36C24925R0007 FINAL PWS CNA.docx

36C24925R0007

B.3 NURSING ASSISTANT - PERFORMANCE OF WORK STATEMENT

1.1 Services Required

The Department of Veterans Affairs, Lt. Col Luke Weathers Jr Medical Center (VAMC) located in Memphis, TN requires Certified Nursing Assistants (contract personnel) to provide onsite patient care services at the point of care. For the purpose of the work statement, a Certified Nursing Assistant is a contract personnel who focus on the care of veterans so they may attain, maintain, or recover to optimal health and quality to life.

1.2 Place of Performance: Lt. Col Luke Weathers Jr VAMC, 1030 Jefferson Ave, Memphis, TN 38104

1.3 Authority: Title 38 USC 8153, Health Care Resources (HCR) Sharing Authority to include FAR Part 12 and VAAR Part 873.

1.4 Policy and Regulation

Nursing Assistants shall comply with all applicable policies and regulations, including but not limited to, the following:

1.4.1 VA Directive 1663: Health Care Resources Contracting - Buying

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

1.5 Definitions and Acronym

1.5.1 ACO: Administrative Contracting Officer

1.5.2 BAA: Business Associate Agreement

1.5.3 CEU: Certified Education Unit

1.5.4 CO: Contracting Officer

1.5.5 CNA: Certified Nursing Assistant

1.5.6 Contractor: A company contracted to do certain work for another individual or company.

1.5.7 COR: Contracting Officer's Representative

1.5.8 COS: Chief of Staff

1.5.9 CPARS: Nursing Assistants Performance Assessment Reporting System

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

1.5.11 Full Time Equivalent (FTE): Certified Nursing Assistants working the equivalent of 80 hours every two weeks, 2080 hours per year. In calculating FTE, any hours not worked on national holidays shall not be included.

1.5.12 HIPPA: Health Insurance Portability and Accountability Act

1.5.13 ICU: Intensive Care Unit

1.5.14 ISO: Information Security Officer

1.5.15 POP: Period of Performance

1.5.16 PWS: Performance Work Statement

1.5.17 QASP: Quality Assurance Surveillance Plan

1.5.18 QMP: Quality Management Program

1.5.19 RN: Registered Nurse

1.5.20 SPE: Senior Procurement Executive

1.5.21 TJC: The Joint Commission

1.5.22 VA: Department of Veterans Affairs

1.5.23 VAMC: Veterans Affairs Medical Center

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

1.5.25 VHA: Veterans Health Administration

1.5.26 ACLS: Advanced Cardiac Life Support

1.5.27 BLS: Basic Life Support

2.1 Schedule

The Certified Nursing Assistants, at the level specified, with a minimum of eight (8)-hour notice by the VA of specific tours required, shall perform services, to include providing personal hygiene including bathing, dressing, linen changes, assisting with meals, lifting and moving patients, assisting with ambulation, assisting with toileting and sitter services (close observation, telesitting, 1:1) for the Department of Veteran Affairs (VA), Lt. Col Luke Weathers Jr VAMC.

2.1.1 Emergency requests for contractor staff may be made by the VA with four (4) hours' notice. Such emergency requests will be at the rates and terms specified herein for standard requirements.

2.1.2 Adjustments to schedules may be coordinated by the VA and the Nursing Assistant with eight (8) hours’ notice to provide for normal workload variations and personnel practices. Requests for services may be cancelled by telephone notice to the contractor’s main business office up to two (2) hours before the start of the tour of duty at no expense to the VA.

2.1.3 Certified Nursing Assistants employees may be released early from a tour if workload permits. If this occurs, the VA will pay an amount equal to the greater of two (2) hours or the actual hours worked that tour.

2.1.4 Certified Nursing Assistants services may be required for holiday coverage. When required, specific services and tours will be requested by the VA with a minimum of eight (8) hours’ notice to the contractor and at the rates specified. The Certified Nursing Assistants will be paid holiday pay for this time.

2.1.5 Written evaluations of performance will be completed at the end of the first three (3) months by the VAMC and then quarterly thereafter. Certified Nursing Assistant employees whose performance is considered below a satisfactory level shall not be rescheduled.

2.1.6 Former Certified Nursing Assistant employees previously terminated, either by the vendor or VAMC shall not be scheduled.

2.1.7 Former Certified Nursing Assistant employees whose performance has been below a satisfactory level shall not be scheduled. The VAMC reserves the right to request that any Certified Nursing Assistant employee not be rescheduled.

2.1.8 Certified Nursing Assistants who do not report to the VA without appropriate notice from the vendor for more than two (2) tours (totaling 16 hours or more) per month shall not be rescheduled.

2.1.9 Certified Nursing Assistants must have one (1)-year experience within the last three (3) years.

2.1.10 All Certified Nursing Assistants who perform work at the Lt. Col Luke Weathers Jr VAMC must be US citizens or must provide proof of citizenship.

