36C25222Q0014.docx

36C25221Q1104

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

36C25222Q0014 09-03-2021 Carol Felgenhauer, Contract Specialist 414-844-4893 09-10-2021 11:00

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

36C585 Department of Veterans Affairs Oscar G. Johnson VA Medical Center 325 East H Street

Iron Mountain MI 49801 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 Urgent Care Physician Services at Oscar G. Johnson VA Medical Center in accordance with specifications, terms and conditions contained within.

One

PATRICE R. BOND

Contracting Officer

Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

36C25221Q1104

Page 1 of Page 1 of

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. Contractor’s CPARS Point of Contact:

Name & Title: ____________________________________________________ Telephone Number: _______________________________________________ Email: __________________________________________________________

c. Government:

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, customer name, contract number, appropriate obligation/funding order number, description of services provided, provider name, number of hours worked 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. SUBCONTRACTORS: Any subcontractor utilized by the Contractor for the provision of services required under this contract must meet the same qualifications as specified herein for the Contractor. A subcontracting plan is required in accordance with Federal Acquisition Regulation 19. Any proposed subcontracting plan must be submitted. The VA’s current departmental goals are:

Owned Small Business Small Disadvantaged Business Women Owned Small Business Certified HUBZone Small Business Small Business

5. POST AWARD ORIENTATION: The Contracting Officer will schedule a post award orientation for contract orientation purposes.

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

[End of Contract Administration Data]

B.2 SCHEDULE OF SERVICES/PRICE

1. AUTHORITY: This procurement is being conducted under the authority of Title 38 U.S.C. 8153, Sharing of Healthcare Resources 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.

2. SERVICES: The contractor shall furnish all personnel to provide services necessary to perform on-site Urgent Care and Medical Officer of the Day (MOD) services at the Oscar G. Johnson VA Medical Center at 325 East H Street in Iron Mountain, Michigan (Iron Mountain VA). The Board Certified/Board Eligible physicians shall cover the range of physician services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards. The Contractor shall propose a minimum of five (5) key personnel to be credentialed and be available for scheduling to meet the requirements of the contract.

3. PLACE OF PERFORMANCE: Services shall be provided on-site at the Iron Mountain VA, 325 East H Street in Iron Mountain, Michigan 49801.

4. PERIOD OF PERFORMANCE: Three-year contract.

The resultant award will be a fixed price contract.

5. PRICING INSTRUCTIONS: Offerors are to provide firm-fixed pricing in accordance with the annual volumes of Line Item Numbers (LINs) listed below for each Ordering Period.

In accordance with FAR Part 13.5 Simplified Procedures for Certain Commercial Items, the Great Lakes Acquisition Center is seeking a contractor to provide contract services of Urgent Care Providers. As such, the Government will utilize simplified procedures for soliciting competition, evaluation, award documentation, and notification.

6. BASIS FOR AWARD: One award will be made to the offeror 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 (unit) price by LIN.

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

PRICE SCHEDULE

ORDERING YEAR ONE – November 1, 2021 THROUGH October 31, 2022

LIN

DESCRIPTION

UNIT

QTY

UNIT

PRICE

TOTAL

ORDERING YEAR TWO – November 1, 2022 THROUGH October 31, 2023

UNIT

QTY

UNIT

PRICE

TOTAL

ORDERING YEAR THREE – November 1, 2023 THROUGH October 31, 2024

UNIT

QTY

UNIT

PRICE

TOTAL

Total Contract Value of all Ordering Periods: $____________

[End of SCHEDULE OF SERVICES/PRICE]

B.3 STATEMENT OF WORK (SOW)

The Contractor shall provide the services of an Emergency Medicine/Urgent Care Group that can dedicate 5 physicians (maximum of 10) who are Board Certified/Board Eligible Urgent Care physicians who are within four years of completing their residency. As the Urgent Care (UC)/Medical Officer of the Day (MOD) at the Oscar G. Johnson VA Medical Center, the physicians will support the direct patient care needs of the Urgent Care Department. The MOD physician is responsible for the coverage of Urgent Care during the night tour, as well as coverage on the 17-bed inpatient floor, and the 40 bed Community Living Center (CLC) hospital unit for urgent needs.

