36C24619Q0354-003.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 97

590-19-3-9215-0153

36C24619Q0354 02-27-2019

Mohamed M. Shakur 757-251-4296 03-06-2019 2:00pm EST

36C246 Marchelle Peyton Department of Veterans Affairs Network Contracting Office 6 100 Emancipation Drive Hampton VA 23667

X 0

Y

622210

$38.5 Million

Net 30

X

N/A

X

36C246

Department of Veterans Affairs Network Contracting Office 6

Department of Veterans Affairs Network Contracting Office 6

757-254-2424

Department of Veterans Affairs Financial Services Center P.O. Box 149971 Austin TX 78714-9971

The Hampton Veterans Affairs Medical Center, has a need for a Contractor to provide off-site inpatient psychiatric services to the beneficiaries of the Hampton VA Medical Center. These services will be required 24 hours a day, 7 days a week, including holidays.

The Contractor shall provide services in accordance the Performance Work Statement.

See Attached Schedule Pages.

X X

X X 1

Marchelle Peyton Contracting Officer

36C24619Q0354

Table of Contents

SECTION A ................................................................................................... Error! Bookmark not defined.

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

Bookmark not defined.

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 SCHEDULE OF SUPPLIES/SERVICES:

B.3 PERFORMANCE WORK STATEMENT

B.4 SPECIAL CONTRACT REQUIREMENTS

SECTION C - CONTRACT CLAUSES

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

2018)

C.2 52.216-18 ORDERING (OCT 1995)

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

C.7 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR 1984) . 44

C.8 52.237-3 CONTINUITY OF SERVICES (JAN 1991)

C.9 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.10 VAAR 852.203-70 COMMERCIAL ADVERTISING (JAN 2008)

C.11 VAAR 852.215-71 EVALUATION FACTOR COMMITMENTS (DEC 2009)

C.12 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.13 VAAR 852.219-74 LIMITATIONS ON SUBCONTRACTING—MONITORING AND

COMPLIANCE (JUL 2018)

C.14 VAAR 852.219-75 SUBCONTRACTING COMMITMENTS MONITORING AND

COMPLIANCE (JUL 2018)

C.15 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV 2012)

C.16 VAAR 852.237-7 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE

(JAN 2008)

C.17 VAAR 852.237-70 CONTRACTOR RESPONSIBILITIES (APR 1984)

C.18 MANDATORY WRITTEN DISCLOSURES

C.19 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS--COMMERCIAL ITEMS (NOV 2012)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

D.1 QUALITY ASSURANCE SURVEILLANCE PLAN (QASP)

D.2 ATTACHMENT C - PAST PERFORMANCE SURVEY

D.3 CONTRACTOR CERTIFICATION

D.4. VA CONTRACTOR RULES OF BEHAVIOR

D.5. ORGANIZATIONAL CONFLICTS OF INTEREST (JAN 2008)

SECTION E - SOLICITATION PROVISIONS

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

E.2 SPECIFIC INSTRUCTIONS TO OFFERORS REGARDING PROPOSAL PREPARATION

SUBMISSION

E.3 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.4 52.209-9 UPDATES OF PUBLICLY AVAILABLE INFORMATION REGARDING

RESPONSIBILITY MATTERS (FEB 2012)

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

E.6 52.217-5 EVALUATION OF OPTIONS (JUL 1990)

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

E.8 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION

(JAN 2008)

E.9 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (JAN 1998)

E.10 VAAR 852.270-1 REPRESENTATIVES OF CONTRACTING OFFICERS (JAN 2008) 83

E.11 VAAR 852.271-70 NONDISCRIMINATION IN SERVICES PROVIDED TO

BENEFICIARIES (JAN 2008)

E.12 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL

ITEMS (DEC 2012)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

(continuation from Standard Form 1449, block 18A.)

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

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C246 Marchelle Peyton 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] Monthly in Arrears

4. GOVERNMENT INVOICE ADDRESS: All invoices from the contractor shall be mailed to the following address:

Department of Veterans Affairs Financial Services Center P.O. 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 SCHEDULE OF SUPPLIES/SERVICES:

Provide psychiatric treatment of beneficiaries of the Hampton VA Medical Center, 100 Emancipation Drive, Hampton, Virginia 23667 from 1 April 2019 through September 30, 2019 with three (3) one (1) year options and one (1) six (6) month priced-option period. In accordance with all terms and conditions, provisions and requirements listed herein. Usage on this contract will be on an as needed basis.

