36C24618R0890-001.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 101

558-19-1-078-0002

36C24618R0890 08-20-2018

Katie Lavely 757-315-3963 09-03-2018 08:00 am EST

36C246

Department of Veterans Affairs Network Contracting Office 6 100 Emancipation Drive Hampton VA 23667

X 100 x

621399

$7.5 Million

N/A

X

Durham, Veterans Affairs Medical Center

508 Fulton Street Durham NC 27705

Department of Veterans Affairs Network Contracting Office 6 100 Emancipation Drive Hampton VA 23667

Department of Veterans Affairs Financial Services Center

PO BOX 149971

Austin TX 78714-9971

See CONTINUATION Page

Prospective offerors shall submit an offer that conforms to all requirements of this solicitation. Please refer to the Performance Work Statement, Schedule, Addendums to 52.212-1 Instructions to Offerors and 52.212-2 Basis for award for additional details.

All questions submitted in response to this solicitation shall be submitted via email by no later than 08:00 AM EST 27 Aug 2018 to katie.lavely@va.gov.The Government makes no assurance that questions received after the established date and time will be addressed. All answers in response to questions shall be published via solicitation amendment and no direct responses will be provided.

$0.00 See CONTINUATION Page

X X x 1

Marchelle Peyton 413024

36C24618R0890

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 LIMITATIONS ON SUBCONTRACTING-- MONITORING AND COMPLIANCE (JUN

2011)

B.3 PRICE/COST SCHEDULE

ITEM INFORMATION

B.4 PERFORMANCE WORK STATEMENT

B.5 SPECIAL CONTRACT REQUIREMENTS

SECTION C - CONTRACT CLAUSES

C.1 52.216-18 ORDERING (OCT 1995)

C.2 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.3 52.216-21 REQUIREMENTS (OCT 1995)

C.4 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.5 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

C.6 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.7 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.8 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV

2012)

C.9 VAAR 852.237-7 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE

(JAN 2008)

C.10 VAAR 852.237-70 CONTRACTOR RESPONSIBILITIES (APR 1984)

C.11 VAAR 852.270-1 REPRESENTATIVES OF CONTRACTING OFFICERS (JAN 2008) 32

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

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (JAN 2018)

C.13 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.14 MANDATORY WRITTEN DISCLOSURES

C.15 IT CONTRACT SECURITY

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

D.1 52.252-1 PAST PERFORMANCE QUESTIONAIRE

D.2 CONTRACTOR CERTIFICATION: IMMIGRATION AND NATIONALITY ACT OF

1952, AS AMENDED

D.3 WAGE DETERMINATION

D.4 QUALITY ASSURANCE SURVEILLANCE PLAN

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS (JAN 2017)

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 ADDENDUM to FAR 52.212-2 EVALUATION-COMMERCIAL ITEMS

E.5 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (JUL 2013)

E.6 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL

ITEMS (NOV 2017)

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)

E.10 VAAR 852.209-70 ORGANIZATIONAL CONFLICTS OF INTEREST (JAN 2008)

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

(JAN 2008)

E.12 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (JAN 1998)

E.13 VAAR 852.271-70 NONDISCRIMINATION IN SERVICES PROVIDED TO

BENEFICIARIES (JAN 2008)

E.14 VAAR 852.273-72 ALTERNATIVE EVALUATION (JAN 2003)

E.15 VAAR 852.273-74 AWARD WITHOUT EXCHANGES (JAN 2003)

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 36C246 Marchelle Peyton Marchelle.Peyton@va.gov

Contract Specialist Katie Lavely katie.lavely@va.gov

Department of Veterans Affairs Network Contracting Office 6 100 Emancipation Drive Hampton VA 23667

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] NTE 1 Invoice Per Month

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.

Department of Veterans Affairs Financial Services Center

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

mailto:Marchelle.Peyton@va.gov mailto:katie.lavely@va.gov

B.2 LIMITATIONS ON SUBCONTRACTING-- MONITORING AND

COMPLIANCE (JUN 2011)

This solicitation includes VAAR 852.219-10 VA Notice of Total Service- Disabled Veteran-Owned Small Business Set-Aside. Accordingly, any contract resulting from this solicitation will include this clause. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) retained by VA to assist in assessing the contractor's compliance with the limitations on subcontracting or percentage of work performance requirements specified in the clause.

