36C25519Q0482-0002000.docx

5. PROJECT NUMBER (if applicable)

CODE

7.

ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF

PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE

OF YOUR

ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office.

is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO:

Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERE

D CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES

SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR

OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendmen t, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED

STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER

16A. NAME AND TITLE OF

CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30

PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF

SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer) 11-19 -2019 N/A 36C255 Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway Leavenworth KS 66048 36C255 Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway Leavenworth KS 66048 To all Offerors/Bidders

36C25519Q0482 10-10-2019

X X X ** HOUR & DATE for Receipt of Offers is EXTENDED to:

X The purpose of this amendment is to provide the revised Performance Work Statement (PWS).

1. The Performance Work Statement (PWS) has been revised to include language regarding the possibility of alternate work site and mileage reimbursement.

2. Changes are in red and located on pages 2 and 4.

3. An example mileage log has been provided as D8 Attachm ent 8_Mileage Log.

4. Questions regarding the revisions to the PWS must be submitted no later than 4:00 pm CST on November 21, 2019 to kayla.haas@va.gov .

5. Only questions regarding the revisons in red (pages 2 and 4) will be answered by an amendment to the solicitation.

Kayla Haas Contracting Officer

B.2 SCHEDULE OF SERVICES ANR PRICE

Base Period of Performance: Award date – 12 months The period of performance and CLIN/SubCLINs will be updated with each exercised option.

Physical Therapist Physical Therapist Key Personnel:

Period of Performance:

Tour of Duty:

Location:

Occupational Therapist Occupational Therapist Key Personnel:

Period of Performance:

Tour of Duty:

Location:

Physical Therapist Assistant Physical Therapist Assistant Key Personnel:

Period of Performance:

Tour of Duty:

Location:

Mileage

1. The contractor agrees to the following terms of the Blanket Purchase Agreement (BPA).

2. The following services can be ordered under this BPA:

a. Physical Therapist (PT): Furnish up to 4.5 PTs to perform the requirement of this BPA. Physical Therapists may be required to work Holidays. Estimate: 9,360 hours

First Shift Weekdays (Monday – Friday) 7:30 am - 4:00 pm 8:00 am - 4:30 pm 8:30 am - 5:00 pm

First Shift (Tuesday-Saturday) 7:30 am - 4:00 pm

First Shift Weekends (Saturday - Sunday) 7:30 am – 4:00 pm

b. Occupational Therapist (OT): Furnish up to 3.0 OTs to perform the requirement of this BPA. Occupational Therapists may be required to work Holidays. Estimate: 6,240 hours First Shift Weekdays (Monday – Friday) 7:30 am - 4:00 pm 8:00 am - 4:30 pm 8:30 am - 5:00 pm

First Shift (Tuesday-Saturday) 7:30 am - 4:00 pm

First Shift Weekends (Saturday - Sunday) 7:30 am – 4:00 pm

c. Physical Therapist Assistant (PTA): Furnish up to 1.5 PTAs to perform the requirement of this BPA. Physical Therapist Assistants may be required to work Holidays. Estimate: 3,120 hours First Shift Weekdays (Monday – Friday) 7:30 am - 4:00 pm 8:00 am - 4:30 pm 8:30 am - 5:00 pm

First Shift (Tuesday-Saturday) 7:30 am - 4:00 pm

3. The services performed under this BPA shall be performed at any of the following facilities and Community-Based Outpatient Clinic (CBOC) locations within the VA-St. Louis Health care System (VASTLHCS)

· John Cochran Division, 915 N. Grand Blvd., St. Louis, MO 63106

· Jefferson Barracks, 1 Jefferson Barracks Dr., St. Louis, MO 63125

· Hope Recovery Center, 515 N. Jefferson Ave., St. Louis, MO 63103

· VASTHLC Primary Care Team 1 Annex, 4974 Manchester Ave., St. Louis, MO 63110

· VASTHLC Primary Care Team 1 Annex, 2727 Washington Ave., St. Louis, MO 63103

· St Charles CBOC, 844 Waterbury Fall Drive, O’Fallon, MO 63368

· St. Clair County CBOC, 1190 Fortune Boulevard, Shiloh, IL 62269

· St. Louis CBOC, 6854 Parker Road, Florissant, MO 63033

· Washington County CBOC, 1627 A Roy Drive, Washington, MO 63090

4. Therapists may be asked to travel between work site locations. When this occurs, the therapist is authorized to use Privately Owned Vehicle (POV) and shall be reimbursed mileage as dictated by the Joint Travel Regulations. It is the Government’s policy to not allow a charge of profit or fee on reimbursable items and to only reimburse actual costs consistent with the Federal Travel Regulation.