Contracting hospital will provide all necessary equipment, hospital supplies, and physician services required for the comprehensive psychiatric treatment of referred VA beneficiaries. Contractor shall only be paid for actual orders received. The Government anticipates award of a Fixed-Price – Indefinite Delivery Indefinite Quantity (IDIQ) Type contract resulting from this solicitation.

The guaranteed minimum contract amount, including the base period and any option years exercised, is 1 Bed Day and the maximum contract amount, including the base year and any option years exercised, shall not exceed the total contract amount for the base period plus the three (3) option years and one (1) priced-option period.

Estimated quantities are provided for informational purposes only. The government is not obligated nor is the contractor guaranteed to be issued orders totaling the estimated quantities.

Base Period April 1, 2019 through September 30, 2019

CLIN ITEM

DESCRIPTION

ESTIMATED

QUANTITY

UNIT OF

ISSUE

UNIT PRICE TOTAL

AMOUNT

0001 Services for Inpatient Psychiatric Bed Days of Care

84 Days $ $

TOTAL FOR BASE PERIOD: ______________________________

Option Year 1 – October 1, 2019 through September 30, 2020

CLIN ITEM

DESCRIPTION

ESTIMATED

QUANTITY

UNIT OF

ISSUE

UNIT PRICE TOTAL

AMOUNT

1001 Services for Inpatient Psychiatric Bed

140 Days $ $

TOTAL FOR OPTION YEAR 1: ______________________________

Option Year 2 – October 1, 2020 through September 30, 2021

CLIN ITEM

DESCRIPTION

ESTIMATED

QUANTITY

UNIT OF

ISSUE

UNIT PRICE EXTENDED

AMOUNT

2001 Services for Inpatient Psychiatric Bed

TOTAL FOR OPTION YEAR 2: ______________________________

Option Year 3 – October 1, 2021 through September 30, 2022

DESCRIPTION

ESTIMATED

QUANTITY

UNIT OF

ISSUE

UNIT PRICE EXTENDED

AMOUNT

3001 Services for Inpatient Psychiatric Bed

TOTAL FOR OPTION YEAR 3: ______________________________

Priced Option Period, Not to Exceed 6 Months October 1, 2022 through March 31, 2023

DESCRIPTION

ESTIMATED

QUANTITY

UNIT OF

ISSUE

UNIT PRICE EXTENDED

AMOUNT

4001 Services for Inpatient Psychiatric Bed

50 Days $ $

TOTAL COST FOR BASE PERIOD AND ALL OPTION PERIODS: $_______________________

B.3 PERFORMANCE WORK STATEMENT

1. GENERAL:

1.1. Services Provided: The Hampton Veteran Affairs Medical Center, 100 Emancipation Drive, Hampton, VA 23667, has a need for a contracting hospital to provide off-site inpatient psychiatric services, in accordance with all terms and conditions, provisions and requirements listed herein. The contractor shall provide qualified professionals who are experienced in the evaluation, diagnosis, treatment and management of patients with moderate to severe psychiatric disorders, consistent with professional licensure laws, regulations, and certifications. Contracting Hospital shall provide routine inpatient psychiatric care (as appropriate) to patients having moderate to severe behavioral problems and/or experiencing withdrawals from drugs/alcohol.

This includes patients with a moderate to high risk suicide risk, assaultiveness, agitation, disorganized behavior disorders and/or symptoms of withdrawal. These services will be required 24 hours a day, 7 days a week, including holidays.

1.2. The contractor shall provide housing, to include a minimum of, beds, restroom, bath, and kitchen facilities, and related furnishings. Adequate safety and security measures in accordance with VA standards and in conformance with state and local safety and health codes as outlined in 38 CFR, Section 17.53b http://vaww.ceosh.med.va.gov/.in order to provide optimum safety for residents.

The contractor shall provide personal hygiene items, first aid supplies, and storage as needed.