3.1 Tours of Duty

3.1.1 Tours of Duty for appropriate coverage will be mutually agreed upon by the vendor and the VA.

3.1.2 Overtime will not be paid for lunch breaks not taken and only in emergency situations with proper approval from program coordinator designee.

3.1.3 Tours will be a minimum of eight (8) hours (i.e., 7:30am-4:00pm; 3:30pm-12am; 11:30pm-8:00am) local time and a maximum of 12 hours (i.e., 7 am- 7 pm or 7pm – 7 am) local time. No double tours or sequential tours will be permitted.

3.1.4 Overtime is not permitted unless prior authorization is given from the unit supervisor or house supervisor.

4.1 Duties of Certified Nursing Assistants (CNAs)

4.1.1 Provide direct patient care and/or close observation of patients. Document on patient's observation flow sheet as directed by RN to document patient behavior, Activity of Daily Living, and physical care every tour. Documentation requirements can occur every 15 minutes as delegated by the nurse or charge nurse.

4.1.2 Delivery of direct patient care to include personal hygiene care (bathing, dressing, toileting), assistance with meals, lifting and moving, and assistance with ambulation.

4.1.3 Ability to assist in the full range of nursing care to patients/residents with physical and/or behavioral problems in a hospital, long term care setting under the direction of a Registered Nurse and/or Licensed Vocational Nurse Licensed Practical Nurse, to include, but not limited to taking measures, records and reports weight, height, vital signs, intake and output, foley care, collecting urine, stool and sputum tests, set up and monitor wall and tank oxygen, continuous and intermittent suction, collects and assembles chest suction equipment.

4.1.4 Ability to communicate orally with patients/residents, families, interdisciplinary team and other personnel. This includes serving as a preceptor to new CNAs by assisting with the coordination of their orientation and overseeing/assessing their practical experience while in a clinical setting.

4.1.5 Ability to recognize and react to emergent patient/resident care situations and intervene while waiting for assistance. For example, recognizing need for basic life support, preventing falls, controlling bleeding and assisting with behavior crisis, etc.

4.1.6 Report changes in mental or physical status immediately to assigned nurse/charge nurse.

5.1 Orientation

5.1.1 Orientation will consist of hospital training in addition to unit specific orientation.

5.1.2 Included in the orientation will be:

a. Infection Control Policy - Standard Precautions

b. Patient Rights and Patient Abuse

c. Standards of Ethical Conduct

d. Documentation Standards for the Clinical Record

e. Smoking Regulations

f. Patient, Visitor and Employee Safety

g. Nursing Employees Response in Emergency Situations

h. Rules of Behavior

i. Dress code policy

j. Close/Continuous Policy

5.1.3 Each Nursing Assistants employee will be expected to review the documents and sign the agreement indicating such a review has occurred. During the mandatory orientation at the VA, each Nursing Assistants employee will be given the opportunity to discuss previously reviewed policies/documents specific to the facility.

5.1.4 Nursing Assistants will complete an orientation assessment before training. Upon completion of training, each Nursing Assistant will complete an orientation assessment measuring the knowledge retained following the training.

6.1 Documentation Requirements

6.1.1 Documents required 30 days prior to start of contract work are:

a. Current resume with detail of length and type of experience

b. Copy (both sides) of current Basic Life Support (AHA or equivalent) and provide evidence to ensure it is always current.

c. Copy of current TB testing and results within the past 12 months and then annually

d. Completed Fingerprint Information Form (will be provided by VA), Record of current Hepatitis B vaccination or declination form.

6.1.2 The following can be accomplished at Orientation:

a. Compliance and Business Integrity

b. VHA Information Security

c. VHA Privacy Training.

7.1 Special Contract Requirements

7.1.1 Under the authority of Public Law 104-262 and 38 USC 8153, the contractor agrees to provide Health Care Resources in accordance with the terms and conditions stated herein, to furnish to and at the Department of Veterans Affairs medical Center, the services and prices specified in the section entitled, Schedule of Supplies/Services of this contract.

7.1.2 The contractor shall provide scheduled services throughout the contract period. Other necessary personnel for the operation of the services contracted for at the VA will be provided by the contractor at levels mutually agreed upon which are compatible with the safety of the patient and personnel and with quality medical care programming.

7.1.3 The services to be performed by the contractor will be performed in accordance with VA policies, procedures, and regulations of the medical staff by laws of the VA facility.

7.1.4 The Government reserves the right to refuse acceptance of Certified Nursing Assistants, if personal or professional conduct jeopardizes patient care. Breaches of conduct include intoxication or debilitation resulting from drug use, Health Insurance Portability and Accountability Act regulations (HIPAA) theft, violation of patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient. Standards for conduct shall mirror those prescribed by current Federal personnel regulations. The Contracting Officer’s Representative shall deal with issues raised concerning the contract personnel's conduct. The final arbiter on questions of acceptability is the Contracting Officer.

