36C24621R0008.docx

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Q509--Solicitation for ER Doctors MD's /NP's FY 21
Solicitation number
36C24621R0008
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This is a solicitation for on-site emergency medicine physician and nurse practitioner/physician assistant services. The Department of Veterans Affairs seeks qualified offerors to provide board certified or board eligible emergency medicine, internal medicine, or family practice physicians, as well as nurse practitioners/physician assistants, to deliver emergency medical services to eligible beneficiaries at the Hampton VA Medical Center in Hampton, Virginia. Offerors must propose physicians to staff daily shifts from 7:00am to 11:00pm, as well as weekend and holiday hours, totaling 19,664 service hours annually. The period of performance is one base year with four one-year option periods. Pricing shall be proposed as hourly rates for each staffing level. The solicitation includes detailed qualifications for clinical personnel, scope of services, reporting requirements, quality assurance measures, and other terms. The award date is not specified.

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36C24621R0008

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 ATTA

CHED

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. SIGNAT

URE 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

36C24621R0008 10/13/2020 Christian Rosado, Contracting Specialist

10-26-2020 4:30pm Department of Veterans Affairs Network Contracting Office 6 Emancipation Drive Hampton VA 23667 X 624193 $16.5 Million N/A X Department of Veterans Affairs Hampton Medical Center (Hampton VAMC) 100 Emancipation Drive Hampton

VA 23667

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

Department of Veterans Affairs Financial Services Center

PO BOX 149971

Austin TX 78714-9971 Contractor shall provide (8) Board Certified/Board Eligible in Emergency medicine, Internal Medicine or Family Practice Physician and (3)

Nurse Practitioner / Physician Assistant 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.

X X X Mario L. Santiago Contracting Officer Table of Contents

SECTION A1
A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS1
SECTION B - CONTINUATION OF SF 1449 BLOCKS4
B.1 CONTRACT ADMINISTRATION DATA4
B.2 SCHEDULE OF SERVICES5
B.3 PERFORMANCE WORK STATEMENT14
SECTION C - CONTRACT CLAUSES45
C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (OCT 2018)45
C.2 52.252-2 CLAUSES INCORPORATED BY REFENCE (FEB 1998)50
C.3 52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR INFORMATION SYSTEM (JUN 2016)51
C.4 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)53
C.5 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)53
C.6 SUPPLEMENTAL INSURANCE REQUIREMENTS53
C.7 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR 1984)54
C.8 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)54
C.9 VAAR 852.207-70 REPORT OF EMPLOYMENT UNDER COMMERCIAL ACTIVITIES (JAN 2008)56
C.10 VAAR 852.219-74 LIMITATIONS ON SUBCONTRACTING—MONITORING AND COMPLIANCE (JUL 2018)58
C.11 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (JUN 2020)59
SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS67
D1. QUALITY ASSURANCE SURVIELLANCE PLAN (QASP)67
D2. CONTRACTOR CERTIFICATION: Immigration and Nationality Act of 1952, As Amended74
D3. PAST PERFORMANCE SURVEY75
D.4 VA CONTRACTOR RULES OF BEHAVIOR80
D.5 ORGANIZATIONAL CONFLICTS OF INTEREST (JAN 2008)84
SECTION E - SOLICITATION PROVISIONS86
E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS (JUN 2020)86
E.2 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998)90
E.3 SPECIFIC INSTRUCTIONS TO OFFERORS REGARDING REQUEST FOR PROPOSAL PREPARATIONS AND SUBMISSION90
E.4 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)93
E.5 52.216-1 TYPE OF CONTRACT (APR 1984)94
E.6 52.233-2 SERVICE OF PROTEST (SEP 2006)95
E.7 VAAR 852.273-73 EVALUATION - HEALTH-CARE RESOURCES (JAN 2003)95
E.8 VAAR 852.273-74 AWARD WITHOUT EXCHANGES (JAN 2003)98
E.9 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL ITEMS (JUN 2020)99

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: Name: ____________________/ Title: ____________________ Email: ___________________/ Phone: ____________________

b. GOVERNMENT: Mario L Santiago Christian Rosado Contracting Officer Administrative Contracting Officer Department of Veterans Affairs Department of Veteran 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:

Department of Veterans Affairs Financial Services Center

PO BOX 149971

Austin TX 78714-9971

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

AMENDMENT NO
DATE

B.2 SCHEDULE OF SERVICES

The Contractor shall furnish all personnel to provide services necessary to perform onsite Emergency Medicine Physician and Nurse Practioner/ Physician Assistant Services to eligible beneficiaries of the Department of Veterans Affairs Medical Center, Hampton, VA (hereinafter referred to as Hampton VAMC).

