36C24619R0009-001.docx

36C24619R0009

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 SI

GN 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. SIGN

ATURE 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

36C24619R0009 4:30 pm 36C246 Department of Veterans Affairs Network Contracting Office 6 100 Emancipation Drive Hampton VA 23667 X $27.5 Million X N/A X Department of Veterans Affairs Network Contracting Office 6 100 Emancipation Drive Hampton VA 23667 36C246 Department of Veterans Affairs Network Contracting Office 6 100 Emancipation Drive Hampton VA 23667

Department of Veterans Affairs Fayetteville VAMC 2300 Ramsey St.

Fayetteville, NC 28301

See CONTINUATION Page Solicitation for Adult Day Health Care Services in the cities and counties for Veterans authorized care from the Fayetteville VAMC, NC for Non- Institutional Care The period of performance for this solicitation will be from See CONTINUATION Page X X 1(one) Christian A. Rosado Ramirez Table of Contents

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:

3. INVOICES: Invoices shall be submitted in arrears:

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

Claim Submission: Submit claims and all documentation for payment by fax, to the VA facility authorizing placement and to the attention of the individual listed for that facility.

1. Fayetteville VA Medical Center 2300 Ramsey Street Fayetteville, NC 28301 Attn: Keninthe Davis Fax: 910-482-5163

VA reserves the right to return a claim with a request for additional information. Preauthorized claims must be submitted within 6 years of treatment date.

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

5. All Adult Day Care Facilities must invoice using the CMS 1450 (UB-04) or HCFA 1500 form.

These forms must be original documents and can be downloaded free from the following site.

https://www.cms.gov/medicare/cms-forms/cms-forms/cms-forms-list.html

6. All claims and supporting documentation should be mailed to the locations, numbers and to the attention of the individuals listed below:

7. Claim Filing Instructions for Preauthorized Care. Claims submitted to VA for payment consideration must include a completed original CMS 1500 and/or CMS1450 (UB-04) billing forms to include at a minimum, the following patient and provider information:

a) Patient’s Name (including middle initial)

b) Patient’s Address (including zip code)

c) Patient’s Social Security Number

d) Provider’s Name

e) National Provider Identifier (NPI) Number

f) Provider Taxonomy Code(s), if known

g) Tax Identification Number (TIN/EIN)

h) Professional Status of Provider (MD, PA, NPA, etc.)

i) Facility Address where care was provided

j) Remit to (mailing address) where payment should be sent

k) All appropriate medical coding

l) All other health insurance information

m) Date(s) of service

n) Per Diem Rate

* The daily/weekly/monthly Attendance Log (sign in/ sign out sheets) signed by the Veteran/Next of Kin/ appropriate staff must be attached to the invoice. Failure to include this information may result in delayed payments.

8. TRANSPORTATION

a) Transportation rates are authorized by Title 38 U.S.C. 111A through the end of each year. If this law is rescinded or otherwise amended by Congress, these services will be removed from this Basic Ordering Agreement through modification to this Basic Ordering Agreement, and will be effective at the beginning of the specified fiscal year (i.e., 10/01/2018).

b) The Contractor is responsible to ensure any transportation services provided pursuant to the Basic Ordering Agreement complies with all pertinent provisions of Federal, State and local statues, rules and regulations.

c) Transportation is defined as either a one way or round trip to/from the Veterans residence and the ADHC facility. The VA reserves the right to return a claim with a request for additional information. Preauthorized claims must be submitted within 6 years of treatment date.

9. AUTHORIZATIONS

a) Authorizations for adult day health care will be accomplished on VA Form 10-7078, Authorization and Invoice for Medical and Hospital Services. Each authorization validity period will be from the initial effective date to disposition. Any extension to the original authorization validity period, regardless of the number of days, requires a new VA Form 10-7078.

b) VA reserves the right to return a claim with a request for additional information. Preauthorized claims must be submitted within 6 years of treatment date.

B.2 BASIC ORDERING AGREEMENT TERMS AND CONDITIONS OF THIS AGREEMENT

This is a basic ordering agreement for the period from 00/00/00 to 00/00/0000, in accordance with FAR 16.7. A contract is formed, in accordance with the terms and conditions of this agreement, when VA agrees to refer a patient to the Community Adult Day Health Care facility (CADHC) and the (CADHC) agrees to accept the patient. Upon acceptance by the contractor of beneficiaries of Department of Veterans Affairs (VA), all terms and conditions of this agreement shall apply during such time as a VA patient attends that (CADHC) at the expense of VA.

