36C24421Q1162.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. 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 81

36C24421Q1162 08-27-2021

Robert Neal, robert.neal2@va.gov 412-822-3779 09-10-2021

13:00 EDT

00244 Department of Veterans Affairs Network Contracting Office 4

1010 Delafield Road Pittsburgh PA 15240

X 100

X

Y

621111

$12 Million

N/A

Lebanon VA Medical Center

1700 South Lincoln Avenue

Lebanon PA 17042-7529

00244

Department of Veterans Affairs Network Contracting Office 4

TBD

Austin Payment Center Department of Veterans Affairs

PO Box 149971 Austin TX 78714-9971

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

See CONTINUATION Page

This procurement is being completed in accordance with FAR 13.5. Any reference to FAR 15 is unintended and the vendor should seek clarification from the Contracting Officer (CO).

A 5-Year Indefinite Delivery Indefinite Quantity Firm-Fixed Price contract will result from this solicitation.

Period of performance is five (5) years from effective date 10/01/2021. Individual Task Orders will be issued for each annual period of service, contingent upon availability of VA Funding.

All questions pertaining to this solicitation shall be emailed to robert.neal2@va.gov no later than 9/3/21.

$0.00 See CONTINUATION Page

Determined at task order level

X 1

Mark Knorr Contracting Officer

36C24421Q1162

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 PERFORMANCE WORK STATEMENT (PWS)

B.3 PRICE/COST SCHEDULE

ITEM INFORMATION

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (OCT 2018) . 32

C.2 52.216-18 ORDERING (AUG 2020)

C.3 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.4 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.5 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.6 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.7 VAAR 852.212-70 PROVISIONS AND CLAUSES APPLICABLE TO VA ACQUISITION OF

COMMERCIAL ITEMS (APR 2020)

C.8 VAAR 852.219-74 LIMITATIONS ON SUBCONTRACTING—MONITORING AND

COMPLIANCE (JUL 2018)

C.9 VAAR 852.219-75 SUBCONTRACTING COMMITMENTS MONITORING AND

COMPLIANCE (JUL 2018)

C.10 VAAR 852.237-75 KEY PERSONNEL (OCT 2019)

C.11 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.12 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (JAN 2021) (JUL 2020)

(DEVIATION)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS (JUL 2021)

E.2 ADDENDUM to FAR 52.212-1 INSTRUCTIONS TO OFFERORS—

COMMERCIAL ITEMS

E.3 52.212-2 EVALUATION—COMMERCIAL ITEMS (OCT 2014)

E.4 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL

ITEMS (FEB 2021) (JUL 2020) (DEVIATION)

E.5 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS AND

VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (OCT 2020)

E.6 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.7 52.216-1 TYPE OF CONTRACT (APR 1984)

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

E.9 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998)80

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: Too be determined.

b. GOVERNMENT: Contract Specialist - Robert Neal 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

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 PERFORMANCE WORK STATEMENT (PWS)

SECTION 1

DESCRIPTION OF SERVICES: Thoracic Surgery Services (Non-personal Services)

1. SCOPE AND OBJECTIVES:

a. The Contractor shall provide Thoracic Surgery services for the Lebanon Veterans Affairs Medical Center (Lebanon VAMC) located at 1700 South Lincoln Avenue, Lebanon, PA 17042. Performance shall be according to the requirements contained in this Performance Work Statement (PWS).

b. Services shall be provided at the Lebanon VA Medical Center location named above, and/or local hospital where contracted provider is credentialed. The Thoracic Surgeon/s will determine the appropriateness of location of treatment based on Veteran condition. (1. a). Changes to the schedule will be communicated to the Contractor ahead of time.

c. Evidence of completion of required certification, required training, current competencies and background investigations must be validated for all Contractor personnel referred to perform services under the Contract prior to providing direct patient care.

d. The Contractor shall not have any personnel report to duty until written notification is received from the Contracting Officer (CO) advising that the candidate(s) presented has met all requirements for Contract performance.

e. Performance shall be according to the requirements contained in this Performance Work Statement (PWS).

f. The resulting Contract is a non-personal health care services contract under which the Contractor is an independent contractor. The Parties agree that the Contractor, Contract staff, agents and sub-contractors shall not be considered VA employees for any purpose.