The Hampton 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, Hampton VAMC,100 Emancipation Drive, Hampton, VA 23667.

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 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 of eleven (11) candidates as key personnel, enough qualified physicians to be credentialed and privileged that meet the number of FTE required to fulfill this contract obligation. The contractor is also required to have as a minimum, eleven (11) additional appropriately qualified candidates, eight (8) Medical Doctors (MD’s) and three (3) appropriately qualified Nurse Practitioners (NP’s) or Physician Assistants (PA’s), for a combined total of twenty-two (22) candidates to be credentialed and privileged and to be available for substitution or placement upon requested by the Government. 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.

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
Emergency Medicine Physician Services. No On-Call required.
19,664
Hours
Do Not Price
Do Not Price

KEY PERSONNEL

None
0001a
FTE Board Certified/Board Eligible Emergency Medicine Physician.
(7:00am-7:00pm & 7:00pm – 7:00am seven days a week).

Level of Experience in the ER field: Five (5) Years Minimum.

8,448
Hours
$_______
$_________
0001b
FTE Board Certified/Board Eligible Emergency Medicine Physician.
(7:00pm-7:00am 7:00pm – 7:00am Holidays).
288
Hours
$_________
$___________
0001c
FTE Board Certified/Board Eligible Emergency Medicine Physician.
(11:00am-11:00pm five days a week).
4,224
Hours
$_________
$___________
0001d
FTE Board Certified/Board Eligible Emergency Medicine Physician.
(8:00am-4:30pm five days a week).
528
Hours
$_________
$___________
0001e
FTE Board Certified/Board Eligible Emergency Medicine Physician.
(11:00am-11:00pm Holidays).
144
Hours
$_________
$___________
0001f
FTE Nurse Practitioner/Physician Assistant Practitioner. (6:00am-4:00pm, 12:00pm - 10:00pm & 4:00pm- 2:00am five days a week). Level of Experience in the ER field: Five (5) Years Minimum.
3,330
Hours
$_________
$___________
0001e
FTE Nurse Practitioner/Physician Assistant. (6:00am-4:00pm, 12:00pm - 10:00pm & 4:00pm- 2:00am Holidays). Level of Experience in the ER field: Five (5) Years Minimum.
270
Hours
$_________
$___________
0001f
FTE Nurse Practitioner/Physician Assistant. (8:00am-6:00pm Saturdays and Sundays). Level of Experience in the ER field: Five (5) Years Minimum.
770
Hours
$_________
$___________
0001g
FTE Nurse Practitioner/Physician Assistant. (8:00am-6:00pm Saturdays and Sundays Holidays). Level of Experience in the ER field: Five (5) Years Minimum.
120
Hours
$_________
$___________
0001h
FTE Nurse Practitioner/Physician Assistant. (11:00am-11:00pm Saturdays and Sundays). Level of Experience in the ER field: Five (5) Years Minimum.
1,212
0001i
FTE Nurse Practitioner/Physician Assistant. (11:00am-11:00pm Saturdays and Sundays Holidays). Level of Experience in the ER field: Five (5) Years Minimum.
36
0001j
MD Orientation / Training Shadowing
210
Hours
$_________
$___________
0001k
NP/PA Orientation / Training Shadowing
84
Hours
$_________
$___________