7.1.5 The Contracting Officer shall resolve complaints concerning Certified Nursing Assistants relations with the Government employees or patients. The Contracting Officer is the final authority on validating complaints. In the event the Nursing Assistants is involved and named in a validated patient complaint, the Government reserves the right to refuse acceptance of the services of such personnel.

7.1.6 The contractor shall, in writing, keep the Contracting Officer informed of any unusual circumstances in conjunction with the contract.

8.1 Work Hours

8.1.1 The services covered by this contract shall be furnished by the contractor as defined herein. The contractor shall be required to furnish services on Federal Holidays, as scheduled and required.

a. The following terms have the following meanings:

(1) Normal working hours: Monday through Sunday local time including Federal holidays.

i. 7:30 AM – 4:00 PM

ii. 3:30 PM – 12:00 AM

iii. 11:30 PM – 8:00 AM

iv. 7:30 AM – 8:00 PM

(2) Federal Holidays: The eleven (11) holidays observed by the Federal Government are:

i. New Year's Day

ii. Martin Luther King Day

iii. President's Day

iv. Memorial Day

v. Juneteenth

vi. Independence Day

vii. Labor Day

viii. Columbus Day

ix. Veterans Day

x. Thanksgiving

xi. Christmas

b. Any other day specifically declared by the President of the United States to be a Federal holiday.

c. When one of the holidays falls on Sunday, the following Monday shall be observed as a Federal Holiday. When a holiday falls on a Saturday, the preceding Friday shall be observed as a Federal Holiday.

d. Off Duty Hours: Hours other than those described in 8.1 (a) (1).

9.1 Key Personnel

9.1.1 In order to provide a continuity of patient care to VA beneficiaries, the contractor shall provide designated CNAs to perform the requirements of this contract.

9.1.2 Because continuity of care is an essential part of VAMC’s medical services, the contractor shall have a contingency plan in place for maintaining Key Personnel due to circumstances such as turnover, illness, unavailability or is unable to perform in accordance with the terms and conditions of the resulting contract.

10.1 National Provider Identifier

10.1.1 The National Provider Identifier (NPI) is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPls in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers). The contractor shall ensure that the health care practitioners and/or medical center providing service under the contract obtains an NPI and provides it to the Contracting Officer, if applicable. This is not applicable to CNA’s.

10.1.2 Prior to acceptance, all contract providers must comply with hospital credentialing guidelines, providing all required information on the timeline established by the Medical Center Credentialing Officer. Credentialing and privileging shall be completed in accordance with the provisions of VHA Handbook 1100.19 dated October 2, 2007.

10.1.3 This Veterans Health Administration (VHA) Handbook provides updated VHA procedures regarding credentialing and privileging, to include incorporating: VHA policy concerning VetPro; the Expedited Medical Staff Appointment Process; credentialing during activation of the facility Disaster Plan; requirements for querying the Federation of State Medical Boards (FSMB); credentialing and privileging requirements for Telemedicine and remote health care; clarifications for the Summary Suspension of Privileges process in order to ensure both patient safety and practitioner rights; and the credentialing requirements for physician assistants (PAS) and advance practice registered nurses (APRNs). The credentialing, but not privileging, requirements of this Handbook apply to physicians, dentists, and other practitioners allowed by law and the facility to practice independently who are assigned to Research or administrative positions not involved in patient care.

11.1 Credentialing

11.1.1 Nursing Assistants shall provide a copy of current certification.

11.1.2 Name of individuals providing services under the contract and their applicable licenses must be submitted to the Contracting Officer with the offer.

*Proposals that do not contain the required licensing/certifications at the time of offers due shall automatically be rendered technically unacceptable and will not be eligible for award.

12.1 Contracting with Parties on the OIG List of Excluded Individuals/Entities

12.1.1 In accordance with The Health Insurance Portability and Accountability Act (HIPAA) and the Balanced Budget Act (BBA) of 1977, the Office of Inspector General 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.

12.1.2 Therefore, the contractor shall review the OIG List of Excluded Individuals/Entities on the OIG web site at www.hhs.gov019 to ensure that the proposed candidate(s) and/or firm(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 minimum and maximum Civil Monetary Penalty (CMP) for each item or service furnished during a period that the person or entity 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 health care providers and entities that employ or enter contracts with excluded individuals or entities to provide item or services to Federal program beneficiaries.

12.1.3 By signing the offer the contractor certifies that he/she has reviewed the OIG List of Excluded Individuals/Entities and that the proposed candidate(s) and/or firm are not listed as of the date the offer was signed.

13.1 Medical Liabilities

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

13.1.2 The contractor is required to ensure that its subcontracts for provisions of Health Care Services contain the requirements set by the State.

