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36C25221Q0532

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

36C25221Q0532 04-06 -2021 Antanette Shellaugh, Contract Specialist 414-844-4814 04- -2021 Noon

CDT

36C252 Department of Veterans Affairs Great Lakes Acquisition Center (GLAC) 115 S 84th Street, Suite 101 Milwaukee WI 53214-1476 X 561320 $30 Million N/A X 36C607 Department of Veterans Affairs William S. Middleton Memorial Veteran Affairs Hospital 2500 Overlook Terrace Madison WI 53705-2254 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 The William S. Middleton VA Hospital is seeking two (2) Certified Surgical Technologist in accordance with specifications, terms, conditions, and pricing contained herein.

38 U.S.C. 513 This is a full and open competitive requirement.

X X one Susan Shirey Table of Contents

SECTION A – SF 14491
SECTION B - CONTINUATION OF SF 1449 BLOCKS3
B.1 CONTRACT ADMINISTRATION DATA3
B.2 SCHEDULE OF SERVICES/PRICE5
B.3 STATEMENT OF WORK9
B.4 SPECIAL CONTRACT REQUIREMENTS10
B.5 CONTRACT SECURITY REQUIREMENTS21
SECTION C - CONTRACT CLAUSES31
C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (OCT 2018)31
C.2 52.204-9 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR PERSONNEL (JAN 2011)37
C.3 52.204-13 SYSTEM FOR AWARD MANAGEMENT MAINTENANCE (OCT 2018)37
C.4 52.204-18 COMMERCIAL AND GOVERNMENT ENTITY CODE MAINTENANCE (AUG 2020)39
C.5 52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR INFORMATION SYSTEMS (JUN 2016)40
C.6 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)42
C.7 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)42
C.8 52.224-1 PRIVACY ACT NOTIFICATION (APR 1984)42
C.9 52.224-2 PRIVACY ACT (APR 1984)42
C.10 52.227-14 RIGHTS IN DATA—GENERAL (MAY 2014)43
C.11 SUPPLEMENTAL INSURANCE REQUIREMENTS48
C.12 52.232-40 PROVIDING ACCELERATED PAYMENTS TO SMALL BUSINESS SUBCONTRACTORS (DEC 2013)49
C.13 VAAR 852.204-70 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR PERSONNEL (MAY 2020)49
C.14 VAAR 852.212-70 PROVISIONS AND CLAUSES APPLICABLE TO VA ACQUISITION OF COMMERCIAL ITEMS (APR 2020)49
C.15 VAAR 852.237-72 CRIME CONTROL ACT—REPORTING OF CHILD ABUSE (OCT 2019)51
C.16 VAAR 852.237-75 KEY PERSONNEL (OCT 2019)52
C.17 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (JAN 2021)52
SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS60
SECTION E - SOLICITATION PROVISIONS61
E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS (JUN 2020)61
E.2 52.204-7 SYSTEM FOR AWARD MANAGEMENT (OCT 2018)66
E.3 52.204-16 COMMERCIAL AND GOVERNMENT ENTITY CODE REPORTING (AUG 2020)67
E.4 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (OCT 2020)68
E.5 52.212-2 EVALUATION—COMMERCIAL ITEMS (OCT 2014)71
E.6 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL ITEMS (FEB 2021)72

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. CONTRACT ADMINISTRATION MATTERS WILL BE HANDLED BY:

a. Contractor’s Name/Address/City-State-Zip (please print or type):

Point of Contact/Title: _________________________________________ Telephone Number:

Fax Number:

Email:

Dun & Bradstreet Number:

Federal Taxpayer Identification Number:

b. Government:

Susan Shirey
Antanette Shellaugh
Contracting Officer
Contract Specialist
Office Phone (414) 844-4875 Susan.Shirey@va.gov
Office Phone: (414) 844-4814 Antanette.Shellaugh@va.gov

Department of Veterans Affairs Great Lakes Acquisition Center 115 S. 84th Street, Suite 101 Milwaukee, WI 53214-1476 Fax: (414) 844-4891

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:

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 submissions 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 VA.Registration@tungsten-network.com or calling 1-877-752- 0900 for Enrollment.

