36C24919R0181-0001002.docx

36C24919R0181 - ATTACHMENT 1 - PERFORMANCE WORK STATEMENT FOR RADIOLOGY SERVICES

1. GENERAL:

1.1. Services Provided:

General duties required for Ultrasound:

Independently performs standard examinations. Evaluates the nature of critical and emergency procedures, and rearranges patients scheduled to accommodate them. Maintains records and image files of patients examined. Cross-indexes interesting cases for teaching purposes.

Performs studies of the liver, gallbladder, pelvis, spleen, pancreas, abdominal aorta, using real time techniques to evaluate the structures for size, abnormal contour, cysts and various pathologic disorders.

Performs Doppler examinations of the portal vein, IVC, scrotum and kidneys. Effectively uses Doppler to supplement the examinations of other organs when needed.

Performs vascular studies of the extremities upper and lower (venous).

Performs studies of the kidneys, adrenal glands, nodes and urinary bladder using real time Gray scale techniques to perform examinations for detection of renal cysts and tumors, adrenal masses, lymph node enlargement, retro peritoneal hematomas, abscesses and abnormalities of the urinary bladder.

General duties required for CT:

Requires specific knowledge of cross-sectional human anatomy and its application in spiral, and/or, multi-slice computer tomography, inclusive of 3-D reconstruction scans, including drainages, biopsies, and peripheral vascular examinations. The technologist requires specific knowledge and training in the location, appearance, and function of the various major and minor systems susceptible to radiological illumination; to interpret the examination request accurately; to understand the functioning and inter-relationship of the various organs; to use the methods and techniques which will identify organs appearing on the digital display monitor, or on film, and the various stages of the examination to judge the acceptability of the image and/or scan for diagnostic use and to emphasize the aspects of particular interest to the physician.

General duties for MRI:

Performs Magnetic Resonance Imaging (MRI) and Magnetic Resonance Angiography (MRA) of the head, neck spine, chest and body. These exams are performed with and without use of contrast materials. The purpose of these exams is to achieve diagnostic studies so that proper diagnosis and treatment may be effectuated.

Requires additional knowledge of super conducting magnets, the physics of superconducting magnets, and how they relate to the human anatomy in medical imaging. The technologist must be educated in the safety factors governing a magnetic environment that patients, visitors, and equipment enter into. The practitioner must have specific specialized knowledge of cross sectional anatomy and how it relates to the soft tissues and vessels of the human body. The technologist must also have specialized knowledge in the radio-frequency surface coils required for each specific anatomical area to be imaged. The technologist requires knowledge of image acquisition in Picture Archiving and Communication Systems (PACS).

General duties for Interventional Technicians:

Performs peripheral and visceral angiography of the abdominal systems and extremities i.e. renal, hepatic, mesenteric, aortic, femoral, etc. The exams involve the use of highly sophisticated x-ray equipment such as IR fluoroscopy, pressure injectors, biplane imaging, patient monitors, etc. Such procedures may be performed in the operating room in lieu of the interventional radiology suite. The purpose of these exams are to achieve diagnostic or therapeutic studies of the vascular systems.

The technologist performs angiography, venograms, myelograms, percutaneous nephrostomy, tumor ablation, vertebraplasty, pain management procedures and other special/interventional procedures. Also, perform vascular procedures in the OR, operate C-Arm , portables, CR, DR radiography, portables and various diagnostic procedures.

Performs myelography of the complete spine utilizing conventional x-ray units, patient immobilizers, etc., when required. The purpose of these exams is to achieve diagnostic studies of the spinal canal.

Performs neuroangiography, including spine, head and neck studies utilizing highly sophisticated x-ray equipment such as computerized fluoroscopy, pressure injectors, biplane imaging, patient monitors, etc. The purpose of these exams is to achieve diagnostic studies of the spinal canal.

Performs most exams utilizing surgical sterile techniques. This requires "scrub-in technique," preparation of surgical trays, preparation of contrast, supplying of catheters and guide wires, sterile assurance of the patient and equipment that may come in contact with the sterile field with the purpose of assuring that all preventive measures have been taken to prevent contamination of the patient. This is done to minimize hazards associated with invasive procedures and involves the use of sterile packs, gloves, syringes, guide wires, catheters, clean-up trays, etc., after exam is completed. Adheres to hospital infection control and safety policies/techniques with emphasis on sterile technique; the storage of sterile supplies; the disposal of body fluids and 'sharps'; proper attire; hand washing practices; and continuing education.

