36C25519Q0237-001.docx

36C25519Q0237

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

36C25519Q0237 08-23-2019 Donahue-MacDonald, Colleen, Contracting 913-946-1123 09-30-2019 36C255 Colleen Donahue-MacDonald Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway Leavenworth KS 66048 X X 621399 $7.5 Million N/A X Kansas City Veterans Administration Medical Center 4801 Linwood Blvd Kansas City, MO 64128

36C255 Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway Leavenworth KS 66048

36C255 Department of Veterans Affairs Financial Services Center http://www.fsc.va.gov/einvoice.asp Austin TX 877-353-9791 512-460-5429 This solicitation is issued under the authority of title 38 U.S.C. 8153 for non-personal nursing services for the Kansas City VA Medical Center (

KCVAMC

), 4801 Linwood Blvd., Kansas City, MO 64128. The purpose of this solicitation is to establish an Indefinite Delivery/Indefinite Quantity (IDIQ) Contract. The period of performance: Base Year plus four (4) one (1) year option periods, if authorized by the Contracting Officer.

X X X Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

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

a. CONTRACTOR (Offerors are required to designate a person for prompt administration):

Name of Company:

Name:

Title:

Address:

Fax No.: _ DUNS Number: ________________________________

b. GOVERNMENT: Contracting Officer:

John W. Pratt Contract Specialist:

Colleen Donahue-MacDonald

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

[] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

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

Department of Veterans Affairs Financial Services Center http://www.fsc.va.gov/einvoice.asp Austin TX

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

AMENDMENT NO DATE

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

6. POST-AWARD ORIENTATION (Contract Awards Exceeding $1M): The Contracting Officer will schedule a post-award orientation conference for contract orientation purposes as required by Procurement Policy Memorandum (PPM) (https://www.va.gov/oal/docs/business/pps/ppm201901.pdf).

7. SUBCONTRACTING PLAN--MONITORING AND COMPLIANCE (JUN 2011)

This solicitation includes FAR 52.219-9, Small Business Subcontracting Plan, and VAAR 852.219-9, VA Small Business Subcontracting Plan Minimum Requirement. Accordingly, any contract resulting from this solicitation will include these clauses. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) to assist in assessing the contractor's compliance with the plan, including reviewing the contractor's accomplishments in achieving the subcontracting goals in the plan. To that end, the support contractor(s) may require access to the contractor's business records or other proprietary data to review such business records regarding the contractor's compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor compliance with the subcontracting plan.

B.2 PRICE/COST SCHEDULE

SCHEDULE OF SERVICES

The Contractor shall furnish all personnel to provide services necessary to perform on-site Nursing Services to eligible beneficiaries of the Kansas City, Department of Veterans Affairs Medical Center (VAMC), Kansas City, MO (hereinafter referred to as KCVAMC).

Contract type is Firm Fixed Price, Indefinite Delivery Indefinite Quantity. Contractor shall price base and option years(s) the same. Contractor will only be compensated for services that are actually performed.

Pricing Instructions:

The offeror is instructed to edit the number of sub- CLINs to correspond with the number of services/key personnel submitted for the contract line item number (CLIN). Offerors shall include the “title” of the personnel submitted. Other commercial health care Offerors shall identify by title/position or level of experience the key personnel submitted. Also, renumber SUB-CLINs if adding or removing Key Personnel.

The offeror is instructed to include all other than price and cost information supporting the proposed price as directed in Instructions to Offerors addendum to 52.212-1 and/or Section D- Contract Documents, Exhibits, or attachments, VA Directive 1663 Appendix B. The Contractor shall propose a minimum of one (2) key personnel to be credentialed and be available for scheduling (back up service when needed) to meet the requirements of the contract. One FTE is defined by VA as a minimum of 80 hours every two weeks and does not include holidays.

