36C25520Q0255.pdf

PAGE 1 OF 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. DUNS: DUNS+4:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 90

36C25520Q0255 9-8-2020

ASHLEY OSBORN, CONTRACTING OFFICER 913-946-1112 10-09-2020

5:00 CST

00255 Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street

Leavenworth KS 66048 x

621492

$38.5 Million

X

N/A

X

00255

Department of Veterans Affairs

NCO 15 Contracting 3450 S 4th Street Leavenworth KS 66048

00255

Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street

00255

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 Public Law 104-262, FAR Part 12 and VAAR 873, the contractor is to provide non-personal health-care services and equipment for the Columbia, MO VAMC in accordance with the terms, conditions and prices as stated herin. Healthcare resources consist of registered nurses trained in dialysis and equipment as outlined in the Performance Work Statement.

est

X X x 1

ASHLEY OSBORN

Contracting Officer

36C25520Q0255

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 SUBCONTRACTING PLAN--MONITORING AND COMPLIANCE (JUN 2011)

B.3 SCHEDULE OF SERVICES

B.4 PERFORMANCE WORK STATEMENT FOR ON-SITE DIALYSIS SERVICES

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (OCT

2018)

C.2 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.3 52.204-9 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR PERSONNEL

(JAN 2011)

C.4 52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR INFORMATION

SYSTEMS (JUN 2016)

C.5 52.204-25 PROHIBITION ON CONTRACTING FOR CERTAIN

TELECOMMUNICATIONS AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT

(AUG 2019)

C.6 52.216-18 ORDERING (OCT 1995)

C.7 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.8 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.9 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.10 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

C.11 52.228-5 INSURNACE-WORK ON A GOVERNMENT INSTALLATION (JAN 1997) . 45

C.12 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.13 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR 1984)

C.14 852.212-70 PROVISIONS AND CLAUSES APPLICABLE TO VA ACQUISITION OF

COMMERCIAL ITEMS (APR 2020)

C.15 VAAR 852.219-76 SUBCONTRACTING PLANS MONITORING AND COMPLIANCE

(JUL 2018) (DEVIATION)

C.16 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (MAR 2020)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS (MAR 2020)

E.2 52.204-7 SYSTEM FOR AWARD MANAGEMENT (Oct 2018)

E.3 52.204-16 COMMERCIAL AND GOVERNMENT ENTITY CODY REPORTING (JUL

2016)

E.4 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (DEC 2019)

E.5 52.204-26 COVERED TELECOMMUNICATIONS EQUIPMENT OR SERVICES—

REPRESENTATION (DEC 2019)

E.6 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.7 52.216-1 TYPE OF CONTRACT (APR 1984)

E.8 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.9 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL

ITEMS (MAR 2020)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

(continuation from Standard Form 1449, block 18A.)

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

a. CONTRACTOR:

Name of Company:

Name:

Title:

Address:

Overnight/Express address if different from above:

E-Mail Address:

Phone No.: Toll Free No.:

Fax No.:

DUNS Number: ___________________________________

b. GOVERNMENT: Contracting Officer 36C255 Ashley Osborn

Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway

Email: Ashley.Osborn@va.gov

SECURE FAX - Please review VA Handbook 6500 that requires the following statement on all fax cover sheets be included:

“This fax is intended only for the use of the person or office to which it is addressed and may contain information that is privileged, confidential, or protected by law. All others are hereby notified that the receipt of this fax does not waive any applicable privilege or exemption for disclosure and that any dissemination, distribution, or copying of this communication is prohibited. If you have received this fax in error, please notify this office immediately at the telephone number listed above.”

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor should be mailed to the following address:

[X] 52.232-33, Payment by Electronic Funds Transfer—System for Award Management, or

[] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] monthly in arrears

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

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

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

AMENDMENT NO DATE

B.2 SUBCONTRACTING PLAN--MONITORING AND COMPLIANCE (JUN 2011)

This solicitation includes FAR 52.219-9, Small Business Subcontracting Plan, and VAAR 852.219-9, VA Small Business Subcontracting Plan Minimum Requirement. Accordingly, any contract resulting from this solicitation will include these clauses. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) to assist in assessing the contractor's compliance with the plan, including reviewing the contractor's accomplishments in achieving the subcontracting goals in the plan.

To that end, the support contractor(s) may require access to the contractor's business records or other proprietary data to review such business records regarding the contractor's compliance with this requirement.

All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor compliance with the subcontracting plan.

