S02 - 36C24621R01007 - ER Physician Staffing Srvcs for Fayetteville.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 109

36C24621R0007 10-09-2020

Warren O'Bryant, Administrative C.O. 757-728-7083 10-23-2020

4:00pm EDST

36C246

Department of Veterans Affairs

Network Contracting Office 6

100 Emancipation Drive

Hampton VA 23667

X 100

X

621493

$16.5 Million

5 Million

N/A

Fayetteville VAMC

2300 Ramsey Street

Fayetteville NC 28301

Network Contracting Office 6

100 Emancipation Drive

Hampton VA 23667

Financial Services Center

PO BOX 149971

Austin TX 78714-9971

See CONTINUATION Page

Contractor shall provide (8) Board Certified/Board Eligible in Emergency Medicine, Internal Medicine or Family Practice

Physician to provide onsite Emergency Medicine Physician

Services.

See B2: For the Schedule of Services Information

See B3: For the Performance Work Statement PWS) Information

Base Year Period of Performance: One (1) year from date of award.

See CONTINUATION Page x X x 1

Mario L. Santiago

36C24621R0007

Table of Contents

SECTION A

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

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 SCHEDULE OF SERVICES

B.3 PERFORMANCE WORK STATEMENT

SECTION C - CONTRACT CLAUSES

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

(OCT 2018)

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

C.3 52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR

INFORMATION SYSTEM (JUN 2016)

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

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

C.6 SUPPLEMENTAL INSURANCE REQUIREMENTS

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

1984)

C.8 VAAR 852.212-70 PROVISIONS AND CLAUSES APPLICABLE TO VA

ACQUISITION OF COMMERCIAL ITEMS (APR 2020)

C.9 VAAR 852.207-70 REPORT OF EMPLOYMENT UNDER COMMERCIAL

ACTIVITIES (JAN 2008)

C.10 VAAR 852.219-74 LIMITATIONS ON SUBCONTRACTING—MONITORING

AND COMPLIANCE (JUL 2018)

C.11 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO

IMPLEMENT STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS

(JUN 2020)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

D.1 QUALITY ASSURANCE SURVIELLANCE PLAN (QASP)

D.2 CONTRACTOR CERTIFICATION: Immigration and Nationality Act of 1952, As

Amended

D.3 PAST PERFORMANCE SURVEY

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)

36C24621R0007

E.2 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE

(FEB 1998)

E.3 SPECIFIC INSTRUCTIONS TO OFFERORS REGARDING REQUEST FOR

PROPOSAL (RFP) PREPARATIONS AND SUBMISSION

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

2018)

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

E.6 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.7 VAAR 852.273-73 EVALUATION - HEALTH-CARE RESOURCES (JAN 2003) 89

E.8 VAAR 852.273-74 AWARD WITHOUT EXCHANGES (JAN 2003)

E.9 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL ITEMS (JUN 2020)

36C246-21-R-0007

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

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

a. CONTRACTOR:

b. GOVERNMENT: Mario L Santiago Warren O’Bryant

Contracting Officer Administrative Contracting Officer

Department of Veterans Affairs Department of Veterans Affairs

Network Contracting Office 6 Network Contracting Office 6

100 Emancipation Drive 100 Emancipation Drive

Hampton VA 23667 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 – Other Than System For Award

Management, or

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Monthly in Arrears

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

Requests. Shall be submitted Electronically To:

Financial Services Center

PO BOX 149971

Austin TX 78714-9971

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

AMENDMENT NO DATE

B.2 SCHEDULE OF SERVICES

The Contractor shall furnish Board Certified/Board Eligible in Emergency Medicine, Internal

Medicine, or Family Practice Physicians to provide services necessary to perform onsite

Emergency Medicine Physician Services to eligible beneficiaries of the Department of Veterans

Affairs Medical Center, Fayetteville, NC (hereinafter referred to as Fayetteville VAMC).

The Fayetteville VAMC Emergency Services are accredited by The Joint Commission (TJC) and follow the standards & guidelines set forth by American College of Emergency Physicians

(ACEP). A contractor providing onsite emergency department physician services shall provide services that meet or exceed the ACEP Guidelines http://www.ACEP.org/.

Place of Performance: Services shall be provided on site, Fayetteville VAMC, 2300 Ramsey

Street, Fayetteville, NC 28301.

