36C24420R0048.pdf

PAGE 1 OF 106 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. DUNS: DUNS+4:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

36C24420R0048

6. SOLICITATION ISSUE

DATE

08-16-2020

L. Adam Bryson 215-823-4369 09-04-2020 16:00

00244 Department of Veterans Affairs Network Contracting Office 4

X

621399

$8 Million

N/A

X

00244

Department of Veterans Affairs Network Contracting Office 4

Austin Payment Center Department of Veterans Affairs

PO Box 149971 Austin TX 78714-9971

(877) 353-9791 (512) 460-5429

See CONTINUATION Page

This is an RFP for Multi-Specialty Nursing & Medical Staffing in support of the VA Pittsburgh Healthcare System.

The Government anticipates awarding an IDIQ contract IAW with FAR Parts 12, 16.5, 16.6, and 17.1. The Government intends to make multiple awards, but reserves the right to make a single award.

The Government intends to use a small business reserve in accordance with FAR 52.219-31 that will consist of at least one large business with multiple SDVOSB, VOSB, or small per labor category. The Government will then give preference when competing at the task order level starting at SDVOSBs and working up to large business if necessary, to ensure the task orders are fair and reasonable.

See CONTINUATION Page

X

36C24420R0048

Table of Contents

SECTION A

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

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

B.3 PERFORMANCE WORK STATEMENT

B.4 IT CONTRACT SECURITY

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (OCT

2018)

C.2 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (JAN 2020)

C.3 52.216-18 ORDERING (OCT 1995)

C.4 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.5 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.6 52.216-32 TASK-ORDER AND DELIVERY-ORDER OMBUDSMAN (SEP 2019) ...68

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

C.8 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.9 VAAR 852.215-70 SERVICE-DISABLED VETERAN-OWNED AND VETERAN-

OWNED SMALL BUSINESS EVALUATION FACTORS (OCT 2019)

C.10 VAAR 852.215-71 EVALUATION FACTOR COMMITMENTS (OCT 2019)

C.11 VAAR 852.219-9 VA SMALL BUSINESS SUBCONTRACTING PLAN MINIMUM

REQUIREMENTS (DEC 2009)

C.12 VAAR 852.219-71 VA MENTOR-PROTÉGÉ PROGRAM (DEC 2009)

C.13 VAAR 852.219-75 SUBCONTRACTING COMMITMENTS MONITORING AND

COMPLIANCE (JUL 2018)

C.14 VAAR 852.219-76 SUBCONTRACTING PLANS MONITORING AND

COMPLIANCE (JUL 2018)

C.15 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS

(NOV 2018)

C.16 VAAR 852.237-70 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE

(OCT 2019)

C.17 VAAR 852.270-1 REPRESENTATIVES OF CONTRACTING OFFICERS (JAN

2008)

C.18 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.19 MANDATORY WRITTEN DISCLOSURES

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS (OCT 2018)

E.2 52.212-2 EVALUATION—COMMERCIAL ITEMS (OCT 2014)

E.3 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (DEC 2019)

E.4 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.5 52.216-1 TYPE OF CONTRACT (APR 1984)

E.6 52.219-31 NOTICE OF SMALL BUSINESS RESERVE (MAR 2020)

E.7 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.8 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.9 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL ITEMS (DEC 2019)

E.10 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE

RESOLUTION (OCT 2018)

E.11 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018)

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 36C244

Department of Veterans Affairs

Network Contracting Office 4

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

[X] 52.232-33, Payment by Electronic Funds Transfer—System For Award Management, or

[] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Monthly 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.

Austin Payment Center

Department of Veterans Affairs

PO Box 149971

Austin TX 78714-9971

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

AMENDMENT NO DATE

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM

NUMBE

R

DESCRIPTION OF

SUPPLIES/SERVIC

ES

QUANTIT

Y

UNI

T UNIT PRICE AMOUNT

0.00

Registered Nurse Contract Period: Base POP Begin: 08-01-2020 POP End: 07-31-2025

0001AA

20,800.00 HR ________________

Registered Nurse, Operating Room (Circulator)-Surgery Contract Period: Base POP Begin: 08-01-2020

Quantity is only an estimate.

