36C25021Q0566.docx

36C25021Q0566

PAGE 1 OF

1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

DUNS:

DUNS+4:

PHONE:

FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Only) 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) 30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

(REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

36C25021Q0566 06-25-2021 Karen Williams 614-257-5220 07-16-2021 2:00 pm

EDT

36C250 Department of Veterans Affairs Network Contracting Office (NCO) 10 Chalmers P. Wylie Ambulatory Care Center 420 North James Road Columbus OH 43219-1834 X X 621112 $12 Million N/A X 36C610 Department of Veterans Affairs VA Northern Indiana Health Care System 1700 E. 38th St.

Marion IN 46953 36C250 Department of Veterans Affairs Network Contracting Office (NCO) 10 Chalmers P. Wylie Outpatient Clinic 420 North James Road Columbus OH 43219-1834

36C250 Department of Veterans Affairs Financial Services Center Invoices to be Submitted Electronically www.ob10.com/us/en/veterans-affairs// e-Invoice Setup Info Phone 877-489-6135 877-353-9791 512-460-5429 See CONTINUATION Page Provide Board Certified/Board Eligible Psychiatrist Services for the VA Northern Indiana Health Care System.

See Schedule of Services beginning on page 6 and the Performance Work statement beginning on page 9.

See CONTINUATION Page X X Karen Williams Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

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

a. CONTRACTOR’S NAME/ADDRESS/CITY/STATE-ZIP (Please print or type):

Point of Contact/Title: ____________________________ ____________

Telephone: _______________________________

E-mail: __________________________________

DUNS NO: ________________________________

b. GOVERNMENT:

Karen Williams, Contract Specialist Department of Veterans Affairs Network Contracting Office (NCO) 10

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with FAR 52.232-33, Payment by Electronic Funds Transfer – System for Award Management.

3. INVOICES: Invoices shall be submitted in arrears: Monthly

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

Invoicing shall be in accordance with The Department of Veterans Affairs (VA) Financial Services Center (VAFSC). The latest information shall be used for invoicing and payments and may change during the Period of Performance of this acquisition. Current Invoicing information is located at http://www.fsc.va.gov/einvoice.asp.

Department of Veterans Affairs

FMS-VA-2(101)

Financial Services Center PO Box 149971 Austin TX 78714-9971

5. SECURE FAX: In accordance with VA Handbook 6500, the following statement is required on all fax cover sheets; if it is determined the ordering process will include a fax: “This fax is intended only for the use of the person or office to which it is addressed and may contain information that is privileged, confidential or protected by law. All others are hereby notified that the receipt of this fax does not waive any applicable privilege or exemption for disclosure and that any dissemination, distribution or copying of this communication is prohibited. If you have received this fax in error, please notify this office immediately at the telephone number listed above.

6. CHANGES/MODIFICATIONS TO THE CONTRACT: The Contracting Officer will be the only person authorized to approve changes or modify any of the requirements under this resultant contract. The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration. Only the Contracting Officer will be authorized to make commitments or issue changes that affect price, quantity, delivery or quality of performance of this resultant contract. In the event the Contractor effects any such change at the direction of any person other than the Contracting Officer, the change shall be considered unauthorized by the local VAMC and no adjustment will be made to the contract price to cover any increase in cost incurred as a result thereof.

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

8. POST AWARD ORIENTATION: The Contracting Officer will conduct a post-award orientation conference in accordance with VA Acquisition Manual, Part M842.502-70 Post-award Orientation.

9. The Contracting Officer’s Representative (COR) will be responsible for the overall technical administration of this contract as outlined in the COR Delegation of Authority.

10. Mandatory Written Disclosures: Mandatory written disclosures required by FAR clause 52.203-13 to the Department of Veterans Affairs, Office of Inspector General (OIG) must be made electronically through the VA OIG Hotline at http://www.va.gov/oig/contacts/hotline.asp and clicking on "FAR clause 52.203-13 Reporting." If you experience difficulty accessing the website, call the Hotline at 1-800-488-8244 for further instructions.