To that end, the support contractor(s) may require access to contractor's offices where the contractor's business records or other proprietary data are retained and to review such business records regarding the contractor's compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor's compliance with the limitations on subcontracting or percentage of work performance requirement.

B.3 PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

200.00 CS _____________ _______________

Intraoperative Neurophysiologic

Monitoring (IONM) Technician.

Durham, NC VAMC 27705 Monday through Friday 7:00 am - 8:00 pm Contract Period: Base POP Begin: 10-01-2018 POP End: 09-30-2019

Monitoring (IONM) Technician.

Durham, NC VAMC 27705 Monday through Friday 7:00 am - 8:00 pm Contract Period: Option 1 POP Begin: 10-01-2019 POP End: 09-30-2020

Monitoring (IONM) Technician.

Durham, NC VAMC 27705 Monday through Friday 7:00 am - 8:00 pm Contract Period: Option 2 POP Begin: 10-01-2020 POP End: 09-30-2021

Monitoring (IONM) Technician.

Durham, NC VAMC 27705 Monday through Friday 7:00 am - 8:00 pm Contract Period: Option 3 POP Begin: 10-01-2021 POP End: 09-30-2022

Monitoring (IONM) Technician.

Durham, NC VAMC 27705 Monday through Friday 7:00 am - 8:00 pm Contract Period: Option 4 POP Begin: 10-01-2022 POP End: 09-30-2023

Total:

B.4 PERFORMANCE WORK STATEMENT

Performance Work Statement

Intraoperative Neurophysiologic Monitoring Technician for the Durham VAMC

02 July 2018

1.0 Description of Services

The Durham, VAMC requires Intraoperative Neurophysiologic Monitoring Services (IONM) to assist in maintaining the medical centers standard of care for the Neurosurgery program. The contractor shall be responsible for providing a Certified Intraoperative Neurophysiologic Monitoring Technician with supplies and equipment. The estimated number of IONM services is estimated at 160 to 200 OR cases per year. Durham is the primary referral center for VISN6.

Place of Performance - Contractor shall furnish services at the Durham VAMC 508 Fulton Street, Durham, NC 27705.

Period of Performance – The Government anticipates the award of a firm fixed price type contract for a base year plus four (4) option year periods. The based year Period of Performance is expected to begin on October 1, 2018.

1.1 Definitions and Acronyms

1.1.1 Definitions

1.1.2 Contracting Officer (CO) - The CO shall ensure performance of all necessary actions for effective contracting, ensure compliance with the contract terms, and shall safeguard the interests of the United States in the contractual relationship. The CO shall also assure that the contractor receives impartial, fair, and equitable treatment under this contract. The CO is ultimately responsible for the final determination of the adequacy of the contractor’s performance.

1.1.3 Contracting Officer’s Representative (COR) - The COR is responsible for technical administration of the contract and shall assure proper Government surveillance of the contractor’s performance.

The COR shall keep a quality assurance file. At the conclusion of the contract or when requested by the CO, the COR shall provide documentation to the CO. The COR is not empowered to make any contractual commitments or to authorize any contractual changes on the Government’s behalf.

The contractor shall refer any changes they deem may affect contract price, terms, or conditions to the CO for action. The COR shall be appointed via separate letter. The COR shall be responsible for the effective oversight of this contract to ensure satisfactory contractor performance and protect the public trust. A copy of the COR Appointment letter shall be provided to the Contractor after contract award and shall contain detailed information in regard to the COR and their associated duties, responsibilities and authorities.

1.1.4 Contractor Performance Assessment Reporting System (CPARS) - CPARS is a web-enabled application that collects and manages the library of automated Contractor Performance Assessment Reports (CPARs). A CPAR assesses a contractor's performance and provides a record, both positive and negative, on a given contractor during a specific period of time. Each assessment is based on objective facts and supported by program and contract management data, such as cost performance reports, customer comments, quality reviews, technical interchange meetings, financial solvency assessments, construction/production management reviews, contractor operations reviews, functional performance evaluations, and earned contract incentives

1.1.5 Government-furnished property - means property in the possession of, or directly acquired by, the

Government and subsequently furnished to the contractor for performance of a contract.