Estimated Period of Performance: BASE YEAR: MM DD, 2019 to MM DD, 2020

0001B

Registered Nurse – Emergency Room

0001C

Registered Nurse – Mental Health

0001D

Registered Nurse - Operating Room

Estimated Period of Performance: Option Year 1: MM DD, 2020 to MM DD, 2021

1001B

Registered Nurse – Emergency Room

1001C

Registered Nurse – Mental Health

1001D

Registered Nurse - Operating Room

Licensed Practical/Vocation Nurses (LP/VN)

Estimated Period of Performance: Option Year 2: MM DD, 2021 to MM DD, 2022

2001B

Registered Nurse – Emergency Room

2001C

Registered Nurse – Mental Health

2001D

Registered Nurse - Operating Room

Estimated Period of Performance: Option Year 3: MM DD, 2022 to MM DD, 2023

3001B

Registered Nurse – Emergency Room

3001C

Registered Nurse – Mental Health

3001D

Registered Nurse - Operating Room

Estimated Period of Performance: Option Year 4: MM DD, 2023 to MM DD, 2024

4001B

Registered Nurse – Emergency Room

4001C

Registered Nurse – Mental Health

4001D

Registered Nurse - Operating Room

B.3 PERFORMANCE WORK STATEMENT

Performance Work Statement Nursing Services

1. GENERAL INFORMATION

1.1. Services Provided: The Clinical Contractor shall provide (Registered Nurses (RN), Licensed Practical Nurses, and Nursing Assistant (CNA) on site in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and the Kansas City VA Medical Center (KCVAMC)

1.2. Place of Performance - Clinical Contractor shall furnish services at the following Community Based Outpatient Care Clinic(s) CBOC and/or Kansas City VAMC locations, as well as any newly built sites of care:

4801 Linwood Blvd, Kansas City, MO 64128 209 Cunningham Industrial Parkway, Belton, MO 64012 1111 Euclid Dr, Cameron, MO 64429 197 McCleary Rd, Excelsior Springs, MO 64024 4251 Northern Ave, Kansas City, MO 64133 322 South Prewitt, Nevada, MO 64772 South Hospital Drive, Paola, KS 66071 6830 Anderson Drive, Shawnee, KS 66226 702 E Young St, Warrensburg, MO 64093 10500 Mastin St, Overland Park, KS 66212

SIN: 621-I 621-025

1.3. Authority: Title 38 USC 8153, Sharing of Health-Care Resources (HCR) Authority.

1.4. Policy/Handbooks:- the Clinical Contractor shall be subject to the following policies, including any subsequent updates during the period of performance:

1.4.1. VA Directive 1663: Health Care Resources Contracting - Buying http://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=347

1.4.2. VHA Handbook 1100.17: National Practitioner Data Bank Reports - http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135

1.4.3. VHA Handbook 1100.18 Reporting And Responding To State Licensing Boards - http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364

1.4.4. VHA Handbook 1100.19 Credentialing and Privileging - http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910

1.4.5. VHA Directive 1177 Cardiopulmonary Resuscitation https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=7487

1.4.6. VHA Directive 1192 “Seasonal Influenza Prevention Program for VHA Health Care Personnel” https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=5472

1.4.7. VHA Handbook 1907.01 Health Information Management and Health Records: http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791

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

1.4.9. HHS OIG Website – http://oig.hhs.gov/exclusions/index.asp

1.4.10. American Journal for Infection Control - AJIC 1998; 26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf

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

1.5.1. ACLS: Advanced Cardiac Life Support

1.5.2. AOD: Admitting Officer of the Day

1.5.3. BCMA: Bar Code Medication Administration

1.5.4. BLS: Basic Life Support

1.5.5. CBOC: Community Based Outpatient Clinic

1.5.6. CCNE: Commission on Collegiate Nursing Education: www.aacn.nche.edu/accreditation

1.5.7. CDC: Centers for Disease Control and Prevention

1.5.8. CR: Contract Discrepancy Report

1.5.9. CEU: Certified Education Unit

1.5.10. CME: Continuing Medical Education

1.5.11. CMS: Centers for Medicare and Medicaid Services

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

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

1.5.14. COS: Chief of Staff

1.5.15. CPARS: Contractor Performance Assessment Reporting System

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

1.5.17. Credentialing: Credentialing is the systematic process of screening and evaluating qualification and other credentials, including licensure, required education, relevant training and experience and current competence and health status.