14.1 Tort Claims

Contractor employees are not covered by the Federal Tort Claims Act. When a contractor employee has been identified as a provider in a tort claim, the contractor is responsible for notifying the Nursing Assistants legal counsel and/or insurance carrier. Any settlement or judgment arising from the contractor’s action or non-action is the responsibility of the contractor and/or insurance carrier.

15.1 Personnel Policy

15.1.1 The contractor shall be responsible for protecting the personnel furnishing services under this contract. To carry out this responsibility, the contractor shall provide the following:

a. Workers' Compensation Insurance

b. Professional Liability Insurance

c. Health Examinations

d. Income Tax Withholding

e. Social Security Payments

f. BLS Certification Training.

15.1.2 The parties agree that the contractor, its employees, agents and shall not be considered VA employees for any purpose.

16.1 Payment

16.1.1 Payment to the contractor shall be made monthly in arrears, upon receipt of a properly prepared invoice. Payment for services will be at the rates specified in the Schedule of Supplies/Services.

16.1.2 Payment for any leave, including sick leave, holiday, or vacation time, shall be the responsibility of the contractor. If the CNA test positive for COVID, the VA will not pay for sick time or time off. VA will pay for actual hours worked.

NOTE: Invoices for payment may be rejected if all information required by FAR Clause 52.212-4(g) is not included. Invoices without the required information will be returned.

17.1 Management and Supervision

17.1.1 The contractor shall be responsible for supervising the daily services provided under this agreement by the Nursing Assistant staff.

17.1.2 The contractor shall have written policies and procedures regarding staff credentials.

17.1.3. The VAMC will provide to the contractor, the policies, procedures and processes necessary to allow cooperative functioning between the contractor and VAMC. Updates and refreshers will be provided to the contractor upon request and when policy procedures or process changes.

17.1.4. The Certified Nursing Assistants shall complete background investigations to ensure that employees do not have a record of criminal offenses or substantiated incidents of patient abuse; and, if required to perform their duties, employees are properly licensed and insured to operate motor vehicles.

18.1. Record Keeping

18.1.1 Contractor employee(s) shall report to the COR or Designee, Nursing Service, upon arrival at the VA Medical Center. VAMC personnel shall brief contractors on VAMC policies and procedures on the first scheduled duty day.

18.1.2 The VAMC, Nursing Service, shall establish and maintain a record keeping system that will record the services performed by the contractor employee(s). This record-keeping system shall consist of time and attendance reports to ensure that required services have been received by the VA Medical Center. Any incidents of the nursing assistant’s non-compliance as evidenced by the monitoring procedure shall be forwarded immediately to the Contracting Officer. Nursing Service will validate time and attendance.

18.1.3 Documentation of services performed shall be reviewed prior to certifying payment. Certified Nursing Assistants shall be present at the VAMC and shall be performing the required services as specified in the contract in order to receive reimbursement. The VAMC shall pay for services performed and in strict accordance with Schedule of Supplies/Services above. Contract monitoring and record-keeping procedures shall be sufficient to ensure proper payment and allow audit verification that services were provided.

19.1 Contract Performance Monitoring

19.1.1. The Contracting Officer's Representative (COR), appointed in writing, will be responsible for monitoring contractor performance.

19.1.2. The COR will 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.

19.1.3. The COR will be responsible for monitoring the Nursing Assistant performance to ensure all specifications and requirement are fulfilled. A record-keeping system of procedures will be maintained through the use of the VA-based VistA hospital computer system. These procedures used by the COR must be able to demonstrate through time and attendance logs, surgical room records, minutes of meetings, or other appropriate records that services called for in the contract have been received. A Nursing designee will review this data monthly when invoices are received and certifying all invoices for payment. He/she will accomplish this through a coordinated effort with the VA medical service requesting services under this agreement. Any evidence of the contractor’s non-compliance as evidenced by the monitoring procedures will be forwarded immediately to the Contracting Officer.

19.1.4. A summary evaluation of Contactor performance, based upon the compliance of contract requirements as evidenced in the monitoring procedures, will be forwarded by the monitoring official to the Contracting Officer prior to exercising any options to extend the contract.

20.1 Quality Improvement

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

21.1 Quality Assurance

21.1.1 The contractor shall provide accreditations that meet or exceed the standards set by the Joint Commission on Accreditation of Health Care Organizations (TJC).

21.1.2. The Department of Veterans Affairs is allowed according to Public Law 99-272 and 101-508, to seek reimbursement from health insurance carriers for the cost of medical care and treatment provided to Veterans for their non-service-connected conditions. The contractor may not bill any Veteran or their health insurance carrier for care provided to a Veteran while working under contract with the Department of Veterans Affairs.

22.1 Performance Standards

22.1.1 Measure: Contractor Quality Performance

Performance Requirement: All Contractor’s nursing assistant(s) shall perform in accordance with clinical standards.