(End of Clause)

B.3 SCHEDULE OF SERVICES

The Contractor shall furnish all personnel, supplies, and equipment to provide services necessary to perform onsite acute/chronic beside dialysis services to eligible beneficiaries of the Department of Veterans Affairs Medical Center, Harry S. Truman Memorial Veterans Hospital (hereinafter referred to as VAMC). Services will be for inpatients and outpatients on an as need basis.

This is a firm fixed price indefinite delivery, indefinite quantity solicitation since it is impossible to determine with any certainty the amount of services that will be required under this contract. The period of performance for this contract will be for a Base Year plus four (4) Option Years. There is no guarantee that option years will be exercised. The minimum value of services and maximum value of services to be provided under this contract during each contract year are as follows:

A. The prices provided in the Price Schedule shall be inclusive of all CLINs defined in the PWS.

B. In accordance with FAR Clause 52.216-22, Indefinite Quantity, the overall contract minimum is

$5,000 and the overall maximum contract amount established for this contract is $1,500,000.

Place of Performance: Services shall be provided on site, Harry S. Truman Memorial Veterans Hospital, 800 Hospital Drive, Columbia MO 65201

Period of Performance: BASE YEAR: January 1, 2021 – December 31, 2022

OPTION YEAR 1: January 1, 2022 – December 31, 2023

CLIN No.

Description

Estimated Qty. Unit

Estimated Unit Cost

Estimated Total Cost

0001 Acute Inpatient Hemodialysis provided to inpatients at VAMC

Each

0002 Acute ICU Hemodialysis provided to inpatients at VAMC

95 Each

0003 Acute Inpatient Peritoneal Dialysis provided to inpatients at VAMC

42 Each

Acute ICU Peritoneal Dialysis provided to inpatients at VAMC

Each

Continuous Renal Replacement Therapy (CRRT)

Each

Estimated Total for Base Year

CLIN No.

Description

Estimated Qty. Unit

Estimated Unit Cost

Estimated Total Cost

1001 Acute Inpatient Hemodialysis provided to inpatients at VAMC

254 Each

OPTION YEAR 2: January 1, 2023 – December 31, 2024

OPTION YEAR 3: January 1, 2024 – December 31, 2025

1002 Acute ICU Hemodialysis provided to inpatients at VAMC

92 Each

1003 Acute Inpatient Peritoneal Dialysis provided to inpatients at VAMC

214 Each

Acute ICU Peritoneal Dialysis provided to inpatients at VAMC

48 Each

Continuous Renal Replacement Therapy (CRRT)

93 Each

Estimated Total for Option Year 1

CLIN No.

Description

Estimated Qty. Unit

Estimated Unit Cost

Estimated Total Cost

2001 Acute Inpatient Hemodialysis provided to inpatients at VAMC

293 Each

2002 Acute ICU Hemodialysis provided to inpatients at VAMC

48 Each

2003 Acute Inpatient Peritoneal Dialysis provided to inpatients at VAMC

60 Each

Acute ICU Peritoneal Dialysis provided to inpatients at VAMC

87 Each

Continuous Renal Replacement Therapy (CRRT)

127 Each

Estimated Total for Option Year 2

CLIN No.

Description

Estimated Qty. Unit

Estimated Unit Cost

Estimated Total Cost

3001 Acute Inpatient Hemodialysis provided to inpatients at VAMC

473 Each

3002 Acute ICU Hemodialysis provided to inpatients at VAMC

43 Each

3003 Acute Inpatient Peritoneal Dialysis provided to inpatients at VAMC

75 Each

OPTION YEAR 4: January 1, 2025 – December 31, 2026

Estimated total for base performance period and all option years: $________________________

Acute ICU Peritoneal Dialysis provided to inpatients at VAMC

109 Each

Continuous Renal Replacement Therapy

(CRRT)

69 Each

Estimated Total for Option Year 3

CLIN No.

Description

Estimated Qty. Unit

Estimated Unit Cost

Estimated Total Cost

4001 Acute Inpatient Hemodialysis provided to inpatients at VAMC

621 Each

4002 Acute ICU Hemodialysis provided to inpatients at VAMC

56 Each

4003 Acute Inpatient Peritoneal Dialysis provided to inpatients at VAMC

24 Each

Acute ICU Peritoneal Dialysis provided to inpatients at VAMC 143

Each

Continuous Renal Replacement Therapy (CRRT) 96

Each

Estimated Total for Option Year 4

B.4 PERFORMANCE WORK STATEMENT FOR ON-SITE DIALYSIS SERVICES

1. GENERAL INFORMATION

a. General

Under the authority of Public Law 104-262, FAR Parts 12, and VAAR 873, the Contractor agrees to provide health care resources (i.e. on-site acute/chronic dialysis services) in accordance with the terms, conditions and prices stated herein to the Department of Veterans Affairs, Columbia, MO (the

“VAMC”).

a. Description of Services

(1) The Contractor shall provide needed labor, supplies, and equipment. Personnel assigned by the contractor to perform services covered by the contract shall have an unrestricted license from the state of Missouri.

