36C24819Q0336-002.docx

36C24819Q0336

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

X 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 CONDITIO

NS 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

675-18-1-2202-0002 36C24819Q0336 02-14-2019 Cyrouse Himid Houshyani 813-631-2816 02-28-2019

2:30 EST.

36C675 Department of Veterans Affairs Network Contracting Office 8 (NCO 8) Orlando VAMC 13800 Veterans Way Orlando, FL 32827 621999 $15.0 Million X N/A X Department of Veterans Affairs Orlando VAMC 13800 Veterans Way Orlando, FL 32827 36C248 Department of Veterans Affairs Network Contracting Office 8 (NCO 8) 8875 Hidden River Pkwy Tampa FL 33637

Department of Veterans Affairs Financial Services Center P.O. Box 149971 Austin TX 78714-9971 See CONTINUATION Page The Contractor shall provide Extracorporeal Shock Wave Lithotripsy (ESWL) Services on-site to support the Orlando VA Medical Center (OVAMC) located at 13800 Veterans Way, Orlando, FL 32827 and the Viera Outpatient Clinic (OPC) at 2900 Veterans Way, Melbourne, FL 32940 This contract will be awarded for a base year with four (4)- one

(1) year options.

Reference page six (6) for the Price Schedule.

See CONTINUATION Page X X x Cyrouse Himid Houshyani NCO813L2-65122 Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

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

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

b. Government: Contracting Officer 36C248 Cyrouse Himid Houshyani Department of Veterans Affairs Network Contracting Officer (NCO) 8 8875 Hidden River Pkwy Suite 525 Tampa FL 33637 Phone: 813-631-2827

Contracting Officer Representative Alfonzo Rosado Department of Veteran Affairs Orlando VA Medical Center 13800 Veterans Way Orlando, FL 32827

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor should be mailed to the following address:

3. INVOICES: Invoices shall be submitted in arrears:

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

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

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

6. REQUEST FOR QUOTE: Quotes for furnishing services identified within the schedule will be submitted electronically to the Contracting Officer at cyrouse.houshyani@va.gov until the date and time specified in block eight (8) of this RFQ.

7. CAUTION: Quoters must complete and return all information designated in FAR 52.212-1, Instructions to Quoters – Commercial Items, Paragraph (b) prior to the time specified in block 8 of SF1449 in order to be considered for award. Late submissions, Modification, and Withdrawals: See Provision 52.212-1. All quotes are subject to all terms and conditions of this RFQ.

8. POST AWARD ORIENTATION: The Contracting Officer will schedule a post award orientation conference for contract orientation purposes as required by IL 003A3-12-04.

http://www.va.gov/oal/docs/library/ils/il12-04.pdf

B.2 LIMITATIONS ON SUBCONTRACTING-- MONITORING AND COMPLIANCE (JUN 2011)

This solicitation includes FAR 52.219-4 Notice of Price Evaluation Preference for HubZone Small Business Concerns. Accordingly, any contract resulting from this solicitation will include this clause. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) retained by VA to assist in assessing the contractor's compliance with the limitations on subcontracting or percentage of work performance requirements specified in the clause. To that end, the support contractor(s) may require access to contractor's offices where the contractor's business records or other proprietary data are retained and to review such business records regarding the contractor's compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor's compliance with the limitations on subcontracting or percentage of work performance requirement.

B.3 SUBCONTRACTING COMMITMENTS--MONITORING AND COMPLIANCE (JUN 2011)

This solicitation includes VAAR 852.215-70, Service-Disabled Veteran-Owned and Veteran-Owned Small Business Evaluation Factors, and VAAR 852.215-71, Evaluation Factor Commitments. Accordingly, any contract resulting from this solicitation will include these clauses. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) to assist in assessing contractor compliance with the subcontracting commitments incorporated into the contract. To that end, the support contractor(s) may require access to the contractor's business records or other proprietary data to review such business records regarding contract compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor compliance with the subcontracting commitments.