0001AB

10,400.00 HR ________________

Registered Nurse, Same Day Surgery (GI check in only)- Surgery Contract Period: Base POP Begin: 08-01-2020

0001AC

7,800.00 HR ________________ ________________

Registered Nurse, Surgical Clinics-Surgery Contract Period: Base POP Begin: 08-01-2020

0001AD

14,040.00 HR ________________

Registered Nurse, (Short Stay)-Surgery Contract Period: Base POP Begin: 08-01-2020

0001AE

Registered Nurse, Cardiac Catherization/EP Lab RN-Medicine Contract Period: Base POP Begin: 08-01-2020

0001AF

Registered Nurse, Hemodialysis RN-Medicine Contract Period: Base POP Begin: 08-01-2020

0001AG

28,080.00 HR ________________

Registered Nurse, Neurology RN-Medicine Contract Period: Base POP Begin: 08-01-2020

0001AH

14,040.00 HR ________________ ________________

Registered Nurse, Diabetes RN-Medicine Contract Period: Base POP Begin: 08-01-2020

0001AJ

Registered Nurse, Oncology/Chemotherapy RN-Medicine Contract Period: Base POP Begin: 08-01-2020

0001AK

Registered Nurse, Pulmonary/Bronchoscopy RN-Medicine Contract Period: Base POP Begin: 08-01-2020

0001AL

Registered Nurse, RN Charge Nurse-Medicine Contract Period: Base POP Begin: 08-01-2020

0001AM

70,200.00 HR ________________

Registered Nurse, RN- Med/Surg Contract Period: Base POP Begin: 08-01-2020

0001AN

15,600.00 HR ________________ ________________

Registered Nurse, RN - Primary Care UD Contract Period: Base POP Begin: 08-01-2020

0001AP

15,600.00 HR ________________

Registered Nurse, RN - Primary Care HJH Contract Period: Base POP Begin: 08-01-2020

Licensed Practical/Vocational Nurse Contract Period: Base

0002AA

Licensed Practical/Vocational Nurse, Surgical Clinics-Surgery Contract Period: Base POP Begin: 08-01-2020

0002AB

Licensed Practical/Vocational Nurse, Heinz Community Living Center (CLC) Contract Period: Base POP Begin: 08-01-2020

0002AC

Licensed Practical/Vocational Nurse, Specialty LPN-Medicine Contract Period: Base POP Begin: 08-01-2020

0002AD

Licensed Practical/Vocational Nurse, LPN -Primary Care UD Contract Period: Base POP Begin: 08-01-2020 POP End: 07-01-2025

0002AE

Licensed Practical/Vocational Nurse, LPN -Primary Care HJH Contract Period: Base POP Begin: 08-01-2020

0002AF

39,000.00 HR ________________

Licensed Practical/Vocational Nurse, Flu LPN- (VAPHS) Contract Period: Base POP Begin: 08-01-2020

70,200.00 HR ________________

Certified Nursing Assistant, Heinz Community Living Center-

(CLC)

Contract Period: Base POP Begin: 08-01-2020

CRNA-Certified Registered Nurse Anesthetist (Surgery) Contract Period: Base POP Begin: 08-01-2020

Nurse Practitioner Contract Period: Base

0005AA

Nurse Practitioner, Gastroenterology Nurse Practitioner (Medicine) Contract Period: Base POP Begin: 08-01-2020

0005AB

7,800.00 HR ________________

Nurse Practitioner, Nurse Practitioner (Primary Care) Contract Period: Base POP Begin: 08-01-2020

Monitor Watcher, Constant Observation Technician (COT), and Social Science Aid Contract Period: Base

0006AA

Monitor Watcher Contract Period: Base

0006AB

98,280.00 HR ________________

Constant Observation Technician (COT) at Heinz Community Living Center-CLC Contract Period: Base POP Begin: 08-01-2020

0006AC

Surgical Clinics- Surgery Contract Period: Base POP Begin: 08-01-2020

0006AD

Same Day Surgery (procedures)-Surgery Contract Period: Base POP Begin: 08-01-2020

0006AE

Tech: Medical Instrument Tech- Medicine Contract Period: Base POP Begin: 08-01-2020

0006AF

HCT-Medicine Contract Period: Base

GRAND TOTAL ________________

B.3 PERFORMANCE WORK STATEMENT

SCHEDULE OF SERVICES

The Contractor shall furnish all personnel to provide services necessary to perform onsite Multi-Specialty Registered Nurse (RN), Licensed Practical Nurse (LPN), Certified Nursing Assistant (CAN), Certified Registered Nurse Anesthetist (CRNA), Nurse Practitioner (NP), Monitor Watcher (MW), and Sitter Locum Services to eligible beneficiaries of the Department of Veterans Affairs; Veterans Affairs Health Care System (VAPHS), (hereinafter referred to as VAPHS). The contractor’s nursing services care shall cover the range of Multi-Specialty RN, LPN, CNA, CRNA, NP, MW, and Sitter Locum 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.