Pricing Instructions:

The offeror is instructed to edit the number of Sub-CLINs to correspond with the number of key personnel submitted for the contract line item number (CLIN). Other commercial health care

Offerors shall identify by title/position or level of experience the key personnel submitted. Also, renumber Sub-CLINs if adding or removing Key Personnel.

The offeror is instructed to include all other than price and cost information supporting the proposed price and copies of both the primary and backups proposed candidates CV /

Resumes with their proposals as directed in the Instructions to Offerors addendum to 52.212-1 and/or Section D- Contract Documents, Exhibits, or attachments. Failure to submit the required CV / Resumes will deem your response to the Request for Proposal (RFP) as Non-

Responsive.

The Contractor shall be required to provide as a minimum, enough appropriately qualified physicians to be credentialed and privileged that meet or exceed twice the number of FTE required to fulfill this contract obligation. The Contractor shall propose a minimum of eight (8) candidates as key personnel to be credentialed and privileged and to be available for scheduling to meet the requirements of the contract. The contractor is also required to have as a minimum, eight (8) additional appropriately qualified Medical Doctors (MD’s) to be available for substitution or placement upon requested by the Government for a combined total of sixteen (16) candidates to be credentialed and privileged. One FTE is defined by VA as a minimum of 80 hours every two weeks and does not include holidays.

The Government will issue a single award resulting from this solicitation.

NOTE: PER DIEM AND TRAVEL WILL NOT BE AUTHORIZED.

http://www.acep.org/

Period of Performance: BASE PERIOD: One (1) Year from Date of Award

CLIN

No.

SUB-

CLIN

Description Qty. Unit Unit Cost Total

Annual Cost

0001 None Board Certified/Board Eligible in

Emergency Medicine, Internal Medicine, or Family Practice Physicians to provide

Emergency Department Physician

Services. No On-Call required.

16,640 Hours Do Not

Price

Do Not Price

KEY PERSONNEL

None 0001a Eight (8) FTE Board Certified/Board

Eligible in Emergency Medicine, Internal Medicine, or Family Practice

Physicians to provide Emergency

Department Physician Services (2) twelve hours shifts seven days week).

Level of Experience in the ER field:

Five (5) Years Minimum.

16,640 Hours $_______ $_________

0002 Onboard Training Hours 200 Hours $________ $__________

0003 Shift Holdovers Hours 200 Hours $________ $__________

TOTAL FOR BASE YEAR PERIOD $___________________

OPTION YEAR 1: _______________

SUB-

CLIN

Description Qty. Unit Unit Cost Total

Annual Cost

1001 None Board Certified/Board Eligible in

Emergency Medicine, Internal Medicine, or Family Practice Physicians to provide

Emergency Department Physician

Services. No On-Call required.

16,640 Hours Do Not

Price

Do Not Price

KEY PERSONNEL

None 1001a Eight (8) FTE Board Certified/Board

Eligible in Emergency Medicine, Internal Medicine, or Family Practice

Physicians to provide Emergency

Department Physician Services. (2) twelve hours shifts seven days week).

1002 Onboard Training Hours 200 Hours $_______ $_________

Shift Holdovers Hours

200 Hours $_______ $_________

TOTAL FOR OPTION YEAR 1 $___________________

OPTION YEAR 2: __________________

SUB-

CLIN

Description Qty. Unit Unit Cost Total

Annual Cost

1001 None Board Certified/Board Eligible in

Emergency Medicine, Internal Medicine, or Family Practice Physicians to provide

Emergency Department Physician

Services. No On-Call required.

16,640 Hours Do Not

Price

Do Not Price

KEY PERSONNEL

None 1001a Eight (8) FTE Board Certified/Board

Eligible in Emergency Medicine, Internal Medicine, or Family Practice

Physicians to provide Emergency

Department Physician Services. (2) twelve hours shifts seven days week).

1002 Onboard Training Hours 200 Hours $_______ $_________

Shift Holdovers Hours

TOTAL FOR OPTION YEAR 2 $___________________

OPTION YEAR 3: _________________

SUB-

CLIN

Description Qty. Unit Unit Cost Total

Annual Cost

3001 None Board Certified/Board Eligible in

Emergency Medicine, Internal Medicine, or Family Practice Physicians to provide

Emergency Department Physician

Services. No On-Call required.