Upon acceptance of a VA patient by the (CADHC), if and when requested by the Contracting Officer or authorized representative, the contractor shall furnish all services herein described, at the per diem rates for the services specified on the authorization for that veteran. VA schedule descriptions are defined in Section D of this agreement.

B.3 RATE DETERMINATION

The per diem rate is established by North Carolina Department of Medical Assistance Services plus a fair market amount (percentage) to cover the cost of supplies, services, and equipment above that the provider under Medicaid established based on the local state Medicaid agency (SMA). Rates established after the effective date of this contract will constitute a modification to the contract, which normally coincide with the start of the state fiscal year (SFY).

The VA will use these published rates to determine rate increases, if any are awarded based on the economic price adjustment clause and establish the base year contract rate.

B.4 PRICE SCHEDULE

11/30/2018 – 11/29/2019 1st Option YR 11/30/2019

– 11/29/2020

*Bathing

*Patient Care

*Transportation

B.5 DESCRIPTION/SPECIFICATIONS/STATEMENT OF WORK

1. Federal Acquisition Regulation (FAR) – Basic Ordering Agreement (BOA). In accordance with FAR 16.703 - Basic Ordering Agreement, this is a BOA for the period 00/00/0000 through 00/00/0000, with four (4) one (1) year options periods renewable annually at the sole discretion of the Government.

2. Services Rendered at VA Per Diem Rates. Upon acceptance of a VA patient by the (CADHC), if and when requested by the VA Contracting Officer or authorized representative, the Contractor shall furnish all supplies and services herein described, at the per diem rates for the” Levels of Care” specified in the Schedule of Items of this BOA. The VA “Levels of Care” are defined in an attachment in Section D.1 of the solicitation and the BOA. VA is obligated only to the extent authorized placement of patients is made in accordance with this BOA.

3. Authorizations. Authorization will be obtained through the referral process of the Veteran’s VA Primary Care Physician and via consult of the Veteran’s VA Licensed Clinical Social Worker utilizing the CPRS system at VA hospital sites (Reference FAR 16.505 (b)(2)(i)(B)). The Non- Institutional Care program will assign Licensed Clinical Social Workers & Registered Nurses (CADHC Team) to serve as agents in the capacity of Contracting Officer’s Representatives (CORs) to identify and determine the need of each facility for this program. They CADHC team will also work with the Veteran’s on authorizations and placement into a suitable facility based on the veteran’s geographical location and desire.

A. Background/Introduction. The Community Adult Day Health Care program is a key component of the Veterans Health Administration (VHA) Non- Institutional Care program’s continuum of care. The Contractor agrees to provide care in accordance with the terms and conditions stated herein to the U.S. Department of Veterans Affairs - Fayetteville Veterans Affairs Medical Center, in Fayetteville, North Carolina at the prices specified in the section titled Schedule of Items of this BOA. Facilities in the CADHC program shall cooperate with VA staff in referral of appropriate veterans for care and acceptance of Veterans for which they have the capability/capacity to care. The term, “facilities,” shall include, but is not be limited to rooms, sections, eating areas, drinking fountains, entrances, and other like areas. Authorized VA representative(s) shall have the right to inspect the CADHC and all appurtenances to ensure that acceptable standards are maintained and necessary care to maintain the well-being of the patient is rendered.

B. Requirements

1. General. Community Contract Adult Day Health Care (CADHC) will be furnished to beneficiaries for whom such care is specifically authorized by the Department of Veterans Affairs Medical Center. It is understood that the type of patient to be cared for under this contract will receive these services as a substitute for institutionalization. The purposes for providing CADHC: to enable functionally impaired individuals to reside in supportive home environments rather than in skilled nursing facilities; to facilitate the return of Veterans to their home and coordinate community resources there by reducing readmissions to hospitals and nursing homes; to maintain the Veteran at the highest level of functioning possible; and to provide support to the family and other caregivers of Veterans. The care provided will include; nursing, Social Work services, assistance with activities of daily living (ADL), activity therapy, case management, and nutrition service including meals.

2. Termination of Services. VA reserves the right to remove any or all VA patients from the CADHC at any time when it is determined to be in the best interest of VA or the patients without additional costs to the Government.