Government-furnished property includes, but is not limited to, spares and property furnished for repair, maintenance, overhaul, or modification. Government-furnished property also includes contractor-acquired property if the contractor-acquired property is a deliverable under a cost contract when accepted by the Government for continued use under the contract.

1.1.6 Government Property - Means all property owned or leased by the Government. Government property includes both Government-furnished property and contractor-acquired property.

Government property includes material, equipment, special tooling, special test equipment, and real property. Government property does not include intellectual property and software.

1.1.7 Indefinite Quantity Contract - An indefinite-quantity contract provides for an indefinite quantity, within stated limits, of supplies or services during a fixed period. The Government places orders for individual requirements. Quantity limits may be stated as number of units or as dollar values.

1.1.8 Loss of Government Property - means unintended, unforeseen or accidental loss, damage, or destruction of Government property that reduces the Government’s expected economic benefits of the property. Loss of Government property does not include occurrences such as purposeful destructive testing, obsolescence, normal wear and tear, or manufacturing defects. Loss of Government property includes, but is not limited to—

(a). Items that cannot be found after a reasonable search;

(b). Theft:

(c). Damage resulting in unexpected harm to property requiring repair to restore the item to usable condition; or

(d). Destruction resulting from incidents that render the item useless for its intended purpose or beyond economical repair.

1.1.9 Nonpersonal Service Contract - means a contract under which the personnel rendering the services are not subject, either by the contract’s terms or by the manner of its administration, to the supervision and control usually prevailing in relationships between the Government and its employees.

1.1.10Performance Work Statement (PWS) - means a statement of work for performance-based acquisitions that describes the required results in clear, specific, and objective terms with measurable outcomes.

1.1.11Quality Assurance Surveillance Plan (QASP) - provides the Government and contractor with evaluation criteria that determines whether or not the performance standards for a specific contract have been met. This does not detail how the contractor accomplishes the work. Rather, the QASP is created with the premise that the contractor is responsible for management and quality control actions to meet the terms of the contract. It is the Government’s responsibility to be objective, fair, and consistent in evaluating performance.

1.1.12 “Services Summary” or “Acceptable Quality Levels” (AQL) The minimum level of acceptable performance that the contractor must meet and still be considered a satisfactory performer

1.1.13 “Task-Order Contract” means a contract for services that does not procure or specify a firm quantity of services (other than a minimum or maximum quantity) and that provides for the issuance of orders for the performance of tasks during the period of the contract.

1.1.14 Task Order (TO) - An individual requirement for services issued against an existing contract.

Note: additional definitions can be found throughout the FAR (2.101) and Sups,

1.2 Acronyms-list and spell out acronyms used in PWS

ABRET American Board of Registration of Electrocephalographic and Evoked Potential Technologists

BAA Business Associate Agreement

BLS Basic life Support

CEU Certified Education Unit (CEU)

CME Continuing Medical Education

CNIM Certified Neurophysiologic Intraoperative Monitoring Technologist

CO Contracting Officer

COR Contracting Officer Representative

COS Chief of Staff

CPARS Contractor Performance Assessment Rating System

CPRS Computerized Patient Recordkeeping System

FAR Federal Acquisition Regulation

FSMB Federation of State Medical Boards

GFP Government Furnished Property

GP Government Property

HIPPA Health Insurance Portability and Accountability Act

R.EEG T Registered Electroencephalographic and Evoked Potential Technologist

PWS Performance Work Statement

QASP Quality Assurance Surveillance Plan

TO Task Order

VAMC Veteran Affairs Medical Center

2.0 Services Summary

The Contractor shall be responsible for providing Intraoperative Neurophysiologic Monitoring Technician Support Services to the Durham, VAMC. At a minimum, the contractor shall be responsible for providing all (to include, but not limited to) project management, labor, supplies, equipment and supervision to ensure the successful performance of all requirements contained within this PWS VA. At a minimum, the contractor support personnel shall be required to:

2.1 Tasks to be Performed

2.1.1 Pre-surgical considerations:

2.1.2 Confirms procedure orders for surgical monitoring requested.

2.1.3 Obtain relevant patient history.

2.1.4 Verifies patient identity according to The Joint Commission Standards.

2.1.5 Explains IONM procedure to the patient.

2.1.6 Obtains or verifies informed consent for IONM.

2.1.7 Reviews all IONM contraindications based on patient history and surgeon orders.

2.1.8 Establishes and confirms an online HIPPA-compliant connection with the attending neurophysiologist.

2.1.9 Determines monitoring and anesthetic preferences of attending neurophysiologist.

2.1.10 Initiates pre-surgical communications with anesthesia team regarding these preferences.

2.1.11 Selects montage(s) appropriate for surgical procedure being performed.

2.1.12 Select the appropriate instrumentation and settings:

2.1.13 Maintains equipment in good working order and confirms bi-annual maintenance checks have been performed according to the hospital’s biomedical standards

2.1.14 If using preprogrammed templates, is sure that the template for the selected surgery to be performed has appropriately set parameters.