1.3. Place of Performance – At the contractors’ facility.

1.4. Authority: Title 38 USC 8153, Health Care Resources (HCR) Sharing Authority.

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

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

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

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

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

1.6.2. Contracting Officer’s Representative (COR) – A person appointed by the CO to take necessary action to ensure the Contractor performs in accordance with and adheres to the specifications contained in the contract and to protect the interest of the Government. The http://vaww.ceosh.med.va.gov/ http://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=347 https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443

COR shall report to the CO promptly any indication of non-compliance in order that appropriate action can be taken.

1.6.3. POP: Period of Performance

1.6.4. QASP: Quality Assurance Surveillance Plan

1.6.5. PWS: Performance Work Statement

1.6.6. ROI: Release of Information

1.6.7. Veterans Affairs Medical Center (VAMC) : Unless identified with the name of a different VA medical Center, for purposes of this contract, this term shall mean the Hampton VA Medical Center.

2. CONTRACTOR RESPONSIBILITIES:

Staff Clinical Personnel Required: The Contractor shall provide contractor employee (s) who are competent, qualified per this performance work statement and adequately trained to perform the following assigned duties:

3. MEDICAL RECORDS:

3.1 Authorities: Contractor’s employee (s) providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the U.S.C.551a (Privacy Act), 38 U.S.C. 5701 (Confidentiality of claimants records), 5 U.S.C.

552 (FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332 (Confidentiality of certain medical records), Title 5 U.S.C. § 522a (Records Maintained on Individuals) as well as 45 C.F.R. Parts 160, 162, and 164 (HIPAA).

3.2 HIPAA: This contract and its requirements meet exception in 45 CFR 164.502(e), and do not require a BAA in order for Covered Entity to disclose Protected Health Information to: a health care provider for treatment. Based on this exception, a BAA is not required for this contract. Treatment and administrative patient records generated by this contract or provided to the Contractors by the VA are covered by the VA system of records entitled ‘Patient Medical Records-VA’ (24VA19). Contractor generated VA Patient records are the property of the VA and shall not be accessed, released, transferred, or destroyed except in accordance with applicable laws and regulations. Contractor shall ensure that all records pertaining to medical care and services are available for immediate transmission when requested by the VA. Records identified for review, audit, or evaluation by VA representatives and authorized federal and state officials, shall be accessed on-site during normal business hours or mailed by the Contractor at his expense. Contractor shall deliver all final patient records, correspondence, and notes to the VA within twenty-one (21) calendar days after the contract expiration date.

3.3 Disclosure: Contractor’s employee (s) may have access to patient medical records: however, Contractor shall obtain permission from the VA before disclosing any patient information.

Subject to applicable federal confidentiality or privacy laws, the Contractor, or their http://www.rms.oit.va.gov/SOR_Records/24VA19.asp http://www.rms.oit.va.gov/SOR_Records/24VA19.asp designated representatives, and designated representatives of federal regulatory agencies having jurisdiction over Contractor, may have access to VA ‘s records, at VA’s place of business on request during normal business hours, to inspect and review and make copies of such records. The VA will provide the Contractor with a copy of VHA Handbook 1907.1, Health Information management and Health Records and VHA Handbook 1605.1, Privacy and Release of Information. The penalties and liabilities for the unauthorized disclosure of VA patient information mandated by the statutes and regulations mentioned above, apply to the Contractor.

3.4 Professional Standards for Documenting Care: Care shall be appropriately documented in medical records in accordance with standard commercial practice and guidelines established by VHA Handbook 1907.01 Health Information Management and Health Records:

http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791 and all guidelines provided by the VAMC.

3.5 Release of Information: The VA shall maintain control of releasing any patient medical information and will follow policies and standards as defined, but not limited to Privacy Act requirements. In the case of the VA authorizing the Contractor to release patient information, the Contractor in compliance with VA regulations, and at his/her own expense, shall use VA Form 3288, Request for and Consent to Release of Information from Individual’s Records, to process “Release of Information Requests.” In addition, the Contractor shall be responsible for locating and forwarding records not kept at their facility.

