36C25526Q0233.docx

Sources Sought Notice Sources Sought Notice

GENERAL INFORMATION

SET-ASIDE

Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway Leavenworth KS 66048

POINT OF CONTACT*

Contracting Officer Mike Carson michael.carson1@va.gov

PLACE OF PERFORMANCE

ADDRESS

Department of Veterans Affairs

Robert J. Dole VA Medical Center (VAMC)

5500 E. Kellogg

Wichita KS

ADDITIONAL INFORMATION

DESCRIPTION

Network Contracting Office 15 is conducting market research to ascertain the capabilities of staffing companies to provide 0.15 FTE (see B.2 EXAMPLE BASE PRICE/COST SCHEDULE and paragraph 3 in B.3 DRAFT PERFORMANCE WORK STATEMENT) on-site Physician – Nephrologist at the Robert J. Dole VA Medical Center (VAMC) in Wichita, KS geographic region. Includes on-call or outside regular duty hours/weekends/holidays required.

THIS IS NOT A SOLICITATION AND NO CONTRACTS SHALL BE AWARDED FROM THIS NOTICE. No reimbursement will be made for any costs associated with providing information in response to this notice or any follow up information requested. Questions will not be entertained at this time.

1. This request is for capability statements to assist with appropriate acquisition decisions and to gain knowledge of concerns with interested and parties capable of providing Physician services relative to North American Industrial Classification System (NAICS) code 621111. The Small Business Size Standard for this acquisition is $16 M.

2. Qualifications of experienced Physician – Nephologists - Board Certified/Eligible (recent graduates up to four (4) years. See paragraph 2 in attached B.3 DRAFT PERFORMANCE WORK STATEMENT.

3. Please provide a capability statement addressing your company’s ability to provide the requested services. This is not a request for offer and in no way, obligates the Government. The list below is requested information that will assist in our market research.

a) Your company’s name, addresses, point of contact, phone number, and email address.

b) What is your company’s socioeconomic status?

c) What is your company’s interest in submitting an offer on a solicitation, if issued.

d) Your company’s ability to meet the requirements.

e) How many contracts has your company been awarded in the last 24 months that were for Physician – Neprologists?

f) How many Physician – Nephrologist Candidates are readily available for placement in the Wichita, KS geographic region? How would you fulfill this requirement?

g) Is your company Veteran Small Business Certification (VetCert) verified? (see para 4 below)

4. Service Disabled Veteran Owned Small Business (SDVOSB) and Veteran Owned Small Business (VOSB) respondents are encouraged to provide proof of verification in VetCert. Consistent with Public Law 109-461 (38 U.S.C. 8127 and 8128), the VA shall award contracts based upon competition restricted to SDVOSBs or VOSBs when a contracting officer has a reasonable expectation, based on market research, that two or more firms listed as verified in VetCert database are likely to submit offers and an award can be made at a fair and reasonable price that offers best value to the United States.

If you are unfamiliar with VetCert or have not verified, you are encouraged to complete this process at https://veterans.certify.sba.gov/ please let me know and I will identify a point of contact for you.

5. Responses and capability statements are to be submitted no later than 17:00 PM (CST) on Friday April 3rd, 2026. All interested companies must be registered in System for Award Management (SAM) (http://www.sam.gov/) to be eligible for award of government contracts. Please email your response to: Mike Carson, NCO 15 Contracting Office: Michael.Carson1@va.gov. Note: Only e-mail responses will be accepted.

See Example Schedule of Services and Draft PWS on follow-on pages.

B.2 EXAMPLE BASE PRICE/COST SCHEDULE (DO NOT PROVIDE PRICING, FOR AWARENESS ONLY)

The Contractor shall furnish all key personnel to provide services necessary to perform onsite Nephrology Physician Services to eligible beneficiaries of the Department of Veterans Affairs Medical Center, Robert J. Dole VAMC (hereinafter referred to VAMC).The Contractor’s physician(s) care shall cover the range of Nephrology 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. Care shall be compliant with all related VHA kidney health policies, including VHA Handbook 1042.01: Criteria and Standards for VA Dialysis Programs and VHA Directive 1053: Chronic Kidney Disease Prevention, Early Recognition, and Management.