3. VA Authorizations. Authorization for community adult day healthcare will be submitted on VA Form 10-7078, “Authorization and Invoice for Medical and Hospital Services.” Each authorization validity period will be noted on the VA Form 10-7078 with a beginning and end date. Any extension to the original authorization validity period, regardless of the number of days, requires a new VA Form 10-7078.

4. Medicaid-Based Rates. The current State Medicaid rates may be used as a basis for determination of VA rates. The VA rate will include adult day services and transportation to and from the facility, if authorized on the authorization form.

5. Emergency Care; Financial Responsibility; Advanced Directives. In emergencies, Community Adult Day Healthcare staff will utilize the 911 local emergency systems as for any resident. When private hospitalization or emergency services are required, the patient, spouse, financial guardian or insurer is financially responsible. Service connected veterans may qualify for VA coverage of emergency care provided the VA Health Care System (VAHCS) is contacted by the private hospital provider within 72-hours of admission on the first business day following a weekend or holiday. This includes the cost of necessary transportation for such care.

6. HIPAA Compliance. HIPAA compliance is required. The Contractor must adhere to the provisions of Public Law 104-191, Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the National Standards to Protect the Privacy and Security of Protected Health Information (PHI). As required by HIPAA, the Department of Health and Human Services (HHS) has promulgated rules governing the security and use and disclosure of protected health information by covered entities, including the Department of Veterans Affairs (VA). In accordance with HIPAA, the Contractor may be required to enter into a Business Associate Agreement (BAA) with VA, but VACO has recognized ADHC Facilities as an entity that does not require a BAA as long as they are conducting health care on VA’s behalf. The ADHC care program qualifies as a medical service, so no BAA is required.

Community Adult Day Health Care (CADHC) shall be furnished to beneficiaries for whom such care is specifically authorized by the Department of Veterans Affairs Medical Center. It is understood that the type of patient to be cared for under this contract will receive these services as a substitute for institutionalization. The purposes for providing CADHC are: to enable functionally impaired individuals to be in supportive environments rather than in nursing home care facilities; to facilitate the return of Veterans to their home and coordinate VA and/or community resources with the goal of reducing admissions to hospitals and nursing homes; to maintain the Veteran at the highest level of functioning possible; and to improve support for the family and other caregivers of Veterans using CADHC services. The care provided will include: nursing care, assistance with activities of daily living (ADL), activity therapy, case management, and nutrition service including meals. Bathing and Transportation are excluded from the per diem rate.

CADHC FACILITY GUIDELINES:

1. CADHC is a therapeutically oriented, outpatient program that provides health maintenance and structured programming to physically, emotionally, and/or cognitively disabled individuals. The CADHC operates in congregate settings and under contract or an agreement with the Department of Veterans Affairs. CADHC programs include nursing care, rehabilitation, social services, nutrition, therapeutic and socialization activities, and care coordination. The major goal of the program is to delay or prevent premature institutionalization of CADHC program participants.

2. CADHC will be provided, in a protective setting during part of the day but less than 24-hours, through contract arrangements with facilities licensed or certified under Medicaid standards or evaluated and approved under Medicaid standards and in good standing with the North Carolina Department of Human Resources and other agencies of the state of North Carolina. A Community Adult Day Care Facility operates as a Medical Model or as a combination of a Medical/Social Model.

3. The VA Community Adult Day Care Program Coordinator(s) will coordinate annual inspections of the CADHC facility.

4. All CADHC facilities must meet the latest edition of the VA Life Safety Code, be state licensed and certified under Medicaid standards or evaluated and approved under Medicaid Standards.

5. CADHC staffing/patient ratio must meet the highest standards of the state licensing body or at a minimum 1 staff member to every 6 patients per state guidelines:

*At a minimum, the center must employ a full time LPN under the supervision of a RN (8 hours a month).

*The center must demonstrate an ability to provide quality care in a safe environment to Veteran clients who are in the target population of this program.

*The contractor shall make available upon request, copies of certificates, training, licensure or other information as requested by the Contracting Officer (CO) or Contracting Officer’s Representative (COR) as evidence of the qualifications and/or experience of personnel providing services under this contract.

6. CADHC facility must agree to conditions stated in this contract for the VAMC in Fayetteville, N.C.

7. The CADHC rate(s) are exclusive of transportation costs. Mileage over 20 miles one way or round-trip is billable to VAMC at the GSA rate stated in the contract.

