36C25218Q9813-001.docx

36C25218Q9813 36C25218Q9813

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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

36C25218Q9813 09-24-2018 Benjamin Dufour 414-844-4826 10-09-2018

1400 CST

36C252 Department of Veterans Affairs Great Lakes Acquisition Center (GLAC) 115 S 84th Street, Suite 101 Milwaukee WI 53214-1476 X X 561320 $27.5 Million X N/A X 36C676 Department of Veterans Affairs Tomah Veterans Affairs Medical Center 500 E. Veterans St.

Tomah WI 54660 36C252 Department of Veterans Affairs Great Lakes Acquisition Center (GLAC) 115 S 84th Street, Suite 101 Milwaukee WI 53214-1476

Department of Veterans Affairs Financial Services Center PO Box 149971 Austin TX 78714-9971 877-353-9791 512-460-5540 Contractor to provide Nursing Services (RNs) as detailed herein to the Tomah VA Medical Center.

This procurement is 100% set-aside for Service Disabled Veteran Owned Businesses (SDVOSB). All SDVOSB offerors must be listed as verified in the Vendor Information Pages (VIP) at the time of offer in accordance with VAAR 819.7003(b).

X X Becky Cincotta Contracting Officer

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1. CONTRACT ADMINISTRATION

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 Number _________________________________

Fax Number ______________________________________

Email ____________________________________________

DUNS Number ___________________________________

Tax ID Number ____________________________________

Vendor POC/Title to respond to Government Evaluations (CPARS) __________________________

Vendor POC Email address for use with CPARS: __________________________________

b. GOVERNMENT:

Becky Cincotta, Contracting Officer Benjamin Dufour, Contract Specialist Department of Veterans Affairs Great Lakes Acquisition Center (36C252) 115 South 84th Street, Suite 101 Milwaukee, WI 53214-1476 Telephone: (414) 844-4822 / (414)-844-4826 Fax: (414) 844-4891 Email: becky.cincotta@va.gov / benjamin.dufour@va.gov

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with Federal Acquisition Regulation (FAR) Clause 52.232-33, Payment by Electronic Funds Transfer--System for Award Management (31 U.S.C. 3332).

3. INVOICES: Payments shall be made monthly in arrears upon receipt of a properly prepared invoice.

a. In order to comply with the Improper Payment Elimination and Recovery Act of 2010 (IPERA), the VA has mandated electronic invoice submission to the Veterans Affairs Financial Services Center (VAFSC). VAFSC has partnered with Tungsten Corporation e-Invoicing network for submission of all electronic invoices to VA. Tungsten Network electronic invoicing is free to all VA vendors. In order to submit electronic invoices, all VA vendors must register with Tungsten Network by submitting an email to Tungsten Network VA.Registration@tungsten-network.com or calling 1-877-752-0900 option 2 for Enrollment.

b. Contractor shall submit an electronic invoice by the tenth (10th) of the following month services were performed to the Veterans Affairs Financial Services Center (VAFSC) e-Invoice through the website at https://portal.tungsten-network.com/Login.aspx. For questions regarding the submission of VA electronic invoices, Tungsten Network customer service may be contacted at 1-877-489-6135.

c. The invoice sent to Tungsten Network shall reference the vendor name and address, customer name, contract number, order number, appropriate obligation/funding, CLIN # and description of services, the quantity (number of hours), the unit price, the extended unit price, and the total invoice cost. Invoices shall also include any payment discount terms.

d. For questions regarding invoice receipt or payment, please call VAFSC directly at 1-877-353-9791. Payments shall be made monthly in arrears upon receipt of a properly prepared invoice.

e. If improper invoices are submitted, they may be rejected and cause delays in payments.

Invoice issues may also be documented in CPARS.

[End of Contract Administration]

B.2. SCHEDULE OF SERVICES AND PRICE

1. Authority: This procurement is being conducted under the authority of Title 38 U.S.C. 513 and Title 38 U.S.C. 8127(d), and in accordance with FAR 13.5 Simplified Procedures for Certain Commercial Items. As such, the Government will utilize simplified procedures for soliciting competition, evaluation, award documentation, and notification. The Great Lakes Acquisition Center is seeking temporary FTE Nursing Services for the Tomah VA Medical Center (VAMC), 500 East Veterans Street, Tomah, WI, 54660. This solicitation is set-aside 100% for service disabled veteran-owned small businesses (SDVOSBs).