16,640 Hours Do Not

Price

Do Not Price

KEY PERSONNEL

None 3001a Eight (8) FTE Board Certified/Board

Eligible in Emergency Medicine, Internal

Medicine, or Family Practice Physicians to provide Emergency Department Physician

Services.

(2) twelve hours shifts seven days week). Level of Experience in the ER field: Five (5) Years Minimum.

3002 Onboard Training Hours 200 Hours $_______ $_________

Shift Holdovers Hours

TOTAL FOR OPTION YEAR 3 $___________________

OPTION YEAR 4: _________________

SUB-

Description Qty. Unit Unit Cost Total

Annual Cost

4001 None Board Certified/Board Eligible in

Emergency Medicine, Internal Medicine, or Family Practice Physicians to provide

Emergency Department Physician

Services. No On-Call required.

16,640 Hours Do Not

Price

Do Not Price

KEY PERSONNEL

None 4001a Eight (8) FTE Board Certified/Board

Eligible in Emergency Medicine, Internal Medicine, or Family Practice

Physicians to provide Emergency

Department Physician Services. (2) twelve hours shifts seven days week).

4002 Onboard Training Hours 200 Hours $_______ $_________

Shift Holdovers Hours

TOTAL FOR OPTION YEAR 4

TOTAL COST FOR BASE AND ALL OPTION YEARS: $ _______________________

B.3 PERFORMANCE WORK STATEMENT

1. GENERAL:

1.1. Services Provided: The Contractor shall provide Board Certified/Board Eligible in

Emergency Medicine, Internal Medicine, or Family Practice Physicians to provide

Emergency Department Physician Services on site in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and the

Fayetteville Veteran Affairs Medical Center (Fayetteville VAMC). A contractor providing onsite emergency department physician services that meet or exceed the

American College of Emergency Physician Guidelines http://www.ACEP.org/.

1.2. Place of Performance - Contractor shall furnish services at the Fayetteville Veteran

Affairs Medical Center, 2300 Ramsey Street, Fayetteville, NC 2830.

1.3. Authority: Title 38 USC 8153 Sharing of Health-Care Resources and VAAR Part 873 in combination with FAR Parts 15.

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

1.4.1. VHA Directive 1101.05(2): Emergency Medicine

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3236

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

1.4.3. VHA Directive 1003 “VHA Customer Service Programs And Veterans’ Health

Care Service Standards” https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=7475.5

1.4.4. VHA Directive 1220 “Facility Procedures Complexity Designation Requirements to

Perform Invasive Procedures In Any Clinical Setting” https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=8365

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

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

1.4.7. VHA Handbook 1100.18 Reporting And Responding To State Licensing Boards – https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364

1.4.8. VHA Handbook 1100.19 Credentialing and Privileging –

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

1.4.9. VHA Handbook 1907.01 Health Information Management and Health Records:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3088

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

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

1.5. 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.

http://www.acep.org/ https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3236 https://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID= https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID= https://www.publichealth.va.gov/docs/flu/VHA_Directive_1192_Sep https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3088 http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm

1.5.1. ABIM: American Board of Internal Medicine http://www.abim.org/

1.5.2. ACEP: American College of Emergency Physicians

1.5.3. ACGME: Accreditation Council for Graduate Medical Education

1.5.4. ACLS: Advanced Cardiac Life Support

1.5.5. ATLS: Advanced Trauma Life Support

1.5.6. AOD: Admitting Officer of the Day

1.5.7. AHA: American Heart Association

1.5.8. BLS: Basic Life Support

1.5.9. CBI: Compliance & Business Integrity

1.5.10. CCNE: Commission on Collegiate Nursing Education:

www.aacn.nche.edu/accreditation

1.5.11. CDC: Centers for Disease Control and Prevention

1.5.12. CR: Contract Discrepancy Report

1.5.13. CEU: Certified Education Unit

1.5.14. CME: Continuing Medical Education

1.5.15. CMS: Centers for Medicare and Medicaid Services

1.5.16. 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.