The Iron Mountain VA is a Level 3 acuity facility:

1. Outpatient Surgery only

2. No Intensive Care Unit Care requiring Intervention (Surgery, MI, CVA, etc.) or Critical Care will be expediently transferred to a higher-level facility

3. No direct ambulance transports to the facility

4. The average daily census is 4.5 patients, capacity is 17 beds

5. Consultative services to the Community Living Center (Nursing Home) patients for acute issues is required

6. Services shall be provided to patients presenting to the Urgent Care Clinic where the average daily census is 12 per day, 1 of which is during the night shift. The Medical Officer of the Day will attend to all Code Blues, Rapid Responses, and other medical emergencies in the facility.

The duties and responsibilities of the providers include but are not limited to the following:

1. Evaluation and recommendation and/or institution of appropriate treatment for patients. The physician will be posted in the Urgent Care Department and provide evaluation and care for all patients who present there. Included in this service is the documentation of an evaluation with follow-up plans communicated, ordering indicated medications, laboratory tests, and procedures/studies and ordering and reviewing radiologic studies.

2. In case of cardiac or respiratory emergency, the physician will respond to the inpatient wards, ICU and the Community Living Center. All documentation will comply with standards set forth by the Department of Veterans Affairs through established directives, policies, and memorandums.

3. The provider shall obtain a medical history, physical examination, diagnosis, and initiate medical treatment.

4. The provider shall complete and work with the additional tools regarding medical care and treatment to include, but is not limited to: Message Manager, View Alert completion, clinical reminders, and various other communication tools utilized involving patient care or patient information.

5. The provider shall complete an Urgent Care Department progress note for each episode of care. All progress notes will be entered in CPRS the day the service is rendered with completion of the electronic encounter form containing the diagnosis of treated conditions, evaluation, and management code. Veteran’s with a Service Connection will require completion of this area based on the reason for the visit.

6. The provider shall document assessments and a plan of care for each patient in accordance with VA policies and procedures (links provided upon request).

The provider shall initiate and facilitate treatment and transfer of patients to other VA’s or outside facilities in emergent situations.

7. The provider shall refer patients as needed to appropriate specialists, health care facilities, and coordinate home health services. The provider shall complete the VA Community Care (VACC) as required for services being sent to other facilities as required. However, the provider cannot refer any patients to his/her own practice.

8. The provider shall act as consultant to other services regarding clinical practice and patient care needs. Providing guidance and making recommendations to outpatient providers, nurses and mid-levels regarding continuum of care and medical needs of the patient.

9. The provider shall collaborate with other disciplines to ensure continuity of patient care.

10. The provider shall collaborate with and act as a patient advocate.

11. The provider shall maintain knowledge of new and current clinical methods.

12. The provider shall work cooperatively with other VA providers, registered nurses, and a variety of allied health professionals to deliver comprehensive health care services.

15. The provider shall utilize the Electronic Document Information System (EDIS) board, which is software utilized to reduce documentation errors, increase revenue for hospitals, improve patient throughput and boos patient satisfaction scores.

[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. 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 three ordering periods with an estimated commencement date of November 1, 2021. The contractor shall perform no services after expiration of any performance period 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 Urgent Care Department is open 24/7/365.

3.1. WORK SCHEDULE: Urgent Care (UC)/Medical Officer of the Day (MOD) services are required 24/7 365 days a year.

The shifts are Sunday thru Saturday as follows:

UC: 7:00 a.m. to 7:00 p.m.

MOD: 7:00 p.m. to 7:00 a.m.

The work schedule includes weekends and holidays. A monthly schedule of coverage will be posted on the Iron Mountain SharePoint site.