2. Services: Contractor will provide all technical support, management, and labor to fulfill the need for one (1) FTE Acute Medical Registered Nurse, two (2) FTE Mental Health Registered Nurses, and four (4) FTE Long-Term Care (CLC) Registered Nurses at the Tomah VA Medical Center (VAMC). All Registered Nurses shall possess a minimum of 3 years of experience and active employment status within the last 6 months. RNs must have a minimum of 1-year experience in the clinical areas of intended assignment. Nursing services for the Acute Medical and CLC units will be 8-hour shifts, second (PM) shift (1530 – 2400) and third (night) shift (2400 – 0800). Nursing services for the Mental Health units will be 12-hour shifts (3 per week, totaling 72 hours every two weeks) from 1930 to 0800. Services are required Sunday through Saturday, except federal holidays. The period of performance is anticipated as November 1, 2018 through September 30, 2019, with four, one-year options to extend through September 30, 2023. The resultant contract will be fixed (unit) price, Indefinite Delivery, Indefinite Quantity (IDIQ) contract.

3. Ordering: The following entities/positions at the Tomah VAMC are authorized by the Contracting Officer to place requests (orders) with the contractor for services required under this contract: Staffing Office, Nurse Division Manager/designee, and the COR (see B.3.III.7 for further details).

4. Government’s Minimum and Maximum: The Government’s guaranteed minimum to be ordered under the contract is $3,200.00. The contract ceiling shall not exceed $6,500,000.00.

5. Price Schedule: Contractor shall complete the unit price, extended price, and total price in the Price Schedule below for all periods. Hourly rates shall be all-inclusive and include per diem and travel, if necessary. Contractor is to provide firm-fixed unit pricing in the Price Schedule. The quantities in the Price Schedule are estimates only. Contractor will be paid only for actual services performed.

PRICE SCHEDULE

a. Base Period: November 1, 2018 through September 30, 2019

QTY

PRICE

EXTENDED TOTAL

Total for Base Period CLIN 0001

QTY

PRICE

EXTENDED TOTAL

1530-2400 All Areas

2400-0800 All Areas

1930-0800 Mental Health

Total for Base Period CLIN 0002

QTY

PRICE

EXTENDED TOTAL

Total for Base Period CLIN 0003

$ 250.00

ESTIMATED TOTAL FOR BASE YEAR (ALL CLINS): $ _

b. Option Year 1: October 1, 2019 through September 30, 2020

QTY

PRICE

EXTENDED TOTAL

Total for Option Year 1 CLIN 1001

QTY

PRICE

EXTENDED TOTAL

1530-2400 All Areas

2400-0800 All Areas

1930-0800 Mental Health

Total for Option Year 1 CLIN 1002

QTY

PRICE

EXTENDED TOTAL

Total for Option Year 1 CLIN 1003

$250.00

ESTIMATED TOTAL FOR OPTION YEAR 1 (ALL CLINS): $__ ______

c. Option Year 2: October 1, 2020 through September 30, 2021

QTY

PRICE

EXTENDED TOTAL

Total for Option Year 2 CLIN 2001

QTY

PRICE

EXTENDED TOTAL

1530-2400 All Areas

2400-0800 All Areas

1930-0800 Mental Health

Total for Option Year 2 CLIN 2002

QTY

PRICE

EXTENDED TOTAL

Total for Option Year 2 CLIN 2003

$250.00

ESTIMATED TOTAL FOR OPTION YEAR 2 (ALL CLINS): $__ _______

d. Option Year 3: October 1, 2021 through September 30, 2022

QTY

PRICE

EXTENDED TOTAL

Total for Option Year 3 CLIN 3001

QTY

PRICE

EXTENDED TOTAL

1530-2400 All Areas

2400-0800 All Areas

1930-0800 Mental Health

Total for Option Year 3 CLIN 3002

QTY

PRICE

EXTENDED TOTAL

Total for Option Year 3 CLIN 3003

$250.00

ESTIMATED TOTAL FOR OPTION YEAR 3 (ALL CLINS): $__ _______

e. Option Year 4: October 1, 2022 through September 30, 2023

QTY

PRICE

EXTENDED TOTAL

Total for Option Year 4 CLIN 4001

QTY

PRICE

EXTENDED TOTAL

1530-2400 All Areas

2400-0800 All Areas

1930-0800 Mental Health

Total for Option Year 4 CLIN 4002

QTY

PRICE

EXTENDED TOTAL

Total for Option Year 4 CLIN 4003

$250.00

ESTIMATED TOTAL FOR OPTION YEAR 4 (ALL CLINS): $__ _______

ESTIMATED CONTRACT TOTAL VALUE (INCLUDING BASE & ALL OPTION YEARS):

f. KEY PERSONNEL: The individuals listed below are authorized to perform services under this contract.