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

1.5.18. COS: Chief of Staff

1.5.19. CPARS: Contractor Performance Assessment Reporting System

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

1.5.21. DEA: Drug Enforcement Agency

1.5.22. ED: Emergency Department

1.5.23. EHR: Electronic Health Record: Electronic health record system used by the VA

1.5.24. FSMB: Federation of State Medical Boards

1.5.25. HHS: Department of Health and Human Services

1.5.26. HIPAA: Health Insurance Portability and Accountability Act

1.5.27. HR: Human Resources

1.5.28. ISO: Information Security Officer

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

1.5.30. MOD: Medical Officer of the Day

1.5.31. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers).

1.5.32. NLNAC: National League for Nursing Accrediting Commission. www.nlnac.org http://www.abim.org/ http://www.aacn.nche.edu/accreditation http://www.nlnac.org/

1.5.33. Non-Contract Provider - any person, organization, agency, or entity that is not directly or indirectly employed by the Contractor or any of its subcontractors

1.5.34. NP: Nurse Practitioner

1.5.35. NPPES: National Plan and Provider Enumeration System

1.5.36. OOORAM: Out of Operating Room Airway Management

1.5.37. PA: Physician Assistant

1.5.38. PALS: Pediatric Advanced Life Support

1.5.39. POP: Period of Performance

1.5.40. PPD: Purified Protein Derivative

1.5.41. PWS: Performance Work Statement

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

1.5.43. QA/QI: Quality Assurance/Quality Improvement

1.5.44. QM/PI: Quality Management/Performance Improvement

1.5.45. QASP: Quality Assurance Surveillance Plan

1.5.46. Veterans’ Health Administration (VHA): The central office for administration of the VA medical centers through throughout the United States. The VHA is located in Washington, D.C.

1.5.47. Veterans Integrated Services Network (VISN): The regional oversight for the VA

Medical Centers.

1.5.48. VISTA (Veterans Integrated Systems Technology Architecture): A PC based system that will capture and store clinical imagery, scanned documents and other non-textual data files and integrates them into patient’s medical record and with the hospital information system.

1.5.49. VetPro: a federal web-based credentialing program for healthcare providers.

1.5.50. 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 Fayetteville VAMC.

2. QUALIFICATIONS:

2.1. Staff/Facility

2.1.1. License – The Contractor’s physician (s) assigned by the Contractor to perform the services covered by this contract shall have a current license to practice medicine in any State, Territory, or Commonwealth of the United States or the District of

Columbia) when services are performed onsite on VA property.

All licenses held by the personnel working on this contract shall be full and unrestricted licenses. Contractor’s physician (s) who have current, full and unrestricted licenses in one or more states, but who have, or ever had, a license restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending action or denied upon application will not be considered for the purposes of this contract.

2.1.2. Board Certification - All contractor’s physician (s) shall be Board Certified/Board

Eligible in Emergency Medicine, Internal Medicine, or Family Practice, and be currently certified in AHA Basic Life Support (BLS), AHA Advanced Cardiac Life

Support (ACLS) or equivalency. Candidates must have five (5) years of experience in the field at the minimum. VA experience is preferred but not mandatory. All continuing education courses required for maintaining certification must be kept up to date at all times. Board certification/eligibility in Emergency Medicine is preferred. Documentation verifying current certification shall be provided by the

Contractor to the VA COR on an annual basis for each year of contract performance.

2.1.3. Credentialing and Privileging –Credentialing and privileging is to be done in accordance with the provisions of VHA Handbook 1100.19 referenced above. The

Contractor is responsible to ensure that proposed physician(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any contractor’s physician (s) prior to obtaining approval by the

(Fayetteville VAMC) Professional Standards Board, Medical Executive Board and

Medical Center Director.

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

2.1.4. Technical Proficiency - Contractor’s physician (s) shall be technically proficient in the skills necessary to fulfill the government’s requirements, including the ability to speak, understand, read and write English fluently. Contractor shall provide documents upon request of the CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed. Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contractor’s physician (s) and contractor’s physician (s) shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior.

2.1.5. Continuing Medical Education (CME)/ Certified Education Unit (CEU)

Requirements: Contractor shall provide the COR copies of current CMEs as required or requested by the VAMC. Contractor’s physician (s) registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. Contractor shall report CME hours to the credential’s office for tracking.

These documents are required for both privileging and re-privileging. Failure to provide shall result in loss of privileges for contract physician(s).