B.2 SCHEDULE OF SERVICES

Contractor shall furnish all personnel to provide 3.4 FTE (7,056 hours), onsite Psychiatrist Services in accordance with specifications contained herein to eligible beneficiaries of the Department of Veterans Affairs Northern Indiana Health Care System (VANIHCS).

Place of Performance:

Marion VAMC, 1700 E. 38th St., Marion, IN;

Ft Wayne VAMC, 2121 Lake Ave., Ft. Wayne, IN; and St Joseph County VA Clinic, 1540 Trinity Place, Mishawaka, IN

Period of Performance: August 1, 2021 (or date of award) through July 31, 2026.

Pricing Instructions: The quoter is instructed to edit the number of Sub-Line Item Numbers (SLIN), to correspond with the number of key personnel submitted for the Line Item Number (LIN). The number of Hours for each SLIN may be adjusted to accommodate additional psychiatrists. However, the total number of hours in each ordering period for SLIN’s must equal 5160.

The Contractor shall propose a sufficient number of key personnel to be credentialed and be available for scheduling to meet the 7,056 hours annually.

FTE is defined by the VA as a minimum of 80 hours every two weeks and does not include holidays.

The guaranteed minimum only applies to the year in which the contract is awarded. The total minimum amount, or guaranteed minimum, is 40 hours. The maximum total value of the contract, inclusive of all ordering periods, shall not exceed 39,000 hours. The Government does not guarantee that it will place any orders under this contract in excess of the guaranteed minimum award amount. Individual task orders shall be funded annually. The Contracting Officer is the only authorized individual that can place annual task orders against this contract for the estimated amount of services for the specific ordering period, and the task orders shall be issued to the contractor.

Travel Cost Reimbursement: Funds for Travel and Lodging are not offered in this contract and will not be reimbursed.

Period of Performance: ORDERING PERIOD 1: August 1, 2021 (or date of award) to July 31, 2022

KEY PERSONNEL

NAME:

TITLE:

NPI:

NAME:

TITLE:

NPI:

NAME:

TITLE:

NPI:

Period of Performance: ORDERING PERIOD 2: August 1, 2022 to July 31, 2023

KEY PERSONNEL

NAME:

TITLE:

NPI:

NAME:

TITLE:

NPI:

NAME:

TITLE:

NPI:

Period of Performance: ORDERING PERIOD 3: August 1, 2023 to July 31, 2024

KEY PERSONNEL

NAME:

TITLE:

NPI:

NAME:

TITLE:

NPI:

NAME:

TITLE:

NPI:

Period of Performance: ORDERING PERIOD 4: August 1, 2024 to July 31, 2025

KEY PERSONNEL

NAME:

TITLE:

NPI:

NAME:

TITLE:

NPI:

NAME:

TITLE:

NPI:

Period of Performance: ORDERING PERIOD 5: August 1, 2025 to July 31, 2026

KEY PERSONNEL

NAME:

TITLE:

NPI:

NAME:

TITLE:

NPI:

NAME:

TITLE:

NPI:

Total for all Ordering Periods: $________________________________

B.3 PERFORMANCE WORK STATEMENT

1. GENERAL:

1.1. Services Provided: The Contractor shall provide (3.4) FTE (or 7,056 hours), Board Certified or Board eligible Psychiatrists on site in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and the VA Northern Indiana Health Care System (VANIHCS). The general assignment will be at the Marion VAMC, Ft. Wayne VAMC and St. Joseph County VA Clinic. Telephone and/or Video Connect consultation may be required, while on duty/on call, for the VANIHCS Muncie and Peru Community Based Outpatient Clinics.

1.2. Place of Performance: VA Northern Indiana Health Care System (VANIHCS): Marion VA Medical Center (VAMC), 1700 E. 38th St., Marion, IN; Ft. Wayne VA Medical Center, 2121 Lake Ave., Ft. Wayne, IN; and St. Joseph County VA Clinic, 1540 Trinity Place, Mishawaka, IN.