Standard: All staff (100%) meet clinical standards of care.

Acceptable Quality Level: 95% meets standards.

Suveillance Method: Data pertinent to care performed for each CNA working under this contract to include the review of the following elements:

A. Patient Care Performance B. Medical/Clinical knowledge C. Practiced Based Learning and Improvement D. Interpersonal and Communication Skills E. Professionalism F. System Based Practice Frequency: Periodic

22.1.2 Measure: Qualifications of Key Personnel

Performance Requirement: All Contractor’s nursing assistant(s) shall have current nursing assistant certification and AHA BLS Certification.

Standard: All (100%) CNA(s) are certified as nursing assistants and BLS certified through the American Heart Association.

Acceptable Quality Level: 95% meets standards.

Suveillance Method: Periodic Inspection or Random Sampling of qualification documents.

Frequency: Periodic

22.1.3 Measure: Mandatory Training

Performance Requirement: All Contractor’s nursing assistant(s) shall complete all required training on time per facility policy.

Standard: All (100%) CNA(s) are required to complete all required training on time.

Acceptable Quality Level: 95% meets standards.

Suveillance Method: Periodic Inspection Frequency: Periodic

22.1.4 Measure: Privacy, Confidentiality and HIPAA

Performance Requirement: Contractor is award 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%) CNA(s) comply with all laws, regulations, and policies and procedures relating to Privacy, Confidentiality, and HIPAA.

Acceptable Quality Level: 98% meets standards.

Suveillance Method: Random Sampling. Contractor shall provide evidence of annual training required by the facility and report violations per VA Handbook 6500.6.

Frequency: Periodic

23.1 ADP Security Responsibilities

In performance of official duties, the contractor employee(s) have regular access to printed and electronic files containing sensitive data, which must be protected under the provisions of the Privacy Act of 1974 (5 U.S.C. 552a), and other applicable laws, Federal Regulations, Veterans Affairs statutes and policies. The contractor employee(s) are responsible for:

a. Protecting that data from unauthorized release or from loss, alteration, or unauthorized deletion

b. Follow all applicable regulations and instructions regarding access to computerized files, release of access codes, etc., as set out in a computer access agreement which the Certified Nursing Assistants employee(s) signs.

24.1 Computerized Patient Records Keeping System

Contract employee(s) shall document all patient services into the VA Computerized Patient Record (CPRS).

25.1 Confidentiality of Patient Records

25.1.1 VA Certified Nursing Assistants shall assist in the provision of health care to patients seeking such care from or through VA. As such, the contractor is considered as being part of the Department health care activity. Contractor Certified Nursing Assistants are a VA Nursing Assistant for purposes of the Privacy Act, Title 5 U.S.C. 552a. Further, for the purpose of VA records access and patient confidentiality. Contract employees are a VA Nursing Assistant for the following provisions:

25.1.2 Title 38 -U.S.C. 5701, 5705, and 7362. Therefore, Certified Nursing Assistants may have access, as would other appropriate components of VA, to patient medical records including patient treatment records pertaining to drug and alcohol abuse, HIV, and sickle cell anemia, to the extent necessary to perform its contractual responsibilities. However, like other components of the Department, and not withstanding any other provisions of the contract, the contractor is restricted from making disclosures of VA records, or information contained in such records, to which it may have access, except to the extent that explicit disclosure authority from VA has been received. The contractor is subject to the same penalties and liabilities for unauthorized disclosures of such records as VA.

25.1.3The records referred to above shall be and remain the property of VA and shall not be removed or transferred from VA except in accordance with U.S.C.551a (Privacy Act), 38 U.S.C. 5701 (Confidentiality of Claimants Records), 5 U.S.C. 552 (Freedom of Information Act (FOIA)), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332 (Confidentiality of certain medical records) and federal laws, rules and regulations. Subject to applicable Federal confidentiality or privacy laws, the contractor employees, or their designated representatives, and designated representatives of Federal regulatory agencies having jurisdiction over the 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.

26.1 Health Insurance Portability and Accountability Act of 1996 (HIPAA)

In accordance with 45 CFR 164.502(e), the Privacy Rule includes exceptions to the Business Associate standard. This contract and its requirements meet the following exception and do not require a Business Associate agreement in order for Covered Entity to disclose Protected Health Information to a health care provider for treatments. Based on this exception, a Business Associate agreement is not required for this contract. The contractor must adhere to all VA security policies and applicable confidentiality statutes, include 38 U.S.C. 5701, 38 U.S.C. 5705, 38 U.S.C. 7332, 5 U.S.C. 552a (Privacy Act), as well as 45 U.S.C. Parts 160, 162 and 164 (Health Insurance Portability and Accountability Act).