8. Invoices: CMS 1500 (02-12) red and white ink HCFA Forms required. All invoices must include the full name and address of the CADHC facility and shall reflect the patient's name, social security number, number of days billed, diagnosis, per diem rate, HCPC Code/Health Care Common Procedure Coding System, Diagnosis Code/ ICD 10, NPI number. Invoices are to be received in the CADHC office by the 10th of each month.

* The daily/weekly/monthly Attendance Log (sign in/ sign out sheets) signed by the Veteran/Next of Kin/ appropriate staff must be attached to the invoice. Failure to include this information may result in delayed payments.

*Mail invoices to: Fayetteville VAMC Geriatrics & Extended Care Service (11G) Attn: Keninthe Davis, COR 2300 Ramsey St.

Fayetteville, NC 28301 910-488-2120 Ext. 7312 (Keninthe Davis)

A MEDICAL CENTER GUIDELINES:

Eligibility and enrollment

1. CADHC is principally targeted for geriatric or disabled Veterans with complex medical, social, functional, mental, behavioral, and/or cognitive impairment. CADHC services include an emphasis on the caregivers and their needs related to support, education, and respite services in order to successfully maintain the Veteran in the home. A Veteran is eligible to receive CADHC if the Veteran is enrolled in the VA healthcare system, is at risk of institutionalization and has a CORE-Score that justifies the biopsychosocial need of CADHC services.

2. The Patient Aligned Care Team (PACT) is responsible for making referrals for the CADHC program and for certifying the continued need for CADHC services on an annual basis.

3. The PACT Social Worker is responsible for coordinating the consult process which includes the following:

(a) Completion of the CORE Score assessment or VA Approved Case Mix assessment;

(b) Documenting the patient/family preference for CADHC services to include location of the CADHC program and whether bathing and/or transportation services are needed;

(c) Administrative processing of an Application for Extended Care Services form (10-10EC) when needed;

(d) Communicating any CADHC co-payments to the Veteran and/or family;

(e) Completing the G&EC Consult for CADHC services in CPRS initially and annually, if the Veteran remains enrolled in the CADHC program and continues to demonstrate need;

(f) Facilitating completion of the CADHC facility’s medical form (if applicable);

(g) Encouraging the Veteran and family to contact the requested CADHC facility to facilitate a tour or trial visit.

4. The CADHC Program Coordinator ensures that the Veteran meets eligibility for the CADHC program and works with VA Community Care to complete the authorization process. This process is completed initially and annually as long as Veteran continues to remain enrolled in the CADHC program.

(a) Payment to the CADHC facility is made only for those days the Veteran attends CADHC during the contract period.

(b) The CADHC program coordinator facilitates the continuation of CADHC services annually, if indicated, by requesting a new CADHC consult and ensuring that clinical documentation indicates accurate eligibility and need.

(c) When continued attendance at CADHC at VA expense is no longer indicated, the CADHC program coordinator will terminate VA authorization effective the last day of authorized attendance. Discontinuation of services will occur at the verbal or written request of the Veteran or family, the CADHC, or when Veteran is no longer appropriate or in need of CADHC services.

5. The VA Care in the Community claims assistant enters the authorization for the services and faxes a copy of the authorization to the CADHC facility.

6. For CADHC placements outside of the Fayetteville VAMC Primary Service Area, concurrence for these placements must be made in advance with the appropriate receiving VAMC.

Oversight and monitoring

1. Each CADHC will be visited quarterly with alternating visits by the CADHC Social Worker Program Coordinator and CADHC Nurse Program Coordinator. Observations will be made regarding the quality of care provided and the progress of the patient. These are documented in the Veteran’s medical record. Quality oversight will comply with national directives.

2. The CADHC Social Work Program Coordinator will assist the Veteran and family with adjustment/transition issues as well as addressing complaints or concerns that may occur at the CADHC.

3. A CADHC Oversight Committee will meet quarterly to review pertinent census numbers, the status of the Electronic Waiting List, the facilities’ recent annual inspection reports, quality of care as defined by the contracts’ performance monitors, and any program issues requiring discussion. The G&EC Oversight Committee provides the mechanism through which the CADHC Oversight minutes are reported to Medical Center Leadership.

Contracting and Inspections

1. Processes for purchasing CADHC services will be developed by the VISN Contract Office and followed via the Contracting Officer and CADHC Program Coordinators. The purchasing options utilized should assure that a broad array of home and community-based care options are accessible to Veterans, and that the Veteran’s preference for specific resources is considered when facilitating referrals.