Place of Performance: Services shall be provided on site, VAPHS University Drive Campus, University Drive C, Pittsburgh, PA 15240 and H.J. Heinz Campus, 1015 Delafield Road, Pittsburgh, PA 15215.

The contract type: Multiple Award IDIQ

Pricing Instructions:

The offeror is instructed to edit the number of sub-clins to correspond with the number of personnel submitted for the contract line item number (CLIN). Other commercial health care Offerors shall identify by title/position or level of experience the personnel submitted. Also, renumber SUB-CLINs if adding or removing Personnel.

The offeror is instructed to include all other than price and cost information supporting the proposed price as directed in Instructions to Offerors addendum to 52.212-1 and/or Section D- Contract Documents, Exhibits, or attachments.

Performance Work Statement

1. GENERAL:

Services Provided: The Contractor shall be able to provide the VA Pittsburgh Healthcare System with Multi-Specialty RN, LPN, CNA, CRNA, NP, MW, and Sitter Services. Providers must be certified in their respective field according to VAPHS regulations in order to perform the requirements of these IDIQs which are expected to include a series of task orders to meet emergent needs of the medical center.

1.1. Place of Performance - Contractor shall furnish services On-site at VA Pittsburgh Healthcare System (VAPHS) UD Division, University Drive, Pittsburgh, PA 15240 and HJ Heinz Division, 1010 Delafield Road, Pittsburgh, PA 15215

1.2. Authority: Title 38 USC 8153

1.3. Policy/Handbooks:

1.3.1. VA Directive 1663: Health Care Resources Contracting - Buying https://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2

1.3.2. VHA Directive 2006-041 “Veterans’ Health Care Service Standards” (expired but still in effect pending revision) https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443

1.3.3. VHA Directive 2010-018 “Facility Infrastructure”

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2227

1.3.4. VHA Directive 1192 “Seasonal Influenza Prevention Program” https://www.publichealth.va.gov/docs/flu/VHA_Directive_1192_Sep

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

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

1.3.7. VHA Handbook 1100.19 Credentialing and Privileging -

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910

1.3.8. VHA Handbook 1400.01 Resident Supervision

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2847

1.3.9. VHA Handbook 1907.01 Health Information Management and Health Records: https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3088

1.3.10. Privacy Act of 1974 (5 U.S.C. 552a) as amended

http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm

1.3.11. VHA Handbook 5005-78 Part II Appendix G8 Physician Assistant Qualifications Standards https://vaww.va.gov/OHRM/Directives- Handbooks/Documents/5005-78.pdf

1.4. 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.

1.4.1. DEFINITIONS:

1.4.1.1. CONTRACTOR. A supplier or vendor awarded a Contract to provide specific https://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2 https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2227 https://www.publichealth.va.gov/docs/flu/VHA_Directive_1192_Sep https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2847 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3088 http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm https://vaww.va.gov/OHRM/Directives-Handbooks/Documents/5005-78.pdf https://vaww.va.gov/OHRM/Directives-Handbooks/Documents/5005-78.pdf supplies or services to the government. The term used in this Contract refers to the prime Contractor.

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

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

1.4.1.4. CREDENTIALING. Credentialing is the systematic process of screening and evaluating qualification and other credentials, including licensure, required education, relevant training and experience and current competence and health status.

1.4.1.5. FULL TIME EQUIVALENT. VA’s definition for full time- working the equivalent of 80 hours every two weeks, 2080 hours per year. In calculating FTE, any hours not worked on national holidays shall not be included.

1.4.1.6. MEDICAL EMERGENCY.a sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably result in: Permanently placing a patient's health in jeopardy, causing other serious medical consequences, causing impairments to body functions, or causing serious or permanent dysfunction of any body-organ or part.