1.5.18. ED: Emergency Department

1.5.19. FSMB: Federation of State Medical Boards

1.5.20. HHS: Department of Health and Human Services

1.5.21. HIPAA: Health Insurance Portability and Accountability Act

1.5.22. HR: Human Resources

1.5.23. ISO: Information Security Officer

1.5.24. KCVAMC: Kansas City Veterans Medical Center

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

1.5.26. MOD: Medical Officer of the Day

1.5.27. NLNAC: National League for Nursing Accrediting Commission. www.nlnac.org

1.5.28. Non-Contract Provider - any person, organization, agency, or entity that is not directly or indirectly employed by the Clinical Contractor or any of its sub-Clinical Contractors

1.5.29. NPPES: National Plan and Provider Enumeration System

1.5.30. PALS: Pediatric Advanced Life Support

1.5.31. POP: Period of Performance

1.5.32. PPD: Purified Protein Derivative

1.5.33. PWS: Performance Work Statement

1.5.34. Privileging (Clinical Privileging): Privileging is the process by which a practitioner, licensed for 8independent practice; e.g., without supervision, direction, required sponsor, preceptor, mandatory collaboration, etc.; is permitted by law and the facility to practice independently, to provide specific medical or other patient care services within the scope of the individual’s license, based upon the individual’s clinical competence as determined by peer references, professional experience, health status, education, training and licensure. Clinical privileges must be facility-specific and provider-specific.

1.5.35. QA/QI: Quality Assurance/Quality Improvement

1.5.36. QM/PI: Quality Management/Performance Improvement

1.5.37. QASP: Quality Assurance Surveillance Plan

1.5.38. Veterans Health Administration (VHA): The central office for administration of the VA medical centers through throughout the United States. The VHA is located in Washington, D.C.

1.5.39. Veterans Integrated Services Network (VISN): The regional oversight for the VA medical centers.

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

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

1.5.42. Veterans Affairs Medical Center (VAMC): Unless identified with the name of a different VA medical Center, for purposes of this contract, this term shall mean the Kansas City, MO. VA Medical Center.

2. GENERAL INFORMATION

2.1. DESCRIPTION OF SERVICES. The Clinical Contractor shall provide Nurses to perform the requirements of this contract at the Kansas City VA Medical Center (KCVAMC). The awarded Clinical Contractor is not guaranteed a 40-hour work week or an eight (8) hour day. In accordance with FAR Clause 52.216-22, Indefinite Quantity, the overall guaranteed minimum contract amount is $10,000.00, including the base year and any option years and the overall maximum amount including the base year and any option years exercised shall not exceed $6,658,080.00. Clinical Contractor employees will supplement current VA staff as needed. Services to be provided on an episodic basis, depending on vacations, resignations, illnesses, etc. of VA employees. A Clinical Contractor’s employee must be present at the VA Medical Center facility and must be performing the required services for the period specified in the task order, or the contract costs will be decreased accordingly during each billing cycle. Duty station(s) are variable and include Community Based Outpatient Clinics (CBOC). The VA reserves the right to select any or all proposed candidates and reject them at any point in time. The government reserves the right to award multiple contracts.

2.2. Nursing services shall be provided in any nurse setting within the KCVAMC and/or CBOC’s. The services to be performed by the Clinical Contractor shall be under the general direction of the Service Line Nurse Executive and/or their designee. The Service Line Nurse Executive and/or their designee is responsible for monitoring contract compliance and for verifying that services called for under the contract attested to by the Clinical Contractor have been received. Notification and scheduling will be mutually agreed upon. The Service Line Nurse Executive and/or their designee shall monitor performance through direct observation as well as observation of work results on an on-going daily basis.

2.3. If a new CBOC is to be opened, the Contracting Officer (CO) will notify the Clinical Contractor in advance of the opening. At that time, the Clinical Contractor shall submit a listing of proposed nurses for that area to the CO and supporting licenses/state certifications documents. Additional CBOCs shall be added to the contract only through the Contracting Officer by a bilateral modification and the issuance of a Notice to Proceed.

2.4. Performance shall be per the requirements contained in this agreement and Veteran’s Healthcare Administration (VHA) rules, regulations, handbooks, policies, and standard operating procedures (SOP’s). Care shall be appropriately documented in medical records in accordance with standard commercial practice. The Clinical Contractor employees shall ensure that Patient-Focused Functions in delivery of patient care is followed. This includes Patient Rights and Organizational Ethics, Assessment of Patients, Care of Patients, Education and Continuum of Care.