1.3. Work Environment: VANIHCS is comprised of medical facilities located in Marion, IN; Ft. Wayne, IN; St. Joseph County, Mishawaka, IN; Muncie, IN; and Peru, IN. The Fort Wayne Campus offers primary and secondary medical and surgical services, and the Marion Campus offers a full range of psychiatry services, nursing home care, and extended care services. Primary care clinics are available at both campuses and at Community Based Outpatient Clinics (CBOCs) located in Muncie and Peru, Indiana. The Marion campus is comprised of a four story outpatient facility, two story mental health facility (one acute psych and one chronic psych inpatient units), a two story inpatient nursing home care/community living center facility (five units consisting of palliative/hospice care unit, rehabilitation unit, two chronic psych units and a dementia unit. The Ft. Wayne campus is comprised of a five-story main hospital and an outpatient annex facility. The Ft. Wayne main hospital has an emergency department and two inpatient units (one unit is a med/surge unit and one is an intensive care unit). St. Joseph County VA Clinic and the Muncie and Peru CBOC’s provide outpatient services. Telephone and/or Video Connect consultation may be required, while on duty/on call, for the VANIHCS Muncie and Peru CBOC’s. Psychiatrist work occurs within a typical office setting, either individually or in meeting with others, or in meeting rooms. Some time will be spent walking to and from the inpatient units in buildings with time spent in inpatient units involved with patients, nursing staff or other staff in activities typical of a mental health care facility.

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

1.5. Policy/Handbooks: The Contractor is required to meet VHA performance and quality criteria and standards listed within this Performance Work Statement (PWS). Performance and quality standards may change during the contract. New or revised quality/performance criteria or standards will be provided to the Contractor before implementation date and throughout the life of the contract through written modifications, as applicable. Copies of current VA and VHA publications can be located at http://www.va.gov/vhapublications/ or at http://www.va.gov/vapubs/. Compliance with mandated performance is required as a condition of this contract. The following Policies, Handbooks, and Directives are applicable to this contract:

1.5.1. VA Directive 1663: Health Care Resources Contracting – Buying

1.5.2. VHA Handbook 1100.17: National Practitioner Data Bank Reports

1.5.3. VHA Handbook 1100.18 Reporting and Responding to State Licensing Boards

1.5.4. VHA Handbook 1100.19 Credentialing and Privileging

1.5.5. VHA Handbook 1907.01 Health Information Management and Health Records

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

1.5.7. VHA Directive 1230(3) Outpatient Scheduling Processes and Procedures (1230(3)_D_2016-07-05.pdf)

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

1.6.1. BLS: Basic Life Support

1.6.2. CDC: Centers for Disease Control and Prevention

1.6.3. CDR: Contract Discrepancy Report

1.6.4. CEU: Certified Education Unit

1.6.5. CME: Continuing Medical Education

1.6.6. CMS: Centers for Medicare and Medicaid Services

1.6.7. Contracting Officer (CO) – The person executing this contract on behalf of the Government with the authority to enter into, administer and modify contracts and make related determinations and findings.

1.6.8. Contracting Officer’s Representative (COR) – A person appointed by the CO to take necessary action to ensure the Contractor performs in accordance with and adheres to the specifications contained in the contract and to protect the interest of the Government. The COR shall report to the CO promptly any indication of non-compliance in order that appropriate action can be taken.

1.6.9. COS: Chief of Staff

1.6.10. CPARS: Contractor Performance Assessment Reporting System

1.6.11. 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.

1.6.12. DEA: Drug Enforcement Agency

1.6.13. FSMB: Federation of State Medical Boards

1.6.14. Full Time Equivalent (FTE): VA’s definition for full time- 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.

1.6.15. HHS: Department of Health and Human Services

1.6.16. HIPAA: Health Insurance Portability and Accountability Act

1.6.17. HR: Human Resources

1.6.18. ISO: Information Security Officer

1.6.19. LIN: Line Item Number

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

1.6.21. MOD: Medical Officer of the Day

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

1.6.23. NOD: Nursing Officer of the Day

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

1.6.25. NPPES: National Plan and Provider Enumeration System

1.6.26. POP: Period of Performance

1.6.27. PPD: Purified Protein Derivative

1.6.28. PWS: Performance Work Statement

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

1.6.30. QASP: Quality Assurance Surveillance Plan

1.6.31. SLIN: Sub-Line Item Number

1.6.32. VANIHCS: Veterans Administration Northern Indiana Health Care System

1.6.33. Veteran’s 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.

1.6.34. Veterans Integrated Services Network (VISN): The regional oversight for the VA medical centers in Michigan and Indiana.

