36C25519Q0482-002.docx

Quality Assurance Surveillance Plan (QASP)

The contractor will be evaluated in accordance with the following:

1. PURPOSE

This Quality Assurance Surveillance Plan (QASP) provides a systematic method to evaluate performance for the stated contract. This QASP explains the following:

· What will be monitored?

· How monitoring will take place.

· Who will conduct the monitoring?

· How monitoring efforts and results will be documented.

This QASP does not detail how the contractor accomplishes the work. Rather, the QASP is created with the premise that the contractor is responsible for management and quality control actions to meet the terms of the contract. It is the Government’s responsibility to be objective, fair, and consistent in evaluating performance.

This QASP is a “living document” and the Government may review and revise it on a regular basis. However, the Government shall coordinate changes with the contractor through contract modification. Copies of the original QASP and revisions shall be provided to the contractor and Government officials implementing surveillance activities.

2. GOVERNMENT ROLES AND RESPONSIBILITIES

The following personnel shall oversee and coordinate surveillance activities.

a. Contracting Officer (CO) – The CO shall ensure performance of all necessary actions for effective contracting, ensure compliance with the contract terms, and shall safeguard the interests of the United States in the contractual relationship. The CO shall also assure that the contractor receives impartial, fair, and equitable treatment under this contract. The CO is ultimately responsible for the final determination of the adequacy of the contractor’s performance.

Assigned CO: Kayla Haas Organization or Agency: Network Contracting Office (NCO) 15

b. Contracting Officer’s Representative (COR) – The COR is responsible for technical administration of the contract and shall assure proper Government surveillance of the contractor’s performance. The COR shall keep a quality assurance file. The COR is not empowered to make any contractual commitments or to authorize any contractual changes on the Government’s behalf.

Assigned COR: Mark Lauridsen Organization or Agency: VA St. Louis Health Care System

3. CONTRACTOR REPRESENTATIVES

The following employee(s) of the contractor serve as the contractor’s program manager(s) for this contract.

a. Primary:

b. Alternate:

Quality Assurance Surveillance Plan (QASP)

4. PERFORMANCE STANDARDS

The contractor is responsible for performance of ALL terms and conditions of the contract. CORs will provide contract progress reports quarterly to the CO reflecting performance on this plan and all other aspects of the resultant contract. The performance standards outlined in this QASP shall be used to determine the level of contractor performance in the elements defined. Performance standards define desired services. The Government performs surveillance to determine the level of Contractor performance to these standards.

The Performance Requirements are listed below in Section 6. The Government shall use these standards to determine contractor performance and shall compare contractor performance to the standard and assign a rating. At the end of the performance period, these ratings will be used, in part, to establish the past performance of the contractor on the contract.

5. METHODS OF QA SURVEILLANCE

Various methods exist to monitor performance. The COR shall use the surveillance methods listed below in the administration of this QASP.

a. DIRECT OBSERVATION. 100% surveillance: Surveillance will be accomplished through site visits; interviews with the veterans, the veteran families, and staff; record review and will be done by COR and assigned VA staff, to evaluate all reports provided.

b. PERIODIC INSPECTION. Inspections scheduled and reported quarterly per COR delegation or as needed. COR will evaluate evaluations and treatment through documentation and/or contractor’s therapist’s notes; randomly selected files will be reviewed and conducted in compliance with VA Privacy and Information security standards.

c. VALIDATED USER/CUSTOMER COMPLAINTS. The Patient Safety Report will be utilized to maintain and track patient complaints; Information from the patient advocacy office will assist in validating the complaints.

d. RANDOM SAMPLING. Periodic Sampling will be taken when a problem and/or deficiency is suspected. Sample results are applicable only for the specific work being inspected. This will occur either on a monthly and/or quarterly basis. All reviews and reports will be conducted in compliance with VA Privacy and Information security standards.