2.5. Clinical Contractor or Clinical Contractor’s employee may be exposed to surroundings which involve moderate risks or discomfort which require special precautions, i.e., infectious diseases, verbal and physical abuse from the emotionally disturbed patient.

2.6. Clinical Contractor or Clinical Contractor’s employee may have personal contact with patients, family, visitors and other employees, including contract employees of various VA services.

2.7. Contact with patients is for the purpose of procedure and information sharing as it relates to the procedures and special requirements. Contact with physicians and other ancillary services personnel are required for information sharing and consultation. Contact with visitors and family members are required for information sharing as it relates to a particular patient.

2.8. Ages of patients served may vary greatly and include young (20s and 30s years of age); middle-aged (40s and 50s years of age); and older patients (60 and upwards).

2.9. Patient record documentation shall be timely and will be the direct responsibility of agency personnel.

3. CONTRACTOR RESPONSIBILITY

3.1. The Clinical Contractor employee shall provide copy of certifications. The nurses will also be expected to chart using Computerized Patient Record System (CPRS), other electronic health records, and Bar Code Medication Administration (BCMA). Orientation consists of two days and should be completed prior to performing services at the Clinical Contractors’ expense. Cyber Security and HIPAA Training are mandatory. These days/hours are at the expense of the Clinical Contractor.

3.2. Clinical Contractor shall provide personnel who possess an unencumbered license to practice as a Registered Nurse, Licensed Practical Nurse or Nursing Assistant in the United States, Puerto Rico or District of Columbia to perform the services covered by this contract. The qualifications of such personnel shall also be subject to review by the facility Associate Director for Patient Care Services (ADPCS) and/or designee. The Department of Health and Human Services OIG Exclusionary List must be queried prior to providing contractual services. These queries must be negative and show no evidence of past disciplinary actions.

3.3. The Clinical Contractor is required to provide the coverage as stated herein and shall submit a properly prepared invoice following the end of each month indicating the contract number, Clinical Contractor employee(s) names, the dates and hours worked. The Clinical Contractor shall receive payment for the services rendered, that are documented in clinic records, patient records, attendance in KCVAMC meetings, the sign-in sheet, etc. The Clinical Contractor’s employee must be present and actually performing the required services at the KCVAMC facility for the period as specified in the contract. Payment for any leave, including sick leave, holiday or vacation time, is the responsibility of the Clinical Contractor.

3.4. The contracted rate will be all-inclusive. The Clinical Contractor shall provide all liability insurance, services, lodging, transportation, and associated expenses (e.g., meals), for Clinical Contractor employees for the performance period.

3.5. Standard Personnel Testing (PPD, etc.): Clinical Contractor shall provide proof of the following tests for nurses within five (5) calendar days after contract award and 30 days prior to the first duty shift to the COR and Contracting Officer. Tests shall be current within the past year.

3.5.1. TUBERCULOSIS TESTING: Clinical Contractor shall provide proof of a negative Tuberculosis Skin Test (TST) or interferon-gamma release assays (IGRA) for all Clinical Contractor’s workers. A negative chest radiographic report for active tuberculosis shall be provided in cases of positive TST or IGRA results. The TST or IGRA testing shall be repeated annually. Clinical Contractor shall provide evidence of retests to COR within ten (10) calendar days of retest.

3.5.2. MEASLES, MUMPS, & RUBELLA TESTING: Clinical Contractors shall provide proof of immunity for all Clinical Contractor workers.

3.5.3. VARICELLA: Clinical Contractors shall provide proof of immunity for all Clinical Contractor workers.

3.5.4. VACELLULAR PERTUSSIS: Clinical Contractors shall provide proof of 1 dose of Tdap vaccination for all Clinical Contractor workers.

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

3.5.6. HEPATITIS B VACCINATION. The Clinical Contractor shall consider the need for Hepatitis B vaccine and vaccination series and follow-up if there has been an exposure incident. VA shall not provide the vaccine or vaccination series.