2.1.15 Ensure that averager and stimulator are functioning appropriately.

2.1.16 Ensure that all stimulators are delivering expected stimuli to the correct site.

2.1.17 Operating room environment:

2.1.18 Follows standard precautions for infection control per facility policy and procedures.

2.1.19 Avoids contamination of sterile drapes, personnel, and instruments, etc.

2.1.20 Passes sterile electrodes to the surgical personnel in an approved sterile fashion.

2.1.21 Places bloody or contaminated items in biohazard containers and sharps in a sharps container.

2.1.22 Follows hazardous material management guidelines.

2.1.23 Observes electrical and general safety precautions in connecting the patient to equipment by arranging cables and equipment to prevent injury.

2.1.24 Intraoperative Neuromonitoring:

2.1.25 Confers with the surgeon regarding structures at risk, modalities to be monitored, and documents the conversation.

2.1.26 Communicates IONM preferences to the anesthesia team and other operating room personnel in a clear, definite, and collegial manner and documents conversation(s) before the patient enters the operating room suite, and/or during intubation and prepping:

a. Sets up and confirms proper operation of all equipment.

b. Applies electrodes (primary and backup) and secures placement.

c. Tests equipment and checks integrity of electrodes by checking and documenting impedances.

2.1.27 Arranges head box, cables, and electrodes for minimization of artifacts and electrical hazards preventing electrodes from being dislodged, dried out, or contaminated with fluids.

2.1.28 Obtains initial responses and obligate peaks after induction and positioning prior to incision and sets baselines as appropriate to the procedure; marks waveforms and calculates the absolute latencies, amplitudes, or inter-peak intervals at baseline.

2.1.29 Sets or resets baselines as appropriate to the surgical procedure according to the facility policy and procedures, but in all cases prior to any part of the surgery that puts neural tissue at risk.

2.1.30 Obtains an interpretation of baselines from the attending neurophysiologist and communicates the information to the surgeon.

2.1.31 Throughout the surgery, reports any change in data which meets the alarm criteria outlined in the facility policy and procedure manual.

2.1.32 During the recording, changes methods of data collection as needed according to facility policies and procedures including:

a. Adjusting stimulus rate as needed to reduce time-locked artifacts.

b. Establishing and documenting that stimulating parameters are within safe limits.

c. Recording from additional electrode derivations in case of technical problems in order to allow continuous recording.

2.1.33 Use a montage that records obligate peak responses from peripheral nerve, spinal cord, subcortical structures, and the cerebral cortex as appropriate.

2.1.34 At the end of the procedure, removes and discards disposable supplies, especially sharps and contaminated items according to facility policies and procedures; cleans and disinfects equipment, cables, etc.

2.1.35 During and throughout the procedure:

2.1.36 Reports Modalities performed and areas monitored

2.1.37 Reports Surgical maneuvers and events

2.1.38 Documents levels of inhaled anesthetics, dosage of intravenous anesthetics, and use of muscle relaxants blood pressure, temperature, and other physiologic parameters as appropriate.

2.1.39 Documents any and all communications or warnings relevant to patient care:

a. With attending surgeon, surgeon replies, and corrective action taken

b. With attending neurophysiologist

c. With anesthesia team and/or other operating room personnel

2.1.40 Reports all technical problems and corrective troubleshooting steps performed and saves all data according to the practice of medical records retention in the state in which the surgery was performed.

2.1.41 Archives exact time, obligate waveform labels, latencies, and amplitudes for all printed traces as detailed in the facility policy and procedures and prepares the documentation for the attending neurophysiologist according to facility policy and procedures.

