RFP 36C24225R0047- KINGSTON CBOC.pdf

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

36C24225R0047 07-23-2025

Danelle Wassink | ACO 607-664-6337 08-25-2025

16:30 ET

36C242 Department of Veterans Affairs Network Contracting Office (NCO) 2 Bath VA Medical Center 76 Veterans Avenue Bath NY 14810-0810 Danelle Wassink Danelle.Wassink@va.gov

X

621498

$25.5 Million

N/A

X

36C528

Department of Veterans Affairs Samuel S. Stratton VA Medical Center Primary Care/ Ambulatory Care ICC 113 Holland Avenue Albany NY 12208-3410

36C242

Department of Veterans Affairs Network Contracting Office 2 Bath VA Medical Center 76 Veterans Avenue Bath NY 14810-0810

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

Contractor shall provide Community Based Outpatient Clinic (CBOC) services for Kingston, NY as described herein for VA beneficiaries in the Samuel S. Stratton VA Medical in the Albany, NY region.

The Schedule of Services begins on Page 8.

The Performance Work Statement (PWS) begins on Page 11.

Instructions to Offerors begins on Page 162.

All questions must be received by August 6, 2025 at 14:30 ET in writing via email to Danelle.Wassink@va.gov.

All proposals, attachments and requested materials must be received via email by August 25, 2025 at 16:30 ET to Danelle.Wassink@va.gov. Faxed or mailed proposals will not be accepted.

X X

X ONE

JADWIGA KUSTRA

CONTRACTING OFFICER

36C24225R0047

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 SCHEDULE OF SERVICES

B.3 PERFORMANCE WORK STATEMENT (PWS)

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES (NOV 2023)

C.2 52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR

INFORMATION SYSTEMS (NOV 2021)

C.3 52.207-3 RIGHT OF FIRST REFUSAL OF EMPLOYMENT (MAY 2006)

C.4 52.216-18 ORDERING (AUG 2020)

C.5 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.6 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.7 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.8 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) . 126

C.9 52.222-30 CONSTRUCTION WAGE RATE REQUIREMENTS—PRICE

ADJUSTMENT (NONE OR SEPARATELY SPECIFIED METHOD) (AUG 2018)

C.10 52.222-32 CONSTRUCTION WAGE RATE REQUIREMENTS—PRICE

ADJUSTMENT (ACTUAL METHOD) (AUG 2018)

C.11 52.228-5 INSURANCE—WORK ON A GOVERNMENT INSTALLATION (JAN

1997)

C.12 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.13 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR

1984)

C.14 VAAR 852.201-70 CONTRACTING OFFICER'S REPRESENTATIVE (DEC 2022)

C.15 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.16 VAAR 852.204-71 INFORMATION AND INFORMATION SYSTEMS SECURITY

(FEB 2023)

C.17 VAAR 852.211-76 LIQUIDATED DAMAGES – REIMBURSEMENT FOR DATA

BREACH COSTS (FEB 2023) ALTERNATE I (FEB 2023)

C.18 852.222-71, COMPLIANCE WITH EXECUTIVE ORDER 13899 (DEVIATION)

(APR 2025)

C.19 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS

(NOV 2018)

C.20 VAAR 852.237-70 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE

(OCT 2019)

C.21 VAAR 852.237-72 CRIME CONTROL ACT—REPORTING OF CHILD ABUSE

(OCT 2019)

C.22 VAAR 852.237-74 NON-DISCRIMINATION IN SERVICE DELIVERY (OCT 2019)

C.23 VAAR 852.237-75 KEY PERSONNEL (OCT 2019)

C.24 VAAR 852.239-76 INFORMATION AND COMMUNICATION TECHNOLOGY

ACCESSIBILITY (FEB 2023)

C.25 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020) 145

C.26 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.27 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (JAN 2025) (DEVIATION FEB 2025)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

D.1- QUALITY ASSURANCE SURVEILLANCE PLAN - QASP ......................... (Attached) D.2- PAST PERFORMANCE REFERENCE INFORMATION ............................ (Attached)

D.3- CONTRACTOR CERTIFICATION - IMMIGRATION AND NATIONALITY ACT OF

1952 ................................................................................................................... (Attached) D.4- ORGANIZATIONAL CONFLICTS OF INTEREST ...................................... (Attached) D.5- KEY PERSONNEL LIST ............................................................................ (Attached) D.6- PATIENT ALIGNED CARE TEAM (PACT) HANDBOOK ........................... (Attached) D.7- WAGE DETERMINATION #2015-4155, REV.30, DATED 05/06/2025 ...... (Attached)

D.8- DAVIS-BACON ACT WAGE DETERMINATION #20250007, DATED 06/20/2025

........................................................................................................................... (Attached) D.9- HEALTH CARE PERSONNEL INFLUENZA VACCINATION FORM ......... (Attached) D.10- RULES OF BEHAVIOR ............................................................................ (Attached) D.11- WARD STOCK AND LAST 12 MONTHS OF ORDERS ........................... (Attached) D.12- US CENSUS DATA- VETERANS LIVING IN ULSTER COUNTY ............. (Attached)