(2) The services to be performed by the registered nurse trained in dialysis will be performed in strict accordance with VAMC policies, procedures, and regulations and the medical staff by-laws (refer to attachment) of the VAMC.

(3) The contract providers will be responsible for the provision of the ordered services to include set-up and safety check of the equipment and water treatment systems, initiating, monitoring and terminating treatment, documenting of procedures and clean-up and storage of dialysis equipment and supplies.

b. Scope

(1) “Contractor employee” within this contract is defined as employee/personnel of the prime contractor or of any subcontractor, affiliate, partner, joint venture, or team members with which the Contractor is associated. It also includes consultants engaged by any of those entities.

(2) The services specified in this 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 contract price, as well as no cost changes.

(B) Require extras or work outside the scope of the contract.

(C) Authorize delivery or disposition of Government property not authorized by the contract.

(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 the contractor to stop or start work, to exclude scheduling of services.

c. Place of Performance

(1) The work to be performed under this contract will be performed at the Harry S. Truman VA Medical Center, 800 Hospital Drive, Columbia, MO 65201.

d. Period of Performance

(1) This contract is for a period of one (1) year from effective date listed in block 3 of the SF 1449, plus four (4) one-year option periods that may be exercised at the sole discretion of the Government.

e. Type of Contract

(1) Contract will be Firm Fixed Price, Indefinite Delivery, Indefinite Quantity (IDIQ).

f. Contracting Officer’s Representative (COR)

(1) Pursuant to VAAR Provision 852.270-1, Representatives of Contracting Officer, the designated representative for this contract is Eric Van Alstine, Administrative Officer, Patient Services.

(2) The Contracting Officer’s Representative (COR) will be responsible for the overall technical administration of this contract as outlined in the COR Delegation of Authority. The Contracting Officer’s Representative contact information is as follows:

Eric Van Alstine Administrative Officer, Patient Services Columbia, MO VA Medical Center 800 Hospital Drive Columbia, MO 65201 Phone: 573-814-6208 E-mail: eric.vanalstine@va.gov

g. Contract Administration Data

(1) All contract administration functions will be retained by the Department of Veterans Affairs. The Contracting Officer will be the only person authorized to approve changes or modify any of the requirements under this contract. The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration. Only the Contracting Officer will be authorized to make commitments or issue changes that affect price, quantity, or quality of performance of this contract. In the event the Contractor effects any such change at the direction of any person other than the Contracting Officer, the change shall be considered unauthorized and no adjustment will be made in the contract price to cover any increase in costs incurred as a result thereof.

(2) After award of contract, all inquiries and correspondence relative to the administration of the contract shall be addressed to:

Ashley Osborn Contract Specialist Network Contracting Office 15 3450 South 4th Street Trafficway

Leavenworth, KS 66048 Phone: 913-946-1112 Fax: 913-946-1198 E-mail: Ashley.osborn@va.gov

h. Acronyms and Definitions

ANNA: American Nephrology Nurses Association

BLS: Basic Life Support. Knowledge and skills to deploy interventions for patients with life-threatening illnesses or injuries until the patient can be given full medical care.

CDC: Center for Disease Control

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.

CLIN: Contract Line Item Number. Unit of work (or supply) to be performed (or delivered) by the contractor as a pay item.

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

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.

CPARS: Contractor Performance Assessment Reporting System. A suite of web-enabled applications that are used to document contractor and grantee performance information that is required by Federal Regulations.

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

CV: Curriculum Vitae. Detailed written description of work experience, educational background and skills.

DOL: Department of Labor.

EHR: Electronic Health Record

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.

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 healthcare-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.

HR: Human Resources.

ICU: Intensive Care Unit: Hospital unit in which is concentrated special equipment and trained personnel for the care of seriously ill patients requiring immediate and continuous attention.

ISO: Information Security Officer. Individual within the VA responsible for ensuring information assets (i.e. VA sensitive information) are adequately protected.

NCO: Network Contracting Office.

NIST: National Institute of Standards and Technology. The federal technology agency that works with industry to develop and apply technology, measurements, and standards.