2. All VHA purchases of CADHC will be made only from licensed and appropriately certified community agencies in good standing with their respective State’s licensing bodies.

3. The CADHC facilities will be inspected and evaluated prior to consummation of a contract with the Medical Center and will be re-inspected annually thereafter. The VA accepts state standards for CADHC health, safety, staffing and program operations. The CADHC facility must provide documentation that its program is in good standing with the state in which it is located.

4. At a minimum, the VA Inspection Team will consist of an RN, Coordinator/Social Worker, Dietician, and Fire and/or Safety Officer and Contracting Officer Representative (COR), which may be a collateral duty for one of the previously-listed team members. The inspection and contract approval process will follow national guidelines as issued by VA Central Office.

REFERENCES:

Pub. L. 106-117, Veterans Millennium Health Care and Benefits Act VHA Directive 1140.11 Uniform Geriatrics and Extended Care Services in VA Medical Centers and Clinics, current edition.

VHA Handbook 1147.03, Adult Day Health Care, current edition.

Manual M-5, “Geriatrics and Extended Care”, part XI, Contract Adult Day Health Care, Chapter 7.

CADHC Patient Guideline

a. Absences of the Veteran from the contractor’s ADHC Program will not be reimbursed. The Contractor’s ADHC Program will meet the VA standards for ADHC as promulgated in 38 CFR 17.51(c) through 17.51(e).

b. Unless specifically excluded in this contract, the per diem rate established will include the services listed in the paragraph above and will also include all services or supplies normally provided other patients by the facility without extra charge. It is agreed that the VA may readily have access to all medical records concerning the Veteran’s care in the CADHC Program.

c. If the VA Medical Center and the Contractor agree that the VA shall provide services under 38 CFR 17.51(f), the agreement will be incorporated into the contract and either the per diem rate will be re-established, or direct payment made to the United States to reflect the cost of VA’s contribution. It is agreed that duly authorized representatives of the VA will provide follow-up supervision visits to Veterans placed to assure the continuity of care and to assist in the Veteran’s transition back into the community. It is understood that these visits do not substitute nor relieve the contractor in any way of the responsibility for the daily care and medical treatment of the Veteran. Upon discharge or death of the patient, medical records on all Department of Veterans Affairs beneficiaries will be retained by the contractor for a period of at least three (3) years following termination of care at the Department of Veterans Affairs expense.

d. The Government may evaluate the quality of professional and administrative services provided, but retains no control over the medical/professional aspects of services rendered (e.g., professional judgments, diagnosis for specific medical treatment) in accordance with FAR 37.401(b).

e. It is agreed that the contractor will notify the authorizing VA Medical Center immediately when a medical emergency requiring hospitalization, re-hospitalization or death occurs at the facility.

f. The contractor agrees and warrants that it does not maintain nor provide dual or segregated patient facilities which are segregated on the basis of race, creed, color or national origin. The contractor may neither require such segregated use by written or oral policies nor tolerate such by local custom. The term “facilities” shall include but not be limited to room, wards, sections, eating areas, drinking fountains, and entrances.

g. It is agreed that the VA will have the right to inspection of the contractor’s facility and all appurtenances by an authorized representative(s) designated by the VA to determine whether acceptable standards are maintained and that adequate care is being rendered. If deficiencies are noted during any inspection, the Contractor will be advised of the inspection team’s findings and given a reasonable amount of time to take corrective action. Any deficiencies will be documented and MUST be corrected within the timeframe specified by the inspection team. The Contractor will notify the CADHC Coordinator/SW who will inform the Contracting Officer when correction (s) has been made. However, if inspection deficiencies are found prior to award of the contract, the contract will not be awarded until noted deficiencies have been eliminated and/or resolved.

h. The contractor agrees to accept referral of and to provide all services specified in this contract for any person determined eligible by the VA under Secretary for Health, or his designee, regardless of race, color, religion, sex, or national origin of person for whom such services are ordered. In addition, the contractor warrants that subcontracting will not be resorted to as a means of circumventing this provision.

i. It is agreed that the VA may readily have access to all medical records concerning the Veteran’s care in the CADHC Program.

j. It is understood that the beneficiary may be provided CADHC at the expense of the VA for a period not in excess of that stated in the treatment referral plan/authorization received from the VA, unless an extension of the authorization is provided in writing by the appropriate VA Medical Center.