Care shall be generally consistent with published clinical practice guidelines including the VA/DoD Clinical Practice Guideline for the Management of Chronic Kidney Disease, those published by Kidney Disease: Improving Global Outcomes (KDIGO: https://www.KDIGO.org) and by the National Kidney Foundation-Kidney Disease Outcomes Quality Initiative (NKF-KDIGO; https://www.kidney.org/professionals/ guidelines).

Place of Performance: Services shall be provided on site, Robert J. Dole VAMC, 5500 E. Kellogg, Wichita, KS 67218. Outpatient clinic is located on the 1st floor in building 26 room 168.

Schedule Explanation: The below pricing is for Board Certified/Eligible (recent graduates up to four (4) years) hourly rate for clinic, on-site call-back, and Weekend/Holiday rounds. Travel, lodging, and per-diem is NOT authorized for this task order.

ITEM INFORMATION

Board Certified/Board Eligible Nephrology Physician Services (Clinic - 208 hrs and on-site call back - 56 hours) Contract Period: Base POP Begin: 12-01-2026 POP End: 11-30-2027

Board Certified/Board Eligible ON-CALL Nephrology Physician Services (includes telephonic response)

Board Certified/Board Eligible Nephrology Physician Services Weekend/Holiday Rounds when on-call

B.3 DRAFT PERFORMANCE WORK STATEMENT

1. GENERAL:

1.1. Services Provided: The Contractor shall provide Board Certified/Board Eligible (recent graduates up to four (4) years) Nephrologist(s) Physician Services on site in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and the Robert J.Dole VA Medical Center.

1.2. Place of Performance: Contractor shall furnish services at the Robert J. Dole VA Medical Center, 5500 E.Kellogg, Wichita, KS 67218. Outpatient clinic is located on the 1st floor in building 26, room 168.

1.3. Authority: Title 38 USC 8153, Sharing of Health Care Resources (HCR) sharing Authority FAR parts used FAR 12 in combination with 15.

1.4. Policy/Directives/Handbooks. The contractor shall be subject to the following policies, including any subsequent updates during the period of performance. The policies listed below can be accessed electronically at the following: VA Publications VHA Publications

1.4.1. VA Directive 1663: Health Care Resources (HCR) Contracting – Buying Title 38 U.S.C. 8153

1.4.2. VHA Directive 1003.04: VHA Patient Advocacy

1.4.3. VHA Directive 1053: Chronic Kidney Disease Prevention, Early Recognition, and Management

1.4.4. VHA Directive 1065: Productivity and Staffing Guidance for Specialty Provider Group Practice

1.4.5. VHA Directive 1088(1): Communicating Test Results to Providers and Patients

1.4.6. VHA Directive 1100.18: Reporting and Responding to State Licensing Boards

1.4.7. VHA Directive 1100.20: Credentialing of Health Care Providers

1.4.8. VHA Directive 1100.21: Privileging

1.4.9. VHA Directive 1192.01: Seasonal Influenza Vaccination Program For VHA Health Care Personnel

1.4.10. VHA Directive 1220(1): Facility Procedure Complexity Designation Requirements to Perform Invasive Procedures In Any Clinical Setting