https://www.gsa.gov/travel/plan-book/transportation-airfare-pov-etc/privately-owned-vehicle-pov-mileage-reimbursement-rates

5. In accordance with the Federal Travel Regulation, subpart D, §301-10.302, mileage shall be captured between the origin and destination as shown in paper or electronic standard highway mileage guide or actual miles driven as determined from odometer readings. Only one method of tracking mileage shall be used. If odometer readings are submitted, an electronic standard highway mileage may be used for comparison of odometer readings as part of VA’s due diligence process.

https://www.gsa.gov/policy-regulations/regulations/federal-travel-regulation-ftr/i1206091#d25e5203

6. Therapist may be required to report to an alternate work location.

a. Therapists may be contacted by VA, not less than an hour prior to their scheduled reporting time, when a change of work site location is required. The therapist shall report as scheduled to the alternate work site location and perform services during their scheduled work hours. Mileage shall not be paid to the therapist as he/she did not report to the primary work site location and later leave for an alternate work site location.

b. If after reporting to the primary work site location, therapists are notified that services are required at an alternate work site location, and the therapist is expected to report to the secondary work site location. Travel between work sites will be in a paid status and the therapist shall be reimbursed mileage between locations when reporting to the alternate work site location. Therapists are not eligible for mileage at the end of the shift from the alternate work site location. Mileage must be tracked on a daily trip log and submitted with the monthly invoices. The Mileage Log is located at Section D, Attachment X.

c. When traveling to the alternate work site location in a paid status, therapists shall use the most direct route, without delay, or unnecessary stops.

7. All other per diems are not authorized under this BPA.

8. The Contractor shall provide all liability insurance, services, lodging, transportation, communications and associated expenses, (e.g., meals) of Contractor employees for the performance period.

9. Fair Opportunity: Before placing an order, the ordering activity’s requirements will be forwarded to each BPA holder through a Request for Quotation (RFQ along with the evaluation criteria using Attachment 3, Fair Opportunity, located in Section D. In order to be considered responsive, BPA holders shall provide all documentation within the predetermined time frame, i.e. quote due date. Evaluations will be based on CV’s (Curriculum Vitae)/resumes, licenses &/or certificates, timeliness/availability of proposed candidate, self-assessment checklists, and price. Based on a best value determination, the order shall be placed with the BPA holder that represents the best value.

10. The BPA is a base period of one (1) year, with four (4) additional option years to be exercised by the VASTLHCS at their sole discretion. The maximum term of this BPA shall be five years from the effective date of this BPA. The VA will review the estimated purchases and the corresponding discounts annually prior to the exercise of any option period.

11. The Government estimates, but does not guarantee, that the annual volume of professional staffing services under this BPA.

12. This BPA does not obligate any funds. The Government is obligated only to the extent of authorized purchases actually made under the BPA via the issuance of an order.

13. Authorized users are NCO 15 Medical Services Warranted Contracting Officers. Authorized users shall only be allowed to issue orders against this BPA if funds are certified and an order number is assigned. The BPA holder shall not accept or perform any purported order that does not contain an order number issued by the above-named Contracting Officers.

14. Pursuant to VAAR Provision 852.270-1, Representatives of Contracting Officer, the designated representatives for this Blanket Purchase Agreement shall be specified when task orders against this BPA are issued.

15. The services specified in the agreement may only be changed by written modification which will be prepared and executed by the Network Contracting Office (NCO) 15. The following actions are the sole responsibility of the Contracting Officer for this Agreement; no other personnel are authorized to:

a. Make changes to BPA provisions. This includes changes involving increases and/or decreases in agreement price, as well as no cost changes.

b. Require extras or work outside the scope of the agreement.

c. Authorize delivery or disposition of Government property not authorized by the agreement.

d. Extend the completion time established in the agreement.

e. Terminate the agreement in whole or in part.

f. Render a decision under the Disputes Clause.

g. Issue instructions to the contractor to stop or start work, to exclude the scheduling of services.

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B.3 PERFORMANCE WORK STATEMENT

Note 1: The use of the term “contract” within the Performance Work Statement, clauses and provisions is not used to denote a binding legal contract for the procurement but rather, a generic term for the agreement. “Contract” and “agreement” may be used interchangeably. “Contractor” refers to the awarded BPA holder(s). “Contractor personnel” or “contract provider” is used to denote the awarded BPA holder’s provider.

Note 2: In order to be eligible for award, the following criteria shall be met and maintained throughout the life of the BPA.

1.0 OVERVIEW

The contractor shall provide non-personal health care services for on-site clinical services needed in accordance with the terms and conditions outlined herein to the VA St. Louis Health Care System (hereinafter referred to as “VASTLHCS”).