2.1.6. Training (ACLS, BLS, CPRS and VA MANDATORY): Contractor shall meet all

VA educational requirements and mandatory course requirements defined herein;

all training must be completed by the contractor’s physician(s) as required by the

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

Training (The following training is mandatory per VHACO for

Contracted Physicians)

Frequency (once a year, etc.) Annual

Hours

Active Threat Training Every 1 Year 1 Hour

Government Ethics Every 1 Year 1 Hour

Prevention of Workplace

Harassment/No Fear Act

Every 1 Year 1 Hour

VA Core Values Training

(ICARE Recommitment)

Every 1 Year 1 Hour

VA Privacy and Information

Security Awareness and Rules of

Behavior

Every 1 Year 1 Hour

Privacy and HIPAA Training Every 1 Year 1 Hour

AHA ACLS/BLS Every 2 Years 3 to 8 Hours

Prevention/Management of

Disruptive Behavior/Violence

Prevention

Every 2 Years 8 Hours

Suicide Prevention: Suicide Risk

Management Training for

Clinicians

Every 1 Year 1 Hour

CPRS Initial Onboarding 4 Hours

OOORAM (course and live) Every 2 Years 2 Hour

OPIOID Training Initial Onboarding 30 Minutes

Service Connection Initial Onboarding 30 Minutes

CBI Every 1 Year 1 Hour

2 Orientation Shifts Onboarding 20 Hours

List other Training per local facility

Courses to be assigned in

TMS as required.

Contractor shall provide to the COR a copy of the training certificates for each applicable employee within one (1) week of the initiation of the contract and annually thereafter, as required. These online courses listed above are located at the following web site: https://www.tms.va.gov/plateau/user/login.jsp. Detail instructions on account setup will be provided to the successful offeror upon contract award. Failure to complete this mandatory training listed above within the timeframe required shall be grounds for suspension or termination of all physical and/or electronic access privileges and removal from work on the contract until such time as the training is completed.

2.1.7. Standard Personnel Testing (PPD, etc.): Contractor shall provide proof of the following tests for physicians within five (5) calendar days after contract award and prior to the first duty shift to the COR and Contracting Officer. Tests shall be current within the past year.

2.1.7.1. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative

Tuberculosis Skin Test (TST) or interferon-gamma release assays (IGRA) for all Contractor’s physician (s) {This is applicable to all health care https://www.tms.va.gov/plateau/user/login.jsp workers}. A negative chest radiographic report for active tuberculosis shall be provided in cases of positive TST or IGRA results. The TST or IGRA testing shall be repeated annually.

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

2.1.7.3. VARICELLA: Contractors shall provide proof of immunity for all

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

2.1.7.4. ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of

Tdap vaccination for all Contractor physicians {This is applicable to all health care workers}.

2.1.7.5. INFLUENZA: Contractors shall provide proof that all Contractor physicians have received the annual Influenza vaccine unless it is contraindicated. If the Contractor physician has a medical contraindication to the vaccine, they shall be required to wear a mask during the Influenza season. {This is applicable to all health care workers}.

2.1.7.6. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE

TO BLOODBORNE PATHOGENS: Contractor shall provide evidence of completing and passing generic self-study blood-borne pathogen training for all Contractor’s physician (s) {This is applicable to all health care workers}; provide their own Hepatitis B vaccination series and hepatitis B surface antigen test results following the hepatitis B vaccination series;

maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident.

2.1.7.7. The VAMC shall notify the Contractor of any significant communicable disease exposures as appropriate. Contractor shall adhere to current

CDC/HICPAC Guideline for Infection Control in health care personnel ( as published in American Journal for Infection Control- AJIC 1998; 26:289-

354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf) for disease control. Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.

2.1.8. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers). The Contractor shall have or obtain appropriate NPI and if pertinent the Taxonomy Code confirmation notice issued by the Centers for Medicare and Medicaid Services (CMS) National

Plan and Provider Enumeration System (NPPES) be provided to the Contracting

Officer with the Proposals.

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

2.1.9. DEA (is required, unrestricted): Contractor shall provide copy of current DEA certificate.

2.1.10. Conflict of Interest: The Contractor and all contractor’s physician (s) are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of Proposals and during the entirety of contract performance.

At the time of Proposals, 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.