1.4.11. VHA Directive 1605.01: Privacy and Release of Information

1.4.12. VHA Directive 1907.01: VHA Health Information Management and Health Records

1.4.13. VHA Handbook 1042.01: Criteria and Standards for VA Dialysis Programs

1.4.14. VHA Handbook 1100.17: National Practitioner Data Bank (NPDB) Reports

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

1.4.16. VA/DoD Clinical Practice Guidelines for the Management of Chronic Kidney disease

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

1.5.1. ACGME: Accreditation Council for Graduate Medical Education

1.5.2. ACLS: Advanced Cardiac Life Support

1.5.3. AOD: Admitting Officer of the Day

1.5.4. BLS: Basic Life Support

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

1.5.6. CDC: Centers for Disease Control and Prevention

1.5.7. CDR: Contract Discrepancy Report

1.5.8. CEU: Certified Education Unit

1.5.9. CME: Continuing Medical Education

1.5.10. CMS: Centers for Medicare and Medicaid Services

1.5.11. CO: Contracting Officer: 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.

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

1.5.13. COS: Chief of Staff

1.5.14. CPARS: Contractor Performance Assessment Reporting System

1.5.15. Credentialing: Credentialing is the process of obtaining, verifying, and assessing the qualifications of a health care provider to provide care or services in or for the VA health care system. Credentials are documented evidence of licensure, education, training, experience, or other qualifications.

1.5.16. DEA: Drug Enforcement Agency

1.5.17. ED: Emergency Department

1.5.18. EHR: Electronic Health Record - electronic health record system used by the VA

1.5.19. FSMB: Federation of State Medical Boards

1.5.20. FTE: Full Time Equivalent: VA’s standard definition is for full time working the equivalent of 80 hours every two weeks, 2080 hours per year. However, providers may propose using their standard FTE definition.

1.5.21. HHS: Department of Health and Human Services

1.5.22. HIPAA: Health Insurance Portability and Accountability Act

1.5.23. HR: Human Resources

1.5.24. ISO: Information Security Officer

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

1.5.26. MOD: Medical Officer of the Day

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

1.5.28. NKF – National Kidney Foundation

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

1.5.30. Non-Contract Provider: any person, organization, agency, or entity that is not directly or indirectly employed by the Contractor or any of its subcontractors

1.5.31. NP: Nurse Practitioner

1.5.32. NPPES: National Plan and Provider Enumeration System

1.5.33. OPPE/FPPE- Ongoing professional practice evaluation/ Focused professional practice evaluation

1.5.34. PA: Physician 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. Clinical Privileging: Clinical Privileging is the process by which a practitioner, licensed for independent 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, and within available resources.

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. VHA: Veterans’ Health Administration

1.5.44. VISN: Veterans Integrated Services Network

1.5.45. VistA Veterans Information Systems Technology Architecture

1.5.46. VETPro: is VHA’s mandatory credentialing software platform to document the credentialing of VHA health care providers. This system facilitates completion of a uniform, accurate, and complete credentials file.

2. QUALIFICATIONS:

2.1. Staff/Facility

2.1.1. License: The Contractor’s physician(s) assigned by the Contractor 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.

All licenses held by the key personnel working on this contract shall be full and unrestricted licenses. Contractor’s physician(s) who have current, full and unrestricted licenses in one or more states, but who have, or ever had, a license restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending action or denied upon application will not be considered for the purposes of this contract.

2.1.2. Board Certification: All contract Nephrology provider(s) shall be Board Certified /Board Eligible (recent graduates up to four (4) years) physicians by either the American Board of Internal Medicine in Nephrology http://www.abim.org/specialty/nephrology.aspx , or the American Osteopathic Board of Internal Medicine https://certification.osteopathic.org/internal-medicine/ . They must also be currently certified in either Basic Life Support (BLS) OR Advanced Cardiac Life Support (ACLS) or equivalency. All continuing education courses required for maintaining certification must always be kept up to date . Documentation verifying current certification shall be provided by the Contractor to the VA COR on an annual basis for each year of contract performance.

2.1.3. Credentialing and Privileging: Credentialing and privileging is to be done in accordance with the provisions of VHA Directive 1100.20 and VHA Directive 1100.21 referenced above. The Contractor is responsible to ensure that proposed physician(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any Contractor’s physician(s) prior to obtaining approval by the Facility Medical Executive Board and Medical Center Director.