TOTAL FOR BASE YEAR PERIOD

19,664
Hours
$___________________

OPTION YEAR 1: __________________________

CLIN No.
SUB-CLIN
Description
Qty.
Unit
Unit Cost
Total

Annual Cost

0002
None
Emergency Medicine Physician Services. No On-Call required.
19,664
Hours
Do Not Price
Do Not Price

KEY PERSONNEL

None
0002a
FTE Board Certified/Board Eligible Emergency Medicine Physician.
(7:00am-7:00pm & 7:00pm – 7:00am seven days a week).
8,448
Hours
$_______
$_________
0002b
FTE Board Certified/Board Eligible Emergency Medicine Physician.
(7:00pm-7:00am 7:00pm – 7:00am Holidays).
288
Hours
$_________
$___________
0002c
FTE Board Certified/Board Eligible Emergency Medicine Physician.
(11:00am-11:00pm five days a week).
4,224
Hours
$_________
$___________
0002d
FTE Board Certified/Board Eligible Emergency Medicine Physician.
(8:00am-4:30pm five days a week).
528
Hours
$_________
$___________
0002e
FTE Board Certified/Board Eligible Emergency Medicine Physician.
(11:00am-11:00pm Holidays).
144
Hours
$_________
$___________
0002f
FTE Nurse Practitioner/Physician Assistant Practitioner. (6:00am-4:00pm, 12:00pm - 10:00pm & 4:00pm- 2:00am five days a week). Level of Experience in the ER field: Five (5) Years Minimum.
3,330
Hours
$_________
$___________
0002g
FTE Nurse Practitioner/Physician Assistant. (6:00am-4:00pm, 12:00pm - 10:00pm & 4:00pm- 2:00am Holidays). Level of Experience in the ER field: Five (5) Years Minimum.
270
Hours
$_________
$___________
0002h
FTE Nurse Practitioner/Physician Assistant. (8:00am-6:00pm Saturdays and Sundays). Level of Experience in the ER field: Five (5) Years Minimum.
770
Hours
$_________
$___________
0002i
FTE Nurse Practitioner/Physician Assistant. (8:00am-6:00pm Saturdays and Sundays Holidays). Level of Experience in the ER field: Five (5) Years Minimum.
120
Hours
$_________
$___________
0002j
FTE Nurse Practitioner/Physician Assistant. (11:00am-11:00pm Saturdays and Sundays). Level of Experience in the ER field: Five (5) Years Minimum.
1,212
0002k
FTE Nurse Practitioner/Physician Assistant. (11:00am-11:00pm Saturdays and Sundays Holidays). Level of Experience in the ER field: Five (5) Years Minimum.
36
0002l
MD Orientation / Training Shadowing
210
Hours
$_________
$___________
0002m
NP/PA Orientation / Training Shadowing
84
Hours
$_________
$___________

OPTION YEAR 1:

19,664
Hours
$___________________

OPTION YEAR 2:___________________________

CLIN No.
SUB-CLIN
Description
Qty.
Unit
Unit Cost
Total

Annual Cost

0003
None
Emergency Medicine Physician Services. No On-Call required.
19,664
Hours
Do Not Price
Do Not Price

KEY PERSONNEL

None
0003a
FTE Board Certified/Board Eligible Emergency Medicine Physician.
(7:00am-7:00pm & 7:00pm – 7:00am seven days a week).
8,448
Hours
$_______
$_________
0003b
FTE Board Certified/Board Eligible Emergency Medicine Physician.
(7:00pm-7:00am 7:00pm – 7:00am Holidays).
288
Hours
$_________
$___________
0003c
FTE Board Certified/Board Eligible Emergency Medicine Physician.
(11:00am-11:00pm five days a week).
4,224
Hours
$_________
$___________
0003d
FTE Board Certified/Board Eligible Emergency Medicine Physicia1`n.
(8:00am-4:30pm five days a week).
528
Hours
$_________
$___________
0003e
FTE Board Certified/Board Eligible Emergency Medicine Physician.
(11:00am-11:00pm Holidays).
144
Hours
$_________
$___________
0003f
FTE Nurse Practitioner/Physician Assistant Practitioner. (6:00am-4:00pm, 12:00pm - 10:00pm & 4:00pm- 2:00am five days a week). Level of Experience in the ER field: Five (5) Years Minimum.
3,330
Hours
$_________
$___________
0003e
FTE Nurse Practitioner/Physician Assistant. (6:00am-4:00pm, 12:00pm - 10:00pm & 4:00pm- 2:00am Holidays). Level of Experience in the ER field: Five (5) Years Minimum.
270
Hours
$_________
$___________
0003f
FTE Nurse Practitioner/Physician Assistant. (8:00am-6:00pm Saturdays and Sundays). Level of Experience in the ER field: Five (5) Years Minimum.
770
Hours
$_________
$___________
0003g
FTE Nurse Practitioner/Physician Assistant. (8:00am-6:00pm Saturdays and Sundays Holidays). Level of Experience in the ER field: Five (5) Years Minimum.
120
Hours
$_________
$___________
0003h
FTE Nurse Practitioner/Physician Assistant. (11:00am-11:00pm Saturdays and Sundays). Level of Experience in the ER field: Five (5) Years Minimum.
1,212
0003i
FTE Nurse Practitioner/Physician Assistant. (11:00am-11:00pm Saturdays and Sundays Holidays). Level of Experience in the ER field: Five (5) Years Minimum.
36
0003j
MD Orientation / Training Shadowing
210
Hours
$_________
$___________
0003k
NP/PA Orientation / Training Shadowing
84
Hours
$_________
$___________