OCI: Organizational Conflict of Interest. Means that because of other activities or relationships with other persons, a person is unable or potentially unable to render impartial assistance or advice to the Government, or the person's objectivity in performing the contract work is or might be otherwise impaired, or a person has an unfair competitive advantage.

OMB: Office of Management and Budget.

OPM: Office of Personnel Management.

OR: Operating Room

PCU: Progressive Care Unit: Hospital unit specializing in the treatment of medical and surgical patients whose needs are not serious enough for the Intensive Care Unit (ICU) but too complex for the regular hospital floor.

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.

PO: Privacy Officer. Individual within the VA who is responsible for managing the risks and impacts of privacy laws and policies.

PWS: Performance Work Statement. A statement of work for performance-based acquisitions that describes the required results in clear, specific and objective terms with measurable outcomes.

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

QASP: Quality Assurance Surveillance Plan. A written document specifying the method used for surveillance of contractor performance.

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

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

TJC: The Joint Commission. Organization that accredits health care organizations and programs in the United States.

VA: Veterans Affairs (or Department of Veterans Affairs).

VAMC: Veterans Affairs Medical Center.

VETS-100: Veterans Employment and Training Service report. Reporting required pursuant to the Vietnam Era Veterans' Readjustment Act of 1972. Federal contractors and subcontractors covered by the Act's affirmative action provisions are required to report annually to the Secretary of Labor the number of employees in their workforces, by job category and hiring location, who are qualified covered veterans.

VHA: Veterans Health Administration.

VISN: Veterans Integrated Service Network. A regional network within the VHA responsible for conducting daily operations and decisions affecting hospitals, clinics, nursing homes, and Vet Centers located within the network.

VISTA (also VistA): Veterans Health Information Systems and Technology Architecture. An integrated system of software applications that directly supports patient care at Veterans Health Administration (VHA) healthcare facilities.

VPN: Virtual Private Network. A secure network that uses primarily public telecommunication infrastructures, such as the Internet, to provide remote offices or traveling users an access to a central organizational network.

2. PERSONNEL

a. Non-Personal Services

(1) This is a non-personal services contract. 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 Government shall not exercise any supervision or control over the contract service providers performing services herein. Such contract service providers shall be accountable solely to the Contractor who, in turn, is responsible to the Government.

b. Tort Claims

(1) Contractor employees are not covered by the Federal Tort Claims Act. When a Contractor employee has been identified as a provider in a tort claim, the Contractor employee is responsible for notifying the Contractor’s legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor employee’s action or non-action is the responsibility of the Contractor and/or insurance carrier.

c. Qualifications

(1) Personnel assigned by the Contractor to perform the services covered by this contract shall be licensed in the State of Missouri. All licenses held by the personnel working on this contract shall be full and unrestricted licenses. The qualifications of such personnel shall also be subject to review by the

VAMC Executive Committee, Chief of Staff and approval by the VAMC Director. Each person assigned by the Contractor to work under this contract shall be licensed by the governing or cognizant licensing board.

(2) The Registered Nurse(s) trained in dialysis shall be BLS certified.

(3) The Contractor(s) shall assure professional competence of all personnel provided to the VAMC.

Personnel assigned by the contract holder(s) to perform the services covered by this contract shall have knowledge of the following standards:

(A) American Nephrology Nurses Association

(B) Advancement of Medical Instrumentation

(4) Prior to the provision of services, the Registered Nurse(s) trained in dialysis must have evidence of the following:

(A) Health examinations including annual TB skin test result.

(B) Either has received the Hepatitis B vaccine series, or are immune as a result of acquired infection, or have been offered and refused the vaccinations

(C) Received measles-mumps-rubella (MMR) vaccine. (Combined vaccine (MMR) is the vaccine of choice if individuals are likely to be susceptible to more than one of the three diseases and is required for all persons born after 1956.

(D) A negative PPD within the last year, or, if a known reactor, a negative chest X-Ray within the past year.

(E) A history of varicella (chicken pox) or, if unknown, results of a varicella antibody test. If non-immune, shall immunize as appropriate.

(F) Received training in Universal Precautions and Blood Borne Pathogens, Hazardous Material Management, and Life Safety Management (fire preparedness).

(5) The Registered Nurse(s) trained in dialysis shall read, understand, speak and write English fluently.

d. Credentialing and Privileging

(1) The Registered Nurse(s) trained in dialysis shall maintain credentialing requirements and notify the COR and Privileging and Credentialing Officer within twenty-four (24) hours of Contractor’s discovery of personnel not in compliance.