D.13- CBOC PATHOLOGY AND LABORATORY MEDICINE CONTRACTOR SUPPLY

LIST (NOT SUPPLIED BY VAMC) ..................................................................... (Attached) D.14- CLINIC STAFFING ................................................................................... (Attached) D.15- SUICIDE PREVENTION- MCP 116-001 .................................................. (Attached)

D.16- SUICIDE PROCEDURE TO MANAGE PATIENTS AT RISK FOR SUICIDE SOP

2-054-18 ............................................................................................................. (Attached) D.17- REACH VET ONE PAGE FLYER ............................................................ (Attached) D.18- REACH VET STEPS- PROVIDER ........................................................... (Attached) D.19- SUICIDE RISK IDENTIFICATION (RISK ID) ............................................ (Attached) D.20- HIMS- HEALTH RECORD DOCUMENTATION PROGRAM GUIDE ....... (Attached) D.21- HIMS- ACTIONS REQUIRED AND ENCOUNTER ERRORS SOP ......... (Attached)

D.22- HIMS- SCANNING ELECTRONIC HEALTH RECORD (EHR) DOCUMENTS

........................................................................................................................... (Attached)

D.23- COMMUNICATING TEST RESULTS TO PROVIDERS AND PATIENTS, MCP 12-

50 ....................................................................................................................... (Attached)

D.24- ALBANY VAMC PRIVACY POLICY AND PROCEDURES MCP SL-00-89

........................................................................................................................... (Attached) D.25- TELEPRESENTER TMS TRAINING COURSES ..................................... (Attached) D.26- TELEHEALTH OPERATIONS MANUAL- CLINIC BASED ....................... (Attached)

D.27- TELEHEALTH- STORE AND FORWARD TELEHEALTH SFT

TELEDERMATOLOGY PROGRAM ................................................................... (Attached)

D.28- TELEHEALTH- TELE-EYE SCREENING IMAGING PROCESS ............. (Attached) D.29- HOME TELEHEALTH OPERATIONS MANUAL ...................................... (Attached) D.30- CARE COORDINATION REVIEW TEAM (CCRT) ................................... (Attached)

D.31- NATIONAL STANDARDIZED SCHEDULER ONBOARDING- TRAINER GUIDE

........................................................................................................................... (Attached)

D.32- MINIMUM SCHEDULING EFFORT FOR OUTPATIENT APPOINTMENTS

........................................................................................................................... (Attached)

D.33- ELECTRONIC MEDICAL RECORD EMR CONTINGENCY PLAN FOR ALBANY

DIVISION AND CBOCs ...................................................................................... (Attached)

D.34- BUSINESS OFFICE- PROCESSING APPLICATIONS FOR ENROLLMENT AND

HEALTHCARE BENEFITS ................................................................................ (Attached)

D.35- PRIMARY CARE CLINICS, COMMUNITY BASED OUTPATIENT CLINICS

(CBOCs) AND HOME TELE-HEALTH STANDARD OPERATION PROCEDURES FOR REGISTERED NURSES .................................................................................... (Attached)

D.36- EOC ASSESSMENT AND COMPLIANCE ROUNDING PROCESS GUIDE

........................................................................................................................... (Attached)

D.37- RADIOLOGY- DIAGNOSTIC IMAGING SERVICES SOP (ORDERING,

COMMUNICATING RESULTS) ......................................................................... (Attached) D.38- GENERAL LAB POLICY AND PROCEDURES ....................................... (Attached) D.39- OUTPATIENT PHLEBOTOMY CLINIC PROCEDURE ............................ (Attached) D.40- ANTICOAGULATION MANAGEMENT PROGRAM ................................. (Attached) D.41- ANCILLARY SITE PROFICIENCY TESTING .......................................... (Attached) D.42- WAIVED TESTING REGULATIONS ........................................................ (Attached) D.43- EMERGENCY MANAGEMENT OF HYPOGLYCEMIA ............................ (Attached) D.44- VERBAL AND TELEPHONE ORDERS .................................................... (Attached) D.45- MEDICATION RECONCILIATION ........................................................... (Attached) D.46- MEDICAL CENTER DRUG CONTROL SOP ........................................... (Attached) D.47- COORDINATED CARE POLICY FOR TRAVELING VETERANS ........... (Attached)

D.48- WOMENS HEALTH- MATERNITY HEALTHCARE AND CARE COORDINATION

........................................................................................................................... (Attached)

D.49- MONITORING AND EVALUATING PROVIDER PRACTICE EVALUATIONS

........................................................................................................................... (Attached)

D.50- GUIDELINES FOR THE CLEANING & DISINFECTION OF NON-CRITICAL

REUSABLE MEDICAL EQUIPMENT (RME) ..................................................... (Attached) D. 51- VA SIGNAGE DESIGN GUIDE PG-18-10............................................... (Attached)

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (SEP 2023)

E.2 52.201-1 ACQUISITION 360: VOLUNTARY SURVEY (SEP 2023)

E.3 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

E.4 52.204-29 FEDERAL ACQUISITION SUPPLY CHAIN SECURITY ACT

ORDERS—REPRESENTATION AND DISCLOSURES (DEC 2023)