The VA’s Release of Information Section shall provide the Contractor with assistance in completing forms. Additionally, the Contractor shall use VA Form 10-5345, Request for and Authorization to Release Medical Records or Health Information, when releasing records protected by 38 U.S.C. 7332. Treatment and release records shall include the patient’s consent form. Completed Release of Information requests will be forwarded to the VA Privacy Officer at the following address: Lisa Wright, 100 Emancipation Drive, Hampton, VA 23667.

4. PATIENT CARE:

4.1 Per the qualification section of this PWS, the Contractor shall provide qualified staff:

4.2 Scope of Care: The following procedures shall be followed when caring for a Hampton

VAMC

Behavioral Health patient:

i. All patients referred to the Contracting Hospital from Hampton VAMC will be approved by the Chief of Mental Health or his/her designee.

ii. For patients referred from Hampton VAMC to the Contracting Hospital Emergency Room (ER), the Hampton VAMC physician will medically clear the patient and provide this recommendation to the Chief of Mental Health or his/her designee. The Chief of Mental Health or his/her designee will authorize inpatient psychiatric care at the Contracting Hospital for medically cleared patients.

iii. If the Contracting Hospital refuses to admit a psychiatric patient sent by Hampton VAMC, the referring physician at Hampton VAMC 757 772-9961 shall be notified immediately, and before the patient is released from the Contracting Hospital.

http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1469 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1469 http://www1.va.gov/vhapublications/viewpublication.asp?pub_id=1423 http://www1.va.gov/vhapublications/viewpublication.asp?pub_id=1423 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791 http://www4.va.gov/vaforms/va/pdf/VA3288.pdf http://www4.va.gov/vaforms/va/pdf/VA3288.pdf http://www4.va.gov/vaforms/medical/pdf/vha-10-5345-fill.pdf http://www4.va.gov/vaforms/medical/pdf/vha-10-5345-fill.pdf

iv. The Contracting Hospital shall provide routine off-site inpatient psychiatric care, to include psychiatric evaluation and treatment, pharmacotherapy, continuous nursing care and observation, inpatient case management, psychological testing and evaluation, psycho educational sessions, and individual, conjoint, group, and activity therapies as appropriate to patient’s diagnosis and clinical status.

v. The anticipated length of stay (LOS) will not exceed (5) five days unless prior written or verbal approval from Chief of Mental Health or his/her designee, Hampton VAMC. Pre-certification must be obtained from the Chief of Mental Health or his/her designee, for any extension of stay on the psychiatric unit beyond (5) days. If a Hampton VAMC patient stays at the Contracting Hospital beyond the certified period without pre-certification/approval from the VAMC, the VA will not pay for expenses incurred beyond the certified episode of care.

vi. The Chief of Mental Health or his/her designee, will be kept informed daily of the patient’s clinical status, response to treatment, and anticipated discharge date.

vii. The Contracting Hospital staff shall inform the Chief of Mental Health, or his/her designee, of discharge or transfer plans in a timely manner, and will coordinate aftercare plans with Hampton VAMC staff.

viii. A Hampton VAMC patient discharged on psychotropic medications will be prescribed medications, which are available on the VA Drug Formulary. The Hampton VAMC formulary will be provided to the Contracting Hospital.

ix. The Contracting Hospital shall provide Hampton VAMC with a copy of the patient’s admitting history and physical, and discharge summary as soon as they are available. They can either be faxed to 728-3174 or mailed to the Chief, Mental Health, Stop 116A, 100 Emancipation Drive, Hampton, VA 23667.

x. Prior authorization is necessary when a medical emergency requiring re-hospitalization occurs. In such instances the Contracting Hospital shall notify the VA immediately of the necessity of such emergency medical hospitalization, and it will be determined if the veteran will be admitted to an appropriate VA facility for such medical treatment.

xi. When emergency admission to a VA facility is not feasible because of the nature of the medical emergency, it is agreed that the hospitalization in a non-federal hospital may be accomplished provided authorization is obtained from Hampton

VAMC.

xii. When hospitalization is required for medical care that is of a non-emergency nature, it is agreed that patient will promptly be referred back to the VA for admission evaluation.

4.3 The Contracting Hospital shall develop and maintain written policies and procedures for credentialing, certification, and continuing education for employees and/or subcontractors providing services under this contract. Competent, qualified, and experienced health care professionals who hold current licensure and/or certification for their specialty from a State, Territory, Commonwealth of the United States, or District of Columbia shall provide all services under this contract.