(2) The Registered Nurse(s) trained in dialysis is required to report to the Contracting Officer within twenty-four (24) hours of Contractor’s discovery any disciplinary action taken by the State Board or the institution against the Registered Nurse(s) trained in dialysis performing under this contract.

(3) The Registered Nurse(s) trained in dialysis is responsible to provide complete and timely documentation to support the Credentialing Process. The Registered Nurse(s) trained in dialysis must be able to pass the VAMC’s credentialing process in accordance with the Department of Veterans Affairs’ guidelines and regulations.

(4) The credentialing and privileging of all contract providers will comply with Veterans Health Administration (VHA) Handbook 1100.19 – Credentialing and Privileging.

(5) Submission of credentials in the VetPro credentialing system is required to be completed annually.

e. Contractor Personnel Responsibilities

(1) The Contractor shall be responsible for protecting the personnel furnishing services under this contract. To carry out this responsibility, the Contractor shall provide or cause the provision of the following for these personnel:

(A) Workers compensation

(B) Professional liability insurance

(C) Health examinations

(D) Income tax withholding, and

(E) Social security payments

(2) The parties agree that the Contractor, its employees, agents and subcontractors shall not be considered VA employees for any purpose.

(3) The Contractor shall insert the substance of this clause, including this paragraph, in all subcontracts for health-care services under this contract. The Contractor shall be responsible for compliance by any subcontractor or lower-tier subcontractor with the provisions set forth in paragraph “(1)” of this clause.

f. Key Personnel and Temporary Emergency Substitutions

(1) The following personnel assigned to this contract by the Contractor are designated as key personnel:

a. .

b. .

c. .

d. .

e. .

f.

(2) During the first ninety (90) days of performance, the Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death, or termination of employment. The

Contractor shall notify the Contracting Officer, in writing, within fifteen (15) calendar days after the occurrence of any of these events and provide the information required by paragraph (3) below. After the initial 90-day period of the contract, the Contractor shall submit the information required by paragraph (3) to the Contracting Officer at least fifteen (15) days prior to making any permanent substitutions.

(3) To the maximum extent practicable, for continuity of care, the Contractor shall provide the same pool of providers to cover the requirements of the contract.

(4) The Contractor shall provide a detailed explanation of the circumstances necessitating the proposed substitutions, complete resumes (curriculum vitaes) for the proposed substitutes, and any additional information requested by the Contracting Officer. Proposed substitutes shall have comparable qualifications to those of the persons being replaced. The Contracting Officer will notify the Contractor within 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.

(5) All Contractor employees requiring credentialing must be credentialed prior to reporting to the VAMC to provide coverage. The credentialing process can take up to 90 days to accomplish; therefore, the Contractor is encouraged to provide all credentialing documentation for any Contractor employee who may perform service under this contract to avoid any lapse in coverage.

(6) Evidence of completion of required licensure, credentials, required training, current competencies and commencement of background investigations must be validated by the Government for all contractor personnel referred to perform services under this contract prior to providing direct patient care.

(7) Contractor shall not have personnel report to duty until written notification is received from the Contracting Officer or designee (e.g. Contracting Officer’s Representative) advising that the candidate(s) presented has met all requirements for performance. Written notification shall be in the form a modification to the contract adding the contractor employee as key personnel.

(8) The Government reserves the right to bar contractor personnel from Government facilities, if personal or professional conduct of the contractor personnel jeopardizes patient care. Unacceptable breaches of conduct include, but are not limited to, provider intoxication or debilitation resulting from alcohol or drug use, theft, patient abuse, dereliction or negligence, or other conduct resulting in formal complaints by patient or staff. The Contracting Officer and Contracting Officer’s Representative (COR) may immediately make determinations relating to contractor personnel access to facilities when conduct of said personnel raises concerns of jeopardized patient care. The Contracting Officer shall advise the contractor of the questionable conduct encountered and may seek contractor input related to continuing access of said personnel to VA facilities, but the Contracting Officer is in no fashion required to reach agreement with the Contractor before acting on restrictions. The final arbiter on questions of action to be taken to restrict contractor personnel from VAMC facilities based on alleged conduct issues is the Contracting Officer.

g. Patient Referral

(1) Neither the Contractor nor Contractor’s employee is authorized under this contract to refer any VAMC patients for additional medical treatment. Separate authorization by the VAMC will be necessary for continued care or referral for additional medical treatment.

h. Contracting with Parties Listed on the OIG List of Excluded Individuals/Entities

(1) In accordance with The Health Insurance Portability and Accountability Act (HIPAA), Sections 1128 and 1128A of the Social Security Act and the Balanced Budget Act (BBA) of 1977, the Office of Inspector General 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) All offerors shall review the Office of the Inspector General (OIG) List of Excluded Individuals/Entities on the OIG web site at www.hhs.gov/oig to ensure that the proposed candidate(s) and/or firm(s) are not listed. Offerors 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) of $10,000 for each item or service furnished during a period that the person or entity was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMPs may also be imposed against health care providers and entities that employ or enter into contracts with excluded individuals or entities to provide items or services to Federal program beneficiaries.

