36C25519Q0762-001.docx

36C25519Q0762

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

36C25519Q0762

Sciortino, Kathleen kathleen.sciortino@va.gov

(913) 946-1122 09-26-2019 4:00pm CST 36C255 Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway

Leavenworth KS 66048

X

621399 $8 Million

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 Financial Services Center http://www.fsc.va.gov/einvoice.asp

Austin TX 877-353-9791 512-460-5429

Under the authority of 38 USC 8153 and FAR Part 13.303 the Request for Quote (RFQ)36C25519Q0762 is for a non-personal healthcare resources for Certified Registered Nurse Anesthetist (CRNA) services for Kansas City Medical Center, Kansas City, MO.

Schedule of Services starts on pg. 6 Performance Work Statement starts on pg. 10 Instruction to Offerors starts on pg. 73

All questions relating to the RFQ can be directed to the POC listed under Section B, pg. 4

This RFQ is a Total Small Business Set Aside.

Notice of Total Small Business set-aside, applies to all items in this solicitation.

x

Table of Contents

SECTION A – STANDARD FORM 1449…….……………………………………………………1

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:

Address:

Overnight/Express Address if different from above:

Data Universal Numbering System (DUNS) Number:

Contact person(s) name:

Contact person(s) email:

Contact person(s) direct telephone:

Contact person(s) fax number:

b. GOVERNMENT: Contracting Officer 36C255 Kathleen Sciortino, Contracting Officer NCO 15 Healthcare Branch Kathleen.sciortino@va.gov, Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway Leavenworth KS 66048

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with FAR 52.232-33, Payment by Electronic Funds Transfer –System for Award Management

3. INVOICES: Invoices shall be submitted in arrears: Invoices shall be submitted in arrears: Submission will be monthly for the previous 30-day period and no later than 15 calendar days of close of the month being invoiced. Invoices will be based on the applicable fixed rates for services provided to referred Veterans in accordance with the contract. The Contracting Officer’s Representative (COR) will review all invoices submitted. The COR is responsible for certifying invoices for payment only for services received and deemed acceptable. Payment will not be authorized unless a proper invoice is submitted, reviewed and accepted

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

5. SECURE FAX: Please review VA Handbook 6500 that requires the following statement on all fax cover sheets be included (if you determine that 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: The Contracting Officer will schedule a post award orientation for contract orientation purposes as required by Procurement Policy Memorandum (PPM) 2019- 01. https://www.va.gov/oal/docs/business/pps/ppm201901.pdf ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

B.2 SCHEDULE OF SERVICES FOR HCR

The Contract Holder shall furnish all non-personnel to provide services necessary to perform onsite Locum Tenen Certified Registered Nurse Anesthesiologist (CRNA) Services to eligible beneficiaries of the Department of Veterans Affairs Medical Center Kansas City, MO (hereinafter referred to as VAMC). The Contract Holder’s personnel care shall cover the range of Anesthesiology services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards as established by: American Society of Anesthesiologist (ASA) Guidelines: http://www.asahq.org/For-Members/Standards-Guidelines-and-Statements.aspx All services shall be performed on-site at 4801 Linwood Blvd., Kansas City, MO 64128-2226; No services shall be off-site. The services are for one year with the option to extend for four (4) one (1) year options, which may be exercised at the discretion of the Government.

Prices shall be based on 0.5 FTE (1,040 hours) (Full Time Equivalent) Board Certified CRNA on an as needed basis; there are no on-call/ call back requirements). An FTE is defined by the VA as a minimum of 80 hours every two weeks and does not include holidays. The Contractor is not guaranteed a forty (40) hour work week or an eight (8) hour day. Personnel rendering services under this contract are not subject, either by the contract's terms or by the manner of its administration, to the supervision and control usually prevailing in relationships between the government and its employees.

The total estimated number of hours equivalent is 1,040 annually. Contractor’s CRNA shall “ONLY” be reimbursed for actual services rendered based on the hourly rates per CRNA CLIN for that period of performance. For all billing and payment processes and procedures, refer to the terms and conditions set forth within the Performance Work Statement under paragraph 6.2 through 6.4.