OPTION YEAR 2:

19,664
Hours
$___________________

OPTION YEAR 3: __________________________

CLIN No.
SUB-CLIN
Description
Qty.
Unit
Unit Cost
Total

Annual Cost

0004
None
Emergency Medicine Physician Services. No On-Call required.
19,664
Hours
Do Not Price
Do Not Price

KEY PERSONNEL

None
0004a
FTE Board Certified/Board Eligible Emergency Medicine Physician.
(7:00am-7:00pm & 7:00pm – 7:00am seven days a week).
8,448
Hours
$_______
$_________
0004b
FTE Board Certified/Board Eligible Emergency Medicine Physician.
(7:00pm-7:00am 7:00pm – 7:00am Holidays).
288
Hours
$_________
$___________
0004c
FTE Board Certified/Board Eligible Emergency Medicine Physician.
(11:00am-11:00pm five days a week).
4,224
Hours
$_________
$___________
0004d
FTE Board Certified/Board Eligible Emergency Medicine Physician.
(8:00am-4:30pm five days a week).
528
Hours
$_________
$___________
0004e
FTE Board Certified/Board Eligible Emergency Medicine Physician.
(11:00am-11:00pm Holidays).
144
Hours
$_________
$___________
0004f
FTE Nurse Practitioner/Physician Assistant. (6:00am-4:00pm, 12:00pm - 10:00pm & 4:00pm- 2:00am five days a week). Level of Experience in the ER field: Five (5) Years Minimum.
3,330
Hours
$_________
$___________
0004e
FTE Nurse Practitioner/Physician Assistant. (6:00am-4:00pm, 12:00pm - 10:00pm & 4:00pm- 2:00am Holidays). Level of Experience in the ER field: Five (5) Years Minimum.
270
Hours
$_________
$___________
0004f
FTE Nurse Practitioner/Physician Assistant. (8:00am-6:00pm Saturdays and Sundays). Level of Experience in the ER field: Five (5) Years Minimum.
770
Hours
$_________
$___________
0004g
FTE Nurse Practitioner/Physician Assistant. (8:00am-6:00pm Saturdays and Sundays Holidays). Level of Experience in the ER field: Five (5) Years Minimum.
120
Hours
$_________
$___________
0004h
FTE Board Certified/Board Eligible Emergency Medicine Nurse Practitioner/Physician Assistant. (11:00am-11:00pm Saturdays and Sundays). Level of Experience in the ER field: Five (5) Years Minimum.
1,212
0004i
FTE Nurse Practitioner/Physician Assistant. (11:00am-11:00pm Saturdays and Sundays Holidays). Level of Experience in the ER field: Five (5) Years Minimum.
36
0004j
MD Orientation / Training Shadowing
210
Hours
$_________
$___________
0004k
NP/PA Orientation / Training Shadowing
84
Hours
$_________
$___________

OPTION YEAR 3:

19,664
Hours
$___________________

OPTION YEAR 4: __________________________

CLIN No.
SUB-CLIN
Description
Qty.
Unit
Unit Cost
Total

Annual Cost

0005
None
Emergency Medicine Physician Services. No On-Call required.
19,664
Hours
Do Not Price
Do Not Price

KEY PERSONNEL

None
0005a
FTE Board Certified/Board Eligible Emergency Medicine Physician.
(7:00am-7:00pm & 7:00pm – 7:00am seven days a week).
8,448
Hours
$_______
$_________
0005b
FTE Board Certified/Board Eligible Emergency Medicine Physician.
(7:00pm-7:00am 7:00pm – 7:00am Holidays).
288
Hours
$_________
$___________
0005c
FTE Board Certified/Board Eligible Emergency Medicine Physician.
(11:00am-11:00pm five days a week).
4,224
Hours
$_________
$___________
0005d
FTE Board Certified/Board Eligible Emergency Medicine Physician.
(8:00am-4:30pm five days a week).
528
Hours
$_________
$___________
0005e
FTE Board Certified/Board Eligible Emergency Medicine Physician.
(11:00am-11:00pm Holidays).
144
Hours
$_________
$___________
0005f
FTE Nurse Practitioner/Physician Assistant. (6:00am-4:00pm, 12:00pm - 10:00pm & 4:00pm- 2:00am five days a week). Level of Experience in the ER field: Five (5) Years Minimum.
3,330
Hours
$_________
$___________
0005e
FTE Nurse Practitioner/Physician Assistant. (6:00am-4:00pm, 12:00pm - 10:00pm & 4:00pm- 2:00am Holidays). Level of Experience in the ER field: Five (5) Years Minimum.
270
Hours
$_________
$___________
0005f
FTE Nurse Practitioner/Physician Assistant. (8:00am-6:00pm Saturdays and Sundays). Level of Experience in the ER field: Five (5) Years Minimum.
770
Hours
$_________
$___________
0005g
FTE Nurse Practitioner/Physician Assistant. (8:00am-6:00pm Saturdays and Sundays Holidays). Level of Experience in the ER field: Five (5) Years Minimum.
120
Hours
$_________
$___________
0005h
FTE Nurse Practitioner/Physician Assistant. (11:00am-11:00pm Saturdays and Sundays). Level of Experience in the ER field: Five (5) Years Minimum.
1,212
0005i
FTE Nurse Practitioner/Physician Assistant. (11:00am-11:00pm Saturdays and Sundays Holidays). Level of Experience in the ER field: Five (5) Years Minimum.
36
0005j
MD Orientation / Training Shadowing
210
Hours
$_________
$___________
0005k
NP/PA Orientation / Training Shadowing
84
Hours
$_________
$___________

OPTION YEAR 4:

19,664
Hours
$___________________

TOTAL CONTRACT COST: $ ___________________________

B.3 PERFORMANCE WORK STATEMENT

GENERAL:

1.1. Services Provided: The Contractor shall provide Board Certified/Board Eligible Emergency Department Physician and Nurse Practioner/ Physician Assistant Services on site in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and the Hampton VA Medical Center. 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 Hampton VA Medical Center, 100 Emancipation Drive, Hampton, VA 23667.

1.3. Authority: Title 38 USC 8153, General Contracting Authority 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.

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. BLS: Basic Life Support

1.5.8. CCNE: Commission on Collegiate Nursing Education: www.aacn.nche.edu/accreditation

1.5.9. CDC: Centers for Disease Control and Prevention

1.5.10. CR: Contract Discrepancy Report

1.5.11. CEU: Certified Education Unit

1.5.12. CME: Continuing Medical Education

1.5.13. CMS: Centers for Medicare and Medicaid Services

1.5.14. 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.

1.5.15. 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.

1.5.16. COS: Chief of Staff

1.5.17. CPARS: Contractor Performance Assessment Reporting System

1.5.18. 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.

1.5.19. DEA: Drug Enforcement Agency

1.5.20. ED: Emergency Department

1.5.21. EHR: Electronic Health Record - electronic health record system used by the VA.

1.5.22. FSMB: Federation of State Medical Boards

1.5.23. HHS: Department of Health and Human Services

1.5.24. HIPAA: Health Insurance Portability and Accountability Act

1.5.25. HR: Human Resources

1.5.26. ISO: Information Security Officer

1.5.27. 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.

1.5.28. MOD: Medical Officer of the Day

1.5.29. 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).

1.5.30. NLNAC: National League for Nursing Accrediting Commission. www.nlnac.org

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

1.5.32. NP: Nurse Practitioner

1.5.33. NPPES: National Plan and Provider Enumeration System

1.5.34. PA: Physician Assistant

1.5.35. PALS: Pediatric Advanced Life Support

1.5.36. POP: Period of Performance

1.5.37. PPD: Purified Protein Derivative

1.5.38. PWS: Performance Work Statement

1.5.39. 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.