(3) By signing the offer/bid, the Contractor certifies that the OIG List of Excluded Individuals/Entities shall be reviewed for each person assigned to the contract by the Contractor prior to that person performing services.

i. Contractor Compliance with the Immigration and Nationality Act of 1952

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

j. Organizational Conflicts of Interest

(1) Contractor personnel performing work under this contract may receive, have access to or participate in the development of proprietary or source selection information (e.g. cost or pricing information, budget information or analyses, work statements, etc.) or perform evaluation services which may create a current or subsequent Organizational Conflict of Interest (OCI) as defined in FAR Subpart 9.5. The Contractor shall notify the Contracting Officer immediately whenever it becomes aware that such access or participation may result in any actual or potential OCI and shall promptly submit a plan to the Contracting Officer to avoid or mitigate any such OCI. The Contractor’s mitigation plan will be determined to be acceptable solely at the discretion of the Contracting Officer and in the event the Contracting Officer unilaterally determines that any such OCI cannot be satisfactorily avoided or mitigated, the Contracting Officer may affect other remedies deemed necessary, including prohibiting the Contractor from participation in subsequent contracted requirements which may be affected by the

OCI.

3. HOURS OF OPERATION

a. Business hours for the VAMC follow:

(1) Work hours: Monday through Friday, 8:00 a.m. - 4:30 p.m.

(2) National Holidays: The 10 holidays observed by the Federal Government are:

New Year’s Day;

Martin Luther King’s Birthday;

Presidents Day;

Memorial Day;

Independence Day;

Labor Day;

Columbus Day;

Veterans Day;

Thanksgiving;

Christmas; and any other day specifically declared by the President of the United States to be a national holiday.

(3) Off-Duty hours: Monday through Friday, 4:30 pm – 8:00 am; Friday 4:30 pm through Monday 8:00 a.m.

4. CONTRACTOR RESPONSIBILITES

a. Work Schedule

(1) Workdays: The Registered Nurse(s) trained in dialysis could be required to furnish services on all calendar days. Normal work hours for the registered nurse(s) (which may be different than the VAMC hours listed in 3.a) above may include all hours/shifts.

(2) Call back: Contract providers will not be paid for on-call services or stand-by pay. Acceptable response time is contingent upon the urgency of the need as determined by the ordering physician:

(A) Emergent Services – within two (2) hours

(B) Immediate Services – within four (4) hours

(C) Chronic Routine – within thirty-six (36) hours

b. Description of Services

(1) The contractor shall provide a continuous contact telephone number for the Columbia, MO VAMC to use in order to schedule services on a 24/7 basis.

(2) Duties of the Registered Nurse(s) trained in dialysis include, but are not limited to:

(A) A specific plan of care shall be designed for each patient based upon nursing diagnosis or clinical nursing problems, expected patient outcomes and nursing intervention. Any of the following nursing diagnosis experienced by the patient shall be addressed by the plan of care:

(i) Impairment of skin integrity;

(ii) Fluid volume excess;

(iii)Alteration in cardiac output related to hyperkalemia

(iv) Alteration in cardiac output secondary to hyperkalemia

(v) Alteration in cardiac output related to uremia or dialysis-associated pericarditis, pericardial effusion and pericardial tamponade secondary to uremia and dialytic therapy;

(vi) Activity intolerance related to uremia

(vii) Sexual dysfunction related to effects of uremia on endocrine system and/or psychosocial impact of renal failure and its treatment.

(viii) Alterations in comfort related to peripheral neuropathy caused by effects of uremia and peripheral nerves

(ix) Impaired gas exchange

(x) Alterations in oral mucous membranes

(xi) Alterations in nutrition, less than body requirements

(xii) Impaired physical mobility

(xiii) Anxiety

(xiv) Powerlessness

(xv) Non-compliance

(xvi) Grieving

(xvii) Alterations in self-concept

(B) On-going teaching programs shall be offered by the contract provider to patients to allow them to gain knowledge of the following:

(i) A self-care concept

(ii) Normal kidney structure and function (iii)Causes of kidney failure

(iv) Effects of kidney failure on the body

(v) Medication regimen

(vi) Dietary regimen

(vii) Circulatory access

(viii) Hemodialysis/continuous ambulatory peritoneal dialysis (CAPD) principles and procedures.