VASTLHCS identifies the following requirement

· Up to 4.5 full time equivalent (FTE) Licensed Physical Therapists

· Up to 3.0 FTE Licensed Occupational Therapists

· Up to 1.5 FTE Licensed Physical Therapist Assistants

The contractor is not guaranteed a 40- hour work week or an eight (8) hour day. The services to be performed by the Contractor employee will be performed in accordance with VASTLHCS policies, procedures, and regulations and the medical staff by-laws of the VASTLHCS. Hours of service must be documented on time and attendance records and attached to the invoice for review and certification by the Contracting Officers Representative (COR) in order for the Contractor to be compensated. The Contractor employee shall not receive compensation from the VA of any hours such as sick leave, holiday leave, or annual leave.

1.1 Blanket Purchase Agreement (BPA)

This BPA will expire five years from the effective date of this BPA. The maximum term of this BPA shall be five (5) years from the effective date of this BPA. The VA will review the estimated purchases and the corresponding discounts for this BPA annually. The annual review shall take place before the next option is exercised.

1.2 Estimated Full Time Equivalents (FTE)

The Contractor shall provide non-personal health care services for up to 4.5 full time equivalent (FTE) Licensed Physical Therapists, up to 3.0 FTE Licensed Occupational Therapists, and up to 1.5 Physical Therapist Assistants with appropriate training and experience to perform the requirements of this contract. A full time equivalent employee is defined as a Contractor’s employee working eight hours in a day. A Contractor’s employee must be present at the VA Medical center facility and must actually be performing the required services for the period specified in the contract or the contract costs will be decreased accordingly during each billing cycle. The payment for any leave, including sick leave, vacation time, and authorized Federal holidays is the responsibility of the Contractor.

1.3 Fair Opportunity

Before placing an order, the ordering activity’s requirements will be forwarded to each BPA holder through a Request for Quotation (RFQ) along with the evaluation criteria using Attachment 3, Fair Opportunity, located in Section D. In order to be considered responsive, BPA holders shall provide all documentation within the predetermined time frame, i.e. quote due date. Evaluations will be based on CV’s (Curriculum Vitae)/resumes, certificates, timeliness/availability of proposed candidate, self-assessment checklists, and price. Based on a best value determination, the order shall be placed with the BPA holder that represents the best value.

2.0 POLICY/HANDBOOKS and ACRONYMS AND DEFINITIONS

2.1 Policy/Handbooks:

2.1.1 VHA Directive 1003 VHA’s Customer Service Program https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=268

2.1.2 VHA Directive 1230 Outpatient Scheduling Processes and Procedures https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3218

2.1.3 VHA Handbook 1003.1 Key Elements of VHA’s Veterans Customer Service Program https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=422

2.1.4 VHA Handbook 1003.2 Service Recovery in the Veterans Health Administration https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=433

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

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

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

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

2.2 Acronyms and Definitions - 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.

2.2.1 BLS: Basic Life Support

2.2.2 BPA: Blanket Purchase Agreement. An agreement that provides a simplified method of filling anticipated repetitive needs for supplies or services.

2.2.3 CDR: Contract Discrepancy Report. Report issued by the Government to the contractor to document a supply or service found to be unacceptable during contract performance.

2.2.4 CFR: Code of Federal Regulations.

2.2.5 CO: Contracting Officer. A person with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings.

2.2.6 COR: Contracting Officer’s Representative. An individual, including a Contracting Officer’s representative (COR), designated and authorized in writing by the Contracting Officer to perform specific technical or administrative functions.

2.2.7 CPR: Cardio Pulmonary Resuscitation.

2.2.8 CPRS: Computerized Patient Record System. Comprehensive system of electronic health records.

2.2.9 CV: Curriculum Vitae. A resume. An overview of a provider’s experience and qualifications.

2.2.10 DOL: Department of Labor.

2.2.11 FAR: Federal Acquisition Regulation. Principal set of rules (i.e. body of laws) in the Federal Acquisition Regulation System that govern the U.S. Federal Government’s procurement process.

2.2.12 FTE: Full Time Equivalent. Defined by VA as a minimum of 80 hours every 2 weeks.

2.2.13 HIPAA: Health Insurance Portability and Accountability Act of 1996. The Act deals with protecting health insurance coverage for people who lose and change jobs and the standardization of health care-related information systems. The HIPAA Privacy Rule provides federal protections for personal health information held by covered entities and gives patients an array of rights with respect to that information.

2.2.14 HR: Human Resources.

2.2.15 ISO: Information Security Officer.

2.2.16 NCO: Network Contracting Office.

2.2.17 NPI: National Provider Identifier.

2.2.18 OT: Occupational Therapist

2.2.19 PIV: Personal Identity Verification. Personal identity verification of Federal Employees and Contractors that secures access to Federal facilities and information systems; assures appropriate levels of security for all applicable Federal applications; and provides interoperability among Federal organizations.