k. It is agreed that the Contractor will submit a report each month on the attendance (daily log sheets), under the contract to the Department of Veterans Affairs along with a monthly invoice for beneficiaries receiving care under the contract. The Veteran/Next of Kin/ appropriate staff will also be requested to sign the daily log sheets and a report of services rendered during each month.

l. It is understood that payment made by the Department of Veterans Affairs under this contract will constitute the total cost of CADHC. The contractor agrees that no additional charges will be billed to the beneficiary or his/her family, whether by the contractor or any third party furnishing services or supplies for such care, unless and until specific prior authorization in writing is obtained by the Department of Veterans Affairs facility that authorized payment.

m. The contractor warrants all applicable fire laws are being complied with and there are no recommendations of fire officials which have not been resolved.

n. It is impossible to determine the exact or estimated amount which will be expended under the contract. It is understood that no obligation will be incurred by the Department of Veterans Affairs under this contract until authorization is issued for CADHC for specific beneficiaries. The Department of Veterans Affairs agrees to make payment on a timely basis for services rendered in accordance with such authorizations upon receipt of billing submitted by the Contractor at the completion of each month’s services. If a beneficiary is admitted to and discharged from the contractor’s CADHC program on the same calendar day payment will be made for one day. Invoices shall be submitted to the Department of Veterans Affairs facility authorizing admission of the patient. . Invoices are to be received in the CADHC office by the 10th of each month.

o. The contractor shall cooperate with VA Quality Improvement activities. The VA shall have access to the contractor’s medical records to the extent permitted by State Laws. The VA allows open practitioner-patient communications regarding appropriate treatment alternatives without penalizing the contractor for discussing medically necessary or appropriate care for the patient.

p. Contractors to the Department of Veteran Affairs may be unintentionally exposed to sensitive information. Information may be overheard, seen on documents or electronic devices, or observed that could potentially violate the privacy and confidentiality of our Veterans, employees, volunteers, and their families. Regulations such as, but not limited to the Health Insurance Portability and Accountability Act of 1996 (HIPPA), Freedom of Information Act (FOIA) and Privacy Act of 1974 have been enacted to protect sensitive information from being improperly disclosed. Information should not be divulged or released to anyone unless specifically authorized by this contract or its’ attached documents in accordance with the contracted services. Failure to comply with applicable statutes and regulations can result in termination of this contract and civil and criminal penalties, including fines and imprisonment. All suspected or actual breeches of privacy and confidentiality should be reported immediately to the Contracting Officer, Contracting Officer’s Representative (COR) or the Facility Privacy Officer.

Personnel Policy: (1) Responsibility: The contractor shall be responsible for protecting the personnel furnishing CADHC services under this contract and, thus, shall provide the following to carry out this responsibility: a. Worker’s Compensation; b, Professional Liability Insurance; c. Health Examinations; d. Withholding income Tax; e. Social Security Payments.

(2) Non-VA Employees: The parties agree that such personnel shall not be considered VA employees for any purpose and shall be considered employees of the contractor.

VA Medical Center Responsibilities: (A) Record-Keeping System:

(1) Establishment/Maintenance: The Chief, Extended Care Service Line, or his/her designee, shall establish and maintain a record-keeping system that will contain the date(s) when CADHC services were provided to VA beneficiaries and confirmation from the Contractor and caregivers of the dates CADHC services were performed.

(2) Certification of Invoices: VAMC’s record-keeping system shall be the basis of determination that services were received by the Government in the certification of invoices for payment. Absences of the patient from the CADHC program will not be reimbursed.

1. GENERAL

Contractors, contractor personnel, subcontractors, and subcontractor personnel shall be subject to the same Federal laws, regulations, standards, and VA Directives and Handbooks as VA and VA personnel regarding information and information system security.

2. ACCESS TO VA INFORMATION AND VA INFORMATION SYSTEMS

a. A contractor/subcontractor shall request logical (technical) or physical access to VA information and VA information systems for their employees, subcontractors, and affiliates only to the extent necessary to perform the services specified in the contract, agreement, or task order.

b. All contractors, subcontractors, and third-party servicers and associates working with VA information are subject to the same investigative requirements as those of VA appointees or employees who have access to the same types of information. The level and process of background security investigations for contractors must be in accordance with VA Directive and Handbook 0710, Personnel Suitability and Security Program. The Office for Operations, Security, and Preparedness is responsible for these policies and procedures.