2.1.11. Citizenship related Requirements:

2.1.11.1. 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;

2.1.11.2. While performing services for the Department of Veterans Affairs, the

Contractor shall not knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States. Additionally, the

Contractor is required to comply with all “E-Verify” requirements consistent with “Executive Order 12989” and any related pertinent

Amendments, as well as applicable Federal Acquisition Regulations.

2.1.11.3. If the Contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the Department of Veterans

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

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

1001.

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

2.2. Annual Office of Inspector General (OIG) Statement: In accordance with HIPAA and the Balanced Budget Act (BBA) of 1977, the Department of Health and

Human Services (HHS) Office of Inspector General (OIG) has established a list of parties and entities excluded from Federal health care programs. Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs.

2.2.1. Therefore, Contractor shall review the HHS OIG List of Excluded

Individuals/Entities on the HHS OIG web site at http://oig.hhs.gov/exclusions/index.asp to ensure that the proposed contractor’s physician (s) are not listed. Contractor should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a Civil

Monetary Penalty (CMP) for each item or service furnished during a period that the person was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMP’s may also be imposed against the Contractor that employ or enter into contracts with excluded individuals to provide items or services to Federal program beneficiaries.

2.2.2. By submitting their Proposals, the Contractor certifies that the HHS OIG List of

Excluded Individuals/Entities has been reviewed and that the Contractors are and/or firm is not listed as of the date the offer/bid was signed.

2.3. Clinical/Professional Performance: The qualifications of Contractor personnel are subject to review by VA Medical Center COS or his/her clinical designee and approval by the Medical Center Director as provided in VHA Handbook 1100.19.

Clinical/Professional performance monitoring and review of all clinical personnel covered by this contract for quality purposes will be provided by the VAMC COS and/or the Chief of the Service or his designee. A clinical COR may be appointed, however, only the CO is authorized to consider any contract modification request and/or make changes to the contract during the administration of the resultant contract.

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

2.5. 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.

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

2.6. Prohibition Against Self-Referral: Contractor’s physicians are prohibited from referring VA patients to contractor’s or their own practice(s).

2.7. Inherent Government Functions: Contractor and Contractor’s physician (s) shall not perform inherently governmental functions. This includes, but is not limited to, determination of agency policy, determination of Federal program priorities for budget requests, direction and control of government employees (outside a clinical context), selection or non-selection of individuals for Federal Government employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for Federal employees, approving any contractual documents, approval of Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy.

2.8. No Employee status: The Contractor shall be responsible for protecting Contractor’s physician (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:

2.8.1 Workers’ compensation

2.8.2 Professional liability insurance

2.8.3 Health examinations

2.8.4 Income tax withholding, and

2.8.5 Social security payments.

2.9. Tort Liability: The Federal Tort Claims Act does not cover Contractor or contract physician(s). When a Contractor or contractor’s physician (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 physician(s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.10. Key Personnel:

2.10.1. The VA Full Time Equivalency (FTE) for the services required is one (1) FTE is defined by VA as a minimum of 80 hours every two weeks and does include holidays.

2.10.2. The minimum number of Board Certified/Board Eligible in Emergency

Medicine, Internal Medicine, or Family Practice Physicians to provide

Emergency Department Physician Services required to be on site on- a- daily basis is eight (8) as defined in paragraph Hours of Operation in this section.

2.10.3. It is essential that continuity of services is maintained to the maximum degree possible hence, substitution of contractor provided Physicians shall be limited to urgent/emergent absences of approved, assigned providers. The Contractor shall be responsible for providing coverage to the VA during periods of vacancies of the Contractor’s personnel due to sick leave, personal leave, vacations and additional coverage as required. In the event a scheduled physician is unable to begin or complete an assigned shift, the contractor shall provide replacement physician coverage within 2 hours and notify the Contracting

Office Representative (COR) at the (Fayetteville VAMC) immediately of the schedule change.

2.10.4. Personnel Substitutions: During the first ninety (90) calendar days of performance, the Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death or termination of employment.

The Contractor shall notify the CO, in writing, within two (2) calendar day (s) after the occurrence of any of these events and provide the information required below. After 90 days, the Contractor shall submit the information required below to the CO at least sixty 60 calendar days prior to making any permanent substitutions.