2.2.20 PO: Privacy Officer.

2.2.21 PM&RS: Physical Medicine and Rehabilitation Services

2.2.22 PT: Physical Therapist

2.2.23 PTA: Physical Therapist Assistant

2.2.24 PWS: Performance Work Statement

2.2.25 QA: Quality Assurance. Actions taken by the government to assure contracted services meet PWS requirements.

2.2.26 QASP: Quality Assurance Surveillance Plan

2.2.27 QC: Quality Control. Actions taken by the contractor to control the performance of contracted services to meet the PWS requirements.

2.2.28 SAC: Special Agreement Check. Federal Bureau of Investigation criminal history check of fingerprints.

2.2.29 VASTLHCS: VA St. Louis Health Care System

2.2.30 VA: Department of Veterans Affairs.

2.2.31 VAAR: Department of Veterans Affairs Acquisition Regulation.

2.2.32 VHA: Veterans Health Administration.

2.2.33 USC: United States Code.

3.0 REQUIREMENTS

3.1 Contractor shall provide personnel who possess an unencumbered license to practice as a Physical Therapist, Occupational Therapist, or Physical Therapist 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. Evidence of completion of required licensure, credentials, required training and current competencies shall be received by the VA credentialing office. Commencement of background investigations must be validated by the contracting officer for all contract provider(s) referred to perform services under this agreement prior to providing direct patient care. 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.

3.2 Contractor is responsible to provide coverage during the hours required. The VASTLHCS will make every attempt to schedule services with at least two weeks’ notice. There may be times when, due to unplanned circumstances, coverage is needed on short notice and the contractor will be asked to fill additional unscheduled shifts within a twenty-four (24) notice. Notification and scheduling will be mutually agreed upon between the VASTLHCS and the contractor. The awarded contractor’s employees are not guaranteed a 40-hour work week or an eight (8) hour day.

3.3 The 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, contractor employee(s) names, the dates and hours worked. The contractor shall receive payment for the services rendered, that are documented in clinic records, patient records, attendance in VASTLHCS meetings, the sign-in sheet, etc. The Contractor’s employee must be present and actually performing the required services at the VASTLHCS 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 Contractor.

3.4 Physical Therapist Requirements

3.4.1.1 To accomplish those objectives, the contracted therapist will need to review paper and electronic records, note salient information, precautions and contraindications. The PT will confer with significant others and interdisciplinary team members. To derive accurate information, the incumbent will need a good grasp of commonly used methods, procedures and tests.

3.4.1.2 The contractor employee will be required to develop time-limited functionally based short and long-term goals. The PT will then provide or oversee the direct patient care, selecting the most appropriate techniques to reach the established goals.

3.4.1.3 The PT will provide clear verbal and written communication of patient progress including documentation of baseline measurements and ongoing assessment data. The PT will begin discharge planning at the time of admission and provide necessary home education programs and after care.

3.4.2 Physical Therapist Assessment: The contractor’s employee will complete all assessments accurately 100% of the time.

3.4.2.1 Assessment for the presence of physical deficits.

3.4.2.2 Determination of function related problems including rationale or basis for making the assessment.

3.4.2.3 Development of individual physical therapy treatment plans.

3.4.2.4 Use of data to implement individualized treatment program.

3.4.2.5 Choice of therapy technique best suited to condition of patient to achieve maximum results.

3.4.2.6 Assessment of adaptive equipment needs, such as manual wheelchairs, canes, walkers, braces.

3.4.3 Physical Therapy treatment includes:

3.4.3.1 Therapeutic exercises

3.4.3.2 Neuromuscular re-education

3.4.3.3 Gait analysis and training

3.4.3.4 Functional activity training

3.4.3.5 Prevention/ Treatment of pain

3.4.3.6 Adaptive equipment evaluation and prescription

3.4.3.7 Electric Modalities, hot/cold packs

3.4.3.8 Wound/Lymphedema

3.4.3.9 Pelvic Health

3.4.3.10 Aquatic Therapy

3.4.3.11 Wheelchair seating and positioning

3.4.4 The Physical Therapist shall:

3.4.4.1 Assess the patient prior to the development of treatment plans and goals.

3.4.4.2 Implement plans in accordance with the initial evaluation findings for treatment aimed at prevention, reducing disability or pain, restoring lost function and increase participation.

3.4.4.3 Provide therapeutic interventions, which focus on posture, wheelchair mobility, gait, transfers, strength, endurance, balance, coordination, joint mobility and flexibility, and functional tasks at each visit

3.4.4.4 Monitor the extent to which services have met the therapeutic goals relative to the initial and all subsequent assessments at each visit.