Works with the vascular surgeon and radiologist as a member of the medical team. Must assist and anticipate the needs of the vascular surgeon and/or radiologists and the performance of the exam. Must be continuously on the alert for the patient's condition, sterile field, catheter and guide wire sizes and configurations, etc. The alertness of the individual is essential to prevent contamination, recognize patient reactions, anticipate technique factor difficulties, etc.

1.2. Place of Performance – The place of performance will be 100% on-site at the Memphis VAMC, 1030 Jefferson Ave, Memphis, TN 38104.

1.3. Authority: Title 38 USC 8153, Health Care Resources (HCR) sharing Authority.

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

1.4.2. 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

1.4.3. VHA Handbook 1907.01 Health Information Management and Health Records: http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791

1.4.4. 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. ARDMS: American Registry for Diagnostic Medical Sonography

1.5.2. ARRT: American Registry of Radiologic Technologists

1.5.3. CR: Contract Discrepancy Report

1.5.4. CEU: Certified Education Unit

1.5.5. CME: Continuing Medical Education

1.5.6. 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.

1.5.7. Contracting Officer 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.

1.5.8. COS: Chief of Staff

1.5.9. CPARS: Contractor Performance Assessment Reporting System

1.5.10. CPRS: Computerized Patient Recordkeeping System- electronic health record system used by the VA.

1.5.11. 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.

1.5.12. HHS: Department of Health and Human Services

1.5.13. HIPAA: Health Insurance Portability and Accountability Act

1.5.14. HR: Human Resources

1.5.15. ISO: Information Security Officer

1.5.16. PACS: Picture Archiving and Communication System. The software product used to capture and display radiology and nuclear medicine images for interpretation and dictation.

1.5.17. POP: Period of Performance

1.5.18. PPD: Purified Protein Derivative

1.5.19. PWS: Performance Work Statement

1.5.20. QA/QI: Quality Assurance/Quality Improvement

1.5.21. QM/PI: Quality Management/Performance Improvement

1.5.22. QASP: Quality Assurance Surveillance Plan

1.5.23. Service Chief: A VA employed physician. Chief of Radiology and Nuclear Medicine.

1.5.24. 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.

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

1.5.26. 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.

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

1.5.28. 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 Memphis VA Medical Center.

2. QUALIFICATIONS:

2.1. Staff/Facility

2.1.1. Certification – The Contractor’s technologist (s) assigned by the Contractor to perform the services covered by this contract shall have a current certification as required in any State, Territory, or Commonwealth of the United States or the District of Columbia when services are performed onsite on VA property. Technologist (s) who work MR, CT must have their advance registry by ARRT. Technician (s) working ultrasound shall be registered by ARDMS.

2.1.1.1. BLS: The contractor is responsible to ensure compliance with the following: All the contractor’s personnel who provide any services on VA property must maintain BLS certification by a certifying organization acceptable to VA.

2.1.2. Training (VA training): Contractor shall meet all VA educational requirements and mandatory course requirements. These change from time to time; all training must be completed by the contractor’s physician (s) as required by the VA. The following are the estimated courses and estimated time involved:

2.1.3. Standard Personnel Testing (PPD, etc.): Contractor shall provide proof of the following tests for technologist (s) 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.

2.1.3.1. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative reaction to PPD testing for all contract physician (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.

2.1.3.2. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO BLOODBORNE PATHOGENS: Contractor shall provide generic self-study training for all contract physician (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.

2.1.4. 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 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.

2.1.5. Citizenship related Requirements:

2.1.5.1. 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;

2.1.5.2. 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.

2.1.5.3. 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.

2.1.5.4. 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.

2.1.5.5. 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.

2.1.6. 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.

2.1.6.1. 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.

2.1.6.2. 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 Service Chief and/or COS or 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.