c. Contract personnel who require access to national security programs must have a valid security clearance. National Industrial Security Program (NISP) was established by Executive Order 12829 to ensure that cleared U.S. defense industry contract personnel safeguard the classified information in their possession while performing work on contracts, programs, bids, or research and development efforts. The Department of Veterans Affairs does not have a Memorandum of Agreement with Defense Security Service (DSS). Verification of a Security Clearance must be processed through the Special Security Officer located in the Planning and National Security Service within the Office of Operations, Security, and Preparedness.

d. Custom software development and outsourced operations must be located in the U.S. to the maximum extent practical. If such services are proposed to be performed abroad and are not disallowed by other VA policy or mandates, the contractor/subcontractor must state where all non-U.S. services are provided and detail a security plan, deemed to be acceptable by VA, specifically to address mitigation of the resulting problems of communication, control, data protection, and so forth. Location within the U.S. may be an evaluation factor.

e. The contractor or subcontractor must notify the Contracting Officer immediately when an employee working on a VA system or with access to VA information is reassigned or leaves the contractor or subcontractor’s employ. The Contracting Officer must also be notified immediately by the contractor or subcontractor prior to an unfriendly termination.

3. VA INFORMATION CUSTODIAL LANGUAGE

a. Information made available to the contractor or subcontractor by VA for the performance or administration of this contract or information developed by the contractor/subcontractor in performance or administration of the contract shall be used only for those purposes and shall not be used in any other way without the prior written agreement of the VA. This clause expressly limits the contractor/subcontractor's rights to use data as described in Rights in Data - General, FAR 52.227-14(d) (1).

b. VA information should not be co-mingled, if possible, with any other data on the contractors/subcontractor’s information systems or media storage systems in order to ensure VA requirements related to data protection and media sanitization can be met. If co-mingling must be allowed to meet the requirements of the business need, the contractor must ensure that VA’s information is returned to the VA or destroyed in accordance with VA’s sanitization requirements. VA reserves the right to conduct onsite inspections of contractor and subcontractor IT resources to ensure data security controls, separation of data and job duties, and destruction/media sanitization procedures are in compliance with VA directive requirements.

c. Prior to termination or completion of this contract, contractor/subcontractor must not destroy information received from VA, or gathered/created by the contractor in the course of performing this contract without prior written approval by the VA. Any data destruction done on behalf of VA by a contractor/subcontractor must be done in accordance with National Archives and Records Administration (NARA) requirements as outlined in VA Directive 6300, Records and Information Management and its Handbook 6300.1 Records Management Procedures, applicable VA Records Control Schedules, and VA Handbook 6500.1, Electronic Media Sanitization. Self-certification by the contractor that the data destruction requirements above have been met must be sent to the VA Contracting Officer within 30 days of termination of the contract.

d. The contractor/subcontractor must receive, gather, store, back up, maintain, use, disclose and dispose of VA information only in compliance with the terms of the contract and applicable Federal and VA information confidentiality and security laws, regulations and policies. If Federal or VA information confidentiality and security laws, regulations and policies become applicable to the VA information or information systems after execution of the contract, or if NIST issues or updates applicable FIPS or Special Publications (SP) after execution of this contract, the parties agree to negotiate in good faith to implement the information confidentiality and security laws, regulations and policies in this contract.

e. The contractor/subcontractor shall not make copies of VA information except as authorized and necessary to perform the terms of the agreement or to preserve electronic information stored on contractor/subcontractor electronic storage media for restoration in case any electronic equipment or data used by the contractor/subcontractor needs to be restored to an operating state. If copies are made for restoration purposes, after the restoration is complete, the copies must be appropriately destroyed.

f. If VA determines that the contractor has violated any of the information confidentiality, privacy, and security provisions of the contract, it shall be sufficient grounds for VA to withhold payment to the contractor or third party or terminate the contract for default or terminate for cause under Federal Acquisition Regulation (FAR) part 12.

g. The contractor/subcontractor must store, transport, or transmit VA sensitive information in an encrypted form, using VA-approved encryption tools that are, at a minimum, FIPS 140-2 validated.

h. The contractor/subcontractor’s firewall and Web services security controls, if applicable, shall meet or exceed VA’s minimum requirements. VA Configuration Guidelines are available upon request.

i. Except for uses and disclosures of VA information authorized by this contract for performance of the contract, the contractor/subcontractor may use and disclose VA information only in two other situations: (i) in response to a qualifying order of a court of competent jurisdiction, or (ii) with VA’s prior written approval. The contractor/subcontractor must refer all requests for, demands for production of, or inquiries about, VA information and information systems to the VA contracting officer for response.