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://authentication.tungsten-network.com/login. For questions regarding the submission of VA electronic invoices, Tungsten Corporation customer service may be contacted at 1-877-489-6135.

All invoices shall reference the vendor name and address, VA facility name, contract number, appropriate obligation/funding order number, description of services provided, provider name, number of hours worked, unit price (hourly rate) and the total cost. Invoices shall also include any payment discount terms.

For questions regarding invoice receipt or payment, please call VAFSC directly at 1-877-353- 9791.

4. POST AWARD ORIENTATION: The Contracting Officer will schedule a post award orientation for contract orientation purposes as required by Procurement Policy Memorandum (PPM) 2019- 01.

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

AMENDMENT NO
DATE

[End of Contract Administration Data]

Page 1 of

Page 1 of Page 1 of

B.2 SCHEDULE OF SERVICES/PRICE

AUTHORITY: Under the authority of 38 USC 513, Contracts and Personal Services and pursuant to FAR 13.5 – Simplified Procedures for Certain Commercial Items. The VA will utilize simplified procedures for soliciting competition, evaluation, award documentation, and notification.

PURPOSE: The Great Lakes Acquisition Center is seeking contract services for two (2) Surgical Technologist. All services at the William S. Middleton Memorial Veterans Hospital located at 2500 Overlook Terrace, Madison, Wisconsin 53705. This procurement is available to all contractors.

BASIS FOR AWARD: Award will be made to the offeror(s) whose quote represents the best value to the Government considering price and non-price factors as listed in clause 52.212-2 Evaluation-Commercial Items. Contract will be firm-fixed price by Line Item Numbers (LIN).

The Government may award on the basis of initial quotes received, without discussions. Therefore, each initial quote should contain the offeror’s best terms from a cost/price and technical standpoint. Instructions to offerors on price and technical quotes submissions are found under Solicitation Section E.1 52.212-1, ADDENDUM TO FAR 52.212-1 – INSTRUCTIONS TO OFFERORS – COMMERCIAL ITEMS.

The NAICS Code for this solicitation is 561320. In order to be considered a small business under this NAICS Code, your average annual receipts must not exceed $30M.

PRICE SCHEDULE

a. BASE PERIOD – FROM DATE OF AWARD FOR SIX MONTHS

LIN

DESCRIPTION

UNIT

ESTIMATED QTY
UNIT PRICE
ESTIMATED

TOTAL

Surgical Technologist Services
Hour
1920
0001
Surgical Technologist

Name:

Hour
960
$
$
0002
Surgical Technologist

Name:

Hour
960
$
$

Surgical Technologist On-Call Services (Weekdays)

Hour
768
0003
Surgical Technologist On-Call Weekdays

Name:

Hour
384
$
$
0004
Surgical Technologist On-Call Weekdays

Name:

Hour
384
$
$

Surgical Technologist On-Call Services (Weeknights)

Hour
768
0005
Surgical Technologist On-Call Weeknights

Name:

Hour
384
$
$
0006
Surgical Technologist On-Call Weeknights

Name:

Hour
384
$
$
Surgical Technologist Overtime
Hour
120
0007
Surgical Technologist Overtime

Name:

Hour
60
$
$
0008
Surgical Technologist Overtime

Name:

Hour
60
$
$

Estimated Total Base Period:

Page 1 of

b. OPTION PERIOD 1 – THREE MONTHS AFTER BASE PERIOD EXPIRATION

CLIN

DESCRIPTION

UNIT

ESTIMATED QTY
UNIT PRICE
ESTIMATED

TOTAL

Surgical Technologist Services
Hour
960
0009
Surgical Technologist

Name:

Hour
480
$
$
0010
Surgical Technologist

Name:

Hour
480
$
$

Surgical Technologist

Hour
384
0011
Surgical Technologist On-Call Weekdays

Name:

Hour
192
$
$
0012
Surgical Technologist On-Call Weekdays

Name:

Hour
192
$
$

Surgical Technologist

Hour
384
0013
Surgical Technologist On-Call Weeknights

Name:

Hour
192
$
$
0014
Surgical Technologist On-Call Weeknights

Name:

Hour
192
$
$
Surgical Technologist Overtime
Hour
60
0015
Surgical Technologist Overtime

Name:

Hour
30
$
$
0016
Surgical Technologist Overtime

Name:

Hour
30
$
$

Estimated Total Option Period 1:

c. OPTION PERIOD 2 – THREE MONTHS AFTER OPTION PERIOD 1 EXPIRATION

CLIN

DESCRIPTION

UNIT

ESTIMATED

QTY

UNIT PRICE
ESTIMATED TOTAL
Surgical Technologist Services
Hour
960
0017
Surgical Technologist

Name:

Hour
480
$
$
0018
Surgical Technologist

Name:

Hour
480
$
$

Surgical Technologist

Hour
384
0019
Surgical Technologist On-Call Weekdays

Name:

Hour
192
$
$
0020
Surgical Technologist On-Call Weekdays

Name:

Hour
192
$
$

Surgical Technologist

Hour
384
0021
Surgical Technologist On-Call Weeknights

Name:

Hour
192
0022
Surgical Technologist On-Call Weeknights

Name:

Hour
192
Surgical Technologist Overtime
Hour
60
0023
Surgical Technologist Overtime

Name:

Hour
30
$
$
0024
Surgical Technologist Overtime

Name:

Hour
30
$
$

Estimated Total Option Period 2:

d. TOTAL ESTIMATED CONTRACT PRICE FOR THE BASE + OPTIONS: NOTE: Contractor must provide a complete price schedule.

[End of B.2] Page 1 of Page 1 of Page 1 of Page 1 of

B.3 STATEMENT OF WORK

Contractor shall provide the services of two (2) experienced Surgical Technologists to support the needs at the William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, Wisconsin 53705. The Surgical Technologists (STs) will be under the direction of surgeons, registered nurses, or other surgical personnel, but will be required to work independently at certain tasks, as specified below. The following include some, but not all, of the job duties an ST will be required to perform.

a) Assist in preparation of the operating room by setting up surgical instruments and equipment, sterile drapes, and sterile solutions.

b) Independently assemble both sterile and non-sterile equipment, as well as adjust and check it to ensure it is working properly.

c) Assist in positioning patients on the operating table and cover them with sterile surgical drapes.

d) Assist the surgical team with putting on their sterile gowns and gloves, as well as passing instruments and other sterile supplies to surgeons and surgeon assistants during surgery.

e) Assist in transferring patients to the recovery room and to clean and restock the operating room after surgery.

f) Independently perform the following tasks properly: collect, decontaminate, process, and prepare reusable medical equipment.

g) Have the skills and knowledge, including understanding the importance of accuracy, in order to independently perform the following tasks properly: collect specimens at the sterile field and hand off the specimen to the circulating RN.

h) Independently able to function as a Surgical Technologist, preferably in all the following areas: PV, General Surgery, Neurosurgery, ENT, GU, Ortho, Cardiac, and Thoracic cases.

[End of Statement of Work]

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 services 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 Statement of Work. 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 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 the VA facility (copies and/or links will be provided upon request). In all cases, dignity of the patient shall be given the highest regard and the precepts of the American Hospital Association’s “Bill of Rights for Patients” 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 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.

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

2. TERM OF CONTRACT

This contract is effective for an estimated period of the date of award for six months, including any exercised options. The contractor shall perform no services after expiration of the base period/year or any option period unless and until the Contracting Officer authorizes such services in writing.