2.1.42 Intraoperative Communications/Data Analysis

2.1.43 Recognizes significant changes, according to facility alarm criteria, and alerts the surgeon and attending neurophysiologist as detailed in facility policy and procedures.

2.1.44 If needed, notifies the surgeon that monitoring is momentarily interrupted for troubleshooting

2.1.45 Prepares technologist case report for the attending neurophysiologist according to facility policy and procedures.

2.1.46 Modalities: Contractor will provide required monitoring equipment and probes

a. Intraoperative electroencephalography (EEG)

b. Spontaneous or evoked electromyography (EMG)

c. Motor cranial nerve recording

d. Spinal Screw and Direct Nerve Stimulation – Threshold Testing

e. Localization of sensorimotor cortex

f. Intraoperative brainstem auditory evoked potential (BAEP)

g. Transcranial Electrical Motor Evoked Potentials

2.2 Contractor Responsibilities

2.2.1 The Contractor shall be responsible for the following, to include but not limited to:

2.2.2 Providing IONM Technician(s) that are technically proficient in the skills necessary to fulfill the requirements of this PWS. Additionally, candidates shall possess the ability to speak, understand, read and write English fluently.

2.2.3 IONM Technician (s) shall be responsible for signing in and out when in attendance. Time sheets will be used by the COR to confirm hours/day and services provided against the contractor’s invoices.

2.2.4 Providing documents upon request of the Contracting Officer (CO)/ Contracting Officers Representative (COR) to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed. Provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contract IONM Technician. Shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior.

2.2.5 Communications with 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.

2.2.6 The Contractor shall provide statements containing the same information for any identified consultants or subcontractors who shall provide services. The Contractor must also provide relevant facts that show how it’s organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest. These statements shall be in response to the Veterans Affairs Acquisition Regulation (VAAR) provision 852.209-70 Organizational Conflicts of Interest (Jan 2008) and fully outlined in response to the subject attachment in Section D of the solicitation document.

2.2.7 Contractor shall provide the COR copies of current CMEs as required or requested by the VAMC. 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 contract IONM Technician.

2.2.8 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.

2.2.9 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.

2.2.10 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.

2.2.11 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.

2.2.12 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.

2.3 Support Personnel Requirements and Qualifications

The Contractor Shall only submit resumes of potential personnel who meet the minimum qualification requirements detailed within which include, but are not limited to:

2.3.1 All Contractor Personnel to perform work at the Durham VAMC, shall be US citizens and shall provide proof of citizenship/naturalization.

2.3.2 Licenses – IONM Technician assigned by the Contractor to perform the services covered by this contract, shall possess a current full and unrestricted license to practice as a IONM Technician, in any State, Territory, or Commonwealth of the United States or the District of Columbia. IONM Technician, who have current, full and unrestricted certifications in one or more states, but who have, or ever had, a license restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending action or denied upon application will not be considered for the purposes of this contract.

2.3.3 Possess a certification in Neurophysiologic Intraoperative Monitoring Technologist (CNIM) and a Registered Electroencephalographic and Evoked Potential Technologist certification (R.EEG T).

2.3.4 Possess two (2) year clinical experience within the Neurodiagnostics field.

2.3.5 IONM Technician, shall be certified in BLS and contractor personnel must complete any additional training required/Mandatory to work at the Durham VAMC and or access Government computer systems. All continuing education courses required for maintaining certification must be in accordance with the National Standards for the American Board of Registration of Electrocephalographic and Evoked Potential Technologists (ABRET) and the Neurodiagnostics Society (ASET). Documentation verifying current certification shall be provided by the Contractor to the VA COR on an annual basis for each year of contract performance.

2.3.6 IONM Technician, will not be permitted to work until they have completed the Veterans Administration Orientation, have been fingerprinted and have a VA Identification (ID) Badge or Personal Identity Verification (PIV) in process, pending issuance.

2.3.7 IONM Technician, 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 Contracting Officer (CO)/ Contracting Officers Representative (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 IONM Technician shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior.

3.0 Quality Assurance Surveillance Plan QASP

3.1.1 Quality Management/Quality Assurance Surveillance: Contract personnel shall be subject to Quality Management measures, such as patient satisfaction surveys. Contractor performance will be monitored by the government using the standards as outlined in this Performance Work Statement (PWS) and methods of surveillance detailed in the Quality Assurance Surveillance Plan (QASP). The QASP shall be attached to the resultant contract and shall define the methods and frequency of surveillance conducted.