INTENTIONALLY LEFT BLANK FOR SOLICITATION

[End of Schedule of Services and Price]

B.3. PERFORMANCE WORK STATEMENT: REGISTERED NURSE AND CERTIFIED NURSE ASSISTANT

I. POSITION DUTIES AND RESPONSIBILITIES

1. Registered Nurse: The RN will utilize their broad based clinical knowledge to effectively assess, implement health promotion and prevention interventions, manage acute and chronic illness states, assist patient/residents in the attainment of optimal levels of functioning rehabilitation, evaluate patient/resident response to actual or potential health problems, and provide supportive measures for the dying patient/resident and their significant others. Nursing care is performed in accordance with the Wisconsin State Practice Act and within the individual nurse’s scope of license. The VA Nurse Manager(s), or appropriate nursing leadership delegate (i.e., Assistant Nurse Manager), will provide the RN with clinical oversight during their tour of duty. More specific duties and responsibilities of the Registered Nurse are described below and shall be assessed by the Tomah VAMC prior to provider acceptance.

a. Maintain patient/resident confidentiality and a safe patient/resident care environment, including familiarity with requirements such as medication administration, patient/resident/family education, discharge process, restraint usage, hazardous waste disposal, etc., as defined by The Joint Commission and all other VA regulatory bodies (i.e., Long Term Care Institute and Office of Inspector General).

b. Provide patient/resident-centered care by performing the following tasks:

· assess the health care needs of the patient/resident and maintain or develop a plan of care to meet interdisciplinary goals

· assess and act on significant changes in the patient’s/resident’s health condition

· carry out the plan of care by performing/assigning delegated tasks

· collect and document pertinent data into the electronic patient/resident medical record

· complete nursing assessments within required time frames

· identify and act on predictable needs of the patient/resident

· meet the health care needs of patient/resident by assessing and assisting the patient/resident to meet expressed needs

· meet the emotional and spiritual needs of patients/residents and/or families

· prioritize and complete tasks within the RN’s assigned shift

· update patient/resident care plans

· notify assigned physician of any changes in condition

· report incidents of verbal or physical abuse immediately to the Nurse Manager of the unit they are assigned; or designated off-shift nursing leadership

c. Perform the following tasks:

· perform head-to-toe assessment

· insert IV lines

· care of PICC lines

· administer medication including IVs

· coordinate and participate in admission and discharge of patient

· measure vital signs, including Pain (the 5th Vital Sign), pulse oximetry, etc.

· perform wound care including dressing changes and obtaining wound cultures as necessary

· obtain and deliver specimens to lab

· perform tracheostomy care

· perform non-acute ventilator care, if needed

· perform suctioning including oral, nasogastic, and tracheostomy

· perform deep suctioning, which may include obtaining specimens

· assess for and administer tube feedings

· assist with routine urinary and bowel elimination including catheters, colostomies, and digital stimulation

· educate patients/residents and/or families regarding health and diagnoses and medication administration

· respond and assist in an emergency situation

· provide clinical oversight to Licensed Practical Nurses, Certified Nursing Assistants and Health Technicians

2. The requirements and responsibilities listed below apply to all RNs.

a. The contract nursing staff shall complete and document all assessments accurately and within assigned timeframes.

b. The contract staff assigned shall be physically able to carry out measures under the “Prevention and Management of Disruptive Behavior (PMDB),” which includes prevention techniques, basic self-defense, and the ability to perform a therapeutic containment (See Attachment C).

c. The contract nursing staff shall, at all times, conduct themselves in a professional manner treating patient/residents, visitors, and staff in a courteous manner. Sustained allegations of patient/resident or coworker abuse, both verbally or physically, will result in immediate removal from the Tomah VAMC, and will also be reported to the Contracting Officer. These incidents may result in that contractor employee not being eligible for continued contract performance.

d. Dress apparel: Contractor personnel shall be required to dress in a professional manner and in accordance with VA Handbook 1850.04 Employee Uniforms.

3. Contract RNs: Bar Code Medication Administration (BCMA) with a 100% accuracy rate shall be used in the applicable areas for medication administration. BCMA is designed to provide electronic validation and documentation of medication administration, reduce medication misadventures, provide an online patient/resident medication record, and promote a safer inpatient/resident care environment. Spot check of patient/resident charts or review of incident reports will be conducted. If issues are found, remedial training of contractor employee will be given. If remedial training is unsuccessful, the contractor employee may be removed from providing services under the contract.