3.4.4.5 Determine the degree to which improvement occurs and, when appropriate, revises the treatment plan at each visit.

3.4.4.6 Provide education to patients, families, and/or significant others regarding deficits incurred and interventions to reduce the existing deficit, and management of any residual deficit in the resumption of life roles in the home and community environment at each visit.

3.4.4.7 Performs chart review prior to scheduled appointment and obtain a subjective history of patients assigned

3.4.5 Physical Therapists Special Requirements:

3.4.5.1 Respects confidentiality and follows established policy regarding patient records.

3.4.5.2 Re-evaluates and upgrades treatment plan at intervals determine by Physical Therapy (PT) Department policy within 24 hours of patients visit greater than 90% of the time.

3.4.5.3 Documents and codes in electronic medical record an initial, progress, and final evaluation that includes measurable goals, goals achieved, treatment provided and functional outcomes using the PT department documentation policy guidelines. Documents patient education according to VA policy.

3.4.5.4 Observes VA policies and procedures relating to infection control, Fire and Safety, Information Security, Patient Safety (mandatory training).

3.4.5.5 Maintains current CPR Certification with recertification is at least 30 days prior to expiration.

3.4.5.6 Communicates, consults and works cooperatively with other team members to provide comprehensive patient care.

3.4.5.7 Assists in the day-to-day operation of the department in routine housekeeping and equipment care.

3.4.5.8 Consults with patients and their families regarding educating, training and advising them about their deficit/disability/disease. Teaches/issues home programs to improve/maintain achieved goals.

3.4.5.9 Use computerized patient record system and other computerized data systems.

3.4.6.0 Participates in team conferences, rounds, discharge planning meetings, specialty clinics, other assigned medical meetings, physical therapy and in-services and meetings as directed.

3.4.6.1 Consults with other physical therapists, physicians, other therapists and medical personnel, patients, family and/or caregivers to maximize benefit of therapy program.

3.4.6.2 Manages time for scheduling patients to allow for unforeseen incidents or interruptions in planned program. Is flexible in treatment program; easily adapts to share in over-all section treatment program, as needed, by assisting in coverage for absent staff members, to insure continuity of quality patient care.

3.4.6.3 Utilizes appropriate and qualified personnel as the situation indicates i.e., P.T. Aids, Rehab Techs, students, etc., or other persons with the appropriate expertise indicated for the task.

3.4.6.4 Employs motivational techniques to enlist patient participation in their treatment program.

3.5 Physical Therapist Assistant (PTA) Requirements

3.5.1 The contractor employee shall conduct physical therapy perform therapeutic treatment plans to patients with patients with diagnosis included but not limited to orthopedics, neurologic, cardiovascular and pulmonary, geriatric, wound care/lymphedema, chronic pain. Under the supervision of a Physical Therapist, the PTA is assigned the responsibility of providing physical therapy services, following an established plan of care to outpatients and inpatients with a variety of diagnoses referred from Primary Care, Specialty/Subspecialty Medicine, Inpatient hospitalists, Physical Medicine and Rehabilitation Services (PM&RS) and Extended Care Line providers. Provide Physical Therapy services to other outpatients and inpatients as needed.

3.5.1.1 To accomplish those objectives, the contracted therapist will need to review paper and electronic records, note salient information, precautions and contraindications. The PTA will confer with significant others and interdisciplinary team members. To derive accurate information, the incumbent will need a good grasp of commonly used methods, procedures and tests.

3.5.1.2 The contractor employee PTA follow functionally based short and long-term goals as written by the referring physical therapist.

3.5.1.3 The PTA will provide clear verbal and written communication of patient progress including documentation.

3.5.2 Physical Therapy Assistant treatment includes:

3.5.2.1 Therapeutic exercises

3.5.2.2 Neuromuscular re-education

3.5.2.3 Gait analysis and training

3.5.2.4 Functional activity training

3.5.2.5 Prevention/ Treatment of pain

3.5.2.6 Adaptive equipment evaluation and prescription

3.5.2.7 Electric Modalities, hot/cold packs

3.5.2.8 Wound/Lymphedema

3.5.2.9 Pelvic Health

3.5.2.10 Aquatic Therapy

3.5.2.11 Wheelchair seating and positioning

3.5.3 The Physical Therapist Assistant shall:

3.5.3.1 Performs chart review prior to all scheduled and /or unscheduled visits appointment and obtains a subjective history of patients assigned.

3.5.3.2 Knowledgeable of treatment techniques needed to assess changes in physical, mental, and/or medical status.

3.5.3.3 Reviews the medical record and the established physical therapy treatment plan of care for each assigned patient prior to providing physical therapy treatment.