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

1.6.36. VA EHR: VA Electronic Health Record

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

1.6.38. 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 Battle Creek VA Medical Center.

2. QUALIFICATIONS:

2.1. Staff/Facility

2.1.1. License: Contract physician(s) assigned by the Contractor to perform the services covered by this contract shall have a current license to practice medicine in any State, Territory, or Commonwealth of the United States or the District of Columbia. All licenses held by the personnel working on this contract shall be full and unrestricted licenses. Contract physician(s) who have current, full and unrestricted licenses in one or more states, but who have, or ever had, a license restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending action or denied upon application will not be considered for the purposes of this contract.

2.1.2. Board Certification: All contract physician(s) shall be board certified or board eligible in psychiatry and be currently certified in Basic Life Support (BLS) or equivalency. All physicians shall have two (2) years-experience in providing psychiatric care. Continuing education courses required for maintaining certification shall be kept up to date at all times by the Contractor. Documentation verifying current certification shall be provided by the Contractor to the VA COR on an annual basis for each year of contract performance.

2.1.3. Credentialing and Privileging: Credentialing and privileging is to be done in accordance with the provisions of VHA Handbook 1100.19 referenced above. The Contractor is responsible to ensure that proposed physician(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any contract physician(s) prior to obtaining approval by the VAMC Northern Indiana Health Care System Professional Standards Board, Medical Executive Board and Medical Center Director.

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

2.1.3.2. VETPRO: Registration into the Veterans Health Administration credentialing software will be required prior to the first day of work.

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

2.1.5. Continuing Medical Education (CME)/ Certified Education Unit (CEU) Requirements: Contractor shall provide the COR copies of current CMEs as required or requested by the VAMC. Contract physician (s) registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. Contractor shall report CME hours to the credentialing office for tracking. These documents are required for both privileging and re-privileging. Failure to provide shall result in loss of privileges for contract physician(s).

2.1.6. Training (BLS, VA EHR and VA MANDATORY): Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training shall be completed by the contract physician (s) as required by the VA. VANIHSC staff shall provide orientation and training to new contract physician staff members. Normally, the orientation shall be accomplished at the earliest possible date, prior to the first day of scheduled duty. All contracted providers shall complete applicable TMS modules, training and orientation prior to providing any services at VANIHCS. Contract physician payment for orientation and training shall be at the expense of the Contractor. VANIHCS will provide a maximum of 40 hours for initial training/orientation per contract physician.

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

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

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

2.1.7.3. VARICELLA: Contractors shall provide proof of immunity for all Contractor physicians {This is applicable to all health care workers}.

2.1.7.4. ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of Tdap vaccination for all Contractor physicians {This is applicable to all health care workers}.

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

2.1.7.6. 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.

2.1.7.7. 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.

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

2.1.9. DEA: Contractor shall provide copy of current DEA certificate as part of the onboarding/credentialing process. Contractor shall provide DEA certificate to Credentialing upon service’s approval of Physician.

2.1.10. Conflict of Interest: The Contractor and all contract physician(s) are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of quote and during the entirety of contract performance. The monitoring and reviewing of conflict of interest responsibilities shall be maintained by the COR and Chief of Mental Health. At the time of quote, 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 shall 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).

2.1.11. Citizenship related Requirements:

2.1.11.1. The Contractor certifies that the Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to Department of Veterans Affairs patient referrals;

2.1.11.2. While performing services for the Department of Veterans Affairs, the Contractor shall not knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States. Additionally, the Contractor is required to comply with all “E-Verify” requirements consistent with “Executive Order 12989” and any related pertinent Amendments, as well as applicable Federal Acquisition Regulations.