II. WORK HOURS

1. Tomah VA Medical Center provides nursing services 24 hours a day, 7 days a week. Contract nursing services shall supplement full time Tomah VAMC staff on an episodic/temporary basis, depending on vacancies, vacations, resignations, and illnesses to ensure required staffing levels are maintained. Coverage may include weekends, evenings, or overnights, and are variable within a 24-hour period. The most common shifts are listed below.

· Second Shift (Evening) – 1530 to 2400

· Third Shift (Night) – 2400 to 0800

· 12 Hour Shift 1930 to 0800 (3, 12-hour days per week)

2. Other shifts that are not listed in the Price Schedule may be determined based on the need of the Medical Center.

3. Overtime may be necessary and is applicable for anything over 40 hours in a one week pay period worked at the Tomah VAMC. Overtime must be pre-approved by the Staffing Office for the contract and will not be allowed for contractor staff to complete charting in the medical record. All patient/resident documentation must be completed prior to leaving for the day. Evening eight-hour (8) tours include a mandatory ½ hour non-paid lunch break as well as all twelve (12) hour shifts. If patient/resident care needs prevent the ability to take a 30-minute lunch, the Nurse Manager or Staffing Office must be notified during the said shift to provide coverage or authorize no lunch.

4. A standardized time card approved by the Contracting Officer’s Representative (COR) is to be used for contractor staff. Time cards must be signed by Nurse Managers, Assistant Nurse Managers, or Nursing Supervisors only. Time cards signed by other than those listed above will not be accepted with invoices for payment. A list of managerial staff will be provided to the contractor after contract award and discussed with contractor staff during orientation.

III. SCHEDULING

1. Temporary contract nursing hours are provided in the Price Schedule, Section B.2.

2. Scheduled coverage requests will be provided by the Tomah VAMC to the contractor no later than 2 weeks in advance for planned shifts requiring coverage. Contractor shall maintain sufficient VA credentialed staff to meet service requests for uncovered shifts.

3. Contractor shall confirm with VA the ability to meet all scheduled coverage requirements within eight (8) hours of the required shift.

4. There may be times when, due to unplanned circumstances, coverage is needed on short notice. For unplanned coverage needs, the contractor is expected to fill all additional unscheduled shifts that are requested by the VA with at least a 24-hour advanced notice.

5. In the case of an unplanned shift with less than a 24-hour advanced notification, the contractor will initiate contact with the established pool of credentialed contract staff and advise VA within 2 hours of requested shift time as to availability of provider(s) to fill the unscheduled shift.

6. Because the exact unit requiring coverage for an unscheduled shift (whether less than or greater than a 24-hour advanced notice) can be uncertain until such time as the contract provider(s) arrives, the contract nursing staff reporting for duty shall be willing and capable to perform duties in ANY of the units associated with their assigned hourly rate, for example:

· Acute Care RNs shall be ready and able to work either Acute Mental Health/Acute Medical units as required.

· Community Living Center (CLC) RNs shall be ready to work in any CLC Long or Short-term units to include, but not limited to: Rehab, Hospices, Mental Health and Dementia.

If a contractor employee is unwilling to work on the unit required, the contractor employee will be sent home at no cost to the Government. The contractor will be notified of the occurrence the same day.

**Please see detailed description of various units in the sections below entitled, “Community Living Centers” (B.3.V), “Mental Health Residential Rehabilitation Treatment Program” (B.3.VI), and “Acute Care Units” (B.3.VII). **

7. The Contractor shall have a 24-hour per day, 7 days a week, capability for the Tomah VAMC to request nursing services via fax, telephone, and/or e-mail. The following entities/positions are authorized by the Contracting Officer to place requests (orders) with the contractor for services required under this contract: Staffing Office, Nurse Division Manager/designee, and the COR. A list of individuals and their contact information (fax, telephone, & email) of authorized personnel will be provided to the contractor after contract award.

8. Contract nursing staff must contact the contractor regarding cancellations, changes in scheduling, etc. The contractor will, in turn, contact the Tomah VAMC of employee cancellation and advise the name of the replacement provider.

9. The missing of two scheduled shifts (“no call/no show”) by contract nursing staff may be grounds to restrict/cease contractor employee from being scheduled for future contract shifts. Contractor shall be responsible for any overtime costs to the government to provide coverage for any “no call/no show” shift. A short notice cancellation of less than four hours shall become the contractor’s responsibility to provide a replacement provider. Notification of, or the inability to provide, a replacement provider must be made to the Tomah VAMC at least two hours prior to the start of the scheduled shift. Contractor shall be responsible for any overtime costs incurred by the Tomah VAMC in providing internal coverage for any short notice cancellation of scheduled vendor shifts.