Contract Minimum and Maximum: In accordance with FAR Clause 52.216-22, Indefinite Quantity, the overall minimum amount established yearly is $2,500 and the overall maximum amount, not to exceed five years for this contract is $900,000.00. The Contractor shall furnish to the Government, when and if ordered, the supplies or services specified in the Schedule up to and including the quantity designated in the Schedule as the “maximum.” The Government shall order at least the quantity of supplies or services designated in the Schedule as the “minimum.

Contractor shall propose a minimum of one (1) key personnel to be credentialed and be available for scheduling to meet the requirements of the contract in your quote submission.

Pricing Instructions:

The offeror is instructed to edit the number of SUB-CLINS to correspond with the number of key personnel submitted for the CLIN. Also, renumber SUB-CLINs if adding additional Key Personnel.

Annual Cost

KEY PERSONNEL

TITLE: CRNA

Annual Cost

Option Year #1: One (1) year commencing on the day following the last day of the base year

Option Year 2: One (1) year commencing on the day following the last day of Option Year One (1)

Annual Cost

Option Year 3: One (1) year commencing on the day following the last day of Option Year One (2)

KEY PERSONNEL

Option Year 4: One (1) year commencing on the day following the last day of Option Year One (3)

KEY PERSONNEL

ESTIMATED GRAND TOTAL $____________________________

1. The services specified in the contract 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 contract; no other personnel are authorized to:

(A) Make changes to contract 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 contract.

(E) Terminate the contract in whole or in part.

(F) Render a decision under the Disputes Clause.

(G) Issue instructions to stop or start work, to exclude the scheduling of services.

2. For payment adjustments for prorated/partial hours worked see PWS 6.3. Payment Adjustments

B.3 PERFORMANCE WORK STATEMENT

Onsite CRNA services

1. General:

1.1. Services provided: This requirement will be a performance based, non-personal service contract acquisition for a period of performance of one (1) base year and up to four (4) one (1) year options if the Government excersies the options. Rates will be firm fixed price. The contract holder shall provide up to .5 Full Time Equivalent (FTE) (1040 hours) Certified Registered Nurse Anesthetist (CRNA) who has a current, unrestricted licensure in a state, territory or commonwealth of the United States or the District of Columbia. The CRNA is not guaranteed a forty (40) hour work week or an eight (8) hour day.

1.2. The services to be performed by the CRNA will be performed in strict accordance with Kansas City VAMC policies, procedures, and regulations and the medical staff by-laws (see Section D attachment D07) for the Kansas City VAMC.

1.3. Authority: title 38 USC 8153, Health Care Resources (HCR) sharing authority.

1.4. Policy/handbooks- the contract holder 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 https://www.va.gov/vapubs/viewpublication.asp?pub_id=969&ftype=2.

1.4.2. VHA Directive 2010-018 “Facility Infrastructure”

www.va.gov/vhapublications/viewpublication.asp?pub_id=2227

1.4.3. VHA Directive 1192 “Seasonal Influenza Prevention Program” https://www.va.gov/vhapublications/viewpublication.asp?pub_id=5472

1.4.4. VHA Handbook 1100.17: National Practitioner Data Bank Reports - https://www.va.gov/vhapublications/viewpublication.asp?pub_id=2135

1.4.5. VHA Handbook 1100.18 Reporting and Responding to State Licensing Boards - https://www.va.gov/vhapublications/viewpublication.asp?pub_id=1364

1.4.6. VHA Handbook 1100.19 Credentialing And Privileging - http://www.va.gov/vhapublications/viewpublication.asp?pub_id=2910

1.4.7. VHA Handbook 1907.01 Health Information Management And Health Records: https://www.va.gov/vhapublications/viewpublication.asp?pub_id=3088

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

1.5. 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. ABA: American board of anesthesiology http://www.theaba.org/

1.5.2. ACGME: Accreditation Council for Graduate Medical Education

1.5.3. ACLS: Advanced Cardiac Life Support

1.5.4. AOD: Admitting Officer of The Day

1.5.5. ASA: American Society of Anesthesiologists

1.5.6. BLS: Basic Life Support

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

1.5.8. CDC: Centers for Disease Control and Prevention

1.5.9. CR: Contract Discrepancy Report

1.5.10. CEU: Certified Education Unit

1.5.11. CME: Continuing Medical Education

1.5.12. CMS: Centers for Medicare and Medicaid Services

1.5.13. 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.