2. AUTHORITY: Under the authority of Public Law 104-262 and 38 United States Code

(U.S.C.) 8153, the contractor agrees to provide Health Care Resources in accordance with the terms and conditions stated herein, to furnish to and at the Department of Veterans Affairs Medical Center, the services and prices specified in Section B, see Price/Cost Schedule of the Contract.

3. POLICY AND REGULATIONS: The Contractor is required to meet Veterans Health Administration (VHA) performance and quality criteria and standards including, but not limited to, customer satisfaction, prevention index, chronic disease index and clinical guidelines. Performance and quality standards may change during the course of the contract. New or revised quality/performance criteria or standards will be provided to the Contractor before implementation date. Compliance with mandated performance is required as a condition of this contract. Contractor shall comply with all relevant Veterans Affairs (VA) policies and procedures, including those related to quality, patient safety and performance, including all policies referenced throughout the Contract and the following:

a. Medical Staff Bylaws, Rules and Regulations, see attached.

4. PERIOD OF PERFORMANCE (POP): The term of this contract is a straight 5-year indefinite delivery indefinite quantity (IDIQ) contract beginning 10/01/2021 thru 09/30/2026, or until the end of the Veterans Affairs (VA) Federal Supply Schedule (FSS) Contract period, whichever occurs earlier.

5. DESCRIPTION OF SERVICES:

Contractor shall Furnish Thoracic Surgery services to include:

1. On-call services for after hour coverage (4:30pm to 8:00am) weekdays (when staff Surgeon/s is NOT on call – normally Wednesday and scheduled leave) and 24-hour coverage for all weekends, and Federal Holidays.

If an emergency Thoracic event arises as identified by a staff physician; phone contact will be made within 15 minutes to the contract Thoracic Surgeon/s on-call. It is required that the contract provider be located within 35 miles of the Lebanon VAMC and on site within 60 minutes of receipt of the phone call. Upon stabilization of the patient and assessment of further needed intervention, the contract provider may decide to transfer the patient to a Non-VA facility for provision of an advanced level of patient care.

2. If Available, provide up to 20 days per year in-house service to provide Scheduled Thoracic Clinic Services (Consult Visits, Post-Operative Visits), and/or Surgical/Operative Services for the Lebanon VA Medical Center (during the hours of 7am to 3:30pm).

a. The contractor agrees to identify a lead physician who shall be the point of contact for any clinical issues arising from this contract. The provider named as the lead Thoracic Surgeon/s remains in that role for the term of the contract. In exceptional circumstances, the lead position may change once within the contract period. The contractor may request appointing a different lead physician with a 30-day notice.

The lead Thoracic Surgeon/s, or designee, must be available for electronic contact for two (2) full workdays per week, except when on vacation in which case a substitute is named.

b. Reporting shall be to the Associate Chief of Staff (ACOS) of Surgery, Lebanon VAMC. The contractor agrees to identify a lead physician who shall be responsible for administration of all services. The lead Thoracic Surgeon/s is also responsible for the oversight and implementation of VHA policies relating to surgical services, including participation in, and implementation of, quality improvement initiatives, and/or issues. The lead Thoracic Surgeon/s may be required to attend meetings where Surgery issues are discussed, i.e. Surgical Case Committee, and Morbidity and Mortality Conference.

c. Services shall be performed on-site at the Department of Veterans Affairs (VA)

Medical Center, Lebanon, Pennsylvania and/or local hospital where contracted provider is credentialed. Facility choice will be determined by the Thoracic Surgeon/s on-call based on the condition of the patient.

d. Administrative and Clinical Documentation: The Thoracic Surgeon/s shall perform the following with conjunction of (f) above:

i. Dictate or keyboard for entry into the electronic medical record a patient’s chief complaints, observations and findings, assessment, and plan/recommendations in a clear and understandable manner at the end of each patient encounter.

ii. Electronically enter all doctor’s orders, consultation referrals, and requests for x-rays and lab work using CPRS.

iii. Telephone significant positive reports, at the time identified, to the referring provider.

iv. Informed Consent: Contract Thoracic Surgeon/s shall explain procedure and risks/benefits to the patient/guardian and obtain informed consent from patient/guardian in accordance with VAMC polices. Complete IMED consent in CPRS for documentation of informed consent discussion and electronically sign.

v. Immediately before starting any procedure, the Thoracic Surgeon/s will accurately identify the patient and the procedure to be performed as per the relevant SOPs and MCMs and complete the “Day of Surgery” evaluation in

CPRS.

vi. Encounter Forms: Properly complete the electronic VA encounter form on each patient seen; listing diagnosis for the visit and all procedures performed based on the current VA requirements along with identification of service-connection for treatment rendered.

e. Contingent upon clinical privileges granted by the VAMC, the contract Thoracic Surgeon/s shall perform surgical procedures and additional procedures as required.

f. Instrumentation and supplies; VA will supply appropriate instrumentation for all procedures and ancillary support staff commensurate with types of patients scheduled.