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

2.1.11.4. This certification concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under 18 U.S.C. 1001.

2.1.11.5. The Contractor agrees to obtain a similar certification from its subcontractors. The certification shall be made as part of the offeror’s response to the RFQ.

2.1.12. Annual Office of Inspector General (OIG) Statement: In accordance with HIPAA and the Balanced Budget Act (BBA) of 1977, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) has established a list of parties and entities excluded from Federal health care programs. Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs.

2.1.12.1. Therefore, Contractor shall review the HHS OIG List of Excluded Individuals/Entities on the HHS OIG web site at http://oig.hhs.gov/exclusions/index.asp to ensure that the proposed contract physicians (s) are not listed. Contractor should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty (CMP) for each item or service furnished during a period that the person was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMP’s may also be imposed against the Contractor that employ or enter into contracts with excluded individuals to provide items or services to Federal program beneficiaries.

2.1.12.2. By submitting their offer, 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 Direction: The qualifications of Contractor personnel are subject to review by VA Medical Center COS or his/her clinical designee and approval by the Medical Center Director as provided in VHA Handbook 1100.19. Clinical/Professional direction of all clinical personnel covered by this contract shall 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-Personal Healthcare Services: The parties agree that the Contractor and all contract physician(s) shall not be considered VA employees for any purpose.

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

2.5. No Employee status: The Contractor shall be responsible for protecting Contract physician (s) furnishing services. To carry out this responsibility, the Contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract:

· Workers’ compensation

· Professional liability insurance

· Health examinations

· Income tax withholding, and

· Social security payments

2.6. Tort Liability: The Federal Tort Claims Act does not cover Contractor or contract physician(s). When a Contractor or contract physician(s) has been identified as a provider in a tort claim, the Contractor shall be responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor’s (or contract physician(s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.7. Emergency Substitutions: During the first ninety (90) calendar days of performance, the Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death, or termination of employment. The Contractor shall notify the CO, in writing, within 30 calendar days prior to 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 30 calendar days prior to making any permanent substitutions.

2.7.1. 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 shall notify the Contractor within 15 calendar days after receipt of all required information of the decision on the proposed substitutes. The contract shall be modified to reflect any approved changes of key personnel.

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

2.7.3. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. Should the VA COS or designee show documented clinical problems or continual unprofessional behavior/actions with any contract physician (s), she/he may request, without cause, immediate replacement of said contract physician (s).

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

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

3. VA HOURS OF OPERATION/SCHEDULING:

3.1. VA Business Hours: Monday through Friday 8:00 am to 4:30pm.

3.2. The services covered by this contract shall be furnished by the contractor as defined herein. The contractor shall be required to provide services on federal holidays.

3.3. Work Schedule: Contract physician shall work efficiently to complete all tasks prior whenever possible, prior to the end of the workday. However, the contract physician is expected to remain on duty until the last patient has been seen. Approval for work beyond end of normal workday shall be approved by the Chief of Mental Health Services or designee PRIOR to performing the work unless the work involves a medical emergency. Methods to obtain approval must be placed via a phone call to the COR first, then the Chief of Mental Health Services and can be done at any point up to 4:00pm.

3.3.1. Patients shall be seen by a contract physician (s) on-site at VA Northern Indiana Medical Center in a timely manner in accordance with VA Rules and Regulations on clinic wait times and consult completion. Contractor shall notify the COR at least monthly about any obstacles to meeting this performance measure.

3.3.2. Contract Physicians shall be available and present in assigned area during normal hours, which shall be established, and may be revised, as deemed appropriate for patient care by the COR and/or the Chief of Mental Health Services. Currently, normal hours are:

Marion Campus: The current, normal work schedule for the Marion campus is Monday through Friday from 7:45am to 4:30pm., with a 45-minute non-paid lunch break. Marion contract physicians will provide weekend psychiatric coverage on a scheduled/rotating basis with other VA psychiatrists on staff and will work 13 weekends per calendar year. Weekend contract physicians will provide Saturday and Sunday coverage from 7:45am to 4:30pm., with a 45-minute non-paid lunch break. Each Marion contract psychiatrist will work three (3) Federal holidays per calendar year, 7:45am to 4:30pm., with a 45-minute non-paid lunch break.