3.5.3.4 Provides physical therapy services as specified in the physical therapy plan of care for each patient

3.5.3.5 All forms of communicates are appropriate and maintains a professional relationship with patients, their families, and visitors.

3.5.3.6 Respects and protects patient privacy at all times.

3.5.3.7 At each visit, implements, treatment programs to meet established goals, taking into consideration the particular rehabilitation problems of each patient.

3.5.3.8 Applies recognized Physical Therapy treatment procedures correctly, safely, and modifies these techniques in such a manner as not to interfere with any traction devices, surgical drains, catheters, or immobilizing appliances.

3.5.3.9 With input from the treating Physical Therapist, modifies treatment techniques as indicated within the patient's physical therapy plan of care.

3.5.3.10 In response to the patient’s reaction to treatment, with input from the treating Physical Therapist, adapts and modifies treatment programs, to better meet the short term and long-term goals established in the physical therapy plan of care.

3.5.3.11 On an on-going basis, confers with Primary PT, regarding each assigned patient's progress or lack of progress toward meeting established goals.

3.5.3.12 Recognizes adverse reaction to treatment, significantly altered physical or mental status of patients, and reports to Primary PT and or appropriate medical authority.

3.5.3.13 With guidance from Primary PT, develops and educations appropriate home program for patient, as needed, prior to discharge.

3.5.3.14 As indicated, instructs family and/or caregiver in ways to assist patient to carry out the home exercise program, safety, recommends equipment for use.

3.5.3.15 Instructs patient/care provider in the use of prescribed assistive devices.

3.5.3.16 Recommends and orders appropriate equipment as needed for the patient.

3.5.3.17 Completes patient and/or family training as indicated.

3.5.3.18 Documents and codes treatment provided and patient response, patient's current status, patient progress towards goals, and patient/family education in patient's medical record within established guidelines. Assists with collection of information appropriate for discharge summary within 24 hours of patients visits greater than 90% of the time.

3.5.3.19 Participates in team conferences, rounds, discharge planning meetings, specialty clinics, other assigned medical meetings, physical therapy and in-services and meetings as directed.

3.5.3.20 Consults with other physical therapists, physicians, other therapists and medical personnel, patients, family and/or caregivers to maximize benefit of therapy program.

3.5.3.21 Manages time for scheduling patients to allow for unforeseen incidents or interruptions in planned program. Is flexible in treatment program; easily adapts to share in over-all section treatment program, as needed, by assisting in coverage for absent staff members, to insure continuity of quality patient care.

3.5.3.22 Utilizes appropriate and qualified personnel as the situation indicates i.e., P.T. Aids, Rehab Techs, students, etc., or other persons with the appropriate expertise indicated for the task.

3.5.3.23 Employs motivational techniques to enlist patient participation in their treatment program.

3.5.4 Physical Therapy Assistants Special Requirements:

3.5.4.1 Respects confidentiality and follows established policy regarding patient records.

3.5.4.2 Refers back to primary therapist and/or other health care professional for all reassessments and as needed when the patients’ needs are outside the scope of practice for a PTA.

3.5.4.3 Documents in electronic medical record treatment provided using the PT department documentation policy guidelines. Documents patient education according to VA policy.

3.5.4.4 Observes VA policies and procedures relating to infection control, Fire and Safety, Information Security, Patient Safety (mandatory training).

3.5.4.5 Maintains current CPR Certification with recertification at least 30 days prior to expiration.

3.5.4.6 Communicates and works cooperatively with other team members to provide comprehensive patient care.

3.5.4.7 Assists in the day-to-day operation of the department in routine housekeeping and equipment care.

3.5.4.8 Communicates with patients and their families regarding educating, training and advising them about their deficit/disability/disease. Teaches/issues home programs to improve/maintain achieved goals.

3.5.4.9 Use computerized patient record system and other computerized data systems.

3.6 Occupational Therapist Requirements

3.6.2 The services to be performed by the Contractor shall be under the general direction of the Occupational Therapy and Physical Therapy Supervisors or his/her designee. The COR shall be responsible for monitoring contract compliance and for verifying that services called for under the contract attested to by the Contractor have been received.

3.6.3 To accomplish those objectives, the employee will need to review paper and electronic records, note salient information, precautions and contraindications. The OT will confer with significant others and interdisciplinary team members. To derive accurate information, the incumbent will need a good grasp of commonly used methods, procedures and evidence-based tests.

3.6.4 The employee will be required to develop time-limited functionally based short and long-term goals. The OT will then provide or oversee the direct patient care, selecting the most appropriate techniques to reach the established goals.

3.6.5 The OT shall provide clear verbal and electronic communication of patient progress through thorough documentation of baseline measurements and ongoing assessment data. The OT shall begin discharge planning at the time of admission and provide necessary home education programs and after care.