E.5 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.6 52.216-1 TYPE OF CONTRACT (APR 1984)

E.7 52.222-5 CONSTRUCTION WAGE RATE REQUIREMENTS—SECONDARY SITE

OF THE WORK (MAY 2014)

E.8 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.9 VAAR 852.209-70 ORGANIZATIONAL CONFLICTS OF INTEREST (OCT 2020)

E.10 VAAR 852.215-72 NOTICE OF INTENT TO RE-SOLICIT (OCT 2019)

E.11 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE

RESOLUTION (OCT 2018)

E.12 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018)

E.13 VAAR 852.239-75 INFORMATION AND COMMUNICATION TECHNOLOGY

ACCESSIBILITY NOTICE (FEB 2023)

E.14 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE

(FEB 1998)

E.15 52.212-2 EVALUATION—COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES (NOV 2021)

E.16 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (MAY 2024) (DEVIATION

FEB 2025)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. CONTRACT ADMINISTRATION:

a. Contractor:

Company Name: ________________________________________

Trade Name/ DBA: ________________________________________

Address Line 1: ________________________________________

Address Line 2: ________________________________________

Address Line 3: ________________________________________

Point of Contact/Title: ________________________________________

Telephone number: ________________________________________

Fax Number: ________________________________________

Email: ________________________________________

SAM UEI: ________________________________________

TIN Number: ________________________________________

b. Government:

Jadwiga Kustra, Contracting Officer Department of Veterans Affairs Network Contracting Office (NCO 2) 130 West Kingsbridge Road Bronx, NY 10468 Phone: 646-285-2761 Email: Jadwiga.Kustra@va.gov

Danelle Wassink, Administrative Contracting Officer Department of Veterans Affairs Network Contracting Office (NCO 2) 76 Veterans Avenue Bath, NY 14810 Phone: 607-664-6337 Email: Danelle.Wassink@va.gov

2. AUTHORIZED NEGOTIATORS: The offeror represents that the following persons are authorized to negotiate on its behalf with the Government in connection with this Request for Proposals:

mailto:Jadwiga.Kustra@va.gov mailto:Danelle.Wassink@va.gov

Name: ________________________ Name: ________________________

Title: ________________________ Title: ________________________

Phone: ________________________ Phone: _______________________

Email: _______________________ Email: ________________________

3. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with 52.232-33, Payment by Electronic Funds Transfer – System for Award Management.

4. INVOICES: Invoices shall be submitted monthly in arrears.

5. 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. Invoicing shall be in accordance with the requirements of The Department of Veterans Affairs (VA) Financial Services Center (VAFSC). The latest information shall be used for invoicing and payments and may change during the Period of Performance of this acquisition. Current invoicing information is located at http://www.fsc.va.gov/einvoice.asp.

6. SOLICITATION/CONTRACT: This solicitation and resulting contract adhere to the format defined in FAR Parts 12 and 15 of the FAR. The text of the FAR is available at https://www.acquisition.gov.

7. SECURE FAX

Please review VA Handbook 6500 that requires the following statement on all fax cover 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.”

8. POST AWARD ORIENTATION: The Contracting Officer will schedule a post award orientation conference for contract orientation purposes.

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

AMENDMENT NO DATE

https://www.acquisition.gov/

B.2 SCHEDULE OF SERVICES

Under the authority of 38 U.S.C. §8153 the Contractor agrees to provide community based outpatient clinic services in accordance with the terms, conditions, and provisions stated herein at the prices specified in the Price Schedule of Services. The proposed Contractor facility must be physically located within Kingston in the State of New York. Veterans to be serviced under this contract reside primarily in Ulster County, however; residency is not restricted to this county.

The Parent Facility for this CBOC is the Samuel S. Stratton VA Medical Center located at 113 Holland Avenue, Albany, NY 12208-3410. Payment for primary care services shall be based on a monthly Per Member Per Month (PMPM) capitated rate, as further explained within this solicitation.

Contract Guaranteed Minimum and Contract Maximum:

The fixed-price indefinite-delivery indefinite-quantity (IDIQ) contract will have a base year period with four option year periods. All PMPM quantities are estimated. The total guaranteed minimum quantity of services that the Government will acquire under this indefinite delivery, indefinite quantity (IDIQ) contract is $25,000.00, which also represents a bona fide need of the current fiscal year. The guaranteed minimum award amount is for the entire contract duration.

The ceiling amount for the entire contract effort is $15,000,000.00. The aggregate value of orders placed under this contract shall not exceed the IDIQ contract maximum.

Ordering Procedures:

The Government does not guarantee that it will place any orders under this contract in excess of the guaranteed minimum award amount of $25,000.00. Any services to be furnished under this contract shall be ordered by issuance of delivery orders or task orders by the Contracting Officer or Administrative Contracting Officer. Firm‐fixed-price task orders (TO) will be placed under this contract via email by the CO prior to the start of each performance period with the fixed quantity of members for the upcoming performance period. See FAR clause 52.216-19, Order Limitations, for minimum and maximum values of each TO. Task Orders are contingent upon availability of funds per FAR clause 52.232-18. See Monthly Billable Roster and Invoice Reconciliation section in the PWS below regarding the invoicing instructions for reconciliation of task orders once the monthly billable roster is finalized.