(C) The Registered Nurse(s) trained in dialysis shall ensure that water treatment systems are in place at the VAMC to meet the Advancement of Medical Instrumentation (AAMI) recommendations regarding water and dialysate fluid safety for hemodialysis.

(D) The Registered Nurse(s) trained in dialysis shall provide documentation of care in the Computerized Patient Record System (CPRS) before the end of the day. The VAMC will provide training on the electronic patient record system prior to use.

(E) The Registered Nurse(s) trained in dialysis will provide monthly culture and endotoxin results according to AAMI and CDC guidelines. Any results above acceptable range will require a written action plan to be submitted along with the results. All monthly results as well as an action plan will be submitted within 48 hours of sampling. Results and plans will be submitted to the VAMC Infection Control Nurse as well as the COR.

(F) The Registered Nurse(s) trained in dialysis shall offer support for the patient and family members in achieving and maintaining a lifestyle meaningful to them. Family members shall be advised on the patient’s nutritional needs, daily living needs, and other special needs.

(3) The Registered Nurse(s) trained in dialysis shall sign in and out at the area designated by the Contracting Officer’s Representative (COR).

(4) The Registered Nurse(s) trained in dialysis shall adhere to Joint Commission Standards (http://www.jointcommission.org/ ) and shall provide all reports requested, information and assistance to support The Joint Commission requirements.

(5) The Registered Nurse(s) trained in dialysis may be exposed to surroundings which involve moderate risks or discomfort which require special precautions, i.e., infectious diseases, verbal and physical abuse from emotionally disturbed patients.

(6) Dress apparel: The Registered Nurse(s) trained in dialysis shall be required to dress in a professional manner.

(7) The Contractor shall have sufficient qualified Registered Nurse(s) trained in dialysis so that services are provided in the event a scheduled Registered Nurse(s) trained in dialysis resigns, is terminated, or is otherwise unavailable to work. Contract requirements are not altered or mitigated by inclement weather.

c. Equipment

(1) The Contractor will be responsible for cleaning, care, and maintenance of all contractor furnished equipment utilized during the contract period. The Contractor will make all equipment records available (i.e., such as maintenance records) on-site for any equipment owned and utilized by contractor employee’s on patients at the VAMC. The contractor will ensure all equipment maintenance is properly performed per manufacturer’s instructions and industry standards. The Contractor shall provide documentation of the manufacturer’s recommended cleaning process for any contractor owned equipment. The Contractor shall provide a Standard Operating Procedure for the cleaning process in accordance with the manufacturer’s recommendation and documentation of training of contract staff on cleaning requirements and competencies. SOP’s shall be reviewed, with necessary updates, on an annual basis. Competencies on cleaning of the equipment will be completed by the contract staff on an annual basis.

(2) The Contractor will be responsible for providing equipment and supplies that are unique and specific to the provision of dialysis services, to include but not be limited to, dialysis machines, water treatment systems and ancillary equipment, plumbing fittings necessary to access VA water supply.

(3) System Function Monitoring – Prior to each treatment, the contract provider shall test the proper functioning of the water treatment equipment. Copies of bacterial counts and chemical test results, as well as equipment service reports, electrical safety check results, and preventive maintenance reports are to be kept on-site.

(4) The contractor will provide microbiology assays as per AAMI standards.

(5) The dialysis machines will be disinfected following the manufacturer’s policies and procedures.

(6) On a yearly basis, or more frequently if a problem is suspected, the contract provider is responsible for testing the unit’s supply water for chemical contaminant. Chemical contaminant testing of RO product water is performed at the time of the machine’s installation, yearly after install, whenever a membrane is replaced, and/or if a problem with product water is suspected. Poor or unexpected result values that are greater than those listed in the AAMI standard will be reported to the Medical Director and the COR. Copies of all assay reports are sent to the COR.