B.4 PRICE SCHEDULE

The Government intends to award a Requirements Contract for Extracorporeal Shock Wave Lithotripsy (ESWL) Services to be performed at the Orlando VAMC. The contract is expected to be awarded for one (1) base year and four (4) - one (1) year options.

a) Minimum and Maximum Quantity:

This requirement is for an estimated maximum amount of Ninety-Six cases of services for the base year and Ninety-Six cases for each option year exercised thereafter (see below i. through ii. for estimated maximum and minimum cases.) A case (CS) is defined as a one (1) procedure of ESWL services. One (1) CS of ESWL services is estimated to last between one (1) and two (2) hours, however these are estimations and the contractor shall work until all task for ESWL services are complete.

i. The guaranteed minimum amount to be ordered for this contract, to include any exercised options, is 30 cases.

ii. The maximum amount to be ordered for this contract for the base, and all option periods, if exercised by the Government, is 480 cases.

Task Order Procedures: In lieu of issuing an individual task order whenever there is a need for service, one (1) task order will be issued to fund the base period and modify increases or decreases of funding as necessary. Task Order will be obligated with a Not to Exceed (NTE) amount and Contractor shall not exceed estimated quantities or dollar threshold without the express or written consent of the Contracting Officer. Adjustment made without approval will be considered an Unauthorized Commitment; violation under Federal Acquisition Regulation, FAR 1.602-3. Should the Government choose to exercise any option periods; an individual task order will be issued for each option period at the time of exercising the option. The task order will contain date of order, order number, contract line item number, description, estimated quantity, unit cost, performance schedule, place of performance, accounting and appropriations data, and method of payment.

Pricing Instructions: The Quoter is instructed to complete the unit price and total annual cost based on the estimated number of cases. Quoters must fill out the cells in the following columns in the Price Schedule for each CLIN. For pricing and evaluation purposes, Quoters must also provide a cost breakdown of their all-inclusive case rate. The Government is seeking a price reduction. If the Quoter is able to provide a price reduction, please show this in your cost breakdown.

ITEM INFORMATION

ANNUAL

PRICE

Contract Period: Base POP Begin: 03-31-2019 POP End: 03-30-2020

Contract Period: Option 1 POP Begin: 03-31-2020 POP End: 03-30-2021

Contract Period: Option 2 POP Begin: 03-31-2021 POP End: 03-30-2022

Contract Period: Option 3 POP Begin: 03-31-2022 POP End: 03-30-2023

Contract Period: Option 4 POP Begin: 03-31-2023 POP End: 03-30-2024

GRAND TOTAL

B.5 PERFORMANCE WORK STATEMENT

LITROTRIPSY SERVICES

1. GENERAL:

1.1. Services Provided: the contractor shall provide State licensed radiologic technician(s) (licensed in diagnostic radiography - X-ray), to perform Extracorporeal Shock Wave Lithotripsy (ESWL), utilizing Orlando VA Medical Center’s (OVAMC) owned equipment (Storz F2 Lithotripter with GE 9900 C Arm). Licensed radiologic technician(s) shall be present at OVAMC and perform the required services for payment. The Contractor will be paid for actual performance, not for standing by or being on-call. Payment for any leave, including sick leave or vacation time, and holiday pay is the responsibility of the Contractor.

1.1.1. The OVAMC reserves the right to refuse to accept any state licensed radiologic technicians who do not meet the requirements set forth, who fails to perform in accordance with the contract requirements, or who fails to adapt to the OVAMC work environment. Licensed radiologic technician(s) shall operate OVAMC owned Lithotripter machine. Advise nursing staff to order ESWL supplies, following completion of each procedure. Contractor shall calibrate and record appropriate ESWL data, to provide OVAMC Operating Room staff, and OVAMC Operating Room staff will only record in Computerized Patient Recordkeeping System (CPRS.)

1.1.2. The OVAMC Surgery Service expects a minimum is Thirty (30) ESWL cases with a maximum of Ninety-Six (96) cases per year. Services are expected to be furnished approximately three (3) to six (6) days per month, with planned procedures being scheduled at a minimum of two (2) weeks prior. For emergent cases, notification may be given within three (3) hours of procedure. One radiologic technologist shall be used to support the elective cases as well as provide for coverage during vacation, illness, etc.