VA has the sole authority to assign Veterans treated by the Contractor into the Primary Care Management Model (PCMM) software program used to track primary care clinic Veteran rosters. Specific billable processes for issuing task orders under the resultant contract include:

determining Veteran eligibility, enrollment eligibility, and at least one qualifying encounter by the Contractor’s primary care provider (PCP) within the previous 12 months.

Billing/Payment Procedures The contractor will be provided a list of all patients on the billable roster at the time when the contractor begins performing clinical services and will be able to bill for those patients on the billable roster in the following month’s invoice. In order to remain on the monthly billable roster, patients shall have at least one qualifying encounter during the previous 12 months. See the Billing and Invoicing Procedures section on page 96. for further information on the billable roster, qualifying encounters, and invoicing procedures.

For Veterans newly assigned in PCMM the contractor may bill for patients newly assigned in PCMM the month following a qualifying encounter.

For unassigned/unenrolled patient visits/encounters - PMPM includes cost of unassigned/unenrolled patient visits. Contractor shall not bill separately or propose an additional LIN for these costs. All quantities are estimated, the government will pay for services performed as certified by the COR.

See Section E instructions to offerors for further information regarding pricing proposals related to clinic buildout.

Award Based on Initial Offers: Offerors are advised of the possibility that award may be made without discussion. Accordingly, offerors are cautioned to submit their initial offers based on their most favorable terms, pricing and technical factors.

*Please note the number of billable enrollees on the most current invoice (May 2025) is 1,559.

The Government will not accept an alternative pricing sheet.

Base Year – April 1, 2026 – March 31, 2027 Line Item

Services Unit

Estimated Quantity

Price per Unit

Total Estimated Cost per month

Total Estimated Cost per year

0001 Primary Care Services at capitation rates per member per month

(PMPM)

PMPM

Estimated Total for Base Year $__________________

Option Year One- April 1, 2027 – March 31, 2028 Line Item

Total Estimated Cost per month

Total Estimated Cost per year

1001 Primary Care Services at capitation rates per

Estimated Total for Option Year 1 $__________________

Option Year 2 – April 1, 2028 – March 31, 2029

Item

Total Estimated Cost per month

Total Estimated Cost per year

2001 Primary Care Services at capitation rates per

Estimated Total for Option Year 2 $__________________

Option Year 3 – April 1, 2029 – March 31, 2030

Item

Estimate d

Total Estimated Cost per month

Total Estimated Cost per year

3001 Primary Care Services at capitation rates per

Estimated Total for Option Year 3 $__________________

Option Year 4 – April 1, 2030 – March 31, 2031

Item

Estimate d per Unit

Total Estimated Cost per month

Total Estimated Cost per year

4001 Primary Care Services at capitation rates per

Estimated Total for Option 4 $__________________

ESTIMATED TOTAL FOR BASE AND 4 OPTION YEARS:

BASE YEAR $

OPTION YEAR 1 $

OPTION YEAR 2 $

OPTION YEAR 3 $

OPTION YEAR 4 $

TOTAL ESTIMATED COST $

B.3 PERFORMANCE WORK STATEMENT (PWS)

1. GENERAL:

1.1 Services Required: The Samuel S. Stratton VA Medical Center in Albany, NY requires the following services to be provided in a private hospital, office, or clinic environment for Veterans, primarily residing in Kingston, New York. The intended facility/resources to be devoted exclusively to the service of VA patients.

1.2 Site Classification: This site is classified as a [X] Primary Care CBOC [] Multi-Specialty CBOC [] Health Care Center (HCC) designated as Ambulatory Surgery Clinic (ASC) [] HCC NOT designated as ASC [] Other Outpatient Services Site.

1.3 Place of Performance: Services shall be performed by contractor within the city limits of Kingston, NY on behalf of the Samuel S. Stratton VA Medical Center.

1.4 Authority: Title 38 United States Code (USC) 8153 and FAR 12 in combination with 15.

1.5 Policy and Regulations: The contractor is required to meet VHA performance and quality criteria, policy and standards including, but not limited to, access, quality of care, Veteran satisfaction, coordination of care, and clinical guidelines. Performance and quality standards may change during the contract. New or revised quality/performance criteria or standards will be provided to the contractor before implementation date and throughout the life of the contract through unilateral or bi-lateral modifications, as applicable. Copies of current VA and VHA publications can be located at http://www.va.gov/vapubs/ or at http://www.va.gov/vhapublications/. Some VA policy documents include Standard Operating Procedures (SOPs) located on internal VA websites that are not available to the public. SOPs relevant to this requirement are provided as attachments under Section D. Compliance with mandated performance is required as a condition of this contract. Contractor shall comply with all relevant VA policies and procedures, including those related to quality, access, patient safety and performance, including, but not limited to the policies listed on the Contracted Clinic Policy Document located at https://www.patientcare.va.gov/primarycare/docs/List-of-contracted-clinic-policy-documents.xlsx#. A link to the VA Qualifications Standards is also included in this document.