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. BUSINESS HOURS

The Operating Room may be utilized 24/7/365

3.1. WORK SCHEDULE

Work schedule will consist of 40 hours per week, 8 hours per day, Monday through Friday with the optional hours of: 6:00 a.m. - 2:30 p.m., 6:45 a.m. - 3:15 p.m. or 9:00 a.m. - 5:30 p.m. or some combination. When possible, STs will be scheduled the same shift for a week at a time. The STs will be scheduled for weekend On-call every 4th to 6th weekend, 3:30 p.m. on Friday through 7:00 a.m. on Monday; weeknight On-call is one per week, 3:30 p.m. – 7:00 a.m. Overtime may be required occasionally. The work schedule hours will begin no earlier than 6:00 a.m. and no later than 7:30 p.m., Monday through Friday, with a ½ hour unpaid lunch break when at least 5 hours will be worked in a day.

3.2 FEDERAL HOLIDAYS

Surgical Technologists could be scheduled to provide weekend on call 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.

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. The Surgical Technologist must be a graduate of an accredited Surgical Technologist Program recognized and accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or the Accrediting Bureau of Health Education Schools (ABHES).

b. The Surgical Technologist shall possess a current Basic Life Support (BLS) certification and maintain it for the duration of the contract.

c. The Surgical Technologist must have a minimum of 12 months of experience as a surgical technologist within the last 3 years.

d. Operating Room experience with hearts, robotic, neuro and peripheral vascular in the last 90 days is preferred.

e. The qualifications of each Surgical Technologist (ST) shall be subject to review by the VA Chief of Staff and approved by the VA Facility Director. 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. Personnel assigned by the contractor to perform the services covered by this contract shall be proficient in written and spoken English (38 USC 7402).

g. Contractor’s assigned personnel must be computer literate as patient documentation is directly inputted in the patient’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.

h. 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.

i. The contract employee(s) will be required to show two proofs of identification on their first day of work. Acceptable proof of identification is 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 Dept of State

j. 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 TB Blood Test (also called interferon-gamma release assays (IGRA)) for all Contractor employees as a baseline. Two TB blood tests are approved by the FDA: the QuantiFERON – TB Gold In-Tube test (QFT-GIT) and the T-SPOT TB test (T-Spot). Subsequent testing is not required, unless the contractor employee has been exposed to someone with TB.

· MEASLES, MUMPS, & RUBELLA TESTING: Contractors shall provide proof of immunity for all Contractor employees, i.e. at least 2 doses of vaccine are required or serologic evidence of immunity.

· VARICELLA: Contractors shall provide proof of immunity for all Contractor employees, i.e. at least 2 doses of vaccine are required or serologic evidence of immunity.

· TDAP (TETNUS/DIPTHERIA/PERTUSSIS): Contractors shall provide proof of 1 dose of Tdap vaccination for all Contractor employees. Boosters are required every 10 years.

· 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 throughout the Influenza season in any VHA location, including both clinical and non-clinical areas. In additional the mask shall be worn during performance of their assigned duties and responsibilities. Contract employees in violation of this requirement may be removed from the providing services under the contract/task order.

MASKING FOR UNVACCINATED CONTRACT EMPLOYEE:

Contract employees may remove the face mask only under the following circumstances:

1. When eating or drinking (excluding elevators, hallways or common areas).

2. When working in an enclosed office alone.

3. When there are physical barriers or at least six feet of distance between the unvaccinated contract employee and any other contract employee, VA health care provider, patient; or other person; for example, when working in a cubicle with its open side at least six feet from anyone else.

4. After exiting the VHA facilities provided that at least six feet of distance between the unvaccinated contract employee and any other contract employee, VA health care provider, patient, or other person can be maintained.

· HEPATITIS B: 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 (3 doses required) plus a serologic titer (1-2 months after final dose) to document immunity 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.

· SPECIAL NOTICE: COVID-19 Due to the current pandemic, Contractor employees entering VHA facilities shall wear a mask (either personal or facility issued). Masks must be worn in all public and patient care areas throughout the Madison VA Hospital.

Contractor employees will be screened for COVID-19, which, at a minimum, should include:

· Fever (in accordance with CDC or facility guidelines)

· New or worsening cough or difficulty breathing

· New symptoms of COVID-19, available at: https://www.cdc.gov/coronavirus/2019- ncov/symptoms-testing/symptoms.html Contractor’s employees screening positive shall not be allowed to enter VHA facilities.