2.1.3.1. If a Contractor’s physician(s) and/or other contract provider(s) are not credentialed and privileged or has credentials/privileges suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government.

2.1.4. Technical Proficiency: Contractor’s physician(s) 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. Contractor 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. Contractor’s physicians shall have knowledge of professional care theories, principles, practices, and procedures to perform assignments of Nephrology patient/critically ill patient population. Contractor’s physician shall demonstrate knowledge of growth and development, and pathophysiology of disease processes specific to the critical care/nephrology population Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for Contractor’s physician(s) shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior.

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

2.1.6. Training (ACLS, BLS, EHR and VA MANDATORY): Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the contractor’s physician(s) as required by the VA. Other training may become required. VA will communicate any changes to the training requirement to the contractor.

2.1.7. STANDARD INFECTION CONTROL MEASURES (PPD, IMMUNIZATIONS, ETC.): Contractor shall provide proof of the following for physicians 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.

2.1.7.1. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative Tuberculosis Skin Test (TST) or interferon-gamma release assays (IGRA) for all Contractor’s physician(s) upon hire in accordance with CDC guidance. (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.

2.1.7.2. MEASLES, MUMPS, & RUBELLA TESTING: Contractors shall provide proof of immunity for all Contractor physicians {This is applicable to all health care workers}.

2.1.7.3. VARICELLA: Contractors shall provide proof of immunity for all Contractor physicians {This is applicable to all health care workers}.

2.1.7.4. ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of Tdap vaccination for all Contractor physicians {This is applicable to all health care workers}.

2.1.7.5. INFLUENZA: Contractors shall provide proof that all Contractor physicians have received the annual Influenza vaccine unless it is contraindicated. If the Contractor physician has 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}.

2.1.7.6. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO BLOODBORNE PATHOGENS: Contractor shall provide evidence of completing and passing generic self-study blood-borne pathogen training for all Contractor’s physician(s) {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.

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

2.1.8. 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 Contractor 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 Quotation.

2.1.9. DEA: Contractor shall provide copy of current DEA certificate.

2.1.10. Conflict of Interest: The Contractor and all Contractor’s physician(s) are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of quotation and during the entirety of contract performance. At the time of quotation, the Contractor shall provide a statement which describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided. The Contractor shall also provide statements containing the same information for any identified consultants or subcontractors who shall provide services. The Contractor 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 and fully outlined in response to the subject attachment in Section D of the solicitation document.

2.1.11. Citizenship related Requirements:

2.1.11.1. The Contractor certifies that 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;

2.1.11.2. While performing services for the Department of Veterans Affairs, the Contractor 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 Contractor 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.

2.1.11.3. If the Contractor 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 Contractor’s place of business that services Department of Veterans Affairs patient referrals; or other place where the Contractor 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.

2.1.11.4. 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.

2.1.11.5. The Contractor agrees to obtain a similar certification from its subcontractors. The certification shall be made as part of the offerors response to the RFP using the subject attachment in Section D of the solicitation document.

2.1.12. 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.

2.1.12.1. Therefore, Contractor 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 Contractor’s physician(s) are not listed. Contractor 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 Contractor that employ or enter into contracts with excluded individuals to provide items or services to Federal program beneficiaries.

2.1.12.2. By submitting their quotation, the Contractor certifies that the HHS OIG List of Excluded Individuals/Entities has been reviewed and that the Contractors are and/or firm is not listed as of the date the offer/bid was signed.

2.2. Clinical/Professional Performance: The qualifications of Contractor 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 Directive 1100.20 and VHA Directive 1100.21. Clinical/Professional performance monitoring and review of all clinical personnel covered by this contract for quality purposes will be provided by the facility COS and/or the Chief of the Service or his designee. The national OPPE/FPPE nephrology performance form shall be used to evaluate each contracted physician’s performance on a recurring basis. 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 Contractor and all Contractor’s physician(s) shall not be considered VA employees for any purpose.