2.3. Non- Personnel Healthcare Services: The parties agree that the Contractor and all contractor’s physician (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. No Employee status: The Contractor shall be responsible for protecting Contractor’s technologist (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:

2.5.1. Workers’ compensation

2.5.2. Professional liability insurance

2.5.3. Health examinations

2.5.4. Income tax withholding, and

2.5.5. Social security payments.

2.6. Key Personnel:

2.6.1. The VA Full Time Equivalency (FTE) for the services required is estimated for the initial year to be 2.0 MRI Technologist, 1.0 CT Technologists and 1.0 Ultrasound Technologists and 1.0 Interventional Technologists. FTE is defined by VA as a minimum of 80 hours every two weeks and does not include holidays.

2.6.2. 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.

2.6.3. 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 15 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 15 calendar days prior to making any permanent substitutions.

2.6.3.1. 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.

2.6.3.2. 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.

2.6.3.3. 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.

2.6.3.4. 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: Work hours (business hours): Monday through Friday, 8:00 a.m. - 4:30 p.m. Reference paragraph 4.2 below for detailed hours of required coverage.

3.2. Federal Holidays: The following holidays are observed by the Department of Veterans Affairs:

· New Year’s Day

· President’s Day

· Martin Luther King’s Birthday

· Memorial Day

· Independence Day

· Labor Day

· Columbus Day

· Veterans Day

· Thanksgiving Day

· Christmas Day

· Any day specifically declared by the President of the United States to be a national holiday.

3.3. Cancellations:

3.3.1. Unless a state of emergency has been declared or clinics are otherwise cancelled by the VAMC, the Contractor shall be responsible for providing services.

4. CONTRACTOR RESPONSIBILITIES:

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

4.2. Hours of Coverage: 8 hours per day 5 days per week for each Tech. Call required.

MRI ON-CALL HOURS:

Monday – Friday - 7pm – 7am Friday - 7am – Midnight Friday - Midnight – Midnight - Saturday Saturday - Midnight – Sunday - Midnight Sunday - Midnight – Monday 7am

Ultrasound ON-CALL HOURS:

Monday – Friday 4:30pm – 10pm Saturday - 7am-10pm Sunday - 7am-10pm

Interventional Radiology ON-CALL HOURS:

Monday – Friday 4:30pm – 7 am Saturday 7am – Monday 7am

4.3. Standards of Care: The contract technologist (s)’ care shall cover the range of diagnostic imaging 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:

4.3.1. The American Registry

4.3.2. of Radiologic technologists: https://www.arrt.org/

4.3.3. American Registry for Diagnostic Medical Sonography: http://www.ardms.org

4.3.4. 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

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

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

4.3.7. The requirements contained in this PWS

4.4. MEDICAL RECORDS:

4.4.1. Authorities: Contractor’s physician (s) providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the U.S.C.551a (Privacy Act), 38 U.S.C. 5701 (Confidentiality of claimants records), 5 U.S.C. 552 (FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332 (Confidentiality of certain medical records), Title 5 U.S.C. § 522a (Records Maintained on Individuals) as well as 45 C.F.R. Parts 160, 162, and 164 (HIPAA).

4.4.2. 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.

4.4.3. Disclosure: Contractor’s physician(s) may have access to patient medical records: however, Contractor shall obtain permission from the VA before disclosing any patient information. Subject to applicable federal confidentiality or privacy laws, the Contractor, or their designated representatives, and designated representatives of federal regulatory agencies having jurisdiction over Contractor, may have access to VA ‘s records, at VA’s place of business on request during normal business hours, to inspect and review and make copies of such records. The VA will provide the Contractor with a copy of VHA Handbook 1907.1, Health Information management and Health Records and VHA Directive 1605.1, Privacy and Release of Information. The penalties and liabilities for the unauthorized disclosure of VA patient information mandated by the statutes and regulations mentioned above, apply to the Contractor.

4.4.4. Professional Standards for Documenting Care: Care shall be appropriately documented in medical records in accordance with standard commercial practice and guidelines established by VHA Handbook 1907.01 Health Information Management and Health Records: http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791 and all guidelines provided by the VAMC.