5. CREDENTIALING

a. Credentials Requested: An application package will be provided by the Credentialing Coordinator and shall be completed by the provider(s) working under this contract and returned within two weeks of receiving the application package. This includes: Facility- specific paperwork, curriculum vitae/resume, current references, signed release of information from candidate, licenses or certifications, CPR/BLS, competencies, statement that candidate does not have any physical or mental health conditions that would adversely affect his/her ability to carry out assigned duties, and any additional credentialing and privileging forms.

Candidate will also be required to complete an application through the VetPro Internet process within two weeks of being enrolled in VetPro. Candidate will need to be enrolled in VetPro by VA personnel. The website address is: https://fcp.vetpro.org. Facility ID number is as follows: 607.

b. National Provider Identifier (NPI): Prior to starting work, the contracted individual or contractor must provide the VA with the contracted individual's National Provider Identifier (NPI) number, if NPI numbers are applicable to Surgical Technologists. If so, and the contracted individual does not have an NPI number he/she must make application and receive the number prior to beginning work at the VA. The website for an on-line application is: https://nppes.cms.hhs.gov/NPPES/Welcome.do. It may take up to a few weeks to receive the NPI number - so early application is advised. NPI number is required as part of the VetPro application.

c. In accordance with the requirements and procedures of the Health Care Quality Improvement Act of 1986 – title IV (Public Law 99-660), which established the National Practitioners Data Bank (NPDB), the facility director will ensure that all individuals who hold clinical privileges are properly screened through the NPDB.

6. APPROVAL OF CONTRACTOR PERSONNEL

The VA reserves the right to refuse acceptance of any contractor employee or subcontractor employee under this contract when that individual does not qualify under the requirements of VHA Handbook 1100.19 (https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910) and/or the specific VA Hospital/Medical Center Policy on Credentialing and Privileging or fails to perform at the proficiency level expected by the VA Facility Director.

In addition, VA reserves the right to restrict the services or require dismissal of any contractor employee or subcontractor employee under this contract if personal or professional conduct jeopardizes patient care. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, physical or verbal abuse, or other conduct resulting in formal complaints by the patient(s). Standards of conduct shall mirror those prescribed by current federal personnel regulations. The Contracting Officer and the Contracting Officer’s Representative (COR) shall deal with issues raised concerning contract personnel’s conduct. The final decision maker on questions of acceptability is the Contracting Officer.

7. KEY PERSONNEL & PERSONNEL SUBSTITUTIONS

a. The Contractor shall make NO changes of key personnel unless the change is necessitated by the individual’s illness, death, or termination of employment or if mutually agreed upon by the Contracting Officer and the contractor. The Contractor shall notify the Contracting Officer as soon as feasible and must follow-up with notification in writing within 5 calendar days after the occurrence of any of these events and provide the information required by paragraph (b) below. For substitutions, the Contractor shall submit the information required by paragraph (b) to the Contracting Officer at least 15 days prior to making any permanent or temporary substitutions. The Contracting Officer must approve all substitutions.

b. 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 Contracting Officer. Proposed substitutes shall have comparable qualifications to those of the persons being replaced. The Contracting Officer will notify the Contractor within 15 days after receipt of all required information of the decision on the proposed substitutes. The contract will be modified to reflect any approved changes of key personnel.

c. Prior to rendering services, substitutes must be credentialed by the medical facility and obtain a medical staff appointment, in accordance with VA Bylaws, Rules and Regulations.

8. HHS/OIG

To ensure that the individuals providing services under the contract have not engaged in fraud or abuse regarding Sections 1128 and 1128A of the Social Security Act regarding federal health care programs, the contractor is required to check the Health and Human Services - Office of Inspector General (HHS/OIG), List of Excluded Individuals/Entities on the OIG Website (https://exclusions.oig.hhs.gov/) for each person providing services under this contract. 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. During the performance of this contract the contractor is prohibited from using any individual or business listed on the List of Excluded Individuals/Entities. Any healthcare provider or entity that employ or enter into contracts with excluded individuals or entities may have a Civil Monetary Penalty (CMP) imposed against them. By signing this offer, the Contractor certifies that all persons or entities listed in the contractor’s proposal have been compared against the OIG list and are NOT listed as of the date the offer was signed.