3.6.6 Occupational Therapist Assessment: The contractor’s employee shall complete all assessments accurately 100% of the time.

3.6.6.1 Assessment for the presence of physical/mental/cognitive deficits.

3.6.6.3 Development of individual occupational therapy treatment plans.

3.6.6.4 Use of data to implement individualized treatment program.

3.6.6.5 Choice of therapy technique best suited to condition of patient to achieve maximum results.

3.6.6.6 Assessment of adaptive equipment needs, such as manual wheelchairs, splints, braces, and Durable Medical Equipment (DME).

3.6.6.7 Assessment of therapeutic activities and adaptations needed for patient’s success.

3.6.7 Occupational Therapist Treatment:

3.6.7.1 Therapeutic exercises.

3.6.7.2 Neuromuscular re-education.

3.6.7.3 Cognitive Therapy

3.6.7.4 Functional activity training.

3.6.7.5 Prevention/ Treatment of UE pain

3.6.7.6 Adaptive equipment evaluations and prescription.

3.6.7.7 Wound/lymphedema

3.6.7.8 Fabrication of splint

3.6.8 Occupational Therapist shall:

3.6.8.1 Assesses the patient prior to the development of treatment plans and goals.

3.6.8.2 Provides therapeutic treatment plans in accordance with the initial evaluation findings for treatment aimed at prevention, reducing disability or pain, and restoring lost function.

3.6.8.3 Provides therapeutic interventions, which focus on function including range of motion strength, coordination, activities of daily living (ADL) and instrumental activities of daily living (IADL).

3.6.8.4 Monitors the extent to which services have met the therapeutic goals relative to the initial and all subsequent examination.

3.6.8.5 Determines the degree to which improvement occurs and, when appropriate, revises the overall treatment plan.

3.6.8.6 Educates/counsel’s patients, families, and/or significant others regarding the disability incurred and about interventions to reduce the existing deficits, and improved management of any residual deficits in the resumption of life roles in the home and community environment.

3.6.9 Occupational Therapist Special Requirements:

3.6.9.1 Respects confidentiality and follows established policy regarding patient records.

3.6.9.2 Re-evaluates and upgrades treatment plan at intervals determine by Occupational Therapy Department policy.

3.6.9.3 Documents in electronic medical record an initial, progress, and final evaluation that includes measurable goals, goals achieved and functional outcomes using the OT department documentation policy guidelines. Documents patient education according to VA policy.

3.6.9.4 Observes VA policies and procedures relating to infection control, Fire and Safety, Information Security, Patient Safety (mandatory training).

3.6.9.5 Maintains current CPR Certification.

3.6.9.6 Communicates, consults and works cooperatively with other team members to provide comprehensive patient care.

3.6.9.7 Assists in the day-to-day operation of the department in routine housekeeping and equipment care.

3.6.9.8 Consults with patients and their families regarding educating, training and advising them about their deficit/disability/disease. Teaches/issues home programs to improve/maintain achieved goals.

3.6.9.9 Document care provided for each patient in accordance with policies and procedures.

3.6.9.10 Use computerized data and record systems

3.7 Dress apparel: Contractor employee shall be required to dress in accordance with local policies. Scrubs are required and shall not be frayed, patched, threadbare, etc. Shoes/Footwear will be conducive to quiet and safe hospital environment. Shoes that are excessively noisy such as, but not limited to, those with metal taps or cleats are considered inappropriate. Shoes/footwear shall be kept clean and presentable, and for safety reasons, shall be appropriate to the contracted PT/OT/PTA position and workplace. For safety reasons, thong/flip flops and beach style sandals (with no backs) are not permitted in the workplace.

3.8 Electronic Devices: Walk-mans, MP-3 players, I-Pods, radios/cassettes, Bluetooth devices, compact disc players, cell phones, head sets, and similar electronic devices shall not be worn or displayed by contracted PT/OT/PTA while on duty.

3.9 The VASTLHCS shall provide the Contractor’s employee a VA issued ID Badge that shall be worn at all times in a highly visible location while performing services under this BPA.

4.0 QUALIFICATIONS

4.1 License

4.1.1 Physical Therapists, Occupational Therapists, and Physical Therapist Assistants shall maintain a current, full, active and unrestricted license as a therapist in a State, Territory, or Commonwealth of the U.S. or the District of Columbia.

4.2 Certifications:

4.3 Education and Experience:

4.3.1 Physical Therapist and Physical Therapy Assistant education and degrees shall be recognized by the U.S. Department of Education from CAPTE accredited colleges, universities, or institutions.

4.3.2 Occupational Therapist education and degrees shall be recognized by the U.S Department of Education, from ACOTE accredited colleges, universities or institution.