1.2. Place of Performance: Contractor shall furnish services at Orlando VA Medical Center (OVAMC) located at 13800 Veterans Way, Orlando, FL 32827 and the Viera Outpatient Clinic (OPC) at 2900 Veterans Way, Melbourne, FL 32940.

1.3. Term of Contract: The contract will be effective for one (1) base year with four (4) – one (1) year options

1.4. Authority: Title 38 USC 8153, Health Care Resources (HCR) sharing Authority, FAR 12 Acquisition of Commercial Items and FAR 13 Simplified Acquisition Procedures

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

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

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

1.5.3. VHA Handbook 1100.17: National Practitioner Data Bank Reports - http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135

1.5.4. VHA Handbook 1100.18 Reporting And Responding To State Licensing Boards - http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364

1.5.5. VHA Handbook 1100.19 Credentialing and Privileging - http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910

1.5.6. VHA Handbook 1907.01 Health Information Management and Health Records: https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3088

1.5.7. Privacy Act of 1974 (5 U.S.C. 552a) as amended http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm

1.5.8. Joint Commission - http://www.jointcommission.org/standards/

1.5.9. HHS OIG Website – http://oig.hhs.gov/exclusions/index.asp

1.5.10. American Journal for Infection Control - AJIC 1998; 26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf

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

1.6.1. ACLS: Advanced Cardiac Life Support

1.6.2. BLS: Basic Life Support

1.6.3. CDC: Centers for Disease Control and Prevention

1.6.4. CDR: Contract Discrepancy Report

1.6.5. CEU: Certified Education Unit

1.6.6. CME: Continuing Medical Education

1.6.7. CMP: Civil Monetary Penalty

1.6.8. CMS: Centers for Medicare and Medicaid Services

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

1.6.10. COR: Contracting Officer’s Representative – 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.

1.6.11. COS: Chief of Staff

1.6.12. CPARS: Contractor Performance Assessment Reporting System

1.6.13. DEA: Drug Enforcement Agency

1.6.14. ED: Emergency Department

1.6.15. ECMO: Extracorporeal Membrane Oxygenation

1.6.16. EMR: Electronic Medical Record

1.6.17. Estimated: The quantities or dollar threshold listed in the Price Schedule, effective for the periods stated are estimates only, and are not purchased by this contract. Except as this contract may otherwise provide, if the VA's requirements do not result in orders in the quantities or dollar amount described, that fact shall not constitute the basis for an equitable price adjustment.

1.6.18. FPPE Focused Provider Practice Evaluation

1.6.19. HHS: Department of Health and Human Services

1.6.20. HIPAA: Health Insurance Portability and Accountability Act

1.6.21. HR: Human Resources

1.6.22. ISO: Information Security Officer

1.6.23. 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).

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

1.6.25. Not To Exceed (NTE): Contractor shall not exceed estimated quantities or dollar threshold without the express or written consent of the Contracting Officer.

Adjustment made without approval will be considered an Unauthorized Commitment; violation under Federal Acquisition Regulation, FAR 1.602-3.

1.6.26. OSHA: Occupational Safety and Health Administration

1.6.27. OIT: Office of Information and Technology

1.6.28. OPC: Out Patient Clinic

1.6.29. OPM: Office of Personnel Management

1.6.30. OPPE: Ongoing Provider Practice Evaluation

1.6.31. OR: Operating Room

1.6.32. OVAMC: Orlando Veteran Affairs Medical Center

1.6.33. PIV: Personal Identity Verification

1.6.34. POP: Period of Performance

1.6.35. PWS: Performance Work Statement

1.6.36. QA/QI: Quality Assurance/Quality Improvement

1.6.37. QM/PI: Quality Management/Performance Improvement

1.6.38. QASP: Quality Assurance Surveillance Plan

1.6.39. RFP: Request for Proposal

1.6.40. VAMC: Veterans Affairs Medical Center

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

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

1.6.43. 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.

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

1.6.45. Veterans Affairs Medical Center (VAMC): Unless identified with the name of a different VA Medical Center, for the purpose of this contract, this term shall mean the Orlando VA Medical Center.