9. JOINT COMMISSION STANDARDS

Although Joint Commission accreditation is not required, the contractor shall perform the required work in compliance with Joint Commission Standards. A copy of these standards may be obtained from the Joint Commission on Accreditation of Healthcare Organizations, One Renaissance Blvd., Oakbrook Terrace, IL 60181.

The Contractor will be responsible to ensure the contractor employees or subcontractors providing work on this contract are fully trained and completely competent to perform the required work. Contractor will gather all credentialing documents requested by the VA as well as any other documentation that the carrying out of this contract may require. However, the contractor is neither able to nor is the contractor required to make clinical competence determinations on behalf of the VA.

10. PERSONNEL POLICY

a. The contractor shall be responsible for protecting the personnel furnishing services under this contract. To carry out this responsibility, to the extent required by law, the contractor shall provide the following for these personnel:

· Workers’ compensation

· Professional liability insurance

· Health examinations/immunizations

· Income tax withholding, and

· Social security payments.

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

c. The VA shall notify the Contractor of any significant communicable disease exposure as appropriate. The Contractor shall adhere to current CDC/HICPAC Guidelines for Infection Control in health care personnel (AIJC 1998: 26:2890354) for disease control. The Contractor shall provide follow up documentation of clearance to return to the workplace prior to contractor’s or subcontractor’s employee(s) return.

11. RECORD KEEPING SYSTEM - CONTRACTOR

Contractor must establish a record keeping system of contractor hours worked.

12. MEDICAL RECORDS

Clinical or other medical records of VA veteran patients treated by Contractor under this contract are VA records.

13. CONFIDENTIALITY OF PATIENT RECORDS

a. The contractor, as a VA provider, will 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 is considered to be a VA provider for purposes of the Privacy Act, Title 5 U.S.C. 552a. Further, for the purpose of VA records access and patient confidentiality, contractor is considered to be a VA contractor for the following provisions: Title 38 U.S.C. 5701, 5705, and 7362. Therefore, contractor 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.

b. The 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 (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, or their designated representatives, and designated representatives of federal regulatory agencies having jurisdiction over contractor, may have access to VA ‘s records, at VA’s place of business on request during normal business hours, to inspect and review and make copies of such records.

14. HIPAA COMPLIANCE

Contractor must adhere to the provisions of Public Law 104-191, Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the National Standards to Protect the Privacy and Security of Protected Health Information (PHI). As required by HIPAA, the Department of Health and Human Services (HHS) has promulgated rules governing the security and use and disclosure of protected health information by covered entities, including the Department of Veterans Affairs (VA). Contractor is conducting health care services on the VA’s behalf – therefore, no BAA is required.

15. DESIGNATION OF CONTRACT REPRESENTATIVE

Name and contact information for the Contracting Officer’s Representative (COR) designated to represent the Contracting Officer will be provided at the time of contract award. The COR will furnish technical guidance and advice regarding the work being performed under this contract. The foregoing is not to be construed as authorization to interpret or furnish advice and information to the Contractor relative to the financial or legal aspects of the contract. Enforcement of these segments is vested in and is the responsibility of the Contracting Officer. The extent and limitations of this designation will be provided in the COR Delegation Memo.

16. CONTRACT PERFORMANCE MONITORING

a. Contractor's employee(s) shall report to the COR or designee, upon arrival at the Madison VA Hospital. Operating Room D7200, telephone number (608) 256-1901 extension 17929.

b. Monitoring of contractor’s performance shall be demonstrated through clinical and administrative record reviews. COR will be responsible for verifying contract compliance. COR will designate appropriate VA personnel to monitor services through one or a combination of the following mechanisms:

1. Departments being served will monitor Contractor performance to ensure that services called for in the contract have been received by VA in a timely manner. The COR will be responsible for verifying contract compliance. Any incidents of Contractor noncompliance as evidenced by the monitoring procedures will be forwarded immediately to the Contracting Officer.