1.6 Acronyms/Definitions:

ABMS: American Board of Medical Specialties ACGME: Accreditation Council for Graduate Medical Education ACIP: Advisory Committee on Immunization Practices ACLS: Advanced Cardiac Life Support ACO: Administrative Contracting Officer ACPE: American Council on Pharmaceutical Education ADE: Adverse Drug Events AED: Automatic External Defibrillator AIS: Automated Information Security ANA: American Nurses Association AOA: American Osteopathic Association APRN: Advanced Practice Registered Nurse ARRT: American Registry of Radiologic Technology ASC: Ambulatory Surgery Center Assigned: A Veteran is “assigned” to an outpatient clinic via PCMM (i.e., CBOC) where the patient receives their primary care after the patient’s eligibility is determined through registration and enrollment.

http://www.va.gov/vapubs/ http://www.va.gov/vhapublications/ https://www.patientcare.va.gov/primarycare/docs/List-of-contracted-clinic-policy-documents.xlsx https://www.patientcare.va.gov/primarycare/docs/List-of-contracted-clinic-policy-documents.xlsx

Asynchronous Care: Care provided outside of bookable time and includes but is not limited to the following activities: refilling prescriptions, reviewing outside records, huddles and case management, team meetings, processing view alerts, secure messaging and training.

BAA: Business Associate Agreement BI-RADS: Breast Imaging-Reporting and Data System; a quality assurance tool designed to standardize mammography reporting.

BLS: Basic Life Support BOS: Bureau of Osteopathic Specialists CAHEA: Committee on Allied Health Education and Accreditation CAP: College of American Pathologists CARF: Commission on Accreditation of Rehabilitation Facilities CBO: VA Central Billing Office.

CCNE: Commission on Collegiate Nursing Education CDC: Centers for Disease Control and Prevention CEU: Certified Education Unit CLIA: Clinical Laboratory Improvement Amendments CME: Continuing Medical Education CMS: Center for Medicare and Medicaid Services CNP: Certified Nurse Practitioner CNS: Clinical Nurse Specialist CO: Contracting Officer COPD: Chronic Obstructive Pulmonary Disease COR: Contracting Officer’s Representative COS: Chief of Staff CPA: Collaborative Practice Agreement CPARS: Contractor Performance Assessment Reporting System CPP: Clinical Pharmacist Practitioner CPT: Current Procedural Terminology CSWE: The Council on Social Work Education the CSWE website is http://www.cswe.org.

CVT: Clinical Video Telehealth DICOM: Digital Image and Communication in Medicine DIGMA: Drop-in Group Medical Appointment DRG: Diagnostic Related Group DSS: Decision Support System ECC: Extended Care Center Enrollment: The process of establishing eligibility for VA’s “Medical Benefits Package.”

Most Veterans are required to “enroll” into the VA Health Care System to be eligible for VA health care and to be assigned to an outpatient clinic like a CBOC, however some can still receive care without enrolling. Applicants are only required to “enroll” once for VA health care unless they are determined ineligible for care at time of application or they have disenrolled.

EPRP: External Peer Review Program FDA: Food and Drug Administration FSMB: Federation of State Medical Boards FTE: Full Time Equivalent HCC: Health Care Center - A HCC is a VA-owned, VA-leased, contract, or shared clinic operated at least 5 days per week that provides primary care, mental health care, on site specialty services, and performs ambulatory surgery and/or invasive procedures which may require moderate sedation or general anesthesia.

HCFA: Health Care Financing Administration HHS: Department of Health and Human Services http://www.cswe.org/

HICPAC: Healthcare Infection Control Practices Advisory Committee - a federal advisory committee made up of 14 external infection control experts who provide advice and guidance to the CDC and the Secretary of HHS regarding the practice of health care infection control, strategies for surveillance and prevention and control of health care associated infections in United States health care facilities.

HPE: Health Professions Education HPT: Health Professions Trainee HT: Home Telehealth ICAVL: Intersocietal Commission for the Accreditation of Vascular Laboratories ICD: International Classification of Diseases iMED: software used by VA for informed consent.

INR: International Normalized Ratio LIP: Licensed Independent Practitioner MCCR: Medical Care Cost Recovery Mental Health Services: per VHA Directive 1160.01 is meant to include services for the evaluation, diagnosis, treatment, rehabilitation, suicide prevention and crisis intervention, and coordination of care for both substance use disorders and other mental disorders.

General mental health services include:

(a) Diagnostic and treatment planning evaluations for the full range of mental health problems, including SUD

(b) Treatment services using evidence-based pharmacotherapy, somatic treatments, or primary evidence-based Psychotherapy (EBP) for patients with mental health conditions and substance use disorders

(c) Patient education

(d) Family education, family consultation, family psychoeducation and couples/marriage and family counseling when it is associated with benefits to the Veterans

(e) Referrals as needed to inpatient and residential care programs; and

(f) Consultation about special emphasis problems including Post Traumatic Stress Disorder (PTSD) and Military Sexual Trauma (MST)

(g) Suicide Prevention

(h) Referrals and coordination of care between other levels of care and community treatment programs.