4.4 The services performed by the Contracting Hospital shall be under the direction of the

Hampton VAMC Chief of Mental Health. The Government may evaluate the quality of professional and administrative services provided, but retains no control over the quality of medical or professional aspects of services rendered.

4.5 The level of service shall be consistent with the current requirements to meet and maintain The Joint Commission (TJC) or equivalent standards.

4.6 Admission standards may include the following: The patient must need rapid intensive assessment, management, and treatment for moderate to severe psychiatric symptoms and require close and constant monitoring and interventions.

4.7 The Hampton VAMC is responsible for patient travel to the Contracting Hospital and the patient is responsible for transportation upon discharge.

4.8 The Contracting Hospital shall develop an initial treatment plan within (24) twenty-four hours of admission and will coordinate the aftercare plans with the designated VA staff. Daily verbal reports are to be provided to designated VA staff regarding the patient’s clinical status, response to treatment and anticipated discharge date. The expectation is that treatment will be provided in a relatively short duration, ordinarily four (4) to five (5) days. Post-evaluation, an anticipated length of stay will be established and the Hampton VAMC Chief of Mental Health or his/her designee will be notified.

4.9 Involuntary Temporary Detention: Although legal proceedings alone are an inadequate basis for establishing payment obligation, any referral of a VA patient for diagnosis and treatment during a medical/psychiatric emergency may establish such an obligation. Therefore, if any Hampton VAMC associate, acting in his/her capacity, requests a temporary detention, and the patient is detained to the Contracting Hospital, the Hampton VAMC will, under this contract, accept a payment obligation not to exceed 48 hours unless the temporary detention order will expire on a Saturday, Sunday or legal holiday, in which case it will be extended until the next business day which is not a Saturday, Sunday or legal holiday.

4.10 If the patient is subsequently involuntarily committed, the expectation is that the patient will be transferred to the VA facility at Hampton, VA, unless the patient elects to stay at the Contracting Hospital at his/her own expense, or Hampton VAMC has sufficient beds to accept the patient for ongoing involuntary treatment. Hampton VAMC authorizes payment for the additional days after involuntary commitment until such time a patient is accepted at VAMC Salem or transferred to Hampton VAMC.

4.11 If the patient is transferred to the Hampton VAMC, a copy of the history and physical, discharge summary and list of discharge medications shall be submitted to Hampton VAMC on the day of transfer, or as soon as available in the case of the discharge summary. A copy of the discharge note with pertinent information must be sent to the VA at the time of discharge with a complete discharge summary to follow within 1 week (7 calendar days).

4.12 It is agreed that the facility will notify the VA immediately when a medical emergency requiring re-hospitalization occurs. It is agreed that the veteran will be admitted to any appropriate VA facility for such medical treatment. When such a re-admission is not feasible because of the nature of the emergency, it is agreed that the hospitalization in a non-federal hospital may be accomplished, provided authorization from the VA is obtained. If hospitalization of a non-emergency nature is required, it is agreed that admission to the VA will be accomplished promptly.

5. LOCATION OF SERVICES:

5.1 All services are performed on an inpatient basis at the Contractor’s facility.

5.2 The contractor will have access to files containing sensitive data, which must be protected under the provisions of the Privacy Act of 1974 (5 USC 552a), and other applicable laws, Federal Regulations, Veterans Affairs statutes and policies. The Contractor’s employee(s) are responsible for (1) protecting that data from unauthorized release or from loss, alteration, or unauthorized deletion and (2) following all applicable regulations and instructions regarding access to computerized files.

6. PERSONNEL:

6.1 A board certified psychiatrist shall be available for consultation with VA patients as follows:

6.1.1 Emergency cases - 24 hours/day, 7 days/week

6.1.2 Routine cases - contracting facility’s normal business hours. A Registered nurse shall be available 24 hours/day, 7 days/week.

7. COMPLAINTS HANDLING:

7.1 The (COR) shall monitor the services provided. Contractor shall cooperate with the COR in providing information and answering questions in a timely manner when requested. The contractor shall refer complaints received directly from the customer(s) to the COR. All patient complaints received by the COR will be forwarded to the contractor and those received by customer (s) regarding quality of care shall be investigated within 72 hours. The contractor shall respond to the COR within 5 working days.