2. Documentation of services performed will be reviewed prior to certifying payment. The COR will perform periodic spot checks and document with the using service to ensure records are properly monitored. VA will pay only for services actually provided, and in strict accordance with the Price Schedule. Contract monitoring and recordkeeping procedures will be sufficient to ensure proper payment and allow audit verification that services were provided.

3. Chief of Staff's office reviews monitoring data. An internal time-keeping form is maintained and reviewed for total number of hours worked per month.

4. The using service, through the COR, will provide a written statement annually to the Contracting Officer to include a summary of Contractor actions and a statement that all requirements of the contract have been fulfilled as agreed. This summary evaluation will be submitted 20 days prior to expiration of contract (and/or prior to election of option year renewals, if applicable).

c. Contractor's employee(s) may not certify bills for payment.

17. QUALITY ASSURANCE MONITORING

a. Contractor shall maintain a Quality Control Program related to the Surgical Technologists services covered under this contract. The results of all Quality Improvement activities performed by the Contractor involving VA patients will be shared with facility staff. This will include, but not be limited to, quality improvement plans, minutes of staff meetings where quality improvement has been discussed and which include practitioner-specific findings, conclusions, recommendations, written plans for actions taken in response to such conclusions and recommendations, and evaluation of those actions taken. Monitors should reflect at a minimum, issues related to quality care and appropriateness of referral.

b. Copies of provider certification are also required to be submitted annually to the COR. In addition, updated Joint Commission survey results for the contractor, if Joint Commission certified, shall be forwarded to the COR upon receipt.

c. The contractor will meet or communicate with the facility staff for process review and improvement of contract performance on an as needed basis.

d. Quality factors that VA may consider when monitoring quality of care may include, but are not limited to: patient medical records, availability of contract staff, security/privacy, and patient satisfaction. These monitoring procedures are further illustrated in the following Performance Requirements Matrix:

PERFORMANCE OBJECTIVE
PERFORMANCE STANDARD
ACCEPTABLE QUALITY LEVEL (AQL)
MONITORING METHOD
INCENTIVES
Invoicing
Properly prepared invoice will be submitted within 10 days of the beginning of the new month
95%
Inspection
Favorable contractor performance evaluation
Annual Training
Key Personnel completes all mandatory training timely
95%
TMS monitoring program
Favorable contractor performance evaluation
Maintain licensing, registration, and certifications
Updated licensing, registration and certification will be provided as they are renewed, (i.e., BLS)
97%
Periodic sampling and random sampling
Favorable contractor performance evaluation

e. Reporting Adverse Events: The contractor shall have an established program to monitor 100% of adverse events (including patient injury or death, medication errors, drug reactions, or unusual situations in which the patient may be involved) associated with care of VA patients. The contractor shall collect and report the program information on a quarterly basis. The contractor shall notify the VA of adverse events (as defined above) involving VA patients during primary care services. The VA may review specific findings, conclusions, recommendations, written plans for corrective action taken in response to conclusions and recommendations and evaluation for those corrective actions.

18. PROHIBITION OF CONTRACT PERFORMANCE OUTSIDE THE U.S.

The entire performance of the contract shall be within the borders of the United States of America, the District of Columbia and/or Puerto Rico. The Contractor shall not access any VA data/information (for example, by remote computer access) from locations that are outside the above-stated borders.

Furthermore, the Contractor shall not send, transfer, mail or otherwise transmit any VA data/information to locations outside the above-stated borders.

19. CONTRACTOR CERTIFICATION: CITIZENSHIP RELATED REQUIREMENTS:

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.

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.

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.

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.

The Contractor agrees to obtain a similar certification from its subcontractors. The certification shall be made as part of the offerors response to the RFQ using the subject attachment in Section D of the solicitation document.