Specialty mental health services include:

(a) Consultation and treatment services for the full range of mental health conditions

(b) Evidence-based psychotherapy

(c) Intensive Community Mental Health Integration (ICMHR)

(d) Psychosocial Rehabilitation Services, including: PRRCs, family psycho-education, family education, skills training, peer support, and Compensated Work Therapy (CWT), supported employment and vocational assistance.

(e) PTSD teams or specialists

(f) MST special clinics

(g) Homeless programs; and

(h) Specialty substance abuse treatment services.

MQSA: Mammography Quality Standards Act MSN: Master of Science in Nursing NLN: National League for Nursing NLNAC: National League for Nursing Accreditation Commission NP: Nurse Practitioner NSQIP/CICSP: National Surgical Quality Improvement Program/Continuous Improvement in Cardiac Surgical Program OTC: Over the Counter PA: Physician Assistant PACS: Picture Archiving and Communications System

PACT: Patient Aligned Care Team Background & Introduction: VA has implemented a PCMH model at all VA Primary Care sites which is referred to as PACT. This initiative supports VHA’s Universal Health Care Services Plan to redesign VHA healthcare delivery through increasing access, coordination, communication, and continuity of care.

PACT provides accessible, coordinated, comprehensive, patient-centered care, in team-based environment including the active involvement of other clinical and non-clinical staff. PACT allows patients to have a more active role in their health care fand is associated with increased quality improvement, patient satisfaction, and a decrease in hospital costs due to fewer hospital visits and readmissions.

PACT Support staff: PACT staff assisting providers in the actual delivery of care to patients. It consists of RNCMs, clinical associates, and administrative associates.

SYNCHRONOUS CARE: Bookable, real-time care provided in person or virtually (VA Video Connect, CVT, telephone) with a Veteran and involves clinical decision-making in a two-way conversation.

Parent Facility: VAMC responsible for performance monitoring and payment for contracted outpatient site of care services.

PBM: Pharmacy Benefits Management PCMH: Patient-Centered Medical Home PCMHI: Primary Care-Mental Health Integration PCMM: Patient Centered Management Module - is an enterprise application that enables users to (1) set up and define health care teams, (2) assign staff and their associated full-time equivalent (FTE) staff to positions within each team, (3) assign patients to the team, and (4) assign patients to specific team members.

PCP: Primary Care Provider Phar.D.: Doctor of Pharmacy PMPM: Per Member Per Month-reimbursement methodology for services provided under the PC and MH LINs based on all-inclusive monthly rate per Veteran that meets qualifying encounter criteria in the previous twelve months of the contract period. This methodology also accounts for costs of unassigned/unenrolled visits based on estimates provided to contractors and it supports the PACT model in increasing coordination, quality, and continuity of care of Veterans receiving services at the Outpatient Site of Care.

POC: Point of Care Testing Primary Care Visit: an episode of care furnished in a clinic or virtually that provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. Primary care includes, but is not limited to, diagnosis and management of acute and chronic biopsychosocial conditions, health promotion, disease prevention, overall care management, and patient and caregiver education. The VHA site classification defines primary care as those encounters that occur within the primary care class of encounters.

PWS: Performance Work Statement QAPI: Quality Assessment and Performance Improvement QASP: Quality Assurance Surveillance Plan REACH VET: Recovery Engagement and Coordination for Health Veterans Enhanced Treatment- REACH VET summarizes information from the Veterans Health Record and uses predictive modeling to identify Veterans at statistical risk for suicide and other negative outcomes. This tool supplements clinical strategies used to identify at-risk Veterans and may help providers intervene prior to these negative outcomes occurring.

RME: Reusable Medical Equipment SFT: Store and Forward Telehealth SMA: Shared Medical Appointments SOP (Clinical): Scope of Practice

SPD: Sterile Processing Division SPE: Senior Procurement Executive Specialty Care Visit: The VHA site classification defines specialty care as those encounters that occur within the geriatric medicine; allergy; cardiology; dermatology;

emergency; employee health; endocrinology; gastroenterology; general medicine;

hematology or oncology; infectious disease; nephrology; neurology; outreach; pulmonary or respiratory disease; rheumatology; amputation follow-up; amputation; anesthesia;

cardio-thoracic; ear, nose, and throat (ENT); eye; general surgery; gynecology (GYN);

neurosurgery; orthopedics; plastic surgery; urology; or vascular clinic stops.

STORM: Stratification Tool for Opioid Risk Monitoring Synchronous Care: Bookable, real-time care provided in person or virtually (VA Video Connect, CVT, telephone) with a Veteran and involves clinical decision-making in a two way conversation.

TCT: Telehealth Clinical Technician TIU: Text Integration Utility TJC: The Joint Commission TMS: Talent Management System VA: Veterans Affairs VA ECHO: VA Extension for Community Health Outcomes VA EHR: VA electronic health record VAMC: Veterans Affairs Medical Center VAST: VHA Site Tracking database VetPro: a federal web-based credentialing program for healthcare providers.