6. POLICY AND REGULATIONS:

a. This contract to provide health care resources is granted pursuant to 38 U.S.C. 8153.

The intent of this document is to establish a contract with the terms, conditions, provisions, and specifications governing the services to be provided by the contractor for the Lebanon Department of Veterans Affairs Medical Center (Lebanon VAMC) located at 1700 S. Lincoln Avenue, Lebanon, PA.

b. Contractor care shall cover the range of services normally provided in a similar civilian health care facility, in accordance with the specifications and requirements contained herein.

c. Contractor should thoroughly review the specifications and become familiar with the areas of coverage in order to become fully aware of the scope of requirements.

Failure to understand the contract requirements shall not relieve the Contractor from performing in accordance with the meaning and intent of the specifications. Costs not incorporated into the Contractor’s price will NOT be reimbursed by the Government.

d. Prior to providing services, the contractor will have employees comply with all mandatory education requirements stipulated by the Department of Veterans Affairs.

New providers must complete ‘New Provider Orientation’. Annual education will include, but is not limited to, VHA Privacy Policy, VHA Information Security Training (Cyber Security), and Ethics Training. All providers must have current BLS & ACLS certification. (QASP Identifier #8)

e. The services provided by the contractor shall be performed within the VA policies and procedures, including but not limited to: informed consent, conscious sedation, utilization review, infection control and the use of barrier protection; and the regulations of the Medical Staff Bylaws and the Resident Supervision Handbook of the VA Medical Center, and OSHA requirements. The services provided will include daily assigned duties, equipment care, maintenance, and cleaning as per the relevant SOPs, MCMs, and minutes of the monthly staff meetings. (QASP Identifier #10)

f. The contractor agrees to adhere to the timeliness standard for medical record completion and signature on all records/notes as indicated in the Medical Staff Bylaws (including VISTA documentation). (QASP Identifier #1)

g. Failure to meet the cancellation performance standard will result in a 5% reduction in payment of hourly rate, for a minimum of 3 months. In the event that the cancellation standard is not met, the Lebanon VAMC shall have the right to determine such failure as non-compliance and can use such non-compliance as grounds for termination of the service of the contract. (QASP Identifier #11)

h. Contractor and Lebanon VAMC shall review the performance of the service within this contract on no less than a quarterly basis, including the appropriateness of each of the providers to function effectively and efficiently at the LVAMC. The parties agree to collaboratively resolve any operational issues that are identified and presented to each other. In the event that Lebanon VAMC determines that the contractor is not meeting any of its obligations, with the exception of the 5% cancellation rate, the Lebanon VAMC shall notify contractor in writing and identify such deficiency and have 30 days to respond and cure such deficiency. (QASP Identifier #9)

i. Relevant directives/publications:

i. The care provided by the Contractor should be patient centered, continuous, accessible, coordinated, and consistent with VA standards, including the thirteen service standards detailed in VHA (Veterans Health Administration) Directive 2006-041, “Veterans Health Care Service Standards,” dated 27 June 2006 (or subsequent revisions thereto). (2006-041 expired on June 30, 2011 but will still be effective until a revision or rescission is published and/or subsequent revisions thereto.

http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443

ii. 42 CFR Part 482 Conditions of Participation http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr;sid=aceca18b9fbe0110ffa37c08075c2b0e;rgn=div5;view=text;nod e=42%3A5.0.1.1.1;idno=42;cc=ecfr

iii. VA Directive 1663: Health Care Resources Contracting - Buying http://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=347

iv. VHA Record Control Schedule 10-1 http://www1.va.gov/vhapublications/rcs10/rcs10-1.pdf

v. "Patient Medical Records-VA" (24VA10A7). 24VA10A7 http://vaww.vhaco.va.gov/privacy/SystemofRecords.htm.