4.4.5. Release of Information: The VA shall maintain control of releasing any patient medical information and will follow policies and standards as defined, but not limited to Privacy Act requirements. In the case of the VA authorizing the Contractor to release patient information, the Contractor in compliance with VA regulations, and at his/her own expense, shall use VA Form 10-5345a, Individual’s Request For A copy of Their Own Health Information to process “Release of Information Requests.” In addition, the Contractor shall be responsible for locating and forwarding records not kept at their facility. The VA’s Release of Information Section shall provide the Contractor with assistance in completing forms. Additionally, the Contractor shall use VA Form 10-5345, Request for and Authorization to Release Medical Records or Health Information, when releasing records protected by 38 U.S.C. 7332. Treatment and release records shall include the patient’s consent form. Completed Release of Information requests will be forwarded to the VA Privacy Officer at the following address: 1030 Jefferson Ave, Memphis, TN.

4.5 PERFORMANCE STANDARDS, QUALITY ASSURANCE (QA) AND QUALITY IMPROVEMENT(QI)

4.5.1 Quality Management/Quality Assurance Surveillance: Contract personnel shall be subject to Quality Management measures, such as patient satisfaction surveys, timely completion of medical records, and Peer Reviews. Methods of Surveillance: Focused Provider Practice Evaluation (FPPE) and Ongoing Provider Practice Evaluation (OPPE). Contractor performance will be monitored by the government using the standards as outlined in this Performance Work Statement (PWS) and methods of surveillance detailed in the Quality Assurance Surveillance Plan (QASP). The QASP shall be attached to the resultant contract and shall define the methods and frequency of surveillance conducted.

4.5.1.1 Patient Complaints: The CO will resolve complaints concerning Contractor relations with the Government employees or patients. The CO is final authority on validating complaints. In the event that The Contractor is involved and named in a validated patient complaint, the Government reserves the right to refuse acceptance of the services of such personnel. This does not preclude refusal in the event of incidents involving physical or verbal abuse.

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

Performance Requirement: Quality of work must meet acceptable guideline determined by the Radiologist as it relates to interpret images. Must be efficient and productive. This includes performing exams timely and sending images to the PACS.

Surveillance Method: Daily monitoring by the Supervisor and review of the patient.

4.5.2.2 Measure: Patient Scanning

Performance Requirement: Must establish departmental scanning parameters, performs exams according to the radiologist protocol. Alert physicians by annotating finding on requisitions, working knowledge of the scanning in order to perform minor troubleshooting if required.

Surveillance Method: Data collection using government software or manual sample.

4.5.2.3. Measure: Patient Access

Performance Requirement: Contractor’s technologist(s) shall be available and in location as needed to properly perform tasks as specified.

Standard: All (100%) Contractor’s technologist(s) are on time and available to perform services 100% of the time.

Acceptable Quality Level: Contractor’s technologist(s) are on-time and available to perform services 98% of the time.

Surveillance Method: Periodic Sampling of Time and Attendance Sheets.

4.5.2.4. Measure: Patient Safety

Performance Requirement: Patient safety incidents shall be reported using Patient Safety Report. All incidents reported immediately (within 24 hours.)

Standard: All (100%) of patient safety incidents are reported using Patient Safety Report within 24 hours of incident.

Acceptable Quality Level: 98% of patient safety incidents are reported using Patient Safety Report within 24 hours of incident Surveillance Method: Direct Observation

4.5.2.5. Measure: Maintaining licensing, registration, and certification Performance Requirement: Updated Licensing, registration and certification shall be provided as they are renewed. Licensing and registration information kept current.

Standard: All (100%) licensing, registration(s) and certification(s) for Contractor’s technologist(s) shall be provided as they are renewed. Licensing and registration information kept current.

Acceptable Quality Level: 100% licensing, registration(s) and certification(s) for Contractor’s employee(s) shall be provided as they are renewed. Licensing and registration information kept current. No acceptable deviation.100%.

Surveillance Method: Record review. Periodic Sampling and Random Sampling.

4.5.2.6 Measure: Mandatory Training Performance Requirement:

Performance Requirement: Contractor shall complete all required training per VAMC policy Standard: All (100%) of required training is complete on time by Contract employee(s).

4.5.2.7. Measure: Privacy, Confidentiality and HIPAA

Performance Requirement: Contractor is aware of all laws, regulations, policies and procedures relating to Privacy, Confidentiality and HIPAA and complies with all standards Zero breaches of privacy or confidentiality.

Standard: All (100%) Contractor’s physician(s) comply with all laws, regulations, policies and procedures relating to Privacy, Confidentiality and HIPAA.