VA Form 10-5549c, Information About Hepatitis B Vaccine (Recombinant), Consent Form, or VA Form 10-549d, Hepatitis B Vaccine Declination (Mandatory) shall be submitted to the COR within thirty (30) days of waiver, or completion of the first in the series of the Hepatitis B vaccine, and at completion of the vaccination series.

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

3.5.8. The KCVAMC shall notify the Clinical Contractor of any significant communicable disease exposures as appropriate. Clinical Contractor shall adhere to current CDC/HICPAC Guideline for Infection Control in health care personnel ( as published in American Journal for Infection Control- AJIC 1998; 26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf) for disease control. Clinical Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.

3.6. INFECTION CONTROL COMPLIANCE: Clinical Contractor shall provide written certification of training compliance with the Blood borne Pathogens Standards, 29 CFR Part 1910.1030 (copy available on request) to the COR, prior to Clinical Contractor compensating work shall receive certification.

3.7. All Clinical Contractor personnel shall be subject to VA’s Drug-Free Workplace Policy. Personnel may receive a drug test and are subject to random drug testing thereafter. This includes situations of “reasonable suspicion” and “accident or unsafe practice testing”. Refusal to be tested or interfering with the testing process shall result in immediate termination of the employment contract.

4. NURSING QUALIFICATIONS

4.1. Certified or registered within any state in the United States, Puerto Rico or District of Columbia.

4.2. Clinical Contractor shall assure professional competence of all personnel provided to the VA by maintaining on file proof certification or registry, per VA standards.

4.3. All personnel assigned by the Clinical Contractor to perform the services covered by this contract shall have an unencumbered license to practice as a Registered Nurse or as a Licensed Practical Nurse in a State, Territory, or Commonwealth of the United States or the District of Columbia. The qualifications of such personnel shall also be subject to review by the facility ADPCS. For facilities, heavily utilizing nursing services it is preferred that employment packages be submitted in advance for any nurses so that they can receive training in advance of any required need. It is also preferred that when there is a requirement that the nurses who have already received training at the facility are utilized first. This can be worked out by the Clinical Contractor, and the COR.

4.4. An employment packet shall be submitted to the COR for each Clinical Contractor personnel prior to their first duty shift. The packet shall consist of the personnel’s name, social security number, copy of license, registration, or certification, copy of Cardiopulmonary Resuscitation (CPR) certificate, Advanced Cardiac Life Support (ACLS) for all RNs in critical care, telemetry and Emergency Department, copy of curriculum vitae and copy of Purified Protein Derivative (PPD) test (or chest x-ray, if appropriate). The Clinical Contractor shall ensure that all contract personnel have met the following criteria:

· Current and valid licenses and certifications with the pre-employment package submitted to the COR prior to each new contract employee’s first day of work.

· Certification in CPR – Clinical Contractor personnel shall be trained in provided Cardiopulmonary Resuscitation (CPR). ACLS certification is preferred and required in some specialties. BLS and ACLS must be American Heart Association or VA certifications.

· Unencumbered License – The Clinical Contractor shall ensure that Clinical Contractor personnel have a valid unencumbered current license in at least one state or territory in the United States or District of Columbia.

· Current Curriculum Vitae – A copy of individual educational and professional qualifications shall be made available by the Clinical Contractor and reviewed by the COR or his/her designee.

The parties agree that such personnel shall not be considered VA employees for any purpose and shall be considered employees of the Clinical Contractor.

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

5. AVAILABILITY/SCHEDULING

5.1. HOURS OF OPERATION: The services covered by this contract shall be furnished by the Clinical Contractor as defined herein.

5.2. Actual shift hours may vary between the Clinical Contractor, the hospitals and by specialties listed on this agreement. Nursing staff will have at least 8 hours off between shifts and will not work more than 12 hours in direct patient care unless designated as an emergency by the Associate Director Patient Care Services or designee. Additionally, no nursing may work more than 60 hours in any seven (7) consecutive day period.

Nursing Shifts

Weekday

Weekend Friday @ Midnight--Sunday @ Midnight

5.3. Weekends shall be defined as starting on Friday at midnight and ending on Sunday at midnight. Tours of duty are specific to the clinical areas and will be stipulated at the time of order placement, e.g. inpatient areas are 12 hour shifts with a 30-minute paid lunch and a 30-minute overlap for patient hand off.