8. CONTRACTOR FACILITY:

8.1 The contract facility must have a current occupancy permit or license required by the authority having jurisdiction.

8.2 The contract facility shall be equipped with operational air conditioning /heating systems.

Air conditioning and heating systems that malfunction will be repaired within three business days; repeated failure to repair inoperable equipment within the timeframe may result in an unfavorable performance evaluation or contract termination.

8.3 The contract facility shall be kept clean free of dirt, grime, mold, infestations or other hazardous substances and damages which noticeably detract from the overall appearance and safety of the facility. Failure to provide a clean, safe environment may result in contract termination.

8.4 The contract facility shall be equipped with first aid kit, fire extinguisher fully charged and non-expired, fire/carbon alarms, evacuation plan in case of emergency.

8.5 The contractor facility shall have windows and doors that can be opened and closed in accordance with manufacturer standards.

8.6 The contractor shall comply with the VA Patient's Bill of Rights as set forth in the Code of Federal regulations, Section 17.34a, Title 38 (copy is available upon request).

9. SAFETY:

9.1 The facility meets applicable fire, safety and sanitation standards in attractive surroundings, conducive to social interaction and the fullest development of the resident's rehabilitative potential.

10. QUALIFICATIONS:

10.1 Staff/Facility

a. Personnel – The contractor will employ sufficient and qualified personnel to carry out the policies, responsibilities, and the program for the facility. Off-site Inpatient Services must be available 24 hours a day, 7 days a week.

b. License / Certification - All contractor’s employee (s) shall be currently certified in American Heart Association Basic Life Support (BLS). Documentation verifying current certification shall be provided by the Contractor to the VA COR on an annual basis for each year of contract performance.

11. CONFLICT OF INTEREST:

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

12. CITIZENSHIP RELATED REQUIREMENTS:

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

12.2 While performing services for the Department of Veterans Affairs, the Contractor knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States.

Additionally, the Contractor is required to comply with all “E-Verify” requirements consistent with “Executive Order 12989” and any related pertinent Amendments, as well as applicable Federal Acquisition Regulations.

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

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

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

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

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

12.8 No Employee status: The Contractor shall be responsible for protecting Contractor’s employee(s) furnishing services. To carry out this responsibility, the Contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract:

2.1.9 Workers’ compensation

2.1.10 Professional liability insurance

2.1.11 Health examinations

2.1.12 Income tax withholding, and

2.1.13 Social security payments.

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

13. PERFORMANCE STANDARDS, QUALITY ASSURANCE (QA) AND QUALITY

IMPROVEMENT(QI)

13.1 Quality Management/Quality Assurance Surveillance: 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.

13.1.1 Patient Complaints: The CO will resolve complaints concerning Contractor relations with the Government employees or patients. The CO is 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.

13.1.2 The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. The CO and COR shall deal with issues raised concerning Contractor’s conduct. The final arbiter on questions of acceptability is the CO.

13.1.3 Performance Standards:

13.1.3.1 Measure: Qualifications

Performance Requirement: Contractor to provide board certified psychiatrist to provide medical service as specified in the performance work statement.

Standard: Qualified personnel are available and in location as needed to properly perform tasks as specified.

Acceptable Quality Level: 90% Surveillance Method: Random Inspection, Quality Assurance Reports.

13.1.3.2 Measure: Patient Safety

Performance Requirement: Patient safety incidents must be reported using Patient Safety Report.

Standard: All incidents reported immediately (within 24 hours).

Acceptable Quality Level: 90% Surveillance Method: Patient Safety Report

13.1.3.3 Measure: Maintains licensing, registration, and certification Performance Requirement: Updated Licensing, registration and certification will be provided as they are renewed.

Standard: Licensing, registration and certification information kept current.

Acceptable Quality Level: 100% Surveillance Method: Periodic sampling and random sampling

13.1.3.4 Measure: Privacy Confidentiality and HIPPA

Performance Requirement: Contractor conducts training on laws, regulations, policies and procedures relating to Privacy, Confidentiality and HIPAA.

Standard: Zero breaches of privacy or confidentiality.