1.4.1.7. NATIONAL PROVIDER IDENTIFIER.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).

1.4.1.8. NON-CONTRACT PROVIDER. any person, organization, agency, or entity that is not directly or indirectly employed by the Contractor or any of its subcontractors

1.4.1.9. PRIVILEGING (CLINICAL PRIVILEGING). Privileging is the process by which a practitioner, licensed for 8independent practice; e.g., without supervision, direction, required sponsor, preceptor, mandatory collaboration, etc.; is permitted by law and the facility to practice independently, to provide specific medical or other patient care services within the scope of the individual’s license, based upon the individual’s clinical competence as determined by peer references, professional experience, health status, education, training and licensure. Clinical privileges must be facility-specific and provider-specific.

1.4.1.10. QUALITY ASSURANCE. The government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.

1.4.1.11. QUALITY ASSURANCE SURVEILLANCE PLAN (QASP). An

organized written document specifying the surveillance methodology to be used for surveillance of Contractor performance.

1.4.1.12. VETERANS’ HEALTH ADMINISTRATION. The central office for administration of the VA medical centers through throughout the United States. The VHA is located in Washington, D.C.

1.4.1.13. VETERANS INTEGRATED SERVICES NETWORK. The regional

oversight for the VA medical centers.

1.4.1.14. 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.

1.4.2. ACRONYMS:

1.4.2.1. ACLS: Advanced Cardiac Life Support

1.4.2.2. AOD: Admitting Officer of the Day

1.4.2.3. BLS: Basic Life Support

1.4.2.4. CCNE: Commission on Collegiate Nursing Education:

www.aacn.nche.edu/accreditation

1.4.2.5. CDC: Centers for Disease Control and Prevention

1.4.2.6. CDR: Contract Discrepancy Report

1.4.2.7. CEU: Certified Education Unit

1.4.2.8. CME: Continuing Medical Education

1.4.2.9. CMS: Centers for Medicare and Medicaid Services

1.4.2.10. CO: Contracting Officer

1.4.2.11. (COR): Contracting Officer’s Representative

1.4.2.12. COS: Chief of Staff

1.4.2.13. CPARS: Contractor Performance Assessment Reporting System

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

http://www.aacn.nche.edu/accreditation http://www.aacn.nche.edu/accreditation

1.4.2.15. DEA: Drug Enforcement Agency

1.4.2.16. FSMB: Federation of State Medical Boards

1.4.2.17. (FTE): Full Time Equivalent

1.4.2.18. HHS: Department of Health and Human Services

1.4.2.19. HIPAA: Health Insurance Portability and Accountability Act

1.4.2.20. HR: Human Resources

1.4.2.21. ISO: Information Security Officer

1.4.2.22. MOD: Medical Officer of the Day

1.4.2.23. NCCPA: National Commission on Certification of Physician Assistants

1.4.2.24. NPI: National Provider Identifier

1.4.2.25. NP: Nurse Practitioner

1.4.2.26. NPPES: National Plan and Provider Enumeration System

1.4.2.27. PA: Physician Assistant

1.4.2.28. PANCE: Physician Assistant National Certifying Examination

1.4.2.29. PALS: Pediatric Advanced Life Support

1.4.2.30. POP: Period of Performance

1.4.2.31. PPD: Purified Protein Derivative

1.4.2.32. PWS: Performance Work Statement

1.4.2.33. QA/QI: Quality Assurance/Quality Improvement

1.4.2.34. QM/PI: Quality Management/Performance Improvement

1.4.2.35. QASP: Quality Assurance Surveillance Plan

1.4.2.36. VAPHS: Veterans Affairs Pittsburgh Healthcare System Unless identified with the name of a different VA medical Center, for purposes of this contract, this term shall mean the VAPHS

1.4.2.37. VHA: Veterans’ Health Administration

1.4.2.38. VISN: Veterans Integrated Services Network

1.4.2.39. VISTA: Veterans Integrated Systems Technology Architecture

2. QUALIFICATIONS:

2.1. Staff/Facility

2.1.1. Registered Nurse (RN)

2.1.1.1. Qualifications: Each RN shall:

2.1.1.2. Every RN shall Hold a Diploma, Associates Degree (AD) or Bachelor of Science in Nursing (BSN) degree from an National League for Nurses (NLN) accredited program, college or university and hold a current license, (with no limitations, stipulations, or pending adverse actions) to practice as a Registered Nurse (RN) in any State. A BSN is preferred. All licenses must be unencumbered and remain in effect during contract employment.