vi. VHA Directive 2009-019, “Ordering and Reporting Test Results,” www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1864

vii. VHA Directive 2010-027 "VHA Outpatient Scheduling Processes and

Procedures” (Note: Lebanon VAMC does not utilize the Electronic Wait List

(EWL))

http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2252

viii. VHA Directive 2011-012 “Medication Reconciliation” http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2390

ix. VHA Handbook 1003.4, "VHA Patient Advocacy Program," http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1303.

x. VHA Handbook 1100.17: National Practitioner Data Bank Reports – http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135

xi. VHA Handbook 1100.18 Reporting and Responding to State Licensing

Boards http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443 http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443 http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443 http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr;sid=aceca18b9fbe0110ffa37c08075c2b0e;rgn=div5;view=text;node=42%3A5.0.1.1.1;idno=42;cc=ecfr http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr;sid=aceca18b9fbe0110ffa37c08075c2b0e;rgn=div5;view=text;node=42%3A5.0.1.1.1;idno=42;cc=ecfr http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr;sid=aceca18b9fbe0110ffa37c08075c2b0e;rgn=div5;view=text;node=42%3A5.0.1.1.1;idno=42;cc=ecfr http://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=347 http://www1.va.gov/vhapublications/rcs10/rcs10-1.pdf http://vaww.vhaco.va.gov/privacy/SystemofRecords.htm http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1864 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2252 http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2390 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1303 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364

xii. VHA Handbook 1100.19 Credentialing and Privileging – http://www.va.gov/VHAPUBLICATIONS/ViewPublication.asp?pub_ID=2910

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

j. The Joint Commission (TJC), (or equivalent), compliance: The assigned physician(s) shall possess the required qualification/elements to be privileged and/or credentialed in accordance with the ordering activity’s guidelines and procedures. Contractor’s credentials/qualifications are subject to review and approval by the Head or designee of the ordering activity. These qualifications at a minimum will be based on The Joint Commission (TJC) quality standards for training, education, and competency. (QASP Identifier #5)

7. CONTRACTOR REQUIREMENTS:

a. The Contractor will be responsible to ensure that Contractor personnel (service provider) providing work on this contract are fully trained and completely competent to perform the required work. All certifications need to be current through the term of the contract, including VA required computer access to Outlook E-Mail, Public Key Infrastructure (PKI), Omnicells, CPRS, ARK-CIS. If renewal is required it will be the contractor’s responsibility to insure that contracted personnel are assigned duties at sufficiently frequent intervals to ensure a) familiarity with all aspects of computer interface, b) renewing of passwords within a 60 day period, and shall be accomplished without interruption to services being provided. (QASP Identifier #7)

b. The Contractor is required to maintain records that document competence/performance level of Contractor personnel (service provider) working on this contract in accordance with TJC and other regulatory body requirements. The Contractor will provide a current copy of the competence assessment checklist and annual performance evaluation to the Contracting Officer's Representative (COR) for each Contractor personnel (service provider) working on this contract.

c. When changes in Contractor personnel are approved in accordance with the "Key Personnel" clause of the contract, the Contractors must provide the providers name, a current address and telephone number, Social Security Number, list of references, list of all training, evidence of an unrestricted license, the current competence assessment, and current performance evaluation that supports #1 above.

d. The Contractor is required to develop and maintain the following documents for each Contractor personnel (service provider) working on the contract: credentials and qualifications for the job; a current competence assessment checklist (an assessment of knowledge, skills, abilities and behaviors required to perform a job correctly and skillfully; includes knowledge and skills required to provide care for certain patient populations, as appropriate.); a current performance evaluation http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364 http://www.va.gov/VHAPUBLICATIONS/ViewPublication.asp?pub_ID=2910 http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm supporting ability of the Contractor personnel (service provider) to successfully perform the work required in this solicitation; and listing of relevant continuing education for the last two years. The Contractor will provide current copies of these records at the time of contract award and annually on the anniversary date of contract award to the VA COTR, or upon request, for each Contractor personnel (service provider) working on the contract.(QASP Indicator #2)

e. The Contractor must be poised to respond quickly to VA policy and procedure changes.

f. Contract Thoracic Surgery staff agrees to treat all Veteran patients with respect and dignity, however, should there be a complaint, notification should be reported to the COR within 24 hours. (QASP Identifier #4)

g. Veterans shall be seen according to previously listed VHA Directive 2010-020.

h. Documentation and clinical records shall be complete, timely, and compliant with

Lebanon VAMC policies, and current Joint Commission Standards. The Contractor shall provide individual patient encounters (visits) workload in accordance with established VA reporting procedures. The Progress Notes for each enrolled patient visit, whether the patient visit was with the Contractor or a subcontractor, shall be entered electronically in the patient's record through the Lebanon VAMC’s Computerized Patient Record System (CPRS) system. All Progress Notes and test results, applicable to services which the Contractor is responsible to provide shall be entered into CPRS by the Contractor by the end of their shift. The results of laboratory tests performed by the Contractor shall be included in the Progress Notes.