2. Qualifications:

2.1. Staff/Facility – The contractor shall provide a state licensed radiologic technologist as required to the Orlando VA Medical Center (OVAMC) at 13800 Veterans Way, Orlando, FL 32827 and Viera Outpatient Clinic (OPC) at 2900 Veterans Way, Melbourne, FL 32940.

2.1.1. License - All state licenses held by the personnel working on this contract shall be full and unrestricted license to the services covered by this contract issued in any State, Territory, or Commonwealth of the United States or the District of Columbia. Contract personnel shall submit evidence of current, full and unrestricted licenses, registration, certification, and/or other relevant credentials for verification prior to appointment and throughout the employment process, as requested by the COR. Contractor is responsible for keeping the COR informed of anything that would adversely affect or otherwise limit their clinical privileges. Failure to meet this requirement may result in termination of the contract.

2.1.2. The licensed radiologic technician(s) shall have a state license as a licensed radiologic technician, with ESWL proficiency. A log of completed ESWL cases per licensed radiologic technician, is required at minimum to exemplify proficiency. All continuing education courses required for maintaining state licensure must be kept up to date at all times. Documentation verifying current certification shall be provided by the Contractor to the VA COR on an annual basis for each year of contract performance. A folder with the stated qualifications will be maintained by the COR.

2.1.3. Credentialing - Contracted licensed radiologic technician(s) fulfilling the conditions of the contract shall be subject to all bylaws, rules, and regulations of the VHA. Each licensed radiologic technician shall be credentialed prior to providing services and must be found acceptable by the Medical Executive committee and Governing Body. Credentialing is to be completed in accordance with VA Handbook 5005/15, Part II, Appendix G27.

2.1.3.1. If a contract personnel (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 - Radiologic technician(s) shall be fully trained and completely competent to perform the required work at OVAMC. All contract licensed radiologic technician(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 and/or services performed. Contractor shall provide verifiable evidence of all educational and training experiences including gaps in educational history for all state licensed radiologic technician(s). State licensed radiologic technician(s) shall be responsible for abiding by the Facility’s Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior. In addition, the Radiologic Technician(s) shall have the following skills:

Familiar in dealing with hospital patient population, including working with elderly and difficult patients. Shall have tact and personality conducive to interacting with ill, disoriented, sometimes difficult inpatient and outpatient population.

Contract personnel (s) / licensed radiologic technician(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 language fluently. Qualifications/eligibilities that are required for all licensed radiologic technician such as citizenship, English language proficiency, and physical requirements. 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 contract personnel(s) and contract personnel (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. Contract personnel (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 credentials office for tracking. These documents are required for both privileging and re-privileging. Failure to provide shall result in loss of privileges for contract personnel (s).

2.1.6. Fluoroscopy Training Requirement: On a yearly basis contractor will provide RSO and COR documentation of proof that all contracted radiologic technicians rendering services at OVAMC are actively certified in radiology and radiation therapy from the American Registry of Radiologic Technologists (ARRT), are considered and demonstrate to have met the didactic training requirement, in compliance with VHA Directive 1105.04 Fluoroscopy Safety.

Attention: Eric Jones, RSO, Health Physicist Email: Eric.Jones1a6194@va.gov

(407) 646-5500

2.1.7. Training: Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the Contractor’s employee as required by the VA.

2.1.8. Standard Personnel Testing (PPD, etc.): Contractor shall provide proof of the following tests for personnel 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.

2.1.8.1. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative reaction to PPD testing for all contract personnel (s). A negative chest radiographic report for active tuberculosis shall be provided in cases of positive PPD results. The PPD test shall be repeated annually.

2.1.8.2. RUBELLA TESTING: Contractor shall provide proof of immunization for all contract personnel (s) for measles, mumps, rubella or a rubella titer of 1.8 or greater. If the titer is less than 1.8, a rubella immunization shall be administered with follow-up documentation to the COR.

2.1.8.3. OSHA regulation concerning occupational exposure to bloodborne pathogens: Contractor shall provide generic self-study training for all contract personnel (s); provide their own Hepatitis B vaccination series at no cost to the VA if they elect to receive it; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident. 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.

2.1.9. National Provider Identification (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 proposal.

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

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.