2.1.1.3. Have been actively practicing as a registered nurse in an acute or long-term setting for at least the last two years.

2.1.1.4. Be capable of providing complex and comprehensive nursing care for adult medical and surgical patients.

2.1.1.5. Have and maintain current Basic Cardiac Life Support (BCLS) and Advanced Cardiac Life Support (ACLS) certification.

2.1.1.6. Have no health or physical disability restrictions that interfere with the performance of assigned duties.

2.1.1.7. Have documented training and skills verification.

2.1.1.8. If a nurse’s NCCPA certification is suspended, revoked or expires, the nurse must be removed from the occupation which may result in termination of employment

2.1.1.1.1. Hemodialysis RN- Have been actively practicing as a registered nurse in a Hemodialysis setting for the past two years. The Dialysis unit is an outpatient chronic dialysis facility providing hemodialysis. Staff also provides inpatient dialysis in the ICUs. The RN is accountable when assigned as a primary nurse for a defined group of patients for the entire episode of care. As the assigned caregiver for a specific shift, the RN is accountable for the care of defined groups of patients on that shift.

2.1.1.1.2. Cardiac Catherization/ EP Lab - Registered Nurse (RN)-. Be capable of providing complex and comprehensive nursing care for adult medical and surgical patients.

2.1.1.1.3. Neurology RN-

Licensed Practical Nurse (LPN)

2.1.2. Qualifications: Each LPN shall:

2.1.2.1. Possess a valid, current license (with no limitations, stipulations, or pending adverse actions) to practice nursing as an LPN and be licensed to practice in the commonwealth of Pennsylvania. All licenses must be unencumbered and remain in effect during contract employment.

2.1.2.2. Have been actively practicing as a licensed practical nurse for at least one year within the past three years.

2.1.2.3. Be capable of providing nursing care for adult medical and surgical patients.

2.1.2.4. Have and maintain current Basic Cardiac Life Support (BCLS) certification.

2.1.2.5. Have no health or physical disability restrictions that interfere with the performance of assigned duties.

2.1.2.6. Have documented training and skills verification.

Certified Nursing Assistant (C.NA)

2.1.3. Qualifications: Each C.NA shall:

2.1.3.1. Be a certified nursing assistant in the commonwealth of Pennsylvania.

2.1.3.2. Be trained and experienced in hospital nursing.

2.1.3.3. Have at least one-year experience working as a CNA.

2.1.3.4. Be capable of providing nursing care for adult medical and surgical patients.

2.1.3.5. Have and maintain current Basic Cardiac Life Support (BCLS) certification.

2.1.3.6. Have no health or physical disability restrictions that interfere with the performance of assigned duties.

2.1.3.7. Have documented training and skills verification.

Certified Registered Nurse Anesthetist-CRNA

2.1.4. Qualifications: Each CRNA shall:\

2.1.4.1. Graduate of an approved school of nursing and hold active current state registration as a graduate professional nurse in a state, territory, or commonwealth of the United States or District of Columbia.

2.1.4.2. Graduate from a nurse anesthesia education program accredited by the American Association of Nurse Anesthetists (AANA) Council on Accreditation of Nurse Anesthesia Education Program.

2.1.4.3. Successfully complete the certification examination administered by

NBCRNA.

2.1.4.4. Comply with criteria for biennial recertification as defined by the NBCRNA.

This criterion includes evidence of a current registered nurse license.

2.1.4.5. Entry Level Grade Nurse II is based on the level of education and experience in the CRNA profession. The Grade II CRNA will:

2.1.4.5.1. Demonstrate knowledge, skills, and abilities at the minimum skill set expected of an Entry Level Nurse.

2.1.4.5.2. Demonstrate the ability to translate the principles of professional nursing practice in the care of assigned patients in order to provide appropriate care.

2.1.4.5.3. Demonstrate the ability to do a pre-anesthetic patient history and physical, which includes collecting pre-operative consults and data.

2.1.4.5.4. Demonstrate the ability to formulate an anesthetic plan and describe the anesthetic risks, benefits, and options to the patient.

2.1.4.5.5. Demonstrate the ability to administer inhalational, regional, intravenous, local, and topical anesthetics and to detect unfavorable reactions in order to continuously evaluate the patient’s physical status.