Acceptable Quality Level: 100% Surveillance Method: Contractor to provide evidence of annual training required by VAMC, reports violations per VA Directive 6500.6.

13.1.3.5 Measure: Timely Invoicing

Performance Requirement: Within 15 days of the end of each month services were provided, as described above, the vendor shall provide itemized invoicing.

Standard: All itemized invoices provided within 15 days of the end of each month services delivered.

Acceptable Quality Level: 90% Surveillance Method: Inspection.

13.2 REGISTRATION WITH CONTRACTOR PERFORMANCE ASSESSMENT REPORTING

SYSTEM

13.2.1 As prescribed in Federal Acquisition Regulation (FAR) Part 42.15, the Department of Veterans Affairs (VA) evaluates Contractor past performance on all contracts that exceed $150,000, and shares those evaluations with other Federal Government contract specialists and procurement officials. The FAR requires that the Contractor be provided an opportunity to comment on past performance evaluations prior to each report closing.

To fulfill this requirement VA uses an online database, CPARS, which is maintained by the Naval Seal Logistics Center in Portsmouth, New Hampshire. CPARS has connectivity with the Past Performance Information Retrieval System (PPIRS) database, which is available to all Federal agencies. PPIRS is the system used to collect and retrieve performance assessment reports used in source selection determinations and completed CPARS report cards transferred to PPIRS. CPARS also includes access to the federal awardee performance and integrity information system (FAPIIS). FAPIIS is a web-enabled application accessed via CPARS for Contractor responsibility determination information.

13.2.2 Each Contractor whose contract award is estimated to exceed $150,000 requires a CPARS evaluation. A government Focal Point will register your contract within thirty days after contract award and, at that time, you will receive an email message with a User ID (to be used when reviewing evaluations). Additional information regarding the evaluation process can be found at www.cpars.gov or if you have any questions, you may contact the Customer Support Desk @ DSN: 684-1690 or COMM: 207-438-1690.

13.2.3 For contracts with a period of one year or less, the contracting officer will perform a single evaluation when the contract is complete. For contracts exceeding one year, the contracting officer will evaluate the Contractor’s performance annually. Interim reports will be filed each year until the last year of the contract, when the final report will be completed. The report shall be assigned in CPARS to the Contractor’s designated representative for comment. The Contractor representative will have sixty (60) days to submit any comments and re-assign the report to the CO.

13.2.3 Failure for the Contractor’s representative to respond to the evaluation within those sixty

(60) days, will result in the Government’s evaluation being placed on file in the database with a statement that the Contractor failed to respond; the Contractor’s representative will be “locked out” of the evaluation and may no longer send comments.

14. GOVERNMENT RESPONSIBILITIES:

14.1 Contract Administration/Performance Monitoring: After award of contract, all inquiries and correspondence relative to the administration of the contract shall be addressed to:

14.1.2 CONTRACTING OFFICER RESPONSIBILITIES:

CO – Marchelle D. Peyton 100 Emancipation Drive Hampton, VA 23667 Phone: 757-728-7013 Email: marchelle.peyton@va.gov

14.1.3 The Contracting Officer is the only person authorized to approve changes or modify any of the requirements of this contract. The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration. Only the Contracting Officer is authorized to make commitments or issue any modification to include (but not limited

to) terms affecting price, quantity or quality of performance of this contract.

14.1.4 The Contracting Officer shall resolve complaints concerning Contractor relations with the

Government employees or patients. The Contracting Officer is final authority on validating complaints. In the event the Contractor effects any such change at the direction of any person other than the Contracting Officer without authority, no adjustment shall be made in the contract price to cover an increase in costs incurred as a result thereof.

14.1.5 In the event that contracted services do not meet quality and/or safety expectations, the best remedy will be implemented, to include but not limited to a targeted and time limited performance improvement plan; increased monitoring of the contracted services;

consultation or training for Contractor personnel to be provided by the VA; replacement of the contract personnel and/or renegotiation of the contract terms or termination of the contract.

http://www.cpars.gov/ mailto:marchelle.peyton@va.gov

14.1.6 COR Responsibilities:

The COR for this contract is: William Jordan, COR / Administrative Officer Behavioral Science Service Line Hampton VAMC 100 Emancipation Drive Hampton, VA 23667 757-722-9961 ext 2002 william.jordan@va.gov

14.1.6.1 The COR shall be the VA official responsible for verifying contract compliance. After contract award, any incidents of Contractor noncompliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer.