1.5.14. Contracting Officer’s Representative (COR) – a person appointed by the CO to take necessary action to ensure the contract holder 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.

1.5.15. COS Chief of Staff

1.5.16. CPARS: Contractor Performance Assessment Reporting System

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

1.5.18. CRNA: Certified Registered Nurse Anesthetist

1.5.19. 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.

1.5.20. DEA: Drug Enforcement Agency

1.5.21. ED: Emergency Department

1.5.22. FSMB: Federation of State Medical Boards

1.5.23. HHS: Department of Health and Human Services

1.5.24. HIPAA: Health Insurance Portability and Accountability Act

1.5.25. HR: Human Resources

1.5.26. ISO: Information Security Officer

1.5.27. 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.

1.5.28. MOD: Medical Officer of The Day

1.5.29. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans health administration must use NPIS in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers).

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

1.5.31. Non-contract provider - any person, organization, agency, or entity that is not directly or indirectly employed by the contract holder or any of its subcontract holders

1.5.32. NP: Nurse Practitioner

1.5.33. NPPES: National Plan and Provider Enumeration System

1.5.34. PA: Personnel Assistant

1.5.35. PALS: Pediatric Advanced Life Support

1.5.36. POP: Period of Performance

1.5.37. PPD: Purified Protein Derivative

1.5.38. PWS: Performance Work Statement

1.5.39. 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.

1.5.40. QA/QI: Quality Assurance/Quality Improvement

1.5.41. QM/PI: Quality Management/Performance Improvement

1.5.42. QASP: Quality Assurance Surveillance Plan

1.5.43. 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.

1.5.44. Veterans Integrated Services Network (VISN: the regional oversight for the VA medical centers.

1.5.45. 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.

1.5.46. VETPRO: a federal web-based credentialing program for healthcare providers.

1.5.47. 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 medical center.

2. Qualifications:

2.1. Staff/facility

2.1.1. License - The contract holder shall assure professional competence of all personnel provided to the VAMC.

2.1.2. Personnel assigned by the contract holder to perform the services covered by this contract shall have a current license to practice medicine in any state, territory, or Commonwealth of the United States or the District of Columbia when services are performed onsite on VA property.

2.1.3. All licenses/certifications held by the personnel working on this agreement shall be full and unrestricted licenses. The qualifications of such personnel shall also be subject to review by the VAMC Chief of Surgery.

2.1.4. Evidence of completion of required education/licensure, credentials, required training, current competencies and commencement of background investigations must be validated for all contract provider(s) referred to perform services under this agreement prior to providing direct patient care.

2.1.5. Credentialing and Privileging –Credentialing and Privileging is to be done in accordance with the provisions of VHA Handbook 1100.19 referenced above. The contract holder is responsible to ensure that proposed personnel(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any contract holder’s personnel prior to obtaining approval by the Kansas City VAMC Professional Standards Board, Medical Executive Board and Medical Center Director.

2.1.5.1. If a contract holder’s personnel are not credentialed and privileged or has credentials/privileges suspended or revoked, the contract holder shall furnish an acceptable substitute without any additional cost to the government.

2.1.6. Technical proficiency - contract holder’s personnel shall be technically proficient in the skills necessary to fulfill the government’s requirements, including the ability to speak, understand, read and write English fluently. Contract holder shall provide documents upon request of the CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed. Contract holder shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contract holder’s personnel and contract holder’s personnel shall be responsible for abiding by the facility's medical staff by-laws, rules, and regulations (referenced herein) that govern medical staff behavior.

2.1.7. Continuing Medical Education (CME)/ Certified Education Unit (CEU) requirements: contract holder shall provide the COR copies of current CMES as required or requested by the VAMC. Contract holder’s personnel registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. Contract holder shall report CME hours to the credential’s office for tracking. These documents are required for both privileging and re-privileging. Failure to provide shall result in loss of privileges for contract holder’s personnel.

2.1.8. Training (ACBLS, CPARS and VA mandatory): contract holder shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the contract holder’s personnel as required by the VA. Other training may become required. VA will communicate any changes to the training requirement to the contract holder.