10. The Tomah VAMC may cancel a shift request at any time for any reason. If cancellation notice is given to the contractor four or more hours prior to scheduled shift, then no charge shall be made to the Government. If cancellation notice is given to the contractor less than four hours prior to scheduled shift or after a shift begins, the VA shall be responsible for payment of a cancellation fee of $250.00 per occurrence.

IV. ORIENTATION

1. All personnel performing services under this contract must complete orientation prior to beginning work on contract shifts:

a. 8 hours of computer based pre-orientation work (off-site by contract nursing staff, non-compensated)

b. 3-day new employee orientation (on-site at Tomah VAMC, compensated)

c. 1-day competency Assessment (on-site at Tomah VAMC, compensated) **Competency Assessment will be pass/fail. Contract Staff must pass the assessment in order to begin working on the units.**

2. In addition, licensed nursing staff (RNs) will undergo orientation consisting of one, 8-hour shift in each unit area the professional intends to work; up to 32 hours (Acute Medicine, Mental Health, CLC).

3. Contractor employees who are former Tomah VAMC employees who have separated from the facility within the previous 6 months will not be required to complete the orientation process prior to being eligible for scheduled shifts.

V. COMMUNITY LIVING CENTERS

The Tomah VAMC has several different CLC units including those numbered as 401A, 401B, 402A, 402B, 403AN, 403B, 406 A&B, 409, and 410. These units consist of the following care specialties.

1. Short-stay Rehabilitation: Short-stay rehabilitation is time limited and goal directed care for the purpose of returning the veteran to functioning as independently as possible.

a. Care and services are provided in a home environment that enhances preparation for discharge and readies the veteran to function in a non-institutional setting. The program may be accredited by Commission on Accreditation of the Rehabilitative Facilities (CARF).

b. Levels of care are ultra-high, very high, high-medium, or low intensity inpatient/resident care depending on the veteran’s needs and goals for rehabilitation. The goals of care are restoration of the highest practicable level of well-being and functional independence.

2. Short-stay Skilled Nursing Care: Short-stay skilled nursing care is time limited and goal directed care for specific conditions or interventions that require the involvement of a licensed nurse, either a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), on a daily basis. Care and services are provided in a home environment that enhances preparation for discharge and readies the veteran to function in a non-institutional setting.

a. Examples of short-stay skilled nursing care services include, but are not limited to: intravenous therapy, care of stages three and four pressure ulcers, complex wound care, ventilator care, suctioning, tracheotomy care, tube feeding, and other interventions where the complexity of the veteran’s needs require direct intervention by a licensed nurse. The goal of care is to prepare the veteran for discharge to a home and community-based setting and to facilitate the achievement of the highest practicable level of well-being and function.

b. Short-stay skilled nursing care for veterans with spinal cord injury or disorder (SCI/D) is identified under skilled nursing. Veterans with a primary diagnosis of SCI/D are often admitted to a CLC for time limited and goal oriented care to achieve and maintain the highest level of function and well-being.

3. Short-stay Restorative: Short-stay restorative care is time limited with the purpose of providing short-term restorative interventions, such as bowel and bladder training and toileting, restorative dining, and ambulation.

a. The goal of care is to facilitate the veteran’s achievement of the highest practicable level of independence, well-being, and function.

b. The purpose of the admission is to provide a transition from the hospital through short-term restorative care prior to discharge to a non-institutional setting that is the least restrictive and most appropriate setting for the veteran.

4. Short-stay Continuing Care: Short-stay continuing care is time limited care for the veteran awaiting alternative placement (for instance, to a community nursing home, State Veterans Home or any other community-based setting) and time limited care for veterans admitted to the CLC for Respite Services.

a. The goal of care is to achieve the highest practicable level of well-being and function as well as prevention of premature decline.

5. Short–stay Mental Health Recovery: Short-stay Mental Health Recovery is time limited recovery-centered care with the purpose of providing evaluation and management such as medication adjustment and evidence-based psychosocial behavioral interventions for veterans with exacerbation of medical and/or behavioral symptoms that can be managed in a non–psychiatric inpatient/resident setting.

a. Veterans receiving this level of care are expected to return to their previous living arrangements upon discharge. In this recovery oriented therapeutic setting, active, evidence-based psychological and psychopharmacological treatment services need to be the focus of care. Veterans and their significant other or family members must be given opportunities to learn how to manage care and challenging behaviors. Education for the veterans and the family must include how to identify factors that present behavioral exacerbation, behavioral management techniques, and assistance in identifying relevant VA and community based resources.

b. The focus of care and therapy must include activities that enhance physical strength and mobility and psychological recovery to maintain the highest practicable level of well-being and overall function.