14.1.6.2 The COR will be responsible for monitoring the Contractor’s performance to ensure all specifications and requirements are fulfilled. Quality Improvement data that will be collected for ongoing monitoring includes but is not limited to: enter data that may be collected.

14.1.6.3 The COR will maintain a record-keeping system of services by electronic storage. The COR will review this data monthly when invoices are received and certify all invoices for payment by comparing the hours documented on the VA record-keeping system and those on the invoices. Any evidence of the Contractor's non-compliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer.

14.1.6.4 The COR will review and certify monthly invoices for payment. If in the event the Contractor fails to provide the services in this contract, payments will be adjusted to compensate the Government for the difference.

14.1.6.5 All contract administration functions will be retained by the VA.

mailto:william.jordan@va.gov

B.4 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 either a unilateral or bilateral written modification to this contract. The unilateral modification shall be prepared by the Contracting Officer (CO). The bilateral modification will be signed by both parties prior to becoming effective.

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. 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 which will be provided to the Contractor staff by the Contracting Officer Representative (COR).

d. 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 (CO) 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.

e. 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.

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

2. WORK HOURS:

a. The services covered by this contract shall be furnished by the contractor as defined herein.

b. There must be, as a minimum, a licensed nursing staff member or designee of equivalent professional capability on duty, on the premises or residing at the contract facility and available for emergencies 24 hours a day, 7 days a week, to include all Federal Holidays.

c. Federal Holidays: The 10 holidays observed by the Federal Government are:

New Year’s Day Martin Luther King’s Birthday President’s Day Memorial Day Independence Day Labor Day Columbus Day Veterans Day Thanksgiving Christmas

AND any other day specifically declared by the President of the United States to be a federal holiday.

When one of the holidays falls on Sunday, the following Monday shall be observed as a Federal Holiday. When a holiday falls on a Saturday, the preceding Friday shall be observed as a Federal Holiday.

Off Duty hours: Not Applicable

3. DESCRIPTION OF FACILITIES/EQUIPMENT/INSTRUMENTS:

a. The Contractors facility must meet all federal, state, VA, and local fire and life safety codes.

4. PERSONNEL POLICY:

The Contractor shall be responsible for protecting the personnel furnishing services under this contract.

To carry out this responsibility, the Contractor shall provide the following:

- Workers’ Compensation Insurance

- Professional Liability Insurance

- Health Examinations

- Income Tax Withholding, and

- Social Security Payments

The parties agree that such personnel shall not be considered VAMC employees for any purpose and shall be considered employee(s) of the Contractor.

5. TERM OF CONTRACT:

This contract is effective for one year from October 1, 2018 to September 30, 2019, plus 4 one-year options and (1) six month priced-option period that may be exercised by the VA. The contract is subject to the availability of VA appropriations. No services shall be performed by the Contractor after Aug 31st of each contract year until the contracting officer authorizes such services in writing.

a. The Contracting Officer will be the only person authorized to approve changes or modify any of the requirements under this contract. The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration. Only the Contracting Officer will be authorized to make commitments or issue changes that affect price, quantity, or quality of performance of this contract. In the event the Contractor effects any such change at the direction of any person other than the Contracting Officer, the change shall be considered unauthorized by the local VAMC and no adjustment will be made in the contract price to cover any increase in costs incurred as a result thereof.

b. The COR will be responsible for the overall technical administration of this contract as outlined in the COR Delegation of Authority.

6. CONTRACTING WITH PARTIES LISTED ON THE OIG LIST OF EXCLUDED

INDIVIDUALS / ENTITIES:

a. In accordance with The Health Insurance Portability and Accountability Act (HIPAA) and the Balanced Budget Act (BBA) of 1977, the Office of Inspector General 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.

b. Therefore, all offerors shall review the OIG List of Excluded Individuals/Entities on the OIG web site at www.hhs.gov/oig to ensure that the proposed candidate(s) and/or firm(s) are not listed.

Offerors should note that any…