VHA: Veterans Health Administration VSSC: VHA Support Service Center VVC: VA Video Connect WHEN: Weekend- Holiday- Every- Night

2. STAFFING AND QUALIFICATIONS:

2.1 Minimum Patient Aligned Care Team (PACT) Staffing Requirements:

PACTs comprise the patients, the patients’ personal support persons, teamlets (Primary Care Providers (PCPs), Registered Nurse Care Managers (RNCMs), Clinical Associates, Administrative Associates), discipline specific team members (Clinical Pharmacist Practitioners (CPPs), Licensed Social Workers, Registered Dietitian/Nutritionists, and Primary Care-Mental Health Integration (PCMHI) staff). The contractor shall provide PACT staffing in numbers and qualifications capable of fulfilling the standards outlined in the resultant contract. The contractor shall provide a sufficient number of primary care providers so that each primary care provider has a caseload ratio to meet VA standards. Current standards are 1200 active patients per full-time physician and 900 active patients per full time midlevel provider. Actual panel sizes can be determined by the VA in accordance with VHA Directive 1406 Patient Centered Management Module (PCMM) for Primary Care. The staffing standard for support staff shall be at least three full-time equivalent (FTE) support staff (1 FTE RNCM, 1 FTE Clinical Associate, 1 FTE Administrative Associate) for each FTE Primary Care Provider. The Clinical Pharmacist Practitioner (CPP) shall be provided the same support staffing when they are working in the capacity of an advanced practice provider. The contractor shall provide personnel in numbers and qualifications capable of fulfilling the standards outlined in the resultant contract. The contractor shall establish and implement contingency plans for ensuring patients receive continuity of and access to appropriate primary care during periods of inadequate resources, extended staff absences, staff turnover, understaffing, and nature-related events (e.g., extreme weather conditions, natural disasters). If the number of patients reaches 90% of maximum panel size assigned by the facility the contractor shall communicate to the VA, the contractor’s future staffing plan to ensure staffing ratio standards remain in accordance with PCMM staffing standards.

The total estimated patients assigned to site is: 1775.

Physician Director (Mandatory for all sites): FTE Ratio Performance Standard: 0.05 FTE per PACT. Responsible Party: Shall be provided by contractor. Qualifications:

Contractor’s Physicians (including subcontractors) providing physician director services under the resultant contract shall demonstrate evidence of education, training, and experience in Internal Medicine or Family Practice. Contractor’s Physicians performing under this contract shall be board certified (or board eligible) by the ABMS in Internal Medicine and/or Family Practice or the BOS in Internal Medicine and/or Family Practice. If proposed staff do not meet VA credentialing requirements, the contractor shall propose substitute acceptable personnel within five (5) calendar days. The physician director may also be credentialed and privileged to function as a PCP. (If so, authorization for prescriptive authority is required). Physicians shall be licensed in the state in which the outpatient site of care (i.e., CBOC) is located; otherwise, qualifications as per VA qualification standards for Physician located in the VA Qualification Standards. See the Policy and Regulations section of this PWS for VA Qualification Standards access information. Position Responsibilities: Serves as medical director to oversee and be responsible for the provision of covered services to assigned and unassigned patients presenting for care at the site. If the Physician Director supervises a Physician’s Assistant (PA) or Nurse Practitioner (NP), this physician shall be on-site, if required to meet New York State requirements, to provide supervision requirements and additional time may be required.

2.2 Primary Care Teamlet Staffing (Mandatory for all sites): All primary care teamlet staffing shall be provided by contractor.

Teamlet Member 1: Primary Care Provider (PCP): FTE Ratio Performance Standard:

Current standards are 1200 active patients per full time physician and 900 active patients per full time mid-level provider. Contractor shall propose quantity of FTE to meet standard FTE ratio to panel size. Contractor to propose mix of PCP from the options below. At least one PCP must be a physician.

Option 1: Physician (MD/DO): Qualifications: Physicians shall demonstrate evidence of education, training, and experience in Internal Medicine or Family Practice. Physicians performing under this contract shall be board certified (or board eligible) by the ABMS in Internal Medicine and/or Family Practice or the BOS in Internal Medicine and/or Family Practice. Authorization for prescriptive authority is required. If proposed staff do not meet VA credentialing requirements, the contractor shall propose substitute acceptable personnel within five (5) calendar days. Physicians shall be licensed in the state in which the outpatient site of care (i.e., CBOC) is located; otherwise, qualifications as per VA qualification standards for Physician located in the VA Qualification Standards. See the Policy and Regulations section of this PWS for VA Qualification Standards access information.

Position Responsibilities: Responsible for the provision of covered services to assigned and unassigned patients presenting for care, providing health care commensurate to the PCP’s licensure and clinical privileges or scope of practice, ensuring the patient’s care plan contains medical recommendations for clinically indicated care, offering clinically indicated health care services to patients assigned to the PACT, and providing or arranging for care to which patients consent, providing leadership to the team including shared delegation of appropriate care and care processes to appropriate team members, reviewing available clinical and performance data with the team, and focusing on continuous improvement of critical team processes, ensuring the patient has same-day access for face-to-face and virtual care visits during regular clinic hours, and collaborating with PACT staff to develop personal health plans that incorporate care management and care coordination appropriate to the patient’s needs. This position may include supervision of PA or NPs, in accordance with NY State law and VHA Directive 1063.