6. Long-stay Continuing Care: Veterans receiving long-stay continuing care are expected to remain in the CLC for 91 days or more. Care is provided in a home environment. The goal of care is to maintain the highest practicable level of well-being and function as well as prevention of further decline.

a. Long-stay Continuing Care may require the involvement of a Registered Nurse (RN) for oversight, including assessment and treatment planning, guiding, directing and observing care, but may not require daily licensed nurse interventions. Examples of long-stay continuing care may include, but is not limited to care for Veterans who:

(1) Have long-standing chronic functional disabilities and active rehabilitation is no longer an option;

(2) Require assistance with basic activities of daily living, medication administration, and general supervision, and who do not require direct skilled nursing services; or

(3) Continue to require skilled nursing interventions that extend beyond the short-stay limit of 90 days. For instance, veterans who continue to require skilled nursing interventions such as complex wound care or ventilator care will convert from a short-stay treating unit to a long-stay continuing care unit until the skilled nursing services are no longer needed.

b. The focus of care and therapy needs to include activities that enhance physical strength and mobility to maintain the highest practicable level of well-being and function.

7. Long-stay Mental Health Recovery: Differentiated from acute long-term psychiatric care and dementia care, veterans admitted to long-stay mental health recovery treating unit have chronic and stable mental illness coupled with geriatric or other syndromes that render them less able to function in non-institutional settings. The goal of care is to maintain the highest practicable level of well-being and function as well as preventing further decline. The home environment and ambience in a program specifically designed for care of this population must:

a. Utilize active, recovery-oriented, evidence-based psychological and psychopharmacological treatment service approaches and therapeutic recreation;

b. Have a structured and creative approach to daily routines;

c. Provide meaningful use of time and create opportunities for socialization to enhance psychosocial functioning, promote quality of life, and prevent behavioral exacerbation or psychological emergencies.

8. Short-stay Dementia Care: Short-stay dementia care is time limited and goal directed care with the purpose of stabilizing symptoms and developing a plan of care to meet ongoing needs with a secure environment of an existing dementia program.

a. Veterans receiving this level of care are expected to return to their previous living arrangements upon discharge. As such, the household environment provides cues for resident behavior management and functional improvements. The family, or significant other, needs to be involved in learning about safe and effective care practices in the home, resources for continued support, access to home telehealth and other services that support the veterans and assist the family or significant other to continue to care for the veteran at home. This program may offer the veteran’s family or significant other behavior management skills and opportunities to practice the skills while the veteran is in the CLC.

b. The focus of care and therapy needs to include activities that enhance physical strength and mobility and promotes maximal psychological functioning to allow the veteran to maintain the highest practicable level of well-being and overall function.

9. Long-stay Dementia Care: Long-stay (greater than 90 days) dementia-specific care may be delivered in any CLC environment where the safety of the veteran is protected or in a dementia-specific household.

a. A dementia-specific household is a model of care where the care neighborhood looks and feels like a home.

1. This type of environment provides the resident with cues for daily living and functioning at the highest level possible. Dementia-specific households need to consider the functional deficits associated with long-term chronic cognitive deficits.

1. The care environment must be appropriately stimulating and minimize challenging behaviors.

1. The home environment and ambience in a household or in a program specifically designed to care for this population must utilize therapeutic recreation, have a structured and creative approach to daily routines, provide meaningful use of time, and create opportunities for socialization to enhance quality of life.

b. The focus of care and therapy needs to include activities that enhance physical strength and mobility and promote maximal psychological functioning to allow the veteran to maintain the highest practicable level of well-being and overall function.

10. Respite: Respite care gives family caregivers and other informal social support systems temporary relief (generally up to two weeks of overnight stay) from the demands of daily care, thereby supporting the veteran’s desire to delay or prevent nursing home placement.

11. Palliative/Hospice: Palliative care is a broader term that includes hospice care as well as other care that emphasizes symptom control, but does not necessarily require presence of an imminently terminal condition, a time–limited prognosis, or exclusion of all aggressive curative therapies.

a. Palliative care may include a balance of comfort measures and curative interventions that vary across a wide spectrum. Palliative care may also include psychosocial as well as spiritual care to help address psychological and existential issues.

b. Hospice care is a model of care that focuses on relieving symptoms and supporting patient/residents with a life expectancy of six months or less. Hospice involves an interdisciplinary approach to provide medical care, pain management, and emotional and spiritual support. The emphasis is on comfort, not curing.