2.4. Indemnification: The Contractor 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 Contractor, its agents, or employees.

2.5. Prohibition against Self-Referral: Contractor’s physicians are prohibited from referring VA patients to contractor’s or their own practice(s).

2.6. Inherent Government Functions: Contractor and Contractor’s physician(s) 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 Contractor shall be responsible for protecting Contractor’s physician(s) furnishing services. To carry out this responsibility, the Contractor 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 Contractor or contract provider(s). When a Contractor or contract provider (s)has been identified as a provider in a tort claim, the Contractor shall be responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor’s (or contract physician(s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.9. Key Personnel:

2.9.1. The VA Full Time Equivalency (FTE) for the services required is 0.15, a total of 208 hours for clinics and 96 hours of potential call-back.

2.9.2. Contractor shall provide minimum number of Board Certified /Board Eligible (recent graduates up to four (4) years) Nephrology providers required to staff the Robert J. Dole VAMC outpatient clinic (208 hours), estimated on-site call-back (56 hours), estimated on-call including telephonic response (3184 hours defined in paragraph 3.1.3), and Weekend/Holiday Rounds when on-call (64 hours defined in paragraph 3.1.4). Outpatient clinic runs as long as it needs in order to see all 8 patients plus overloads and to do return to clinic orders, Lab, phone calls, documentation of the visit, etc. It is determined that an ½ day a week outpatient clinic on Thursdays from 1:00pm to 5:00pm is needed to finish up all requirements for patients in the outpatient clinic and inpatient locations as needed to get the Veteran taken care of located within the VA Medical Center.

2.9.3. The Contractor shall be responsible for providing coverage to the VA during periods of vacancies of the Contractor’s personnel due to sick leave, personal leave, vacations and additional coverage as required. In the event a scheduled physician is unable to complete an assigned shift, the contractor shall provide replacement physician coverage within 2 hours and notify the Contracting Office Representative (COR) immediately of the schedule change.

2.9.4. Personnel Substitutions: During the first ninety (90) calendar 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 CO, in writing, within 30 calendar day(s) after the occurrence of any of these events and provide the information required below. After 90 days, the Contractor shall submit the information required below to the CO at least 30 calendar days prior to making any permanent substitutions.

2.9.4.1. The Contractor 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 Contractor within 30 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 workdays or more, the Contractor 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 Contractor 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 Contractor’s physician(s), s/he may request, without cause, immediate replacement of said Contractor’s physician(s). The CO and COR shall deal with issues raised concerning Contractor’s physician(s) 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 the Facility’s medical services, The Contractor shall have a contingency plan in place to be utilized if the Contractor’s physician(s) leaves Contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract.

3. VA HOURS OF OPERATION/SCHEDULING

3.1. VA Business Hours: Nephrology Clinic services will be provided from one ½ day a week on Thursdays from 1pm to 5pm and on call coverage as needed.

3.1.1. Patients must be seen by a Contractor’s physician(s) on-site at the facility in a timely manner in accordance with VA Rules and Regulations on clinic wait times and consult completion. Contractor shall notify the COR at least monthly about any obstacles to meeting this performance measure.

3.1.2. Contractor’s physician(s) shall be available and present in clinic during normal facility clinic hours, which will be established, and may be revised, as deemed appropriate for patient care by the Chief of Staff. Currently, normal clinic hours are

3.1.3. Off-hours Coverage: The VAMC will notify the Contractor when call coverage needed. A call schedule is made up for each month with each day of the month showing when coverage is needed. Contractor must make the contractor’s physician(s) available on-call during all hours on the call schedule that they are scheduled for when the Robert J. Dole VAMC including evenings, weekends and holidays. Annual anticipated coverage requirements follow:

3.1.3.1. 480 hours of weekday Hours (8:00am to 4pm,; 8-hour period) – equates to 60 shifts.