2.10.5. The Contractor shall provide a detailed explanation of the circumstances necessitating the proposed substitutions, complete resumes for the proposed substitutes, and any additional information requested by the CO. Proposed substitutes shall have comparable qualifications to those of the persons being replaced. The CO will notify the Contractor within seven (7) calendar days after receipt of all required information of the decision on the proposed substitutes.

The contract will be modified to reflect any approved changes of key personnel.

2.10.6. For temporary substitutions where the key person shall not be reporting to work for three (3) consecutive workdays or more, the Contractor shall provide a qualified replacement for the key person. The substitute shall have comparable qualifications to the key person. Any period exceeding two weeks will require the procedure as stated above.

2.10.7. 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. Should the VA COS or designee show documented clinical problems or continual unprofessional behavior/actions with any Contractor’s physician (s), s/he may request, without cause, immediate replacement of said

Contractor’s physician (s). The CO and COR shall deal with issues raised concerning Contractor’s physician (s) conduct. The final arbiter on questions of acceptability is the CO.

2.10.8. Contingency Plan: Because continuity of care is an essential part of VAMC’s medical services, The Contractor shall have a contingency plan in place to be utilized if the Contractor’s physician (s) leaves Contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract.

3. HOURS OF OPERATION

3.1. VA Business Hours: From 7:00 AM to 7:00PM and 7:00PM to 7:00AM, 365 days a year.

3.1.1. Work Schedule: Twelve (12) hours coverage. Contractor to provide enough personnel to cover one (2) twelve hours shift seven (7) days a week to include holidays, 365 days a year.

3.1.2. Patients must be seen by a contractor’s physician (s) on-site at Fayetteville

VAMC in a timely manner in accordance with VA Rules and Regulations on clinic wait times and consult completion. Contractor shall notify the COR at least monthly about any obstacles to meeting this performance measure.

3.1.3. Contractor’s Physician(s) shall be available and present in clinic during normal Fayetteville VAMC clinic hours, Fayetteville VAMC which will be established, and may be revised, as deemed appropriate for patient care by the Chief of Staff. Currently, normal evening clinic hours are from 7:00 PM to 7:00AM.

3.2 Off-hours Coverage: Not Required.

4 CONTRACTOR RESPONSIBILITIES

4.1 Clinical Personnel Required: The Contractor shall provide Board Certified/Board

Eligible in Emergency Medicine, Internal Medicine, or Family Practice Physicians who are competent, qualified per this performance work statement and adequately trained to perform assigned duties.

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

4.2. Standards of Care: The contractor’s physician (s)’ care shall cover the range of Emergency services as would be provided in a state-of-the-art health care treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards as established by:

4.2.1 The American Board of Emergency Medicine.

4.2.2 American Board of Osteopathic Emergency Medicine.

4.2.3 Relevant professional societies including ACEP. SAEM, AAEM American

College of Emergency Physicians: http://www.acep.org.

4.2.4 The American Board of Internal Medicine http://www.abim.org/.

4.2.5 VA Standards: VHA Directive 2006-041 “Veterans’ Health Care Service

Standards” (expired but still in effect pending revision) https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443.

4.2.6 The professional standards of The Joint Commission (TJC) http://www.jointcommission.org/emergency_department/.

4.2.7 The standards of the American Hospital Association (AHA) http://www.acep.org/ http://www.abim.org/ https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443 http://www.jointcommission.org/emergency_department/ http://www.hpoe.org/resources?show=100&type=8 and;

4.2.8 The requirements contained in this PWS.

4.3. MEDICAL RECORDS

4.3.1. Authorities: Contractor’s physician (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).

4.3.2. 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.

4.3.3. Disclosure: Contractor’s physician (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 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.

4.3.4. 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.

http://www.hpoe.org/resources?show=100&type=8 http://www.rms.oit.va.gov/SOR_Records/24VA19.asp 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

4.3.5. 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: Christopher Kelly.

2300 Ramsey Street, Fayetteville, NC 28301.

4.4. Direct Patient Care: Estimated 90% of the time involved in direct patient care.

4.4.1. Per the qualification section of this PWS, the Contractor shall provide the following staff:

4.4.2. Board Certified /Board Eligible in Emergency Medicine, Internal Medicine or

Family Practice. Board certification/eligibility in Emergency Medicine is preferred.

4.5. Scope of Care: Contractor’s physician (s) (as appropriate and within scope of practice/privileging) shall be responsible for providing Emergency…