2.1.9. Standard personnel testing (PPD, etc.): contract holder shall provide proof of the following tests for personnel within five (5) calendar days after contract award and prior to the first duty shift to the COR and contracting officer. Tests shall be current within the past year.

2.1.10. Tuberculosis testing: contract holder shall provide proof of a negative tuberculosis skin test (TST) or interferon-gamma release assays (IGRA) for all contract holder’s personnel {this is applicable to all health care 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.

2.1.11. Measles, mumps, & rubella testing: contract holders shall provide proof of immunity for all contract holder’s personnel {this is applicable to all health care workers}.

2.1.12. Varicella: contract holders shall provide proof of immunity for all contract holder’s personnel {this is applicable to all health care workers}.

2.1.13. Acellular pertussis: contract holders shall provide proof of 1 dose of TDAP vaccination for all contract holder’s personnel {this is applicable to all health care workers}.

2.1.14. Influenza: contract holders shall provide proof that all contract holder’s personnel have received the annual influenza vaccine unless it is contraindicated. If the contract holder’s personnel have a medical contraindication to the vaccine, they shall be required to wear a mask during the influenza season. {this is applicable to all health care workers}.

2.1.15. Osha regulation concerning occupational exposure to bloodborne pathogens: contract holder shall provide evidence of completing and passing generic self-study blood-borne pathogen training for all contract holder’s personnel {this is applicable to all health care 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.

2.1.16. The VAMC shall notify the contract holder of any significant communicable disease exposures as appropriate. Contract holder shall adhere to current CDC/HICPAC guideline for infection control in health care personnel ( as published in American journal for infection control- AIIC1998; 26:289-354 http://www.cdc.gov/hicpac/pdf/infectcontrol98.pdf) for disease control. Contract holder shall provide follow up documentation of clearance to return to the workplace prior to their return.

2.1.17. National provider identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers). The contract holder shall have or obtain appropriate NPI and if pertinent the taxonomy code confirmation notice issued by the centers for Medicare and Medicaid services (CMS) National Plan and Provider Enumeration System (NPPES) be provided to the contracting officer with the proposal.

2.1.18. Drug Enforcement Agency (DEA) (as required) - contract holder shall provide copy of current DEA certificate.

2.1.19. Conflict of Interest: the contract holder and all contract holder’s personnel 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. At the time of proposal, the contract holder 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. The contract holder shall also provide statements containing the same information for any identified consultants or subcontract holders who shall provide services. The contract holder must also provide relevant facts that show how it’s organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest. These statements shall be in response to the VAAR provision 852.209-70 organizational conflicts of interest (Jan 2008). (See Section D attachment D03).

2.1.20. Citizenship Related Requirements:

2.1.20.1. The contract holder certifies that the contract holder shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, as amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the contract holder while providing services to Department Of Veterans Affairs patient referrals;

2.1.20.2. While performing services for the Department of Veterans Affairs, the contract holder shall not knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States. Additionally, the contract holder is required to comply with all “e-verify” requirements consistent with “executive order 12989” and any related pertinent amendments, as well as applicable federal acquisition regulations.

2.1.20.3. If the contract holder fails to comply with any requirements outlined in the preceding paragraphs or its agency regulations, the Department Of Veterans Affairs may, at its discretion, require that the foreign national who failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor, shall be prohibited from working at the contract holder’s place of business that services Department of Veterans Affairs patient referrals; or other place where the contract holder provides services to veterans who have been referred by the Department of Veterans Affairs; and shall form the basis for termination of this contract for breach.

2.1.20.4. This certification concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under 18 U.S.C. 1001.

2.1.20.5. The contract holder agrees to obtain a similar certification from its subcontract holders. The certification shall be made as part of the offeror’s response to the RFQ (see Section D, attachment D02).

2.1.21. Annual office of Inspector General (OIG) statement: in accordance with HIPAA and the Balanced Budget Act (BBA) of 1977, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) has established a list of parties and entities excluded from federal health care programs. Specifically, the listed parties and entities may not receive federal health care program payments due to fraud and/or abuse of the Medicare and Medicaid programs.