Progress Notes must meet Centers for Medicare & Medicaid Services (CMS) guidelines for documentation which include the three (3) key components to determine the level of evaluation and management (E/M). These key components include: (1) History; (2) Exam; and (3) Medical decision making. Progress Notes associated with each clinic visit will include pertinent medical treatment, a treatment plan, teaching that was provided to the patient and/or the patient’s family, the date of appointment, and the electronic signature of the treating clinician. All notes must be linked to the correct visit. The process for entry of data may include manual entry or an automated procedure. Questions may be directed to the VA Information Security Officer, contact information to be provided after award. (QASP Indicator #1)

i. Contractor shall be responsible for prescribing medications as needed. Prior to prescribing any medications, the Contractor shall review medication profiles in CPRS for duplicate therapy and known allergies. The Contractor shall utilize the Lebanon VAMC drug formulary. The formulary is available online through the PBM website http://www.pbm.va.gov/PBM/nationalformulary.asp or electronically under Drug File Inquiry in the VISTA physician package. Non-formulary drugs are also marked “NF” in the CPRS drug file. Non-formulary medications can be obtained with appropriate clinical justification by utilization of the electronic non-formulary medication order form in CPRS. The Contractor is required to follow national and local VA guidelines for the use of non-formulary or restricted medications. These guidelines can be http://www.pbm.va.gov/PBM/nationalformulary.asp accessed in CPRS through the Tools menu, Web links, Pharmacy Benefits Management (PBM) website or directly through the PBM website at http://www.pbm.va.gov/PBM/clinicalguidance.asp .

j. The Contractor shall forward reports of adverse drug events (ADEs) to the Lebanon VAMC Pharmacy as they occur via e-mail to the Pharmacy Outpatient Supervisor, contact information to be provided after award. Reports of ADEs will be documented in the patients’ medical record (under the Allergy/Adverse Drug Reaction tracking option in CPRS) and the specifics of the event must be forwarded to VA Pharmacy as they occur via encrypted E-mail to Deborah.Miskie@va.gov. All medication errors and medication related incidents shall be reported immediately to the Chief, Pharmacy Service or designee. Additionally, the Contractor shall record and report these events to prescribers and the VA Chief Pharmacy service on a routine basis (as determined by the VA Chief, Pharmacy Service).

k. In accordance with JC regulations, when appropriate, the Contractor shall provide the patient with an accurate, reconciled list of medication to include medications that the patient is receiving from the VA, medications that he takes from non-VA providers, and any OTC, herbal or alternative medications that the patient reports taking. The Contractor shall meet all requirements of VHA Directive 2011-012 “Medication Reconciliation” (or subsequent revisions thereto) as well as VA policy related to medication reconciliation.

http://www.va.gov/VHAPUBLICATIONS/ViewPublication.asp?pub_ID=2390

l. The Contractor shall participate in educational activities involving the Lebanon VAMC Residents, and Student Registered Nurse Anesthetists (SRNA), as needed. The Contractor shall comply with Veterans Health Administration (VHA) Handbook 1400.1, “Resident Supervision,” dated 27 July 2005 (or subsequent revisions thereto).

m. The Contractor shall ensure all equipment is properly cleaned and stored at the end of each work shift, following national guidelines listed below.

http://www.va.gov/VHAPUBLICATIONS/ViewPublication.asp?pub_ID=1824

n. The Contractor shall participate in ongoing Peer Review process.

http://www.va.gov/VHAPUBLICATIONS/ViewPublication.asp?pub_ID=2250

o. The Contractor shall participate in the Ongoing Professional Practice Evaluation