3.1.3.2. 640 hours of weeknights hours (4pm to 8am – 16-hour period) 640 hours – equates to 40 shifts of weeknight on call.

3.1.3.3. 1920 hours of weekend hours 2-24 hour periods; (8am Saturday – 8am Monday); equates to 80 – 24 hour shifts.

3.1.3.4. 48 hours of holidays days: (8am to 4pm 8-hour period); equates to 6 shifts of eight hours each.

3.1.3.5. 96 hours of holidays nights: (4pm to 8am; 16-hour period) equates to 6 shifts of sixteen hours each.

3.1.3.6. On-call Contractor’s physician(s) must always be available for phone consultations with VA residents and physicians.

3.1.3.7. On-call providers must be available within 15 minutes by phone and on-site within 60 minutes.

3.1.4. Weekend/Holiday Rounds when On-call: Daily visit for rounds while on-call during weekends and holidays. May include up to 10 patients per day. Maximum hours doctor can stay for rounds is eight hours, but estimated required time is 30 minutes to 1 hour per visit. Duties to be completed during the rounds will include the following:

3.1.4.1. Complete new consults and follow up visits with proper chart documentation.

3.1.4.2. Order needed labs, imaging and new medications/adjust dosing if needed, discontinue medication if appropriate.

3.1.4.3. Communicate with primary team and dialysis nurses as needed.

3.1.4.4. Order dialysis treatments as necessary.

3.1.4.5. Provide hand-off documentation for returning Nephrologists.

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

· Juneteenth

· Independence Day

· Labor Day

· Columbus Day

· Veterans Day

· Thanksgiving

· Christmas

· Any day specifically declared to be a national holiday.

3.3. Cancellations: Cancellations of clinic schedules should be communicated within 45 days of the cancellation or as soon as possible for emergencies.

4. CONTRACTOR RESPONSIBILITIES

4.1. Clinical Personnel Required: The Contractor shall provide contractor’s physician(s) who are competent, qualified per this performance work statement and adequately trained to perform assigned duties.

4.1.1. Contractor’s physician(s) shall be responsible for signing in and out when in attendance. Time sheets will be used by the COR to confirm hours/day and services provided against the contractor’s invoices.

4.2. Standards of Care:

The Contractor’s physician(s)’ care shall cover the range of Nephrology services as would be provided in a state-of-the-art civilian medical treatment facility and shall be of a quality that meets or exceeds community standards. Care shall be compliant with all related VHA kidney health policies, recognized TJC standards, and generally consistent with guidance available at :

4.2.1. The professional standards of the Joint Commission (TJC): http://www.jointcommission.org/standards_information/standards.aspx

4.2.2. The standards of the American Hospital Association (AHA): http://www.hpoe.org/resources?show=100&type=8

4.2.3. The National Kidney Foundation (https://www.kidney.org/professionals/guidelines/guidelines_commentaries) ;

4.2.4. VA Handbook 1042.01 Criteria and Standards for VA Dialysis

4.2.5. VA Directive 1053 Prevention, Early Recognition and Management of Chronic Kidney Disease

4.2.6. VA/DoD Clinical Practice Guidelines for the Management of Chronic Kidney Disease

4.2.7. Kidney Disease: Improving Global Outcomes (KDIGO: https://www.KDIGO.org

4.2.8. National Kidney Foundation-Kidney Disease Outcomes Quality Initiative (NKF-KDIGO; https://www.kidney.org/professionals/ guidelines).

4.2.9. The requirements contained in this PWS

4.3. MEDICAL RECORDS

4.3.1. Authorities: Contractor’s physician(s) providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the 5 U.S.C.552a (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 of VA patients. Based on this exception, a BAA is not required for this contract. Health records generated by this contract or provided to the Contractors by the VA are covered by the VA Privacy Act system of records entitled ‘Patient Medical Records-VA’ (24VA10A7). Contractor 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. Contractor shall ensure that all records pertaining to medical care and services provided to VA patients are captured in the VA electronic health record system as required by VA policy as discussed in 4.4.4. 4.4.3.