VI. MENTAL HEALTH RESIDENTIAL REHABILITATION TREATMENT PROGRAM (MHRRTP)

The residential unit (404 & 405) focuses on treatment of Substance Abuse/Dual Diagnosis (SA RRTP) and Posttraumatic Stress Disorder (PTSD RRTP). Care is also provided for veterans with other mental illnesses and addictive disorders who require additional structure and support to address multiple and severe psychosocial deficits, including homelessness and unemployment. The MH RRTP recognizes the need for psychiatric treatment and symptom reduction of mental and addictive disorders, while also providing psychosocial rehabilitation that focuses on a veteran’s strengths, needs, abilities, and preferences. Programming is designed to provide comprehensive treatment and rehabilitative services that will improve the quality of life and diminish reliance upon more resource intensive forms of treatment.

VII. ACUTE CARE UNITS

1. Acute Medical (400): Inpatient medical services for acute and chronic illnesses, to include alcohol detoxification, requiring but not limited to telemetry, IV therapy, blood transfusions, and continued monitoring. Acute Medicine focuses on shared decision-making with patient regarding plan of care, discharge planning, and returning home.

2. Acute Mental Health (403A): High-intensity inpatient mental health services for veterans with acute and severe emotional and/or behavioral symptoms causing a safety risk to self or others, and/or resulting in severely compromised functional status.

[End of Performance Work Statement]

B.4. SPECIAL CONTRACT REQUIREMENTS

1. SERVICES

a. The services specified herein may be changed by written modification to this contract. The VA Contracting Officer will prepare the modification (reference FAR clause 52.212-4(c), Changes) and, prior to becoming effective, shall be properly executed. Only the Contracting Officer is authorized to make commitments or issue changes that affect price, quantity, or quality of performance of this 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 and no adjustment will be made in the contract price to cover any increase in costs incurred as a result thereof.

b. This is a non-personal service contract as defined in FAR 37.101. There is no employer-employee relationship between the Government and the contractor or the contractor’s employee(s). Contractor personnel are not subject to the supervision and control of a Government officer or employee. Rather, contractor personnel perform their duties in accordance with the Performance Work Statement. Supervisory functions such as hiring, firing, directing, and counseling of contractor personnel are not performed by the Government. The healthcare provider who furnishes services under this contract is subject to Government technical oversight of the services. The Government retains the right to reject services for contractual non-performance.

c. The Government may evaluate the quality of professional and administrative services provided, but retains no control over the medical, professional aspects of services rendered.

d. Contractor is required to maintain medical liability insurance for the duration of this contract. Medical Liability insurance must cover the provider(s) for services in all states where services are rendered by the provider.

e. The services to be performed by the contractor will be performed in accordance with VA policies, procedures, regulations, and the medical staff bylaws of each VA facility (copies and/or links will be provided upon request). In all cases, dignity of the patient/resident shall be given the highest regard and the precepts of the American Hospital Association’s “Bill of Rights for Patient/residents” shall be observed.

f. Contractor shall provide the required services listed herein throughout the contract period. Other necessary personnel for the operation of the services contracted for at the Tomah VAMC will be provided by the Tomah VAMC at levels mutually agreed upon which are compatible with the safety of the patient/resident and personnel and with quality medical care programming.

g. Contractor, and its employees, shall observe all VA policies and procedures relating to infection control, Fire and Safety, Information Security, and Patient/resident Safety (mandatory training).

h. Contractor shall, in writing, keep the Contracting Officer informed of any unusual circumstances in conjunction with the contract.

2. TERM OF CONTRACT

a. This contract is effective for the period November 1, 2018 through September 30, 2019, and any options exercised at the Government’s discretion. Contractor shall not perform any service after September 30 of any year, without prior written authorization from the Contracting Officer.

b. Availability of Funds during a Continuing Resolution: At the beginning of each new fiscal year (October 1st) the federal government or parts thereof may be operating under a Continuing Resolution (CR) and only be funded for a limited period of time rather than for the entire fiscal year. If, at any time, funds for this contract are provided under a CR, funds will only be available for performance under this contract up to and including the expiration date of the CR, and any extension thereof. The government’s obligation for performance of this contract beyond that date is contingent upon the availability of appropriated funds from which payment for contract purposes can be made. No legal liability on the part of the government for any payment may arise for performance under this contract beyond the expiration date of the CR, and any extension thereof, until funds are made available to the contracting officer for performance and until the contractor receives notice of availability.