Below is a matrix table listing a summary of the performance objectives and performance thresholds required by the government in contractor performance.

3.2 Measurable Terms

Performance Requirements Reference Output/Outcome

Key Personnel Para 2.3 95% Shall consistently provide personnel with qualifications outline in PWS.

Patient Safety Para 10.0 95% Shall report all incidents immediately or within 24hrs.

Maintains Licensing, Registration and Certification Para 2.3.2 95% Maintains Licensing and certifications.

Mandatory Training Para 2.3.5 90% Shall complete all required training on time per VAMC policy.

Privacy, Confidentiality and HIPAA Para 9.0

And Special Contract Requireme nts

98% Comply with all laws, regulations, policies and procedures relating to Privacy, Confidentiality and HIPAA.

Timely Invoicing 8.0 100% All itemized invoices provided within 30 days of end of each month services delivered

4.0 Deliverables

Support Area Title Delivery Date/Description

Management Monthly Report Not later than submission of Invoice

Management Quarterly Report No later than 10 business days after the end of the quarter

5.1 Monthly Reporting:

The contractor shall be required to submit a Monthly Report for each Active Task Order. The Report shall be submitted to the COR via email no later than time of invoice. Failure to submit a complete and accurate report may result in invoice rejection. This may be submitted as a single report if it contains all required information. At a minimum, Monthly Reports shall include, but not limited to, the following:

a. Any billing/invoice issues

b. Reflect a Declining Balance on Delivery/Task Order Level

c. Invoice Log on Delivery/Task Order Level

d. A copy of all applicable invoices for reporting period that have been or will be submitted electronically for payment. This may be submitted for coordination prior to electronic submission for payment.

5.2 Quarterly/Annually

The contractor shall be required to submit quarterly reports, at the contract level to the COR via email no later than 10 business days at the end of the quarter. Failure to submit a complete and accurate report may result in invoice rejection and negative reflections in CPARS recordings. The 4th Quarter Report shall also serve as the annual report. This may be submitted as a single report if it contains all required information. At a minimum, Quarterly Reports shall include, but not limited to, the following:

a. Summary of all Active Task Orders under the Basic Contract

b. Summary of all monthly reports for the applicable Quarter for each Task Order.

c. Any billing/invoice issues

d. Reflect a Declining Balance on active Task Orders

e. Invoice Log for each active Delivery/Task Orders

5.3 Criteria for Acceptance. All deliverables shall be submitted in a draft format mutually agreed upon by the Contractor and the Government

6.0 Hours

7.0 Normal working hours: Monday through Friday, 7:00 a.m. – 8:00 p.m., excluding federal holidays.

7.1 Government agencies will not be available during scheduled holidays, inclement weather, weekends, after duty hours. All chargeable work will be directly attributable to the task being performed by the individual.

7.2 Scheduled Holidays. New Year’s Day; Dr. Martin Luther King, Jr. Birthday; President’s Day;

Memorial Day; Independence Day; Labor Day; Columbus Day; Veteran’s Day; Thanksgiving Day;

Christmas Day.

7.2.1 Contractor services may be required for holiday coverage. When required, specific services and tours will be requested by the VA with a minimum of 8 hours’ notice to the Contractor and at the rates specified. The Contractor will be paid holiday pay for this time.

7.2.2 In the event the assigned contract IONM Technician cannot report to duty, with or without prior notice, the contractor shall provide another IONM Technician within 2 (two) hours.

7.2.3 Contractor employees shall not be permitted overtime, as services are provided and compensated case by case. The schedule is completed a month or two in advance.

7.2.4 Adjustments to schedules may be coordinated by the VA and the Contractor with

24 hours’ notice to provide for normal workload variations and personnel practices.

8.0 Invoicing

The Contractor shall be responsible for timely invoice submissions not to excess 30 days after the invoicing cycle. Invoices submitted without aforementioned reports shall be immediately rejected. At a minimum, invoices shall contain the follow information:

a. Contract Number and Purchase Order Number (If applicable)

b. Name of IONM Technician

c. Hourly Rate

d. Total cases worked per Month

e. Weekly timesheets must be signed by COR

9.0 Other Regulations or Compliance Requirements

10.0 Patient Safety Compliance and Reporting: IONM Technician shall follow all established patient safety and infection control standards of care. Contract IONM Technician (s) shall make every effort to prevent medication errors, falls, and patient injury caused by acts of commission or omission in the delivery of care. All events related to patient injury, medication errors, and other breeches of patient safety shall be reported to the COR VA Safety Policy. As soon as practicable (but within 24 hours)

Contractors shall notify COR of incident and submit to the COR the Patient Safety Report, following up with COR as required or requested.