j. Notwithstanding the provision above, the contractor/subcontractor shall not release VA records protected by Title 38 U.S.C. 5705, confidentiality of medical quality assurance records and/or Title 38 U.S.C. 7332, confidentiality of certain health records pertaining to drug addiction, sickle cell anemia, alcoholism or alcohol abuse, or infection with human immunodeficiency virus. If the contractor/subcontractor is in receipt of a court order or other requests for the above mentioned information, that contractor/subcontractor shall immediately refer such court orders or other requests to the VA contracting officer for response.

k. For service that involves the storage, generating, transmitting, or exchanging of VA sensitive information but does not require C&A or an MOU-ISA for system interconnection, the contractor/subcontractor must complete a Contractor Security Control Assessment (CSCA) on a yearly basis and provide it to the COR.

4. INFORMATION SYSTEM DESIGN AND DEVELOPMENT

a. Information systems that are designed or developed for or on behalf of VA at non-VA facilities shall comply with all VA directives developed in accordance with FISMA, HIPAA, NIST, and related VA security and privacy control requirements for Federal information systems. This includes standards for the protection of electronic PHI, outlined in 45 C.F.R. Part 164, Subpart C, information and system security categorization level designations in accordance with FIPS 199 and FIPS 200 with implementation of all baseline security controls commensurate with the FIPS 199 system security categorization (reference Appendix D of VA Handbook 6500, VA Information Security Program). During the development cycle a Privacy Impact Assessment (PIA) must be completed, provided to the COR, and approved by the VA Privacy Service in accordance with Directive 6507, VA Privacy Impact Assessment.

b. The contractor/subcontractor shall certify to the COR that applications are fully functional and operate correctly as intended on systems using the VA Federal Desktop Core Configuration (FDCC), and the common security configuration guidelines provided by NIST or the VA. This includes Internet Explorer 7 configured to operate on Windows XP and Vista (in Protected Mode on Vista) and future versions, as required.

c. The standard installation, operation, maintenance, updating, and patching of software shall not alter the configuration settings from the VA approved and FDCC configuration. Information technology staff must also use the Windows Installer Service for installation to the default “program files” directory and silently install and uninstall.

d. Applications designed for normal end users shall run in the standard user context without elevated system administration privileges.

e. The security controls must be designed, developed, approved by VA, and implemented in accordance with the provisions of VA security system development life cycle as outlined in NIST Special Publication 800-37, Guide for Applying the Risk Management Framework to Federal Information Systems, VA Handbook 6500, Information Security Program and VA Handbook 6500.5, Incorporating Security and Privacy in System Development Lifecycle.

f. The contractor/subcontractor is required to design, develop, or operate a System of Records Notice (SOR) on individuals to accomplish an agency function subject to the Privacy Act of 1974, (as amended), Public Law 93-579, December 31, 1974 (5 U.S.C. 552a) and applicable agency regulations. Violation of the Privacy Act may involve the imposition of criminal and civil penalties.

g. The contractor/subcontractor agrees to:

(1) Comply with the Privacy Act of 1974 (the Act) and the agency rules and regulations issued under the Act in the design, development, or operation of any system of records on individuals to accomplish an agency function when the contract specifically identifies:

(a) The Systems of Records (SOR); and

(b) The design, development, or operation work that the contractor/subcontractor is to perform;

(2) Include the Privacy Act notification contained in this contract in every solicitation and resulting subcontract and in every subcontract awarded without a solicitation, when the work statement in the proposed subcontract requires the redesign, development, or operation of a SOR on individuals that is subject to the Privacy Act; and

(3) Include this Privacy Act clause, including this subparagraph (3), in all subcontracts awarded under this contract which requires the design, development, or operation of such a SOR.

h. In the event of violations of the Act, a civil action may be brought against the agency involved when the violation concerns the design, development, or operation of a SOR on individuals to accomplish an agency function, and criminal penalties may be imposed upon the officers or employees of the agency when the violation concerns the operation of a SOR on individuals to accomplish an agency function. For purposes of the Act, when the contract is for the operation of a SOR on individuals to accomplish an agency function, the contractor/subcontractor is considered to be an employee of the agency.

(1) “Operation of a System of Records” means performance of any of the activities associated with maintaining the SOR, including the collection, use, maintenance, and dissemination of records.

(2…