(OPPE) and Focused Professional Practice Evaluation (FPPE) as described in previously referenced VHA directive on Credentialing and Privileging. (QASP Indicator #9) This process establishes guidance regarding the ongoing and focused evaluation for Licensed Independent Providers in the following categories:

i. Patient Care

ii. Medical/Clinical Knowledge

iii. Practice-Based Learning and Improvement

iv. Interpersonal and Communication Skills

v. Professionalism http://www.pbm.va.gov/PBM/clinicalguidance.asp http://www.va.gov/VHAPUBLICATIONS/ViewPublication.asp?pub_ID=2390 http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2847 http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2847 http://www.va.gov/VHAPUBLICATIONS/ViewPublication.asp?pub_ID=1824 http://www.va.gov/VHAPUBLICATIONS/ViewPublication.asp?pub_ID=2250

vi. Systems-Based Practice

p. The Contractor personnel shall be required to provide and complete a timesheet when they are on-site at the Lebanon VAMC providing care. The timesheet shall be signed by the COR or their designee. Timesheets shall be submitted with each invoice.

8. STAFFING:

a. Contractor agrees to provide Thoracic Surgery staff, as qualified registered health care professional to the VA Medical Center, 1700 S. Lincoln Avenue, Lebanon, PA 17042.

b. Furnish, approximately 170 days per year of, weekday on-call coverage, approximately 106 days per year of weekend/Holiday on-call coverage, and (if available) up to 20 days per year of scheduled Outpatient/Operative care. The VA will provide adequate office space, and office systems/infrastructure.

c. Consultations:

i. Each consultant shall be qualified to give an opinion in the field in which his/her opinion is sought and possess privileges in said field.

ii. All consultations shall be documented within CPRS and shall reflect pertinent examination of the patient and the patient’s records. When fellows and other house staff participate in consultations, the consultation note shall reflect discussion with the attending physician and shall be co-signed by the attending physician. Routine consultations for hospitalized patients shall result in consultation note within 12 hours of receipt of documented request. With the consent of the requesting physician, a consult can be delayed for cause but not more than 72 hours.

d. Reporting shall be to the ACOS, Surgical Care Line, Lebanon VAMC.

e. A staffing plan, to include back-up coverage, shall be approved by the VAMC prior to commencement of patient activities. Staffing schedules are to be provided to VAMC at least 3 months in advance (6 months preferred).

f. THE GOVERNMENT RESERVES THE RIGHT TO REFUSE ACCEPTANCE of Contractor, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction, or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. The CO and COR shall deal with issues raised concerning contract personnel’s conduct.

The final arbiter on questions of acceptability is the CO.

g. Instrumentation and supplies: VA will supply appropriate instrumentation for all procedures and ancillary support staff commensurate with types of patients scheduled.

9. ADMINISTRATIVE AND CLINICAL DOCUMENTATION: The Thoracic Surgery staff shall perform the following in conjunction with the above services:

a. Keyboard for entry into the electronic medical record a patient’s chief complaints, observations and findings, assessment, and plan/recommendations in a clear and understandable manner at the end of each patient encounter. (QASP Identifier #3)

b. Electronically correct dictations, as necessary, before electronically authenticating within

(7) calendar days of transcription and address “view alerts” within 14 days.

c. Electronically enter all doctor’s orders, consultation referrals, and requests for x-rays and lab work using CPRS. Any provider off station more than 3 days must assign a view alert surrogate to address all outstanding issues until their return.

d. Telephone significant positive reports, at the time identified, to the referring provider.

e. Informed Consent: Contract Thoracic Surgery staff shall explain procedure and risks/benefits to the patient/guardian and obtain informed consent from patient/guardian in accordance with VAMC policies. Complete the progress note template in CPRS/IMED consent for documentation of informed consent discussion and electronically sign.

f. Immediately before starting any operative procedure the Thoracic Surgery staff will accurately identify the patient and the procedure to be performed as per the relevant SOPs and MCMs and document the verification process in the medical record. Contract Thoracic Surgery staff will also complete an updated note regarding history and physical (template note available).

g. Encounter Forms: Properly complete the electronic VA encounter form on each patient seen; listing diagnosis for the visit and all procedures performed based on the current VA requirements along with identification of service-connection for treatment rendered.

h. Operative Reports: Operative reports are submitted to CPRS via software which includes: pre-operative diagnosis, post-operative diagnosis, procedure, unusual findings, specimens removed, assistants (if any) and identifies Surgeon/s. In the case of an attending without computer access monitoring a Resident, i.e., Without Compensation Employee (WOC) an Attestation to Operative Report (VA Form 595-028) must be completed and added as an addendum to the Operative report dictated by the Resident.