2.1.4.5.6. Demonstrate the ability to respond to emergency situations by providing airway management, administration of emergency fluids and drugs, and using appropriate resuscitation procedures for patient care.

2.1.4.5.7. Demonstrate the ability to provide patient care that is abreast of changing concepts and advancements in the profession.

2.1.4.5.8. Demonstrate the ability to work effectively in an interdisciplinary environment for the improvement of services for patient care.

2.1.4.5.9. Demonstrate the ability to practice nurse anesthesia with colleagues and peers utilizing a collaborative team concept of care.

2.1.4.5.10. Full performance is Nurse III. This CRNA will typically have 2 years of progressively responsible experience in the administration of anesthesia which includes demonstrated accomplishments in upgrading services to patients or involves program responsibilities.

Experience and Education. In addition to meeting the requirements for Entry Level, the CRNA has had progressively responsible experience in the administration of anesthetics as indicated in the knowledge, skills and abilities listed below. These individuals must demonstrate the ability to participate in a program for nurse anesthesia care and demonstrate knowledge of anesthetizing locations, methods, equipment and procedures.

At this level, the CRNA has experience in the administration of anesthetics that has demonstrated the nurse anesthetist’s ability to participate in team programs that are technically challenging and/or complicated. Typically candidates can demonstrate the knowledge, skills and abilities of Full Performance Level within 2 years from entering the occupation. VA HANDBOOK 5005/37,PART II ,App G7

2.1.4.6. CRNAs are an advanced practice nurse who utilizes specialized clinical skills and education to administer anesthesia care throughout the medical center.

The practice of nurse anesthesia is a recognized specialty within the profession of nursing. As independently licensed health professionals, CRNAs are responsible and accountable for their practice. The scope of practice includes direct patient care, administration, educational, and research activities.

2.1.4.7. CRNAs practice in collaboration with other health care professionals in a collegial relationship to achieve common goals for care, safety, and welfare of patients. In their position, CRNAs provide anesthetic services within four general categories:

2.1.4.7.1. Pre-anesthesia preparation and evaluation that includes a patient history, physical examination, and the collection of preoperative consults and data, from which an appropriate anesthetic plan can be formulated.

2.1.4.7.2. Anesthesia induction, maintenance and emergence.

2.1.4.7.3. Post anesthesia care

2.1.4.7.4. Peri-anesthetic and clinical support functions outside the OR suite.

Nurse Practitioner

2.1.5. Qualifications: Each Nurse Practitioner shall:

2.1.5.1. U.S. citizenship. Non-citizens may be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.

2.1.5.2. Graduate of a school of professional nursing approved by the appropriate State- accrediting agency and 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). In cases of graduates of foreign schools of professional nursing, possession of current, full, active and unrestricted registration will meet the requirement of graduation from an approved school of professional nursing.

2.1.5.3. The completion of coursework equivalent to a nursing degree in an MSN Bridge Program that qualifies for professional nursing registration constitutes the completion of an approved course of study of professional nursing. Students should submit the certificate of professional nursing to sit for the NCLEX to the VA along with a copy of the MSN transcript.

(Reference VA Handbook 5005, Appendix G6)

2.1.5.4. Current, full, active, and unrestricted registration as a graduate professional nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or the District of Columbia.

Health Care Technician (HCT)

2.1.6. Qualifications: Each HCT shall:

2.1.6.1. Be a certified nursing assistant or possess comparable certification in a related healthcare field including medical assistant, paramedic or emergency medical technician.

2.1.6.2. Have documented training and skills verification.

2.1.6.3. Be trained and experienced in patient care.

2.1.6.4. Have at least one-year experience working in direct patient care; ambulatory or emergency care preferred.

2.1.6.5. Be capable of providing nursing care for adult medical and surgical patients.

2.1.6.6. Have and maintain current Basic Life Support (BLS) certification.

2.1.6.7. Have no health or physical disability restrictions that interfere with the performance of assigned duties.

2.1.6.7.1. Gastro-intestinal (GI) Technician

Monitor Watcher

2.1.7. Qualifications: Each Monitor Watcher shall:

2.1.7.1. Specialized Experience: You must have 3 months of general experience OR,

2.1.7.2. Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have a high school diploma or equivalent from an accredited institution

Constant Observation Technician (COT)/Sitters

2.1.8. Qualifications: Each COT/Sitter shall:

2.1.8.1. No education, experience or certification requirements for these positions. Contractor Agency sitters will be monitored by staff Registered Nurses.