5.4. FEDERAL HOLIDAYS. Clinical Contractor shall perform work on federal holidays. The ten (10) Federal holidays observed by VA are as follows. Asterisk (*) indicates the dates change each year.

List of Federal Holidays

5.5. If the Clinical Contractor employee is scheduled to provide services on a VA holiday, VA is responsible for payment at a rate of time and one-half of the hourly rates.

5.6. Nurses covered by this contract shall be furnished by the contract agency on all calendar days. The contract agency shall be required to furnish such services on all shifts, weekends and national holidays.

5.7. A request for shift coverage is considered a late request if the request is made after the start of the shift. Any requests made prior to the start of a shift will not be considered a late request. Actual late requests may be billed for the entire shift.

5.8. Shift requirements are subject to change. The Clinical Contractor will be expected to fill all additional unscheduled shifts with a 2-hour notice.

5.9. The Clinical Contractor cannot make any change to the required shifts unless the change is requested and approved by the KCVAMC.

5.10. Clinical Contractor employees must contact the agency regarding cancellations, changes in scheduling, etc., not the KCVAMC. The Clinical Contractor will in turn contact the KCVAMC of employee cancellation and advise the name of the replacement nurse.

5.11. It is the Clinical Contractor’s responsibility to furnish employees, twenty-four (24) hours per day, seven days (7) per week. The actual number of hours and employee scheduled will be determined by vacancies within the KCVAMC. Costs will be based on the contracted hourly rate for the scheduled shift. The COR will notify the Contracting Officer in writing of all scheduled shifts missed by the Clinical Contractor. This will allow the COR to calculate the costs and notify the Clinical Contractor in writing of the deduction.

5.12. The Clinical Contractor shall have sufficient qualified employees to ensure that services are provided, in the event an employee scheduled to work becomes ill, resigns, is terminated, or is otherwise unavailable to work. Contract requirements are not altered or mitigated by inclement weather.

6. PERSONNEL REQUIREMENTS

6.1. Dress apparel: Clinical Contractor personnel shall be required to dress in a professional manner and in accordance with local policies.

6.2. VA shall provide the Clinical Contractor’s employee with an ID Badge that shall be worn, by Clinical Contractor or Clinical Contractor’s employee at all times, while performing services under this contract at the KCVAMC and CBOC(s).

6.3. EVALUATION OF PERSONNEL: In accordance with the requirement of the JCAHO Commission, the outside agency will conduct an annual evaluation of each employee using a performance-based method. Both the mechanism for evaluation and the verification of its use will be available and will be acceptable to the hospital. The VAMC reserves the right to deny any nurse to be scheduled who has demonstrated problems with conduct, performance, punctuality or similar issues.

7. BILLING

7.1. Invoice requirements and supporting documentation: Supporting documentation and invoice must be submitted no later than the 15th day of the month. Subsequent changes or corrections shall be submitted by separate invoice. In addition to information required for submission of a “proper” invoice in accordance with FAR 52.212-4 (g), all invoices to the following addresses: See 5.2.1

7.2. Clinical Contractor shall complete CMS Uniform Bill (UB) UB92 (HCFA-1450) claim form, VA Form 7078 (Authorization and Invoice for Medical and Hospital Services), and VA Form 10-7079 (Request for Outpatient Services) and submit supporting documentation, third party invoices, etc., for all items.

7.3. The Clinical Contractor shall submit the invoice and all supporting documentation monthly in arrears covering the services performed under this contract.