Note: A medical officer of the day (MOD) is on duty 24 hours a day and is on station for any psychiatry admission to the Marion campus Mental Health inpatient units when the contract physician(s) is off duty. The MOD will consult with the Ft. Wayne campus on-call contract physician(s) as needed for off tour mental health admissions.

Ft. Wayne Campus: The current, normal work schedule for the Ft. Wayne campus is Monday through Friday from 8:00am to 4:30pm., with a 30-minute non-paid lunch break. Ft. Wayne contract physicians will provide on-call weekend, after hours and federal holiday psychiatric coverage on a scheduled/rotating basis with other VA psychiatrists on staff. Each contract physician will provide rotating on-call coverage on a Wednesday – Tuesday schedule. Coverage may include consultations by the Marion campus MOD and/or contract physician(s). Coverage for Wednesday, Thursday, Friday, Monday and Tuesday will be from 4:30pm to 8:00am. Saturday on-call coverage will begin at 8:00am and end at 8:00am on Monday. Each Ft. Wayne contract physician will work four (4) Federal holidays per calendar year, 8:00am to 4:30pm., with a 30-minute non-paid lunch break.

A medical officer of the day (MOD) is on duty 24 hours a day. The Ft. Wayne contract physician scheduled for evening/weekend/holiday call must be available and if needed, report on station for any psychiatry needs. The patient must be seen and evaluated within 24 hours of admission. The psychiatrist must be available by telephone if the MOD has issues/concerns about psychiatry patients.

St. Joseph County VA Clinic: The current, work schedule for the St. Joseph County VA Clinic is Monday through Friday from 12:30pm to 4:30pm. The St. Joseph County VA Clinic will not work Federal holidays or weekends and will not provide on-call coverage.

3.3.3. Duties: Provide Psychiatry coverage to the Inpatient Mental Health Unit, Psychiatric consultation to the Medical Center, evaluate Veterans in need of mental health care in the Urgent Care/ED setting, and process needs including possible admissions, respond to Psychiatric emergencies and provide triage reviews of outside facilities requesting transfer to VANIHCS Mental Health Inpatient Mental Health unit.

Mental Health Services include:

Acute Psych inpatient unit – 12 beds Psych-Nursing Home Care inpatient unit (Intermediate type pts) – 16 beds Psych-Nursing Home Care inpatient unit (long-term type pts)/ Extended Care – Consultation only with the Veteran’s Community Living Center (VCLC) – 100 beds Residential Treatment Program – PTSD/Sub Abuse/Dual Diagnosis – 30- 50 beds Consults to our Acute Medicine inpatient unit and Intensive Care unit- 26 bed Outpatient Mental Health services/consultations at VA Northern Indiana Health Care System (VANIHCS), Marion VA Medical Center (VAMC); Ft. Wayne VA Medical Center; St. Joseph County VA Clinic; and the Community Based Outpatient Clinic’s (CBOC) Muncie VA Clinic and Peru VA Clinic. Only telephone and/or video connect consultation may be required for Muncie and Peru CBOC’s, and will be covered by any one of the other three location, Marion VAMC, Ft. Wayne VAMC, or St. Joseph County VA Clinic.

3.4. Triage Duties: Provide Psychiatric review/clinical review of outside hospitals/Emergency Room’s requests for possible admission to VA Northern Indiana VAMC Inpatient Mental Health. This is done over the phone in conference with external provider and internal Transfer Coordinator during normal business hours or after hours in collaboration with the MOD and/or NOD.

3.5. Federal Holidays: Contract psychiatrists shall not be required work on federal holidays. The following holidays are observed by the Department of Veterans Affairs:

· New Year’s Day

· Martin Luther King’s Birthday

· President’s Day

· Memorial Day

· Independence Day

· Labor Day

· Columbus Day

· Veterans Day

· Thanksgiving

· Christmas

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

3.6. Cancellations: In the event of a last-minute cancellation, the Contractor shall notify the COR and Chief of Mental Health of cancellation by phone as soon as…