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

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

10.3 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

10.4 VHA Handbook 1100.18 Reporting and Responding to State Licensing Boards -http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364

10.5 VHA Handbook 1100.19 Credentialing and Privileging -

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

10.6 VHA Handbook 1907.01 Health Information Management and Health Records:

http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791

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

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

10.8 Standards of Care: The contract IONM Technician (s)’ care shall cover the range of

IONM Technician services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards as established by:

10.8.1 VA Standards: 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

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

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

10.8.4 The requirements contained in this PWS

http://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=347 https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364 http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791 http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443 http://www.jointcommission.org/standards_information/standards.aspx http://www.hpoe.org/resources?show=100&type=8

B.5 SPECIAL CONTRACT REQUIREMENTS

1. Under the authority of Public Law 104-262 and 38 USC 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 the Section entitled Schedule of Supplies/Services of this contract.

a. The services specified in Section B. - Schedule of Supplies/Services may be changed by written modification to this contract. The modification shall be prepared by the Contracting Officer (CO) and, prior to becoming effective, shall be signed by both parties.

b. Contractor shall provide scheduled services throughout the contract period. Other necessary personnel for the operation of the services contracted for at the VA will be provided by the Contractor at levels mutually agreed upon which are compatible with the safety of the patient and personnel and with quality medical care programming.

c. If required providers must maintain current and active Drug Enforcement Agency (DEA) and

Basic Life Support (BLS) certification, and provide copy of BLS certification to COR every two years.

d. The services to be performed by the contractor shall be performed in accordance with VA policies, procedures and regulations of the medical staff by laws of the VA facility.

e. The Government reserves the right to refuse acceptance of Contractor, if personal or professional conduct jeopardizes patient care. 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.

Standards for conduct shall mirror those prescribed by current federal personnel regulations.

The Contracting Officer and Contracting Officer Representative (COR) shall deal with issues raised concerning contract personnel’s conduct. The final arbiter on questions of acceptability is the Contracting Officer.

f. The Contracting Officer shall resolve complaints concerning Contractor relations with the

Government employees or patients. The Contracting Officer is the final authority on validating complaints. In the event that the Contractor is involved and named in a validated patient complaint, the Government reserves the right to refuse acceptance of the services of such personnel. This does not preclude refusal in the event of incidents involving physical or verbal abuse.

g. Contractor shall, in writing, keep the Contracting Officer informed of any unusual circumstances in conjunction with the contract.

2. CREDENTIALING AND PRIVILEGES

a. Contractor and applicant should provide all necessary documents and complete the Vet Pro application process (30) days in advance for full privileges-which requires three (3) current references, plus application for VA privileges to include a copy of privileges from most recent work assignment from another hospital. Providers referred to provide services under the contract must obtain an individual NPI number. Number must be provided with the offer to the Contracting Officer along with a copy of current license and malpractice insurance certificate.

b. Name of individuals providing services under the contract and their applicable licenses must be submitted to the Contracting Officer with the offer, including individual Social Security Numbers, dates of birth, place of birth (city, state and country and addresses in order to comply with VA Credentialing and Privileging requirements.

c. The National provider identifier (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 ensure that the health care practitioners and/or medical center providing service under the contract obtains a NPI and provides it to the Contracting Officer.

3. BADGES:

Contractor is required to wear I.D. badge during the entire time he/she is on VAMC grounds. I.D.

badges MUST have an identification picture and shall be issued by VAMC.