2.1.12.1. Therefore, Contractor shall review the HHS OIG List of Excluded Individuals/Entities on the HHS OIG web site referenced above to ensure that the proposed contract 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.

2.1.12.2. By submitting their proposal, 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.

2.2. 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 Chief of Urology or their Designee will serve as the Clinical Subject Matter expert to ensure quality metrics/certification/training requirements are met. 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.

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

2.4. 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.

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

2.6. Inherent Government Functions: Contractor and Contract personnel (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.

2.7. No Employee status: The Contractor shall be responsible for protecting Contract personnel (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 to include:

2.7.4. Annual TB Skin Test and recent chest X-ray if there is a history of positive TB skin test

2.7.5. Evidence of Hepatitis B immunity (hepatitis immune titer, if the individual has had the series of shots; if no immunity, evidence that the individual has started the Hepatitis B vaccination series

2.7.6. Evidence of a Hepatitis C titer

2.7.7. Varicella titer if contracted employee has not had chicken pox

2.7.8. Income tax withholding, and

2.7.9. Social security payments

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

2.9. Key Personnel:

2.9.1. The number of State Licensed Radiologic Technologist required to be on site during each case is one (1) as defined in paragraph “Services Provided” of the PWS listed herein.

2.9.2. 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 provider is unable to complete an assigned case, the contractor shall provide replacement provider coverage within 2 hours and notify the Contracting Office Representative (COR) at the (Orlando VA Medical Facility) immediately of the schedule change.

2.9.3. Contractor shall provide the names of the contracted employee(s) assigned to the performance:

Key Personnel / Substitute Name (s)

Identifier Number

radiologic technologist radiologic technologist radiologic technologist radiologic technologist

2.10. Emergency 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 15 calendar days 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 15 calendar days prior to making any permanent substitutions.

2.10.1. 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 15 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.

2.10.2. For temporary substitutions where the key person shall not be reporting to work for three (3) consecutive work days 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.

2.10.3. 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 contract personnel (s), s/he may request, without cause, immediate replacement of said contract personnel (s).

2.10.4. The CO and COR shall deal with issues raised concerning Contract personnel (s) conduct. The final arbiter on questions of acceptability is the CO.

2.10.5. 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 contract personnel (s) leaves Contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract.

2.10.6. Note: Evidence of completion of required licensure, credentials, required training, current competencies and background investigations must be validated for all contractor personnel referred to perform services under this contract prior to providing direct patient care. Contractor shall not have any personnel report to duty until written notification is received from the Contracting Officer advising that the candidate (s) presented has met all requirements for contract performance.

3. HOURS OF OPERATION:

3.1.1. VA Business Hours: VA business hours are Monday – Friday, 7:00 a.m. - 4:30 p.m., excluding federal holidays.

3.1.2. Emergency Operations: Twenty-Four (24) hours a day, seven (7) days a week

4. CONTRACTOR RESPONSIBILITIES:

4.1. Clinical Personnel Required: The Contractor shall provide contract personnel (s) who are competent, qualified per this performance work statement and adequately trained to perform assigned duties.

4.1.1. Contract personnel (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.

4.1.2. Radiologic Technician(s) shall assist Orlando VA Medical Center (VAMC) Surgical Service, Surgeons with Lithotripsy services. The contractor shall perform onsite Lithotripsy Services in the treatment of care for eligible veteran beneficiaries as referred and authorized by the Orlando VAMC. Radiologic Technicians are responsible for preparation and operation of the Lithotripsy Equipment. Radiologic Technicians assemble supplies and equipment for the case and operates equipment that provides lithotripsy services to the patient.

4.1.3. The Radiologic Technician(s) is responsible to check with the Operating Room (OR) Manager, or (OR) Coordinator, or the attending Urologist for afterhours cases, to determine where services are to be rendered. Radiologic technician(s) assure proper breakdown of equipment and disposables, if utilized, after completion of each procure.

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

4.2.3. 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

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

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

4.2.6. The requirements contained in this PWS

4.3. Medical Records

4.3.1. Authorities: Contract personnel (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: Contract personnel (s) may have access to patient medical records: however, Contractor shall obtain permission from the VA before disclosing any patient information.