4.3.3. Disclosure: Contractor’s physician(s) may have access to patient medical records for the purpose of providing medical care and services to VA patients and performing services under the contract; however, Contractor shall obtain permission from the VA before disclosing any patient information outside VA. VA authorizes the Contractor to discuss patient health information for coordination of care with community health care providers in compliance with VA regulations, HIPAA and VHA Directive 1605.01, Privacy and Release of Information. The VA will provide the Contractor with a copy of VHA Directive 1907.01, Health Information Management and Health Records and VHA Directive 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 Contractor.

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 Directive 1907.01 Health Information Management and Health Records:

4.3.5. Release of Information: The VA shall maintain control of releasing any copies of patient health information or health records and will follow policies and standards as defined, but not limited to Privacy Act requirements. Contractor will not release or disclose copies of records and will refer all such requests to the Release of Information Department at the VA facility were assigned.

4.3.6. Management for Medical Records: National Archives and Records Administration record disposition requirements are found in RCS 10-1 Chapter 6, 6000 series.

4.4. Direct Patient Care: estimated 100% of the time involved in direct patient care.

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

4.4.1.1. Board Certified /Board Eligible (recent graduates up to 4 years) Nephrologist(s)

4.4.2. Scope of Care: Contractor’s physician(s) (as appropriate and within scope of practice/privileging) shall be responsible for providing Nephrology care, including, but not limited to :

4.4.2.1. Medical Care: Contractor’s physician(s) shall provide clinical Nephrology services. Contractor’s physician(s) shall be present on time for any scheduled clinics as documented by physical presence in the clinic at the scheduled start time.

4.4.2.1.1. Contractor’s physician(s) shall provide comprehensive clinical Nephrology services including, but not limited to, evaluation and management of acute kidney injury (AKI), chronic kidney disease, end stage kidney disease (ESKD), fluid and electrolyte disorders, and hypertension; medical evaluation and management of nephrolithiasis; medical management of kidney transplant patients; and evaluation and management of extracorporeal treatment for poisonings and intoxications. Management of AKI and ESKD includes prescription and medical oversight of the performance of kidney replacement therapy, including hemodialysis, peritoneal dialysis, prolonged intermittent kidney replacement therapy and/or continuous kidney replacement therapy, including management of vascular access and procedural complications. Additional procedural services may include placement of central and femoral venous dialysis catheters and percutaneous kidney biopsy, unless otherwise provided by or separately contracted for by VA facility.

4.4.2.1.2. Contractor’s physician(s) shall provide consultative services at the patient’s bedside if the patient is not ambulatory and in the clinic setting if the patient is able to report to the outpatient clinic. Procedures shall be scheduled for completion within 30 days of the date of the consult.

4.4.2.1.3. Mechanisms must be in-place to provide notification of test results for patients receiving care in accordance with VHA Directive 1088, Communicating Test Results to Providers and Patients.

4.4.2.2. Medications: Contractor’s physician(s) shall follow all established medication policies and procedures. No sample medications shall be provided to patients.

4.4.2.3. Discharge education: Contractor’s physician(s) shall provide discharge education and follow up instructions that are coordinated with the next care setting for all Nephrology clinical patients.

4.4.3. ADMINISTRATIVE: None

4.4.3.1. QA/QI documentation: The Contractor’s physician(s) shall complete the appropriate QM/PI documentation pertaining to all procedures, complications and outcome of examinations.