26.1 Required Registration with Certified Nursing Assistants Performance Assessment System (CPARS)

26.1.1 As prescribed in Federal Acquisition Regulation (FAR) Part 42.15, the Department of Veterans Affairs (VA) evaluates the contractor’s past performance on all contracts that exceed $250,000.00 and shares those evaluation with other Federal Government contract specialist 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 (FAPllS). FAPllS is a webenabled application accessed via CPARS for Nursing Assistants responsibility determination information.

26.1.2. Each contractor whose contract award is estimated to exceed $250,000.00 is required to register with CPARS database at the following web address: www.cpars.csd.disa.mil. Help in registering can be obtained by contacting Customer Support Desk @ DSN: 684-1690 or COMM: 207-438- 1690. Registration should occur no later than thirty (30) days after contract award and must be kept current should there be any change to the contractor’s registered representative.

26.1.3. 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’s representative will have thirty (30) days to submit any comments and re-assign the report to the VA Contracting Officer.

26.1.4 Failure to have a current registration in the CPARS database, or to re-assign the report to the VA Contracting Officer within those thirty (30) days, will result in the Government's evaluation being placed on file in the database with a statement that the contractor failed to respond.

27.1 Certified Nursing Assistant Personnel Security Requirement

27.1.1 All contractor employees who require access to the Department of Veterans Affairs' computer systems shall be the subject of a background investigation and must receive a favorable adjudication from the VA Security Investigations Center prior to contract performance. This requirement is applicable to all personnel requiring the same access. If the investigation is not completed prior to the start date of the contract, the contractor shall be responsible for the actions of those individuals they provide to perform work for the VA.

a. Position sensitivity- The position sensitivity has been designated as LOW

RISK.

b. Background Investigation- The level of background investigation commensurate with the required level of access is National Agency Check with written inquiries.

c. Contractor Responsibilities

1.The VA Security Investigations Center will provide the necessary forms to the contractor after receiving the required information.

2.Upon receipt, the VA Security Investigations Center will review the completed forms for accuracy and forward the forms to Office of Personnel Management (OPM) to conduct the background investigation.

3.The VA Security Investigations Center will notify the Contracting Officer after adjudicating the results of the background investigations received from OPM.

4.Further Instructions regarding the background investigation process and procedures will be provided at time of award.

28.1 Infection Control Requirement

28.1.1 The contractor shall provide proof of the following tests within five (5) calendar days prior to the first duty shift to the COR. Tests shall be current within the past year.

a. Tuberculosis Testing: the contractor shall provide proof of a negative reaction to Purified Protein Derivative (PPD) testing. A negative chest radiographic report for active tuberculosis shall be provided in cases of positive PPD results. The PPD test shall be repeated annually.

b. Rubella Testing: The contractor shall provide proof of the Certified Nursing Assistant immunization 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 Contracting Officer's Representative (COR).

c. OSHA Regulation Concerning Occupational Exposure to Blood borne Pathogens: Certified Nursing Assistants from the contractor shall provide a generic self-study training; 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.

d. The VAMC shall notify the contractor of any significant communicable disease exposures as appropriate. The contractor shall adhere to current Centers for Disease Control/Healthcare Infection Control Practices Advisory Committee (CDCHICPAC) Guideline for Infection Control in health care personnel (AJIC 1998; 26:289-354) for disease control. The contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.

e. Influenza Vaccination: the contractor shall provide proof that the Certified Nursing Assistant has a current influenza vaccination in compliance with VHA Directive 1192.01 Seasonal Influenza Prevention Program. The contractor is responsible for submitting legal documentation of the date the influence vaccination was given or documentation listed in VHA Directive 1192.01. The influenza vaccine is required yearly during flu season.

29.1 VA Information and Information Security and Privacy Language for Inclusion in Contracts as Appropriate

1. GENERAL. This entire section applies to all acquisitions requiring any Information Security and Privacy language. Contractors, contractor personnel, subcontractors and subcontractor personnel will be subject to the same federal laws, regulations, standards, VA directives and handbooks, as VA personnel regarding information and information system security and privacy.

2. VA INFORMATION CUSTODIAL LANGUAGE. This entire section applies to all acquisitions requiring any Information Security and Privacy language.

a. The Government shall receive unlimited rights to data/intellectual property first produced and delivered in the performance of this contract or order (hereinafter “contract”) unless expressly stated otherwise in this contract. This includes all rights to source code and all documentation created in support thereof. The primary clause used to define Government and Contractor data rights is FAR 52.227-14 Rights in Data – General. The primary clause used to define computer software license (not data/intellectual property first produced under this contractor or order) is FAR 52.227-19, Commercial Computer Software License.

b. Information made available to the contractor by VA for the performance or administration of this contract will be used only for the purposes specified in the service agreement, SOW, PWS, PD, and/or contract. The contractor shall not use VA information in any other manner without prior written approval from a VA Contracting Officer (CO). The primary clause used to define Government and Contractor data rights is FAR 52.227-14 Rights in Data – General.