2.1.21.1. Therefore, contract holder shall review the HHS OIG list of excluded individuals/entities on the HHS OIG web site at http://oig.hhs.gov/exclusions/index.asp to ensure that the proposed contract holder’s personnel are not listed. Contract holder should note that any excluded individual or entity that submits a claim for reimbursement to a federal health care program, or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty (CMP) for each item or service furnished during a period that the person was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMP’s may also be imposed against the contract holder that employ or enter into contracts with excluded individuals to provide items or services to federal program beneficiaries.

2.1.21.2. By submitting their proposal, the contract holder certifies that the HHS OIG list of excluded individuals/entities has been reviewed and that the contract holders are and/or firm is not listed as of the date the offer/bid was signed.

2.2. Clinical/professional performance: the qualifications of contract holder personnel are subject to review by VA Medical Center cos or his/her clinical designee and approval by the Medical Center Director as provided in VHA Handbook 1100.19. Clinical/professional performance monitoring and review of all clinical personnel covered by this contract for quality purposes will be provided by the VAMC cos and/or the chief of the service or his designee. A clinical COR may be appointed, however, only the CO is authorized to consider any contract modification request and/or make changes to the contract during the administration of the resultant contract.

2.3. Non-personal healthcare services: the parties agree that the contract holder and contract holder’s personnel shall not be considered VA employees for any purpose.

2.4. Indemnification: the contract holder shall be liable for, and shall indemnify and hold harmless the government against, all actions or claims for loss of or damage to property or the injury or death of persons, arising out of or resulting from the fault, negligence, or act or omission of the contract holder, its agents, or employees.

2.5. Prohibition against self-referral: contract holder’s personnel are prohibited from referring VA patients to contract holder’s or their own practice(s)

2.6. Inherent government functions: contract holder and contract holder’s personnel shall not perform inherently governmental functions. This includes, but is not limited to, determination of agency policy, determination of federal program priorities for budget requests, direction and control of government employees (outside a clinical context), selection or non-selection of individuals for federal government employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for federal employees, approving any contractual documents, approval of federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy.

2.7. No employee status: the contract holder shall be responsible for protecting contract holder’s personnel (s) furnishing services. To carry out this responsibility, the contract holder shall provide or certify that the following is provided for all their staff providing services under the resultant contract:

2.7.1. Workers’ compensation

2.7.2. Professional liability insurance

2.7.3. Health examinations

2.7.4. Income tax withholding, and

2.7.5. Social security payments.

2.8. Tort liability: the federal tort claims act does not cover contract holder or contract holder’s personnel. When contract holder or contract holder’s personnel has been identified as a provider in a tort claim, the contract holder shall be responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a contract holder’s (or contract holder’s personnel) action or non-action shall be the responsibility of the contract holder and/or insurance carrier.

2.9. Key personnel:

2.9.1. Personnel assigned to this agreement by the contract holder and added via the issuance of a task order are designated as key personnel.

2.9.2. The VA full time equivalency (FTE) for the services required is 1040 hours= .5 VA FTE. FTE is defined by VA as a minimum of 80 hours every two weeks and does not include holidays.

2.9.3. The contract holder shall be responsible for providing coverage to the VA during periods of vacancies of the contract holder’s personnel due to sick leave, personal leave, vacations and additional coverage as required only during the hours of operation listed in paragraph 3.0. In the event a scheduled contracted CRNA is unable to complete an assigned shift, the contract holder who provided the contracted CRNA, shall provide replacement CRNA coverage within 2 hours and notify the contracting office representative (COR) at the Kansas City VAMC immediately of the schedule change. If one cannot be provided, the CO or COR will follow up with awarded contract holders for replacement coverage possibilities.

2.9.4. Personnel substitutions: during the first ninety (90) calendar days of performance, the contract holder shall make no substitutions of key personnel unless the substitution is necessitated by illness, death or termination of employment. The contract holder shall notify the CO, in writing, within fifteen (15) calendar day (s) after the occurrence of any of these events and provide the information required below. After 90 days, the contract holder shall submit the information required below to the CO at least fifteen (15) calendar days prior to making any permanent substitutions.