2.1.8.2. SKILLS, KNOWLEDGE, AND ABILITIES

2.1.8.2.1. Excellent verbal, written and interpersonal

communication skills

2.1.8.2.2. Demonstrates an independent work initiative, sound judgment and attention to detail

2.1.8.2.3. Ability to organize workload and use effective

time management

2.1.8.2.4. Ability to work effectively in a team environment

2.1.8.2.5. Basic knowledge of medical terminology

2.1.8.2.6. Demonstrate sensitivity to cultural diversity, race, gender, and others individual differences in the workplace

2.2. If one of the Multi-Specialty RN, LPN, CNA, CRNA, NP, MW, and Sitter certification is suspended, revoked or expires, the individual must be removed from the occupation which may result in termination of employment for the services on site in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and the Veterans Affairs Health Care System (VAPHS).

2.3. Credentialing and Privileging –Credentialing and privileging is to be done in accordance with the provisions of VHA Handbook 1100.19 referenced above. The Contractor is responsible to ensure that proposed employee(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any contractor’s employee(s) prior to obtaining approval by VAPHS Professional Standards Board, Medical Executive Board and Medical Center Director.

2.3.1. If a contractor’s employee(s) is not credentialed and privileged or has credentials/ privileges suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government.

2.4. Technical Proficiency - Contractor’s employee (s) 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 CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed.

Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contractor’s employee(s) and contractor’s employee(s) shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior.

2.5. Continuing Medical Education (CME)/ Certified Education Unit (CEU) Requirements:

Contractor shall provide the COR copies of current CMEs as required or requested by the VAPHS. Contractor’s employee(s) registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current.

Contractor shall report CME hours to the credentials office for tracking. These documents are required for both privileging and re- privileging. Failure to provide shall result in loss of privileges for contractor’s employee(s).

2.6. Training (ACLS, BLS, CPRS 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 employee(s) as required by the VA.

Other training may become required. VA will communicate any changes to the training requirement to the contractor:

Training Frequency (once a year, etc.)

Annual Hours

Active Threat Training One Time Training 1.00 Blood Administration:

Complications

One Time Training 1.00

Blood Administration:

Administration ( all contract employees who administer blood components)

One Time Training 2.00

Government Ethics Bi-Annual 1.00 VA Privacy and Information Security Awareness and Rules of Behavior

Annual 1.00

VHA Privacy and HIPAA Focused Training

Annual 1.00

ACLS/BLS Bi-Annual 1.00 Patient Safety Annual 1.00 Patient Rights Annual .50 Patient Abuse Annual .50 Prevention/Management of Disruptive Behavior/Violence Prevention Level I

Bi-Annual 2.00

Suicide Prevention: Suicide Risk Management Training for Clinicians

One Time Training 4.50

SUX Infection Control and Blood Borne Pathogens

Annual 1.00

CPRS One Time Training 1.00 VISTA Imaging One Time Training 1.00 List other Training per local facility

One Time Training 1.00

2.7. Standard Personnel Testing (PPD, etc.): Contractor shall provide proof of the following tests for employees 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.

2.7.1. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative Tuberculosis Skin Test (TST) or interferon-gamma release assays (IGRA) for all Contractor’s employee (s) {This is applicable to all health care workers}. A negative chest radiographic report for active tuberculosis shall be provided in cases of positive TST or IGRA results. The TST or IGRA testing shall be repeated annually.

2.7.2. MEASLES, MUMPS, & RUBELLA TESTING: Contractors shall provide proof of immunity for all Contractor employees {This is applicable to all health care workers}.

2.7.3. VARICELLA: Contractors shall provide proof of immunity for all Contractor employees {This is applicable to all health care workers}.

2.7.3.1. ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of Tdap vaccination for all Contractor employees {This is applicable to all health care workers}.

2.7.3.2. INFLUENZA: Contractors shall provide proof that all Contractor employees have received the annual Influenza vaccine unless it is contraindicated. If the Contractor employee has a medical contraindication to the vaccine, they shall be required to wear a mask during the Influenza season

. {This is applicable to all health care workers}.

2.7.3.3. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO

BLOODBORNE PATHOGENS: Contractor shall provide evidence of completing and passing generic self-study blood-borne pathogen training for all Contractor’s employee {This is applicable to all health care workers};

provide their own Hepatitis B vaccination series and hepatitis B surface antigen test results following the hepatitis B vaccination series; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident.