5. GOVERNMENT RESPONSIBILTIES

a. Identification

VA will issue a Security Badge or PIV Card to each Contractor employee who is to be given routine, unescorted access to VA facilities or access to VA systems and does not already possess a Security Badge or PIV Card. VA will not issue the Security Badge or PIV Card until the Contractor employee has successfully cleared the FBI National Criminal History Fingerprint Check.

b. Government Services (Support Personnel)

(1) Other necessary personnel for the operation of the services contracted for at the VAMC will be provided by the VAMC at levels mutually agreed upon which are compatible with the safety of the patient and personnel and with quality medical care programming.

c. Medications

(1) Required medications (anti-hypertensives, erythropoietin, antimicrobial agents, etc.) will be provided by the VA pharmacy upon submission of an electronic prescription by the VA or appropriate Medical Center Physician staff.

d. Facilities and Equipment

(1) The Biomedical Department of the VAMC will be required to conduct a safety check of all contractor equipment brought into the facility prior to the commencement of direct patient care. The Contractor shall contact Biomedical at extension 56370 upon arrival with new equipment. The VA Biomedical Department shall conduct an electrical safety inspection of all contractor provided equipment every six months.

(2) The VAMC will provide the facilities, equipment, and supplies necessary to support these services and to support procedures which can currently be carried out at the VAMC. This includes adequate space for storage of contractor owned equipment when such equipment is not in use.

(3) The Government will provide cleaning and maintenance for any government owned equipment utilized during the course of patient treatment.

(4) Columbia, MO VAMC Housekeeping is responsible for the cleaning and general maintenance of storage space for the contractor’s equipment.

e. Personal Protective Equipment

(1) For services performed at the VAMC, the VAMC shall provide personal protective equipment (PPE) as required, as well as training on use. Failure to return items issued to the Contractor’s employee following discontinuance of the Contractor employee’s services under this contract shall result in a charge against payment of the Contractor’s invoice.

6. PERFORMANCE STANDARDS, QUALITY ASSURANCE AND QUALITY IMPROVEMENT

a. Quality Assurance and Improvement

(1) Surveillance and Monitoring

(A) The contract provider will provide quarterly outcomes on the following performance metrics:

(i) Time out safety per NPSG standards;

(ii) Nephrologist notified of critical lab values if drawn during Dialysis treatment;

(iii)Handoff communication completed and documented pre dialysis (hospital nurse to contract dialysis nurse);

(iv) Handoff communication completed and documented post dialysis (contract dialysis nurse to hospital nurse);

(v) Routine, scheduled water quality standards met;

(vi) Pre-treatment water quality check completed, and standards met;

(vii) Pre-treatment dialysis machine safety checks completed, and standards met;

(viii) Emergent, after hours treatments done; and

(ix) Consent entry verified by RN prior to treatment

(B) The Contractor and the Columbia, MO VAMC will both individually provide Quality Management surveillance and oversight of the services provided by the Contractor’s employees for care provided to VAMC patients.

(C) The Contractor will monitor the contractor’s employees for quality of performance of service and provide both sustainment and corrective training to staff to ensure top quality care in accordance with standards set by the American Medical Association (AMA), American Nephrology Nurses Association and VA and VHA regulations and policy.

(D) In order to provide a systematic method of evaluating contractor performance a Quality Assurance Surveillance Plan (QASP) shall be utilized. The Government shall evaluate the contractor’s performance in accordance with the Quality Assurance Surveillance Plan. This plan is primarily focused on what the Government must do to ensure the Contractor has performed in accordance with the performance standards. The plan defines how the performance standards will be applied, the frequency of surveillance, and the minimum acceptable levels on a quarterly basis.

(E) Delivery Summary

(i) The Registered Nurse will provide documentation of care provided in the form of comprehensive notes in the clinical record (CPRS) prior to end of day of treatment.

(ii) Contractor owned equipment will be serviced/maintained according to manufacturer specifications and documented in logbook in dialysis area.

(iii)Response times are within emergent, immediate and routine procedure response times

(F) The COR may perform surveillance of services by:

(i) Observing actual performance;

(ii) Checking time and attendance logs;

(iii)Checking operating room records;

(iv) Reviewing minutes of meetings;

(v) Reviewing charting;

(vi) Inspecting the services to determine whether or not the performance meets the performance standards

(vii) R eview of any other appropriate electronic records.

(G) As part of the surveillance plan, the COR shall review all invoices for accuracy prior to payment.

(H) In all cases, surveillance shall not be so intrusive as to impact the Contractor’s successful accomplishment of the mission.

(I) When unacceptable performance occurs, the COR shall inform the Contractor. This will normally be in writing unless circumstances necessitate verbal communication. In any case the COR shall document the discussion and place it in the COR file. When the COR determines formal written communication is required, the COR shall prepare a Contract Discrepancy Report (CDR) and present it to the contractor's program manager. 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 COR.