6. QASP Matrix /Quarterly Report Format

Quarterly Report is due no later than the 15th of the beginning of each new quarter

"FOR Official USE ONLY"

1) Task Order #:

2) Contractor:

3) COR:

4) Surveillance Period:

Contracting Officer’s Representative Overall Comments:

1. Evidence-based practice

PWS para 6.2.1.1

Periodic Inspection

2. Consults and PMR standards

PWS para 6.2.1.2

Periodic Inspection

3. Assessments

PWS para 6.2.1.3

Assessments shall not exceed two episodes, on a quarterly basis, where documents are untimely, incomplete, or inaccurate.

Periodic Inspection;

Random Sampling

4. Datix Common Classification System

PWS para 6.2.1.4

5. Customer Service

PWS para 6.2.1.5

6. Productivity Standard

PWS para 6.2.1.6

7. Scheduling of Patients

PWS para 6.2.1.7

Validated User/Customer Complaints

8. Reporting as scheduled

PWS para 6.2.1.10

Shall not be tardy more than three shifts per quarter.

Direct Observation

9. Communication

PWS para 6.2.1.11

Communication, when unable to report, shall occur 100% of the time.

Direct Observation

10. Courtesy

PWS para 6.2.1.13

11. Mandatory Training

PWS para 6.2.1.14 PWS para 6.2.1.15

Mandatory training shall be completed on time.

Periodic Inspection

Periodic sampling Contractor personnel (s) shall provide evidence of annual training required by VAMC, reports violations per VA Directive 6500.6.

7. CPAR RATINGS ASSIGNED TO QASP ITEMS:

Metrics and methods are designed to determine rating for a given standard and acceptable quality level. The following ratings shall be used (Reference: CPARS User Manual https://www.cpars.gov/pdfs/CPARS-Guidance.pdf p. A2-1):

Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Note: To justify an Exceptional rating, you should identify multiple significant events in each category and state how it was a benefit to the GOVERNMENT. However a singular event could be of such magnitude that it alone constitutes an Exceptional rating. Also there should have been NO significant weaknesses identified.

Note: To justify a Very Good rating, you should identify a significant event in each category and state how it was a benefit to the GOVERNMENT. Also there should have been NO significant weaknesses identified.

Note: To justify a Satisfactory rating, there should have been only minor problems, or major problems the contractor recovered from without impact to the contract. Also there should have been NO significant weaknesses identified.

8. DOCUMENTING PERFORMANCE

The contractor shall acknowledge receipt of the CDR in writing. The CDR will specify if the contractor is required to prepare a corrective action plan to document how the contractor shall correct the unacceptable performance and avoid a recurrence. The CDR will also state how long after receipt the contractor has to present this corrective action plan to the CO. The Government shall review the contractor's corrective action plan to determine acceptability. The CO shall also assure that the contractor receives impartial, fair, and equitable treatment. The CO is ultimately responsible for the final determination of the adequacy of the contractor’s performance and the acceptability of the Contractor’s corrective action plan.

Any CDRs may become a part of the supporting documentation for any contractual action deemed necessary by the CO.

2. TO: (Contractor and Manager Name)

3. FROM: (Contracting Officer’s Representative Name)

DATES

CONTRACTOR NOTIFICATION:

4. DISCREPANCY OR PROBLEM (Describe in detail; Include reference in PWS / Directive. Attach continuation sheet if necessary.)

5. SIGNATURE OF CONTRACTING OFFICER’S REPRESENTATIVE (COR)

6. TO: (COR)

7. FROM: (Contractor)

8. CONTRACTOR RESPONSE AS TO CAUSE, CORRECTIVE ACTION, AND ACTIONS TO PREVENT RECURRENCE (Attach continuation sheet if necessary.)

9. SIGNATURE OF CONTRACTOR REPRESENTATIVE

10. DATE

11. GOVERNMENT EVALUATION OF CONTRACTOR RESPONSE/RESOLUTION PLAN (Acceptable response/plan, partial acceptance of response/plan, rejection. Attach continuation sheet if necessary)

12. GOVERNMENT ACTIONS (Payment withholding, cure notice, show cause, other.)

CLOSE OUT

CONTRACTOR

NOTIFIED

COR

CONTRACTING

OFFICER

9. COR AND CONTRACTOR ACKNOWLEDGEMENT OF QASP

SIGNED:

COR NAME/TITLE DATE

SIGNED:

CONTRACTOR NAME/TITLE DATE