4.5.3 Registration with Contractor Performance Assessment Reporting System

4.5.3.1 As prescribed in Federal Acquisition Regulation (FAR) Part 42.15, the Department of Veterans Affairs (VA) evaluates Contractor past performance on all contracts that exceed Simplified Acquisition Threshold, and shares those evaluations with other Federal Government contract specialists and procurement officials. The FAR requires that the Contractor be provided an opportunity to comment on past performance evaluations prior to each report closing. To fulfill this requirement VA uses an online database, CPARS, which is maintained by the Naval Seal Logistics Center in Portsmouth, New Hampshire. CPARS has connectivity with the Past Performance Information Retrieval System (PPIRS) database, which is available to all Federal agencies. PPIRS is the system used to collect and retrieve performance assessment reports used in source selection determinations and completed CPARS report cards transferred to PPIRS. CPARS also includes access to the federal awardee performance and integrity information system (FAPIIS). FAPIIS is a web-enabled application accessed via CPARS for Contractor responsibility determination information. Each Contractor whose contract award is estimated to exceed Simplified Acquisition Threshold requires a CPARS evaluation. A government Focal Point will register your contract within thirty days after contract award and, at that time, you will receive an email message with a User ID (to be used when reviewing evaluations). Additional information regarding the evaluation process can be found at www.cpars.gov or if you have any questions, you may contact the Customer Support Desk @ DSN: 684-1690 or COMM: 207-438-1690.

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

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

5 GOVERNMENT RESPONSIBILITIES:

5.1 VA Support Personnel, Services or Equipment: The government will schedule and provide an initial orientation which all contract physicians shall attend prior to working in the VAMC. After the first six weeks of the initial contract period any additional orientation of any current or newly assigned provider is the responsibility of the lead contractor physician. The VAMC will provide all ancillary personnel services required for performing services, including but not limited to x-ray technologists, medical assistants, laboratory technicians and nursing personnel. The government will provide an identification badge to each contract physician. The physician shall wear the identification badge on the front of the outer clothing at all times when providing services under this contract. Adequate space for patient care will be provided. Computers with connection to the VA Hospital Information System (VISTA) shall be available. Reading space shall be provided and may be within a common reading room. The government will provide PACS workstations loaded with viewing and voice recognition software.

5.2 Government Furnished Equipment

5.2.1 The VA Medical Center has an electronic medical record (CPRS) that shall be utilized by the contractor. All radiology reports, progress notes and physician orders shall be entered and signed electronically using the government provided CPRS system. PACS and voice recognition software, email, training software (TMS) and various websites must also be used to function efficiently as a radiologist at VAMC Memphis. During the initial 6 weeks of this agreement’s first period the VA facility will offer training to all contractor’s radiologists who are assigned to work on-site and to the lead contracted radiologist. After the first 6 weeks of the first contract period the lead radiologist will be responsible for any needed training of newly assigned personnel and for any “refresher” or “remedial” training. It is anticipated that the lead contracted physician will be computer literate to the level needed to carry out this function.

5.3 Contract Administration/Performance Monitoring: After award of contract, all inquiries and correspondence relative to the administration of the contract shall be addressed to: Contracting Officer, and Reginald Penny-COR, Administrative Officer, Reginald.Penny@va.gov, (901) 523-8990 ext. 5382.

5.3.1 CO RESPONSIBILITIES:

CO – Cheri Burton-Crutcher, 615-225-6404. The Contracting Officer is the only person authorized to approve changes or modify any of the requirements of this contract. The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration. Only the Contracting Officer is authorized to make commitments or issue any modification to include (but not limited to) terms affecting price, quantity or quality of performance of this contract.

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

5.3.1.2 In the event that contracted services do not meet quality and/or safety expectations, the best remedy will be implemented, to include but not limited to a targeted and time limited performance improvement plan; increased monitoring of the contracted services; consultation or training for Contractor personnel to be provided by the VA; replacement of the contract personnel and/or renegotiation of the contract terms or termination of the contract.

5.3.2 COR Responsibilities:

The COR for this contract is: Reginald Penny; reginald.penny@va.gov. The alternate COR for this contract is TBD.