3.2 FEDERAL HOLIDAYS: Contractor is required to provide services on Federal holidays.

The 11 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), Juneteenth Day (June 19th), 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 Contractor’s physicians assigned by the Contractor to perform the services covered by this contract shall have a current license(s) to practice medicine in any State, Territory, or Commonwealth of the United States (or the District of Columbia) when services are performed on-site on VA property.

b. All licenses held by the personnel working on this contract shall be full and unrestricted license(s). Contractor’s physicians who have current, full, and unrestricted license(s) in any State, Territory, or Commonwealth of the United States (or the District of Columbia), but who have, or ever had, license(s) restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending action, or denied upon application will not be considered for the purposes of this contract.

c. Personnel assigned by the contractor to perform the services covered by this contract shall have all certifications as required by law and this contract. Contract physicians shall be Board Certified in Emergency Medicine, Board Certified in Surgery, Medicine or Family Medicine as recognized by American Board of Medical Specialties (ABMS). The Contractor is responsible for keeping the VA Contracting Officer Representative (COR) apprised of anything that would adversely affect or otherwise limit their clinical privileges.

d. 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.

e. Personnel assigned by the contractor to perform the services necessary to fulfill the government’s requirements, including the ability to speak, understand, read, and write English (38 USC 7402).

f. Each Contract Physician providing services under this contract must have at least two (2) years’ experience in Acute Medicine providing the types of services required by this contract, should remain updated in the latest techniques.

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. Contractor’s assigned personnel shall be certified in Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS). Certifications must be obtained or issued by the American Heart Association (AHA), an organization recognized by the AHA, or Military Training Network (MTN) and maintained during their work at the VA.

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. Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by Contractor personnel as required by the VA.

i. The contracted individual 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.

· 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 & MASKING REQUIREMENTS

Due to the current pandemic, Contractor employees who enter VHA facilities shall follow current masking, vaccination and other guidance per the facility. Contractor employees may be screened for COVID-19, and if results are positive for COVID-19, they shall not be allowed to enter VHA facilities.

Contractor employees must be fully vaccinated and complete the Certification of Vaccination Form located at Vaccination Certification Form (NDHs and Visitors) (usaid.gov) regarding their vaccination status prior to performing services. The form must be kept with them while on federal premises and presented upon request. A Federal program will be established that will include weekly or twice weekly testing for not fully vaccinated on-site contractors.

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 three days 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/ACLS, 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: 585.

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 the contracted individual does not have a 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. During the first ninety (90) days of performance, 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, in writing, within 5 calendar days after the occurrence of any of these events and provide the information required by paragraph (b) below. After the initial 90-day period of the contract, the Contractor shall submit the information required by paragraph (b) to the Contracting Officer at least 15 days prior to making any permanent 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 and privileged 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 contract 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/vaccinations

· 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.552a (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 VA. The reporting instructions will be provided at time of award.

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 urgent care physician 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 licensure/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, patient satisfaction, Ongoing Provider Performance Evaluation (OPPE), Qualifications of Key Personnel, Licensing/Registration/Certification, Response Times, Punctuality, Patient Safety Incidents, Mandatory Training/Privacy/ Confidentiality and HIPAA, Clinical Information Return, Documentation/Timesheet.

Reporting Adverse Events: The contractor shall have an established program to monitor 100% of adverse events (including patient injury or death, 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 perfusion 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.

f. These measures, standards, and monitoring procedures are illustrated in the following Performance Requirements Summary Matrix:

Direct Observation and periodic inspection

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 offeror’s response to the RFQ using the subject attachment in Section D of the solicitation document.

20. REQUIRED REGISTRATION WITH CONTRACTOR PERFORMANCE ASSESSMENT SYSTEM (CPARS)

a. As prescribed in Federal Acquisition Regulation (FAR) Part 42.15, the Department of Veterans Affairs (VA) evaluates contractor past performance on all contracts that exceed the thresholds outlined in FAR Part 42.15, and shares those evaluations with other Federal Government contract specialists and procurement officials. The FAR requires that the contractor be provided an opportunity to comment on past performance evaluations prior to the posting of each report. To fulfill this requirement VA uses an online database, the Contractor Performance Assessment Reporting System (CPARS), which is available to all Federal agencies.

b. Each contractor whose contract award is estimated to exceed the thresholds outlined in FAR Part 42.15 is required to provide to the contracting officer contact information for the contractor’s representative with their response to the solicitation. The contractor is responsible to notify the contracting officer of any change to the contractor’s representative during the contract performance period. Contractor’s representative contact information consists of a name and email address.

c. The Government will register the contract within thirty days after contract award.