2.9.4.1. The contract holder shall provide a detailed explanation of the circumstances necessitating the proposed substitutions, complete resumes for the proposed substitutes, and any additional information requested by the CO. Proposed substitutes shall have comparable qualifications to those of the persons being replaced. The CO will notify the contract holder within fifteen (15) calendar days after receipt of all required information of the decision on the proposed substitutes. The contract will be modified to reflect any approved changes of key personnel.

2.9.4.2. For temporary substitutions where the key person shall not be reporting to work for three (3) consecutive work days or more, the contract holder shall provide a qualified replacement for the key person. The substitute shall have comparable qualifications to the key person. Any period exceeding two weeks will require the procedure as stated above.

2.9.4.3. The government reserves the right to refuse acceptance of any contract holder personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. Should the VA cos or designee show documented clinical problems or continual unprofessional behavior/actions with any contract holder’s personnel, s/he may request, without cause, immediate replacement of said contract holder’s personnel. The CO and COR shall deal with issues raised concerning contract holder’s personnel conduct. The final arbiter on questions of acceptability is the CO.

2.9.4.4. Contingency plan: because continuity of care is an essential part of VAMC’s medical services, the contract holder shall have a contingency plan in place to be utilized if the contract holder’s personnel leaves contract holder’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract.

3. Hours of Operation

3.1. VA business hours: Kansas City VAMC administrative hours: Monday through Friday, 8:00 a.m. – 4:00 p.m.

clinic or OR Schedule: 6:30am to 3:00 pm Patients must be seen by a contract holder’s personnel (s) on-site at Kansas City VAMC in a timely manner in accordance with VA rules and regulations on clinic wait times and consult completion.

3.1.1. Contract holder’s personnel shall be available and present during normal Kansas City VAMC clinic hours. Kansas City VAMC clinic hours may be revised, as deemed appropriate for patient care by the chief of staff. Currently, normal clinic hours are Monday through Friday 6:30 a.m. - 3:00 p.m. All contracted CRNA services will be performed during the hours shift referenced as such. There will be no on-call or call back requirements under the terms and conditions set forth within this PWS.

3.1.2. The contract holder and/or contract holder’s employee must be able to perform the required services for the period specified in the order for services.

3.2. Federal holidays: the following holidays are observed by the department of Veterans Affairs:

· New Year’s Day

· President’s Day

· Martin Luther king’s birthday

· Memorial Day

· Independence Day

· Labor Day

· Columbus Day

· Veterans Day

· Thanksgiving

· Christmas

· Any day specifically declared by the president of the United States to be a national holiday.

3.3. Cancellations: the contract holder shall be responsible notifying the Contracting Officer Representative (COR) at the Kansas City VAMC immediately of cancellations and rescheduling of clinics.

3.3.1. Unless a state of emergency has been declared, the contract holder shall be responsible for providing services.

4. Contract holder responsibilities

4.1. Clinical personnel required: the contract holder shall provide contract holder’s personnel who are competent, qualified per this performance work statement and adequately trained to perform assigned duties.

4.1.1. Contract holder’s personnel shall be responsible for signing in and out when in attendance. Time sheets will be used by the to confirm hours/day and services provided against the contract holder’s invoices. (see section d attachment d05 consultant and attending visit record form)

4.2. Standards of care: the contract holder’s personnel care shall cover the range of anesthesiology services as would be provided in a state-of-the-art health care facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards as established by:

4.2.1. American Society of Anesthesiology (ASA) guidelines: http://www.asahq.org/for-members/standards-guidelines-and-statements.aspx

4.2.2. The Professional Standards of the Joint Commission (TJC) http://www.jointcommission.org/standards_information/standards.aspx

4.2.3. The Standards of the American Hospital Association (aha) http://www.hpoe.org/resources?show=100&type=8 and;

4.2.4. The requirements contained in this PWS.

4.3. Medical records

4.3.1. Authorities: contract holder’s personnel providing healthcare services to VA patients shall be considered as part of the department healthcare activity and shall comply with the U.S.C. 551a (privacy act), 38 U.S.C. 5701 (confidentiality of claimants records), 5 U.S.C. 552 (FOIA), 38 U.S.C. 5705 (confidentiality of medical quality assurance records) 38 U.S.C. 7332 (confidentiality of certain medical records), title 5 U.S.C. § 522a (records maintained on individuals) as well as 45 C.F.R. parts 160, 162, and 164 (HIPAA).