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

5.3.2.2 The COR will be responsible for monitoring the Contractor’s performance to ensure all specifications and requirements are fulfilled. Quality Improvement data that will be collected for ongoing monitoring includes but is not limited to those described in section 4.5.

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

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

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

6 SPECIAL CONTRACT REQUIREMENTS:

6.1 Reports/Deliverables: The Contractor shall be responsible for complying with all reporting requirements established by the Contract. Contractor shall be responsible for assuring the accuracy and completeness of all reports and other documents as well as the timely submission of each. Contractor shall comply with contract requirements regarding the appropriate reporting formats, instructions, submission timetables, and technical assistance as required.

6.1.1 The following are brief descriptions of required documents that must be submitted by Contractor: upon award; weekly; monthly; quarterly; annually, etc. identified throughout the PWS and is provided here as a guide for Contractor convenience. If an item is within the PWS and not listed here, the Contractor remains responsible for the delivery of the item.

6.2 Billing:

6.2.1 Invoice requirements and supporting documentation: Supporting documentation and invoice must be submitted no later than the 20th workday of the month. Subsequent changes or corrections shall be submitted by separate invoice. In addition to information required for submission of a “proper” invoice in accordance with FAR 52.212-4 (g), all invoices must include:

6.2.1.1 Name and Address of Contractor

6.2.1.2 Invoice Date and Invoice Number

6.2.1.3 Contract Number and Purchase/Task Order Number

6.2.1.4 Date of Service

6.2.1.5 Contractor’s technician (s) (Name of Contractor’s employee)

6.2.1.6 Hourly Rate

6.2.1.7 Quantity of hours worked

6.2.1.8 Total price

6.2.2 Vendor Electronic Invoice Submission Methods

Vendor Electronic Invoice Submission Methods:

Invoices will be electronically submitted to the Tungsten website at http://www.tungstennetwork.com/uk/en/ Tungsten direct vendor support number is 877-489-6135 for VA contracts. The VA-FSC pays all associated transaction fees for VA orders. During Implementation (technical set-up) Tungsten will confirm your Tax Payer ID Number with the VA-FSC. This process can take up to 5 business days to complete to ensure your invoice is automatically routed to your Certifying Official for approval and payment. In order to successfully submit an invoice to VA-FSC please review “How to Create an Invoice” within the how to guides. All invoices submitted through Tungsten to the VA-FSC should mirror your current submission of Invoice, with the following items required. Clarification of additional requirements should be confirmed with your Certifying Official (your CO or buyer). The VA-FSC requires specific information in compliance with the Prompt Pay Act and Business Requirements. For additional information, please contact:

Tungsten Support Phone: 1-877-489-6135 Website: http://www.tungsten-network.com/uk/en/ Department of Veterans Affairs Financial Service Center Phone: 1-877-353-9791 Email: vafscched@va.gov

6.3 Payment Adjustments:

6.3.1 Invoices will be prorated for partial hours worked. The contractor shall be paid only for actual work performed. In the event that the Contract provider works a portion of an hour, the government may adjust payments by 15 minute increments. Contract providers shall be responsible for reporting time worked accurately. The Contract shall be paid for actual hours performed.

6.4 Payments in full/no billing VA beneficiaries: The Contractor shall accept payment for services rendered under this contract as payment in full. VA beneficiaries shall not under any circumstances be charged nor their insurance companies charged for services rendered by the Contractor, even if VA does not pay for those services. This provision shall survive the termination or ending of the contract.

6.4.1 To the extent that the Veteran desires services which are not a VA benefit or covered under the terms of this contract, the Contractor must notify the Veteran that there will be a charge for such service and that the VA will not be responsible for payment.

6.4.2 The Contractor shall not bill, charge, collect a deposit from, seek compensation, remuneration, or reimbursement from, or have any recourse against, any person or entity other than VA for services provided pursuant to this contract. It shall be considered fraudulent for the Contractor to bill other third party insurance sources (including Medicare) for services rendered to Veteran enrollees under this contract.

6.5 VA Information and Information System Security/Privacy

1. GENERAL:

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

2. ACCESS TO VA INFORMATION AND VA INFORMATION SYSTEMS:

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

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

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

d. Custom software development and outsourced operations must be located in the U.S. to the maximum extent practical.