c. VA information will not be co-mingled with any other data on the contractor’s information systems or media storage systems. The contractor shall ensure compliance with Federal and VA requirements related to data protection, data encryption, physical data segregation, logical data segregation, classification requirements and media sanitization.

d. VA reserves the right to conduct scheduled or unscheduled audits, assessments, or investigations of contractor Information Technology (IT) resources to ensure information security is compliant with Federal and VA requirements. The contractor shall provide all necessary access to records (including electronic and documentary materials related to the contracts and subcontracts) and support (including access to contractor and subcontractor staff associated with the contract) to VA, VA's Office Inspector General (OIG), and/or Government Accountability Office (GAO) staff during periodic control assessments, audits, or investigations.

e. The contractor may only use VA information within the terms of the contract and applicable Federal law, regulations, and VA policies. If new Federal information security laws, regulations or VA policies become applicable after execution of the contract, the parties agree to negotiate contract modification and adjustment necessary to implement the new laws, regulations, and/or policies.

f. The contractor shall not make copies of VA information except as specifically authorized and necessary to perform the terms of the contract. If copies are made for restoration purposes, after the restoration is complete, the copies shall be destroyed in accordance with VA Directive 6500, VA Cybersecurity Program and VA Information Security Knowledge Service.

g. If a Veterans Health Administration (VHA) contract is terminated for default or cause with a business associate, the related local Business Associate Agreement (BAA) shall also be terminated and actions taken in accordance with VHA Directive 1605.05, Business Associate Agreements. If there is an executed national BAA associated with the contract, VA will determine what actions are appropriate and notify the contactor.

h. The contractor shall store and transmit VA sensitive information in an encrypted form, using VA-approved encryption tools which are, at a minimum, Federal Information Processing Standards (FIPS) 140-2, Security Requirements for Cryptographic Modules (or its successor) validated and in conformance with VA Information Security Knowledge Service requirements. The contractor shall transmit VA sensitive information using VA approved Transport Layer Security (TLS) configured with FIPS based cipher suites in conformance with National Institute of Standards and Technology (NIST) 800-52, Guidelines for the Selection, Configuration and Use of Transport Layer Security (TLS) Implementations.

i. The contractor’s firewall and web services security controls, as applicable, shall meet or exceed VA’s minimum requirements.

j. Except for uses and disclosures of VA information authorized by this contract for performance of the contract, the contractor may use and disclose VA information only in two situations: (i) in response to a qualifying order of a court of competent jurisdiction after notification to VA CO (ii) with written approval from the VA CO. The contractor shall refer all requests for, demands for production of or inquiries about, VA information and information systems to the VA CO for response.

k. Notwithstanding the provision above, the contractor shall not release VA records protected by Title 38 U.S.C. § 5705, Confidentiality of medical quality- assurance records and/or Title 38 U.S.C. § 7332, Confidentiality of certain medical records pertaining to drug addiction, sickle cell anemia, alcoholism or alcohol abuse or infection with Human Immunodeficiency Virus (HIV). If the contractor is in receipt of a court order or other requests for the above- mentioned information, the contractor shall immediately refer such court order or other requests to the VA CO for response.

l. Information made available to the contractor by VA for the performance or administration of this contract or information developed by the contractor in performance or administration of the contract will be protected and secured in accordance with VA Directive 6500 and Identity and Access Management (IAM) Security processes specified in the VA Information Security Knowledge Service.

m. Any data destruction done on behalf of VA by a contractor shall be done in accordance with National Archives and Records Administration (NARA) requirements as outlined in VA Directive 6300, Records and Information Management, VA Handbook 6300.1, Records Management Procedures, and applicable VA Records Control Schedules.

n. The contractor shall provide its plan for destruction of all VA data in its possession according to VA Directive 6500 and NIST 800-88, Guidelines for Media Sanitization prior to termination or completion of this contract. If directed by the COR/CO, the contractor shall return all Federal Records to VA for disposition.

o. Any media, such as paper, magnetic tape, magnetic disks, solid state devices or optical discs that is used to store, process, or access VA information that cannot be destroyed shall be returned to VA.The contractor shall hold the appropriate material until otherwise directed by the Contracting Officer’s Representative (COR) or CO. Items shall be returned securely via VA-approved methods. VA sensitive information must be transmitted utilizing VA-approved encryption tools which are validated under FIPS 140-2 (or its successor) and NIST 800-52. If mailed, the contractor shall send via a trackable method (USPS, UPS, FedEx, etc.) and immediately provide the COR/CO with the tracking information. Self-certification by the contractor that the data destruction requirements above have been met shall be sent to the COR/CO within 30 business days of termination of the contract.

p. All electronic storage media (hard drives, optical disks, CDs, back-up tapes, etc.) used to store, process or access VA information will not be returned to the contractor at the end of lease, loan, or trade-in. Exceptions to this paragraph will only be granted with the written approval of the VA CO.