4.4.3.2. Patient Safety Compliance and Reporting: Contractor’s physician(s) shall follow all established patient safety and infection control standards of care. Contractor’s physician(s) shall make every effort to prevent medication errors, falls, and patient injury caused by acts of commission or omission in the delivery of care. All events related to patient injury, medication errors, and other breeches of patient safety shall be documented in the medical record of those impacted and disclosed to the patient or surrogate. As soon as practicable (but within 24 hours) Contractors shall notify COR of incident and submit an entry in the VA Patient Safety Reporting System, following up with COR as required or requested.

4.5. PERFORMANCE STANDARDS, QUALITY ASSURANCE (QA) AND QUALITY IMPROVEMENT(QI)

4.5.1. Quality Management/Quality Assurance Surveillance: Contractor’s physician(s) shall be subject to Quality Management measures, such as patient satisfaction surveys, timely completion of medical records, and Peer Reviews. Methods of Surveillance: Focused Provider Practice Evaluation (FPPE) and Ongoing Provider Practice Evaluation (OPPE). Contractor performance will be monitored by the government using the standards as outlined in this Performance Work Statement (PWS) and methods of surveillance detailed in the Quality Assurance Surveillance Plan (QASP). The QASP shall be attached to the resultant contract and shall define the methods and frequency of surveillance conducted.

4.5.2. Patient Complaints: The CO will resolve complaints concerning Contractor relations with the Government employees or patients. The CO is final authority on validating complaints. If the Contractor is involved and named in a validated patient complaint, the Government reserves the right to refuse acceptance of the services of such personnel. This does not preclude refusal in the event of incidents involving physical or verbal abuse.

4.5.3. The Government reserves the right to refuse acceptance of any Contractor 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. The CO and COR shall deal with issues raised concerning Contractor’s conduct. The final arbiter on questions of acceptability is the CO.

4.5.4. Performance Standards: Must be evaluated using the national VA OPPE/FPPE Nephrology performance evaluation tool and metrics.

4.5.4.1. Measure: Provider Quality Performance

Performance Requirement: All Contractor’s physician(s) shall perform in accordance with clinical standards Standard: OPPE documentation for all (100%) staff providing services under the contract. All staff (95%) meet Standards.

Acceptable Quality Level: 95% meet Standards Surveillance Method: OPPE data pertinent to care performed for each provider working under this contract. OPPE data will review the following elements:

A. Patient Care Performance B. Medical/Clinical knowledge C. Practiced Based Learning and Improvement D. Interpersonal and Communication Skills E. Professionalism F. System Based Practice Frequency: Yearly

4.5.4.2. Measure: Qualifications of Key Personnel

Performance Requirement: All Contractor’s physician(s) shall be Board Certified /Board Eligible (recent graduates up to four (4) years) in accordance with American Board of Internal Medicine’s Nephrology Standards.

Standard: All (100%) Contractor’s physician(s) are Board Certified /Board Eligible (recent graduates up to four (4) years).

Acceptable Quality Level: 100% Surveillance Method: Periodic Inspection or Random Sampling of qualification documents Frequency: Quarterly

4.5.4.3. Measure: Scope of Practice/Privileging

Performance Requirement: Contractor’s physician(s) perform within their individual scopes of practice/privileging.

Standard: All (100%) Contractor’s physician(s) perform within their scope of practice/privileges 100% of the time.

Acceptable Quality Level: 100% Contractor’s physician(s) perform within their scope of practice/privileges 100% of the time.

Surveillance Method: Periodic Inspection or Random Sampling of records.

Frequency: Quarterly

4.5.4.4. Measure: Patient Access

Performance Requirement: The Contractor shall provide contract provider(s) in accordance with the operating hours and VA clinical schedule outlined in this PWS.

Standard: All (100%) Contractor’s physician(s) are on time and available to perform services.

Acceptable Quality Level: Contractor’s physician(s) is on-time and available to perform services 95% of the time Surveillance Method: Periodic Inspection or Random Sampling of Time and Attendance Sheets Frequency: Quarterly

4.5.4.5. Measure: Patient Safety

Performance Requirement: Patient safety incidents…