11. HOURS OF OPERATION: The services covered by this contract shall be furnished by the contractor as defined herein.

3. On-call services for after hour coverage (4:30pm to 8:00am) weekdays (when staff Surgeon/s is NOT on call – normally Wednesdays and scheduled Leave) and 24-hour coverage for all weekends, and Federal Holidays.

If an emergency Thoracic event arises as identified by a staff physician; phone contact will be made within 15 minutes to the contract Thoracic Surgeon/s on-call. It is required that the contract provider be on site within 60 minutes of receipt of the phone call. Upon stabilization of the patient and assessment of further needed intervention, the contract provider may decide to transfer the patient to a Non-VA facility for provision of an advanced level of patient care.

Federal Holidays listed below:

New Year’s Day Martin Luther King ‘s Birthday

President’s Day Juneteenth

Memorial Day

Independence Day Labor Day Columbus Day Veterans Day Thanksgiving Day Christmas Day

a. When one of the holidays falls on Sunday, the following Monday shall be observed as a national holiday. When a holiday falls on a Saturday, the preceding Friday is observed as a national holiday by U.S. Government Agencies. Also included would be any day specifically declared by the President of the United States of America as a National holiday.

4. If Available, provide up to 20 days per year in-house service to provide Scheduled Thoracic Clinic Services (Consult Visits, Post-Operative Visits), and/or Surgical/Operative Services for the Lebanon VA Medical Center (during the hours of 7am to 3:30pm). This coverage will include:

a. Outpatient clinic services for medical Thoracic Services at LVAMC and/or

Lancaster General Hospital via Contracted Surgeon credentialed and privileged at both LVAMC, and Lancaster General Hospital.

b. Inpatient medical consultations and/or surgical procedures at LVAMC and/or Lancaster General Hospital via Contracted Surgeon credentialed and privileged at both LVAMC, and Lancaster General Hospital.

12. Estimated Workload and Support Staff Provided by Lebanon VAMC:

a. Annual Visits

• Approximately 4,455 surgical procedures per year

• Approximately, 1200 clinic visits per year

b. Support Staff

• Nursing Support

• Anesthesia Support

SECTION 2

GOVERNMENT FURNISHED PROPERTY AND SERVICES

1. GOVERNMENT FURNISHED PROPERTY AND SERVICES:

The Government will provide the equipment, supplies, and services listed below:

a. PROPERTY: The Contractor shall have joint use of the Lebanon VAMC for performance of this contract.

b. COMPUTER ACCESS:

i. The Veterans Affairs (VA) will provide access to systems, applications, and information on the VA network required to perform the services identified in the PWS.

c. OFFICE/WORK/LOCKER AREA: The Contractor shall maintain areas (office, exam room, etc.) provided for contractor use in a neat, orderly appearance.

Contractor personnel shall ensure these areas are tidy and any decorative items present a professional, modest appearance in keeping with community standards. An administrative area will be provided within the clinic area.

Contractor personnel must maintain security and confidentiality of patient information. The Government will not be responsible for loss or damage of personal items brought into the Lebanon VAMC.

d. EQUIPMENT: Contractor personnel shall have joint use of all available equipment required to provide Dental services.

e. PERSONAL PROTECTIVE EQUIPMENT (PPE): The Government will furnish appropriate PPE. The Government will be responsible for any repair, cleaning and inventory required for the PPE. This does not include any type of uniform or laboratory coat, which the Contractor shall provide.

f. FORMS: The Lebanon VAMC will provide required Government forms used in the performance of services.

g. SUPPLIES: The Lebanon VAMC will provide medical and non-medical supplies commonly used in the facility for the care and management of patients.

h. ADMINISTRATIVE SUPPORT: Contractor personnel shall be authorized to use all administrative support available to the Government employees. This will include, but is not limited to computers, printers, copy machines, fax machines, medical library, and telephone lines. The same restrictions to limit use of these items for official Government business apply.