3. ACCESS TO VA INFORMATION AND VA INFORMATION SYSTEMS. This section applies when any person requires access to information made available to the contractor by VA for the performance or administration of this contract or information developed by the contractor in performance or administration of the contract.

a. A contractor/subcontractor shall request logical (technical) or physical access to VA information and VA information systems for their employees and subcontractors only to the extent necessary to perform the services specified in the solicitation or contract. This includes indirect entities, both affiliate of contractor/subcontractor and agent of contractor/subcontractor.

b. Contractors and subcontractors shall sign the VA Information Security Rule of Behavior (ROB) before access is provided to VA information and information systems (see Section 4, Training, below). The ROB contains the minimum user compliance requirements and does not supersede any policies of VA facilities or other agency components which provide higher levels of protection to VA’s information or information systems. Users who require privileged access shall complete the VA elevated privilege access request processes before privileged access is granted.

c. All contractors and subcontractors working with VA information are subject to the same security investigative and clearance 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 shall be in accordance with VA Directive and Handbook 0710, Personnel Suitability and Security Program. The Office of Human Resources and Administration/Operations, Security and Preparedness (HRA/OSP) is responsible for these policies and procedures. Contract personnel who require access to classified information or information systems shall have an appropriate security clearance. Verification of a Security Clearance shall be processed through the Special Security Officer located in HRA/OSP. Contractors shall conform to all requirements stated in the National Industrial Security Program Operating Manual (NISPOM).

d. All contractors and subcontractors shall comply with conditions specified in VAAR 852.204-71(d); Contractor operations required to be in United States. All contractors and subcontractors working with VA information must be permanently located within a jurisdiction subject to the law of the United States or its Territories to the maximum extent feasible. If services are proposed to be performed abroad the contractor must state where all non-U.S. services are provided. The contractor shall deliver to VA a detailed plan specifically addressing communications, personnel control, data protection and potential legal issues. The plan shall be approved by the COR/CO in writing prior to access being granted.

e. The contractor shall notify the COR/CO in writing immediately (no later than 24 hours) after personnel separation or occurrence of other causes. Causes may include the following:

(1) Contractor/subcontractor personnel no longer has a need for access to VA information or VA information systems.

(2) Contractor/subcontractor personnel are terminated, suspended, or otherwise has their work on a VA project discontinued for any reason.

(3) Contractor believes their own personnel or subcontractor personnel may pose a threat to their company’s working environment or to any company- owned property. This includes contractor-owned assets, buildings, confidential data, customers, employees, networks, systems, trade secrets and/or VA data.

(4) Any previously undisclosed changes to contractor/subcontractor background history are brought to light, including but not limited to changes to background investigation or employee record.

(5) Contractor/subcontractor personnel have their authorization to work in the United States revoked.

(6) Agreement by which contractor provides products and services to VA has either been fulfilled or terminated, such that VA can cut off electronic and/or physical access for contractor personnel.

f. In such cases of contract fulfillment, termination, or other causes; the contractor shall take the necessary measures to immediately revoke access to VA network, property, information, and information systems (logical and physical) by contractor/subcontractor personnel. These measures include (but are not limited to): removing and then securing Personal Identity Verification (PIV) badges and PIV – Interoperable (PIV-I) access badges, VA-issued photo badges, credentials for VA facilities and devices, VA-issued laptops, and authentication tokens. Contractors shall notify the appropriate VA COR/CO immediately to initiate access removal.

g. Contractors/subcontractors who no longer require VA accesses will return VA- issued property to VA. This property includes (but is not limited to): documents, electronic equipment, keys, and parking passes. PIV and PIV-I access badges shall be returned to the nearest VA PIV Badge Issuance Office. Once they have had access to VA information, information systems, networks and VA property in their possessions removed, contractors shall notify the appropriate VA COR/CO.

4. TRAINING. This entire section applies to all acquisitions which include section 3.

a. All contractors and subcontractors requiring access to VA information and VA information systems shall successfully complete the following before being granted access to VA information and its systems:

(1) VA Privacy and Information Security Awareness and Rules of Behavior course (Talent Management System (TMS) #10176) initially and annually thereafter.

(2) Sign and acknowledge (electronically through TMS #10176) understanding of and responsibilities for compliance with the Organizational Rules of Behavior, relating to access to VA information and information systems initially and annually thereafter; and

(3) Successfully complete any additional cyber security or privacy training, as required for VA personnel with equivalent information system or information access [to be defined by the VA program official and provided to the VA CO for inclusion in the solicitation document – i.e., any role- based information security training].

b. The contractor shall provide to the COR/CO a copy of the training certificates and certification of signing the…