7.4. Subsequent changes or corrections shall be submitted by separate invoice and associated forms as outlined.

7.4.1. The invoices must include:

7.4.1.1. Name and Address of Clinical Contractor

7.4.1.2. Invoice Date and Invoice Number

7.4.1.3. Contract Number, Order Number, Invoicing obligation number

7.4.1.4. Name of Patient(s)

7.4.1.5. Date of Service

7.4.1.6. Clinical Contractor’s Hourly Rate

7.4.1.7. Quantity of hours worked

7.4.1.8. Total price

7.4.2. Vendor Electronic Invoice Submission Methods: Facsimile, e-mail, and scanned documents are not acceptable forms of submission for payment requests. Electronic form means an automated system transmitting information electronically according to the accepted electronic data transmission methods below:

7.4.3. Invoices will be electronically submitted to the Tungsten website at http://www.tungsten-network.com/us/en/veterans-affairs/. Tungsten direct vendor support number is 1-877-489-6135 for VA contracts. The VA-FSC pays all associated transaction fees for VA orders. During Implementation (technical set-up) Tungsten will confirm your Tax Payer ID Number with the VA-FSC. This process can take up to 5 business days to complete to ensure your invoice is automatically routed to your Certifying Official for approval and payment. In order to successfully submit an invoice to VA-FSC please review “How to Create an Invoice” within the how to guides. All invoices submitted through Tungsten to the VA-FSC should mirror your current submission of Invoice, with the following items required. Clarification of additional requirements should be confirmed with your Certifying Official (your CO or buyer). The VA-FSC requires specific information in compliance with the Prompt Pay Act and Business Requirements. For additional information, please contact:

Tungsten Support Phone: 1-877-489-6135 Website: http://www.tungsten-network.com/us/support/ Department of Veterans Affairs Financial Service Center Phone: 1-877-353-9791

7.5. Payment Adjustments:

7.5.1. Invoices will be prorated for partial days/hours worked. The Clinical Contractor shall be paid only for actual work performed onsite. In the event the Clinical Contractor provider works a portion of an hour, the government may adjust payment by 15-minute increments. Contract providers shall be responsible for reporting time worked accurately. The Contract shall be paid for actual hours performed.

7.5.2. The contract shall be adjusted at the end of the period of performance, base or option year in accordance with actual performance.

7.6. Payments in full/no billing VA beneficiaries: The Clinical Contractor shall accept payment for services rendered under this contract as payment in full. VA beneficiaries shall not under any circumstances be charged nor their insurance companies charged for services rendered by the Clinical Contractor, even if VA does not pay for those services. This provision shall survive the termination or ending of the contract.

7.6.1. To the extent that the Veteran desires services which are not a VA benefit or covered under the terms of this contract, the Clinical Contractor must notify the Veteran that there will be a charge for such service and that the VA will not be responsible for payment.

7.6.2. The Clinical Contractor shall not bill, charge, collect a deposit from, seek compensation, remuneration, or reimbursement from, or have any recourse against, any person or entity other than VA for services provided pursuant to this contract. It shall be considered fraudulent for the Clinical Contractor to bill other third-party insurance sources (including Medicare) for services rendered to Veteran enrollees under this contract.

7.6.3. Facsimile (Fax) Privacy Statement: Should the Clinical Contractor require the use of facsimile communication during the life of the contract, the VA requires the following statement on all fax cover sheets be included: This fax is intended only for the use of the person or office to which it is addressed and may contain information that is privileged, confidential, or protected by law. All others are hereby notified that the receipt of this fax does not waive any applicable privilege or exemption for disclosure and that any dissemination, distribution, or copying of this communication is prohibited. If you have received this fax in error, please notify this office immediately at the telephone number listed above.

7.7. Clinical Contractor Security Requirements (VA Handbook 6500.6)

7.7.1. All Clinical Contractor employees are subject to the same level of investigation as VA employees who have access to VA Sensitive Information. The level of background investigation commensurate with the level of access needed to perform the statement of work is: Tier 1. This requirement is applicable to all subClinical Contractor personnel requiring the same access.

7.7.2. All Clinical Contractor Physician(s) who require access to the Department of Veterans Affairs computer systems shall be the subject of a background investigation and must receive a favorable adjudication from the VA Officer of Security and Law Enforcement prior to contract performance. This requirement is applicable to all subClinical Contractor personnel requiring the same access.

7.7.3. Position Sensitivity – The position sensitivity has been designated as: Low Risk

7.7.4. Background Investigation – The level of background investigation commensurate with the required level of access is minimum background investigation, if required.

7.7.5. Clinical Contractor responsibilities:

7.7.6. The Clinical Contractor shall obtain background investigations through the COR.

7.7.7. The Clinical Contractor shall submit or have their personnel submit the following forms to the…