4.3.2. HIPAA: this contract and its requirements meet exception in 45 CFR 164.502(e), and do not require a baa in order for covered entity to disclose protected health information to: a health care provider for treatment. Based on this exception, a baa is not required for this contract. Treatment and administrative patient records generated by this contract or provided to the contract holders by the VA are covered by the VA system of records entitled ‘patient medical records-VA’ (24va19). Contract holder generated VA patient records are the property of the VA and shall not be accessed, released, transferred, or destroyed except in accordance with applicable laws and regulations. Contract holder shall ensure that all records pertaining to medical care and services are available for immediate transmission when requested by the VA. Records identified for review, audit, or evaluation by VA representatives and authorized federal and state officials, shall be accessed on-site during normal business hours or mailed by the contract holder at his expense. Contract holder shall deliver all final patient records, correspondence, and notes to the VA within twenty-one (21) calendar days after the contract expiration date.

4.3.3. Disclosure: contract holder’s personnel may have access to patient medical records: however, contract holder shall obtain permission from the VA before disclosing any patient information. Subject to applicable federal confidentiality or privacy laws, the contract holder, or their designated representatives, and designated representatives of federal regulatory agencies having jurisdiction over contract holder, may have access to VA ‘s records, at VA’s place of business on request during normal business hours, to inspect and review and make copies of such records. The VA will provide the contract holder with a copy of VHA handbook 1907.1, health information management and health records and VHA handbook 1605.1, privacy and release of information. The penalties and liabilities for the unauthorized disclosure of VA patient information mandated by the statutes and regulations mentioned above, apply to the contract holder.

4.3.4. Professional standards for documenting care: care shall be appropriately documented in medical records in accordance with standard commercial practice and guidelines established by VHA handbook 1907.01 health information management and health records: http://www1.va.gov/vhapublications/viewpublication.asp?pub_id=2791 and all guidelines provided by the VAMC.

4.3.5. Release of Information: the VA shall maintain control of releasing any patient medical information and will follow policies and standards as defined, but not limited to privacy act requirements. In the case of the VA authorizing the contract holder to release patient information, the contract holder in compliance with VA regulations, and at his/her own expense, shall use VA form 3288, request for and consent to release of information from individual’s records, to process “release of information requests.” In addition, the contract holder shall be responsible for locating and forwarding records not kept at their facility. The VA’s release of information section shall provide the contract holder with assistance in completing forms. Additionally, the contract holder shall use VA form 10-5345, request for and authorization to release medical records or health information, when releasing records protected by 38 U.S.C.. 7332. Treatment and release records shall include the patient’s consent form. Completed release of information requests will be forwarded to the VA privacy officer at the following address: Ann Lynn Olkowski (816)861-4700 ext.56001

4.4. Direct patient care: estimated 90% of the time involved in direct patient care.

4.4.1. Per the qualification section of this PWS, the contract holder shall provide the following staff:

4.4.1.1. Board certified /board eligible anesthesiologist.

4.4.2. Scope of care: contract holder’s personnel (as appropriate and within scope of practice/privileging) shall be responsible for providing anesthesiology care, including, but not limited to:

4.4.2.1. Clinic and surgical care: contract holder’s personnel shall provide clinical anesthesiology services. Contract holder’s personnel shall be present on time for any scheduled clinics/surgeries as documented by physical presence in the clinic or operating room at the scheduled start time.

4.4.2.1.1. Operative services: contract holder’s personnel shall provide comprehensive clinical anesthesiology services including patients undergoing cardiac surgery, orthopedic joint replacement, and major vascular, thoracic, neurosurgical, plastic, ENT, urologic and ophthalmologic operations.

4.4.2.1.2. Contract holder’s personnel shall provide clinical care of patients undergoing electroconvulsive therapy and diagnostic and therapeutic procedures in the cardiac catheterization laboratory, electrophysiology, gastrointestinal and radiological suites.

4.4.2.1.3. Contract holder’s personnel shall provide primary coverage for all patients in the surgical intensive care, short stay unit, acute and chronic pain management services, diagnostic trans…