4.3.3 Personnel assigned by the Contractor to perform PT/OT/PTA services may require a minimum of two years of hospital experience or two years of ambulatory care experience, dependent up on the specialty area, i.e. lymphedema. When applicable, this experience will be identified within the RFQ and Fair Opportunity notice.

4.3.4 Candidates shall complete and submit a self-assessment regarding their clinical competencies, experience, and advanced skills. See Section D for the checklists.

· Attachment 6, Self-Assessment Skills Checklist Occupational Therapist

· Attachment 7, Self-Assessment Skills Checklist Physical Therapist and Physical Therapist Assistant

4.4 Credentialing:

4.4.1 All contracted PT/OT/PTA providing services under this agreement shall be credentialed in accordance with VHA Handbook 1100.19 – Credentialing and Privileging prior to the provision of any services.

4.4.2 The Contractor is responsible to provide complete and timely documentation to support the Credentialing Process which will initially commence on award of the contract and then upon contract renewal (or extension). Contractor employees must be able to pass the VASTLHCS’s credentialing process in accordance with the Department of Veterans Affairs’ guidelines and regulations.

4.4.3 VetPro is VHA’s electronic credentialing system and shall be used for credentialing all practitioners who are granted clinical privileges or are credentialed for other reasons.

4.4.4 Credentialing shall be completed prior to the initial appointment and contract performance.

4.4.5 Re-credentialing and reappointment shall occur every year prior to any option period renewal. Current contract providers must supply credentialing information at least 30 days prior to an option year expiration to allow for medical staff and VetPro renewal and approval.

4.5 Conflicts of Interest:

4.5.1 The Contractor shall not employ any person who is an employee of the United States Government if the employment of that person would create a conflict of interest. The Contractor shall not employ any person who is an employee of the Department of Veterans Affairs unless such person seeks and receives approval in accordance with VA Regulations and public law.

4.5.2 Local policy and VA ethics process shall be followed when the contractor proposes an employee that is related to a member of VA staff family or contractor staff.

4.5.3 The Contractor and contracted PT/OT/PTA are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of proposal and during the entirety of contract performance.

4.5.4 At the time of proposal, the Contractor shall provide a statement which describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided.

4.5.5 The Contractor shall also provide statements containing the same information for any identified consultants or subcontractors who shall provide services.

4.6 The contractor is required to report to the Contracting Officer (CO) and COR within twenty-four (24) hours of contractor’s discovery of any disciplinary action taken by any federal, state or local agencies related to contractor or any of its assigned employees under this agreement.

4.7 English language requirement. The contract providers shall read, understand, speak, and write English fluently under the authority of U.S.C. 7402(d) and 7407(d).

4.8 Orientation:

4.8.1 The contractor shall ensure that all contract employees participate in the VASTLHCS Orientation procedures that include regulations specific to their professional specialty and hospital and VHA policy and procedures.

4.8.3 On-going orientation may be provided as needed; however, every attempt shall be made by the Service Level orientation to send the same trained employees familiar with the assigned Department at each location. If the contractor employee has not worked at the requesting facility within six (6) months, the individual shall be re-oriented.

5.0 GENERAL INFORMATION

5.1 WORK LOCATIONS: The services performed under this BPA shall be performed at any of the following facilities and Community-Based Outpatient Clinic (CBOC) locations within the VA-St. Louis Health care System (VASTLHCS).

5.1.1 John Cochran Division, 915 N. Grand Blvd., St. Louis, MO 63106

5.1.2 Jefferson Barracks, 1 Jefferson Barracks Dr., St. Louis, MO 63125

5.1.3 Hope Recovery Center, 515 N. Jefferson Ave., St. Louis, MO 63103

5.1.4 VASTHLC Primary Care Team 1 Annex, 4974 Manchester Ave., St. Louis, MO 63110

5.1.5 VASTHLC Primary Care Team 1 Annex, 2727 Washington Ave., St. Louis, MO 63103

5.1.6 St. Charles CBOC, 844 Waterbury Fall Drive, O’Fallon, MO 63368

5.1.7 St. Clair County CBOC, 1190 Fortune Boulevard, Shiloh, IL 62269

5.1.8 St. Louis CBOC, 6854 Parker Road, Florissant, MO 63033

5.1.9 Washing County CBOC, 1627 A Roy Drive, Washington, MO 63090

5.2 Work hours are listed in Central Time (CT). The current shifts are listed below but are subject to change. The Contractor shall furnish the services covered by this contract on all workdays as defined herein. Contractor may be required to furnish services on all calendar days. Actual shift hours may vary between the contractor, the hospitals and by specialties listed on this agreement.

5.2.3 First Shift Weekends (Saturday - Sunday)

7:30 am – 4:00 pm

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