4. PERSONNEL POLICY

The Contractor shall assume full responsibility for the protection of its personnel furnishing services under this contract. To carry this out the Contractor shall provide the following for these personnel:

Worker’s compensation Professional liability insurance Health examinations Income tax withholding, and Social Security payments

5. QUALITY ASSURANCE

a. Contractor will provide evidence of participation and preparation in meeting or exceeding all Joint Commission for Accreditation of Hospital standards.

b. The Department of Veterans Affairs is allowed according to public law 99-272 and 101-508, to seek reimbursement from health insurance carriers for the cost of medical care and treatment provided to veterans for their non-service connected conditions. The contractor is not allowed to bill health insurance carriers for the services provided to Veterans while employed by or working under contract with the Department of Veterans Affairs.

c. The contractor may not bill any veteran or their health insurance carrier for care provided to a veteran while employed by or working under contract with the Department of Veterans Affairs, nor may the contractor keep any reimbursement for the erroneous billing of a veteran or their Third- Party insurance. Such reimbursements or billing errors should such occur, must be returned to the Medical Care Cost Fund (MCCF) section for processing.

6. TORT CLAIMS

Contractor employees are not covered by the Federal Tort Claims Act. When a Contractor employee has been identified as a provider in a tort claim, the Contractor employee is responsible for notifying the Contractor’s legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor employee’s action or non-action is the responsibility of the Contractor and/or insurance carrier.

7. JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE

ORGANIZATIONS (JCAHO), AND VHA (VETERANS HEALTH ADMINISTRATION)

STANDARDS

a. Contractor must meet or exceed Joint Commission or equivalent standards and maintain the standards for the duration of the contract.

b. The contractor shall be responsible to ensure that Contractor employees providing work on this contract are fully trained and competent to perform the work required.

c. The contractor shall be required to maintain records that document competence/performance level of contractor employees working on this contract in accordance with JCAHO and other regulatory body requirements.

d. The VA will monitor the contractor employees' work to ensure contract compliance.

e. If the contractor is not Joint Commission accredited, the contractor must perform the required work in accordance with Joint Commission hospital standards. A copy of these standards may be obtained from the Joint Commission, One Renaissance Blvd., Oakbrook Terrance, IL 60181.

f. Contractor shall ensure contractor staff are trained on, and comply with, the current Joint Commission Environment of Care standards and related Standard Operating Procedures.

g. The local VAMC may be surveyed by Joint Commission as part of the accreditation process during the term of this contract. The Contractor’s facility may also be subject to a site visit and review by Joint Commission as part of the local VAMC survey process.

The contractor agrees to cooperate with the local VAMC and Joint Commission during the survey process.

h. The contractor(s) must perform the required work in accordance with Joint Commission standards. The contractor(s) must comply with all annual updates as issued.

i. The contractor(s) shall meet all federal, state, and local fire and life safety codes.

j. The contractor(s) shall comply with the policies of VA.

8. HIPAA COMPLIANCE

Contractor and any subcontractors must adhere to the provisions of Public Law 104-191, Health Insurance Portability and Accountability Act (HIPAA) of 1996. This includes both Privacy and Security Rules published by the Department of Health and Human Services (HHS). As required by HIPAA, HHS has promulgated rules governing the use and disclosure of protected health information by covered entities. The covered entity component of the Department of Veterans Affairs is the Veterans Health Administration (VHA). In accordance with HIPAA, the contractor may be required to enter into a Business Associate Agreement (BAA) with VHA.

9. CONFIDENTIALITY

a. To the extent permitted by federal privacy statutes, rules and regulations, the VA shall provide the Contract with access to pertinent medical information for the purpose of providing coordinated comprehensive health care to veterans. The Contractor shall access only those records of the enrolled veterans and shall maintain the confidentiality of all such patient information and shall be held liable in the event of a breach of confidentiality by the Contractor.

b. The Contractor shall not release any medical records directly to a veteran. The Contractor acknowledges that all records are subject to the Privacy Act and that the VA is the sole entity authorized to release such information and implementing regulations.

c. The VA acknowledges that in receiving, storing, processing or otherwise dealing with any patient information received from the Contractor, the VA is fully bound by federal confidentiality statutes and implementing regulations.

d. Contractor shall provide health care to patients seeking such care from or through VA. As such, contractor is considered a part of the Department health activity for purposes of the following statutes and the VA regulations implementing these statutes: the Privacy Act, 5.S.C. sec 552a, and U.S.C. sections 5701, 7705, and 7332. Contractor and its’ employees are subject to the penalties and liabilities provided in the statutes and regulations mentioned in the paragraph for unauthorized disclosures of such records and their contents.

e. Records created by the contractor in the course…