1.5.40. QA/QI: Quality Assurance/Quality Improvement

1.5.41. QM/PI: Quality Management/Performance Improvement

1.5.42. QASP: Quality Assurance Surveillance Plan

1.5.43. 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.

1.5.44. Veterans Integrated Services Network (VISN) : The regional oversight for the VA medical centers.

1.5.45. 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.

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

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

2. 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 and are strongly encouraged but not required to be certified in Basic Life Support (BLS) Advanced Cardiac Life Support (ACLS) or equivalency All continuing education courses required for maintaining certification must always be kept up to date. 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 Hampton 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, EHR 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. For Emergency Departments, Board Certified Emergency Medical Physicians are strongly encouraged, but not required, to have current BLS and ACLS certification. However, PLEASE KNOW THAT YOU MUST FOLLOW YOUR LOCAL FACILITIES POLICY. Other training may become required. VA will communicate any changes to the training requirement to the contractor.

Training (The following training is mandatory per VHA for Contracted Physicians) Frequency

Annual Hours

Active Threat Training (VA24638)
Once per year
1.0
Blood Administration: Complications (VA 8562)
Once per year

1.0

Blood Administration: Administration (VA 8563)
Once per year

1.0

Government Ethics (VA 3812493)
Once per year
1.0

Hospice and Pallative Care for VA Clinicians (VA 1367764)

Once per year

0.5

Military Sexual Trauma (MST) for Medical Professionals (VA 30925)

Once per year

1.0

Moderate Sedation In-Service Training (VA 31266)

Once per year

2.0

Prevention of Workplace Harassment/No Fear Act (VA 8872)

Once per year

1.5

VHA MRI Safety Training Level 1 Training (all who enter MRI suites)

(VA 1345930)

Once per year

0.5

VA Core Values Training (ICARE Recommitment) (VA 3901227)

Once per year

1.0

VA Privacy and Information Security Awareness and Rules of Behavior

(VA 10176)

Once per year

1.0

VHA Privacy and HIPAA Focused Training (VA 10204)

Once per year

1.0

VHA Compliance and Business Integrity (CBI) Awareness Mandatory Training (VA 7318)

Once per year

0.75

Patient Safety Brief (VA 3893929)

Once per year

1.0

Recognizing Signs of Abuse (VA 1341670)

Once per year

1.0

Patient Rights
Once per year
1.0

Prevention/Management of Disruptive Behavior/Violence Prevention Level I (VA 37659)

Once per year

1.0

Suicide Prevention: Suicide Risk Management Training for Clinicians (VA6201)

Once per year

1.0

+Infection Prevention and Antimicrobial Stewardship

(VA 1341471)

Once per year

1.0

Bood Borne Pathogens- OSHA

(VA 1341225)

Once per year
1.0
CPRS Computer Training
Once
4.0
VISTA Imaging
Once
0.25
EDIS Training
15 min
0.25
Orientation to ED/Shadow
Once
8
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 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.

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.

2.1.12 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.

2.2.7.1. 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.

2.2.7.2. 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.

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:

2.7.1 Workers’ compensation

2.7.2 Professional liability insurance

2.7.3 Health examinations

2.7.4 Income tax withholding, and

2.7.5 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:

2.9.1 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.

2.9.2 The minimum number of Board Certified /Board Eligible Emergency Department Physicians required to be on site daily is eight (8) as defined in paragraph Hours of Operation in this section.

2.9.3 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 Hampton VA Medical Center immediately of the schedule change.

2.9.4 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.

2.9.4.1 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.

2.9.4.2 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.

2.9.4.3 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.

2.9.4.4 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: 24 hours a day

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

3.1.2 Below are the shifts that will be required to staff:

Emergency Department Physician:

a. 7:00am to 7:00pm - daily (12-hours tour)

b. 7:00pm to 7:00am - daily (12-hours tour)

c. 11:00am to 11:00pm - Monday through Friday (12-hours tour)

d. 8:00am to 4:30 pm - Monday through Friday (8-hours tour)

e.

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