SECTION 3

GENERAL INFORMATION

1. QUALIFICATIONS:

a. Providers offered under this contract shall:

i. have a full and unrestricted license in a US state, territory, or US commonwealth.

ii. speak English proficiently.

iii. provide evidence of demonstrated current clinical competence to perform care as specified in RFP Attachment 1 (Application for Clinical Privileges).

iv. be a US citizen.

v. have a professional degree and education applicable to medical staff members, e.g., MD, DO, DDS, DMD.

vi. Submit evidence of a minimum of twenty-four (24) months of experience within the last thirty-six (36) months providing Thoracic Surgery Services in a direct patient care setting.

vii. provide evidence of current professional liability insurance; be board certified or board eligible in Anesthesiology (preferred board certified)

viii. provide evidence of current privileges (if applicable).

ix. provide names of most current employer(s) and two peer reference contacts as identified in the Medical Center Bylaws.

x. successfully complete the VAMC Lebanon's Credentialing and Privileging process

xi. Contractor is responsible for keeping the VA COR apprised of anything that would adversely affect or otherwise limit their clinical privileges. Note: Failure to keep VA fully informed on these matters may result in administrative or disciplinary action.

xii. Possess demonstrated ability in the areas of interpersonal relations, critical thinking, and problem-solving and conflict resolution.

xiii. Contractor staff shall have a current Drug Enforcement Administration (DEA) licensure. Contractor shall provide copies of DEA cards for all staff providing services under this Contract.

xiv. Required to prescribe controlled substances.

xv. Contractor staff shall complete VA mandatory privacy and information security training (reference Section 8c below) and complete BLS and ACLS training and keep BLS and ACLS certifications current throughout the life of the contract.

Copies of current certifications shall be provided to the COR.

xvi. In addition, if providing medical services, Contractor staff shall attend CPRS training prior to providing any patient care services. Contractor staff shall document patient care in CPRS to comply with all VA and equivalent Joint Commission standards.

xvii. Contractors 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 as needed to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed.

xviii. Contractor shall provide proof of the following tests for their staff 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.

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

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

o OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO BLOODBORNE PATHOGENS: Contractors shall provide generic self-study training for all Contractor staff; provide their own Hepatitis B vaccination series at no cost to the VA if they elect to receive it; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident.

xix. The VAMC shall notify the Contractor of any significant communicable disease exposures as appropriate. Contractors 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.

Contractors shall provide follow up documentation of clearance to return to the workplace prior to their return.

xx. Evidence of completion of required licensure, credentials, required training, current competencies and background investigations shall be validated for all Contractor personnel providing services under this Contract.

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

xxi. The Contractor shall not have any scheduled personnel until written notification is received from the CO advising that the candidate(s) presented has met all requirements for Contract performance.

xxii. Contractor staff qualifications, licenses, certifications, and facility accreditation must be maintained in good standing throughout the contract period of performance. Documentation must be provided to the COR to ensure adequate certification. All actions required for maintaining certification must be kept up to date at all times. Documentation verifying current licenses, certifications and facility accreditation must be provided by the Contractor on an annual basis.

xxiii. CONFLICT OF INTEREST: The Contractor and all Contractor staff 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 sub-Contractors 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.

xxiv. Citizenship related Requirements: While performing services for the VA, 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. The Contractor must return a signed certification at the time of proposal that the Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to the VA. 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 and is applicable to the entire POP.

2. ANNUAL OFFICE OF INSPECTOR GENERAL (OIG) STATEMENT:

In accordance with HIPAA and the Balanced Budget Act (BBA) of 1977, the VA 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.

a. Therefore, all Contractors shall review the OIG List of Excluded Individuals/Entities on the OIG web site at www.hhs.gov/oig to ensure that the proposed Contractors and/or http://www.hhs.gov/oig firm(s) are not listed. Contractors should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty (CMP) for each item or service furnished during a period that the person or entity 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 Contractors and entities that employ or enter into contracts with excluded individuals or entities to provide items or services to Federal program beneficiaries.

b. By submitting their proposal, the Contractor certifies that the 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.

c. TECHNICAL DIRECTION: 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. Technical direction of all clinical personnel covered by this contract will be provided by the VAMC COS and/or the Chief of the Service or his designee. A clinical COR may be appointed, however, only the CO is authorized to consider any contract modification request during the administration of the resultant contract.

d. NON-PERSONAL SERVICES: The parties agree that The Contractor, all Contractor staff, agents, and sub-Contractors shall not be considered VA employees for any purpose.

e. Government Inherent Functions: Contractor and Contractor staff 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, 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.

f. No Employee status: The Contractor shall be responsible for protecting the Contractor’s staff 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:

i. Workers’ compensation

ii. Professional liability insurance

iii. Health examinations

iv. Income tax withholding, and

v. Social security payments.

g. TORT: The Federal Tort Claims Act does not cover Contractors or Contractor’s staff.

When a Contractor or a member of their staff has been identified as a provider in a tort claim, The…