2.7.3.4. The VAPHS 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.

2.7.4. 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). The Contractor shall have or obtain appropriate NPI and if pertinent the Taxonomy Code confirmation notice issued by the Centers for Medicare and Medicaid Services (CMS) National Plan and Provider Enumeration System (NPPES) be provided to the Contracting Officer with the proposal.

2.7.5. DEA (as required) - Contractor shall provide copy of current DEA certificate.

2.7.6. Conflict of Interest: The Contractor and all contractor’s employee(s) are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of proposal and during the entirety of contract performance. At the time of proposal, 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.

2.7.7. Citizenship related Requirements:

2.7.7.1. 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 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf

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;

2.7.7.2. 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.\

2.7.7.3. 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.

2.7.7.4. 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.

2.7.7.5. The Contractor agrees to obtain a similar certification from its subcontractors. The certification shall be made as part of the offerors response to the RFP using the subject attachment in Section D of the solicitation document.

2.7.8. 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.

2.7.8.1. 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 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 http://oig.hhs.gov/exclusions/index.asp

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.

2.7.8.2. By submitting their proposal, 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.

2.8. Clinical/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.

Clinical/Professional performance monitoring and review of all clinical personnel covered by this contract for quality purposes will be provided by the VAPHS COS and/or the Chief of the Service or his designee. A clinical COR maybe 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.

2.9. Non-Personal Healthcare Services: The parties agree that the Contractor and all contractor’s specialties shall not be considered VA employees for any purpose.

2.10. 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.

2.11. Inherent Government Functions: Contractor 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.

2.12. No Employee status: The Contractor shall be responsible for protecting Contractor’s 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:

2.12.1. Workers’ compensation

2.12.2. Professional liability insurance

2.12.3. Health examinations

2.12.4. Income tax withholding, and

2.12.5. Social security payments.

2.13. Tort Liability: The Federal Tort Claims Act does not cover Contractors. When a Contractor has 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 (action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.14. Addition Required Qualifications:

2.14.1. In addition to the immunizations mentioned in section 2.1.2, the contractor will also include, at their expense, in the orientation profile file for each employee, the following information from the VA Orientation Profile Checklist. A copy of the current checklist will be provided to the contractor. This list is determined by the Service Line Representative and changes from time to time. The CO or COR will notify the contractor of changes via e-mail.

Name:

Position:

Projected/Requested work area E-Mail of Credential Review Completed:

Background Check (within 90 days) Physical (within 90 days) include VA provided template PPD (2-step within 90 days) Chest X-Ray & Questionnaire for Hx positive PPDCPR Card (American Red Cross, American Heart Association, or the Military Network) Flu or Declination with copy of Appendix B (attached at the bottom of this document) Hepatitis B or Declination MMR or Declination Rubella or Declination Varicella or Declination Hepatitis C or Declination Tetanus (within 10 years) Facility Staffing Guide (FSG) OSHA Exam Minimum work/Training Requirement Resume

2.15. Key Personnel:

2.15.1. The VA Full Time Equivalency Employee (FTEE): FTEE is defined by VA as a minimum of 80 hours every two weeks and does not include holidays.

2.15.2. Contract employees will be certified in their field according to VAPHS regulations in order to perform the requirements of this IDIQ which is expected to include a series of task orders to meet emergent needs of the medical center.

2.15.3. The Contractor shall be responsible for providing coverage to the VA during periods of vacancies of the Contractor’s personnel due to sick leave, personal leave, vacations and additional coverage as required. In the event a scheduled contractor is unable to complete an assigned shift, the contractor shall provide replacement personnel within 2 hours and notify the Contracting Office Representative (COR) at the VAPHS immediately of the schedule change.

2.15.4. Personnel Substitutions: During the first ninety (90) calendar days of performance, the Contractor shall make NO substitutions of personnel unless the substitution is necessitated by illness, death or termination of employment. The Contractor shall notify the CO, in writing, within fifteen (15) calendar day (s) after the occurrence of any of these events and provide the information required below. After 90 calendar days, the Contractor shall submit the information required below to the CO at least fifteen (15) calendar days prior to making any permanent substitutions.

2.15.5. The Contractor shall provide a detailed explanation of the circumstances…