3. FEDERAL HOLIDAYS

a. Contractor will not be required to provide services on Federal Holidays. The 10 holidays observed by the Federal Government are: New Year’s Day (January 1st), Martin Luther King’s Birthday (3rd Monday in January), Presidents’ Day (3rd Monday in February), Memorial Day (last Monday in May), Independence Day (July 4th), Labor Day (1st Monday in September), Columbus Day (2nd Monday in October), Veterans Day (November 11), Thanksgiving Day (4th Thursday in November), Christmas Day (December 25th) and any other day specifically declared by the President of the United States to be a national holiday.

b. When one of the above designated legal holidays falls on a Sunday, the following Monday will be observed as a legal holiday. When a legal holiday falls on a Saturday, the preceding Friday is observed as a holiday by U.S. Government agencies.

4. QUALIFICATIONS OF PERSONNEL

a. Contractor nursing staff must possess the knowledge and skills necessary to effectively apply all aspects of the nursing process within a collaborative, interdisciplinary practice setting.

b. Personnel assigned by the contractor to perform the services covered by this contract shall be proficient in written and spoken English (38 USC 7402). Contractor’s assigned personnel must be computer literate as patient/resident documentation is directly entered in the patient/resident’s electronic medical record. Proficiency in the use of the Veterans Health Information Systems and Technology Architecture (VISTA) system and the Computerized Patient Record System (CPRS) are preferred.

c. Registered Nurses must be a graduate of an accredited Diploma, Associate, or Baccalaureate School of Nursing. Registered Nurses assigned by the contractor to perform the services covered by this contract must have a current and unrestricted license in a State, Territory, or Commonwealth of the United States or the District of Columbia and current BLS certification by a provider recognized by the American Heart Association. ACLS by the American Heart Association is required for nurses performing in the Acute Medical/Mental Health Unit. Renewal of BLS and ACLS certification is the responsibility of the contractor and will not be provided by the Tomah VAMC. All licensed personnel (RNs) shall possess a minimum of three years of experience and active employment status within the previous past six months. RNs must have a minimum of one-year experience in the clinical areas of intended assignment, i.e. acute care Mental Health or CLC.

d. Evidence of completion of required licensure, credentials, required training, current competencies and background investigations must be validated for all contractor personnel referred to perform services under this contract prior to providing direct patient care.

e. The Contracting Officer will be notified prior to any changes in personnel. VA reserves the right to approve the assignment of individual personnel furnished by the contractor to perform the functions specified in the contract.

f. Contractor shall not have any personnel report to duty until written notification is received from the Contracting Officer advising that the candidate(s) presented has met all requirements for performance under the contract.

g. The contracted individual(s) will be required to show two proofs of identification on their first day of work. Acceptable proofs of identification are listed below:

Acceptable PICTURE IDs:

· State-Issued Driver’s License

· State DMV-Issued ID Card

· US Passport

· Military ID/Dependents Card

· Foreign Passport

· Permanent Resident Card/Alien Registration Card w/Photo Acceptable NON-PICTURE IDs:

· Social Security Card

· Certified Birth Certificate

· State Voter Registration Card

· Native American Tribal Document

· Certificate of US Citizenship

· Certificate of Birth Abroad Issued by Department of State

h. Physical Requirements: The contractor must provide documentation that demonstrates that all contractor employees have a satisfactory health status including a current physical, which includes the following:

· TUBERCULOSIS TESTING: Contractor shall provide proof of a negative Tuberculosis Skin Test (TST) or interferon-gamma release assays (IGRA) for all Contractor employees. A negative chest radiographic report for active tuberculosis shall be provided in cases of positive TST or IGRA results. The TST or IGRA testing shall be repeated annually.

· MEASLES, MUMPS, & RUBELLA TESTING: Contractors shall provide proof of immunity for all Contractor employees.

· VARICELLA: Contractors shall provide proof of immunity for all Contractor employees.

· ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of Tdap vaccination for all Contractor employees.

· INFLUENZA: Contractors shall provide proof that all Contractor employees have received the annual Influenza vaccine unless it is contraindicated. If the Contractor employees has a medical contraindication to the vaccine they shall be required to wear a mask during the Influenza season.

· OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO BLOODBORNE PATHOGENS: Contractor shall provide evidence of completing and passing generic self-study blood-borne pathogen training for all Contractor employees; provide their own Hepatitis B vaccination series and hepatitis B surface antigen test results following the hepatitis B vaccination series; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident.

i. Any new requirements for mandatory education and/or competency reassessment, which occur during the contract period must be completed by the individual contractor employee(s) within established timeframes.

5. CREDENTIALING & PRIVILEGING

a. Credentials Requested: An application package will be provided by the Credentialing Coordinator and shall be completed by the provider(s)…