removing the contractor’ supplied equipment from the operating room upon completion of each procedure.

4.7. Equipment: Albany VAMC will not procure, or provide separate compensation for contractor’s use of, any equipment required to perform services or necessary accessories/supplies under this contract. The Albany VAMC will not be responsible for the contractor’s equipment for costs of repairs and or replacements of such equipment, technology, or software. Contractor has full responsibility of using its own technology to conduct IONM services. The contractor shall abide by all Albany VAMC policies and procedures regarding the maintenance, use and safety of any clinical equipment utilized by the technicians in the or at Albany VAMC.

4.7.1. Equipment Set Up/ Inspection: Delivery activities shall consist of the following:

4.7.1.1. Upon arrival at the VAMC on each scheduled day of service, the Contractor shall report to the VA Human Resources (HR) Service to obtain a temporary VA Contractor Badge.

4.7.1.2. After obtaining a temporary VA Contractor badge, the Contractor shall take all equipment to BioMed Service for preoperative electrical safety check.

4.7.1.3. Equipment Set Up: All necessary preparation required to ready the Neuromonitoring Equipment for operation/service.

4.7.1.4. Maintenance: The Contractor shall maintain equipment in accordance with manufacturer’s specifications. The Contractor shall provide written documentation of Preventive Maintenance Services (PMS)/Maintenance has been performed as required for verification by the COR or his/her designee for all scheduled services. Documentation shall describe the maintenance and repair service performed on the equipment in sufficient detail so as to be acceptable by field inspectors of the Joint Commission and other inspecting bodies. This shall include a list of all parts replaced, all service performed as well as a statement that the equipment is operating per manufacturer’s specifications after repair. The service report will be signed by the Contractor’s service technician, and by designated the Albany VA Medical Center personnel.

4.7.2. Contractor shall be responsible for computer networking assistance reasonably necessary for the technologist to perform IONM services at its own expense if using company owned equipment.

4.7.3. The Electro Neurophysiologic Technologist will be sufficiently knowledgeable and test equipment prior to use and to make any adjustments in the equipment settings that are required. The Electro Neurophysiologic Technologist will select predetermined electrode combinations as well as non-standard assortments as necessary. The Electro Neurophysiologic Technologist will obtain standard recordings and report on-going status of patient’s nervous system to the surgeon.

4.7.4. The contractor shall submit an equipment service report to the COR within 24 hours of the completion of the surgical case.

4.8. Neurophysiologic Technologists must be accredited by ABRET, (American Board of Registration of Electroencephalographic and Evoked Potential Technologist). Additionally, 80% of techs or more must have a Certificate of Neurophysiologic intraoperative monitoring (CNIM). Contractor must have a diplomat of American Board of Neuromonitoring on the team. Contractor must be proven competent in the operating of monitoring equipment, including troubleshooting and electrical safety by the Albany VAMC.

4.8.1. The Albany VAMC may refuse services from a Neurophysiologic Technologist who does not demonstrate adequate technical knowledge, at any time. The Contractor must provide a replacement from the VA-approved Key Personnel at no cost to the Government within 1.5 hours.

4.9. Contracted personnel shall be responsible for signing in and out when in attendance in the operating room. Attendance rosters shall be used for verification of worked performed by the COR. Failure to sign in and out on the attendance log may delay payment for services being rendered.

4.10. Supplies/ Specialty Supplies: The Contractor shall supply all supplies per procedure. Specialty Supplies referenced in the Price Schedule shall be provided when deemed necessary by the Surgeons/ Physicians in the Albany VA Medical Center.

4.11. Contractor Special Agreement Check (SAC): A Special Agreement Check (SAC) is an FBI criminal history check of fingerprints which is initiated prior to entry on duty for all new Contractor provider employees who perform services for at least ten (10) days and who:

· Have access to sensitive information

· Provide direct and/or ancillary healthcare services at VA facilities.

· Have access to VA computer/information systems

5. STANDARDS OF CARE: The Electro Neurophysiologic Technologist care shall cover the range of Neurological services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards as established by:

· Certification in American Board of Psychiatry and Neurology http://www.abpn.com

· Neurophysiologic Intraoperative Monitoring (CNIM) from the American Board of Registered Electro Neurophysiologic Technologist (http://www.abret.org)

· This technical certification intended for technologists who work under supervision by a neurophysiologist or neurologist. American Board of Neurophysiologic Monitoring (ABNM) certification (http://abnm.info)

· The American College of Neurology (ANN): https://www.aan.com/policy-and-guidelines/guidelines/

· The professional standards of the Joint Commission (TJC) http://www.jointcommission.org/standards_information/hap_requirements.aspx

· The standards of the American Hospital Association (AHA) http://www.hpoe.org/resources?show=100&type=8 and;

· The requirements contained in this PWS.

6. MEDICAL RECORDS:

6.1. Authorities: Contractors providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the U.S.C.551a (Privacy Act), 38 U.S.C. 5701 (Confidentiality of claimants records), 5 U.S.C. 552 (FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332 (Confidentiality of certain medical records), Title 5 U.S.C. § 522a (Records Maintained on Individuals) as well as 45 C.F.R. Parts 160, 162, and 164 (HIPAA).

6.2. HIPAA: This contract and its requirements meet exception in 45 CFR 164.502(e), and do not require a BAA in order for Covered Entity to disclose Protected Health Information to: a health care provider for treatment. Based on this exception, a BAA is not required for this contract.

6.2.1. Health Insurance Portability and Accountability Act of 1996 (HIPAA): 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).

6.2.2. Treatment and administrative patient records generated by this contract or provided to the contractors by the VA are covered by the VA system of records entitled ‘Patient Medical Records-VA’ (24VA19). Contractor generated VA Patient records are the property of the VA and shall not be accessed, released, transferred, or destroyed except in accordance with applicable laws and regulations.