Option 2: Advanced Practice Registered Nurse (APRN): Qualifications:

APRN’s (including subcontractors) shall possess a master’s degree from a program accredited by the National League for Nursing Accreditation Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE) and maintain full and current certification as a Certified Nurse Practitioner (CNP) from the American Nurses Association or another nationally recognized certifying body in either Adult Health or Family Practice. Authorization for prescriptive authority is required. CNPs shall prescribe controlled substances in accordance with limitations imposed by the Controlled Substances Act and the CNP’s State licensure on the authority to prescribe or administer controlled substances. Three years of clinical nursing experience is required. A minimum of one (1) year clinical experience as a CNP is required (three (3) years preferred). Experience in outpatient care in a Family Medicine or Internal Medicine environment is preferred. CNP shall have current, full, active, and unrestricted license and registration as a graduate professional nurse in the state in which the outpatient site of care (i.e., CBOC) is located;

otherwise, qualifications as per VA qualification standards for Advanced Practice Nurse located in the VA Qualification Standards. See the Policy and Regulations section of this PWS for VA Qualification Standards access information. Position Responsibilities:

Responsible for the provision of covered services to assigned and unassigned patients presenting for care, providing health care commensurate to the PCP’s licensure and clinical privileges or scope of practice, ensuring the patient’s care plan contains medical recommendations for clinically indicated care, offering clinically indicated health care services to patients assigned to the PACT, and providing or arranging for care to which patients consent, providing leadership to the team including shared delegation of appropriate care and care processes to appropriate team members, reviewing available clinical and performance data with the team, and focusing on continuous improvement of critical team processes, ensuring the patient has same-day access for face-to-face and virtual care visits during regular clinic hours, and collaborating with PACT staff to develop personal health plans that incorporate care management and care coordination appropriate to the patient’s needs.

Option 3: Physician Assistant (PA): Qualifications: PA’s (including subcontractors) shall be a graduate of a training program which is accredited by the Accreditation Review Commission on Education of PA (ARC-PA) or one of its predecessor organizations.

Additionally, PAs shall have a master’s degree in any discipline or a bachelor’s degree in any discipline with one year of experience as a PA. PAs shall have successfully passed the PA National Certifying Exam (PANCE). Authorization for prescriptive authority is required.

PA shall have current, full, active, and unrestricted license and registration in the state in which the outpatient site of care (i.e., CBOC) is located; otherwise, qualifications as per VA qualification standards for Physician Assistant located in the VA Qualification Standards.

See the Policy and Regulations section of this PWS for VA Qualification Standards access information. Position Responsibilities: Responsible for the provision of covered services to assigned and unassigned patients presenting for care, providing health care commensurate to the PCP’s licensure and clinical privileges or scope of practice, ensuring the patient’s care plan contains medical recommendations for clinically indicated care, offering clinically indicated health care services to patients assigned to the PACT, and providing or arranging for care to which patients consent, providing leadership to the team including shared delegation of appropriate care and care processes to appropriate team members, reviewing available clinical and performance data with the team, and focusing on continuous improvement of critical team processes, ensuring the patient has same-day access for face-to-face and virtual care visits during regular clinic hours, and collaborating with PACT staff to develop personal health plans that incorporate care management and care coordination appropriate to the patient’s needs.

Teamlet Member 2: Registered Nurse (RN) Care Manager: FTE Ratio Performance Standard: Current standard is 1.0 FTE RNCM per 1.0 FTE PCP Qualifications: Graduate of a school of professional nursing accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The accreditation Commission for Education in Nursing (ACEN) or the commission on Collegiate Nursing Education (CCNE).

Current, full, active, and unrestricted registration as a graduate professional nurse in the state in which the outpatient site of care (i.e., CBOC) is located; otherwise, qualifications as per VA qualification standards for Nurse located in the VA Qualification Standards. See the Policy and Regulations section of this PWS for VA Qualification Standards access information. Position Responsibilities: Responsible for the provision of covered services to assigned and unassigned patients presenting for care at the site, providing all aspects of professional nursing services consistent with licensure, certification, nursing professional standards of practice, and the clinician’s Functional Statement with elements of practice, enhancing patient safety and quality of care by collaborating with PACT staff to develop, oversee, and manage care management plans and care coordination for patients assigned to PACTs, participating in modes of communication and care delivery including, but not limited to, secure messaging, virtual care, view alerts management, shared medical appointments, face to face visits, etc., as part of care management, identifying patient needs for involvement of discipline-specific team members and discussing nursing recommendations with the PCP, engaging relevant PACT staff to support nursing care, according to locally established informal and formal communication processes, including entering consultation requests to discipline-specific PACT members, if required for formal communications, assuming full accountability for the appropriateness of assignments made by the RNCM to clinical associates or administrative associates related to care management, care coordination, nursing services, and outcomes of care, entering orders in the VA EHR for tests per approved standardized RN care management protocols or PCP orders, ensuring the RNCM has same-day access for face-to-face and virtual care visits, using nursing expertise, evidence-based guidelines, standardized nursing protocols, and professionally accepted practice standards to promote patient engagement, self-care and…