20. PAYMENT

a. Contractor’s employees must be present at the VA facility and must be actually performing the required services for the period specified within the contract or the contract cost will be decreased accordingly during each billing cycle. Contract providers shall be responsible for reporting time worked accurately. The Contractor shall be paid for actual hours performed. In the event that the Contract provider works a portion of an hour, the government will adjust payments by 15-minute increments.

b. The VA agrees to reimburse the contractor for services performed, minus any deductions, monthly in arrears, upon receipt of a properly prepared invoice submitted by the contractor. Payments made by the VA under this contract shall constitute the total cost of services provided by the contractor. The contractor hereby agrees; that in no event, shall contractor bill, charge, collect a deposit from, seek compensation, remuneration, or reimbursement from, or have any recourse against the beneficiary, the beneficiary’s family, private insurer, Medicare or any other entity acting on the beneficiary’s behalf, for services provided pursuant to this contract. Billings rendered by the contractor to the VA for services furnished a VA beneficiary under the terms of this contract shall be billings in full. This provision shall survive the termination or ending of the contract.

c. The payment for any leave, to include sick leave, annual leave, administrative leave, and holidays, are the responsibility of the Contractor.

[End of Special Contract Requirements]

B.5 CONTRACT SECURITY REQUIREMENTS

1. GENERAL

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

2. CONTRACTOR PERSONNEL SECURITY REQUIREMENTS

Failure to comply with the contractor personnel security requirements may result in termination of the contract for default.

SAC

All Contractor Employees who require access to the Department of Veterans Affairs computer systems or who have access to sensitive information shall be required to have, at a minimum, a Special Agreement Check (SAC) which includes electronic fingerprinting. A Contractor Employee shall not perform any contract work (except for any other required orientation and training that does not require access to a VA computer system) until fingerprinting is completed by the local Human Resource Management Service. Fingerprinting should take place on the first day that a Contractor Employee enters on duty. The Contracting Officer’s Representative shall facilitate the SAC process for the Contractor and Contractor Employee.

If the SAC identifies “potentially actionable issues” in connection with a Contractor Employee and it is determined that the Contractor Employee needs to be removed, the Contracting Officer shall notify the Contractor and the Contractor shall immediately remove that Employee from contract work. The removal of the Employee shall not excuse any failure to meet contract requirements.

SACs and fingerprinting of Contractor Employees may be required even when an Employee will not be working on-site at a VA Facility. The Contracting Officer can identify other options for accomplishing these SACs.

The current FY20 fees associated with Special Agreement Checks are $18.00 each.

NACI

All contractor employees who require access to the Department of Veterans Affairs' computer systems or have access to sensitive information shall be the subject of a background investigation. The VA obtains the Background Investigation through the Electronic Questionnaires for Investigations Process (e-QIP). Upon receiving a request for the investigation from the Contracting Officer, the contractor’s employee will be initiated into e-QIP for the Background Investigation followed by an e-mail with instructions to log into e-QIP. A contractor’s employee shall not commence working at VA under contract until the Contracting Officer receives notification from the VA Office of Security and Law Enforcement that the contract employee’s application was received complete. A favorable adjudication from the VA Office of Security and Law Enforcement must be received in order for a contractor employee to continue contract performance. This requirement is applicable to all subcontractor personnel.

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 contractor shall bear the expense of obtaining background investigations. If the Office of Personnel Management (OPM) conducts the investigation, the contractor shall reimburse VA within 30 days. If timely payment is not made within 30 days from date of bill for collection, then VA shall deduct the cost incurred from the contractors 1st month’s invoice(s) for services rendered.

(2) It is imperative for the contractor to provide, at the request of VA, a listing of contractor personnel performing services under the contract in order for the background investigation process to commence. This list will include name (first, middle, last) social security number; date of birth; city, state, and country of birth.

(3) The contractor or their employees shall submit a complete background investigation packet through the Electronic Questionnaires for Investigations Process (e-QIP). Additional guidance and information will be provided through e-mail from the VA Office of Security and Law Enforcement.

(4) The following required forms must be submitted through the e-QIP system to the VA Office of Security and Law Enforcement before contract performance begins:

(i) e-QIP Signature Pages (two) (print, sign and submit)

(ii) Optional Form 306, Declaration for Federal Employment

(iii) Electronic…

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