36C25526Q0259_Final Version.docx

36C25526Q0259

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.

UEI:

EFT:

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. NOV 2021)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

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

36C25526Q0259

Showers, Stephen, stephen.showers@va.gov 785-350-3111 Ext 52487 06-15-2026

CDT

36C255 Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway Leavenworth, KS 66048

X

621399 $10 Million

N/A

Kansas City VA Medical Center 4801 Linwood Boulevard Kansas City, MO 64128-2226

36C255 Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway

Leavenworth KS 66048

36C255 Department of Veterans Affairs Financial Services Center http://www.fsc.va.gov/einvoice.asp

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

See CONTINUATION Page Contractor to provide qualified Intraoperative Neurophysiologic Monitoring (IONM) Services and and instrumentation for Kansas City VA Medical Center 4801 Linwood Boulevard, Kansas City, MO 64128-2226

All services to be provided IAW the Performance Work Statement.

Section B.2 Cost and Pricing Schedule begins on page 4.

Reports and Deliverables begins on page 27.

Instructions to Offerors begins on page 72.

See CONTINUATION Page

Stephen Showers

Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

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

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer (90C) Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway Leavenworth, KS 66048

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

3. INVOICES: Invoices shall be submitted in arrears:

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

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

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

B.2 SCHEDULE OF SERVICES AND PRICE

BASE YEAR TOTAL

Option Year 1 Total

Option Year 2 Total

Option Year 3 Total

Option Year 4 Total

Grand Total

B.3 PERFOMANCE WORK STATEMENT

1. GENERAL:

1.1. Services Provided: The Contractor shall provide VA and Joint Commission Certified Intraoperative Monitoring services that meet the standards of the Department of Veterans Affairs (VA) and The Joint Commission. Services shall be delivered in accordance with the specifications outlined in this Performance Work Statement (PWS) to beneficiaries of the Department of Veterans Affairs (VA) and Kansas City VA Medical Center (herein, known as KCVAMC).

1.2. Place of Performance: - Contractor shall furnish services at the KCVAMC VA Medical Center. Address: Kansas City VA Medical Center, 4801 Linwood Boulevard, Kansas City, MO 64128-2226.

1.3. Authority: Title 38 USC 8153, Health Care Resources (HCR) sharing Authority and FAR 12.

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. VHA Directive 1100.18: Reporting And Responding To State Licensing Boards: https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9174

1.4.2. VHA Directive 1100.20 Credentialing of Health Care Providers: https://www.va.gov/vhapublications/publications.cfm?pub=1

1.4.3. VHA Directive 1192.01: Seasonal Influenza Prevention Program: https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=5472

1.4.4. VHA Directive 1605.01: Privacy and Release of Information: https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3233

1.4.5. VHA Directive 1907.01: VHA Health Information Management and Health Records: https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9235

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

1.4.7. Joint Commission: http://www.jointcommission.org/standards/

1.4.8. HHS OIG Website: http://oig.hhs.gov/exclusions/index.asp

1.4.9. American Journal for Infection Control - AJIC 1998; 26:289-354: http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf

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. ABNS: American Board of Neurological Surgery http://www.abns.org/content/default.asp

1.5.2. ABRET: American Board of Registration of Electroencephalographic and Evoked Potential Technologists

1.5.3. ACLS: Advanced Cardiac Life Support

1.5.4. IONM: Intraoperative Neuromonitoring.

1.5.5. BLS: Basic Life Support

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. Contracting Officer (CO): – The person executing this contract on behalf of the Government with the authority to enter into and administer contracts and make related determinations and findings.

1.5.11. Contracting Officer’s Representative (COR): – 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.

1.5.12. Contracting Officer’s Representative (COR):–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. CPRS: Computerized Patient Recordkeeping System- electronic health record system used by the VA.

1.5.16. Credentialing: Credentialing is the systematic process of screening and evaluating qualification and other credentials, including licensure, required education, relevant training and experience and current competence and health status.

1.5.17. DNEPs: Descending neurogenic evoked potential

1.5.18. DEA: Drug Enforcement Agency

1.5.19. EEG (intraoperative): Electroencephalogram

1.5.20. FSMB: Federation of State Medical Boards

1.5.21. ED: Emergency Department

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

1.5.23. HHS: Department of Health and Human Services

1.5.24. HIPAA: Health Insurance Portability and Accountability Act

1.5.25. ISO: Information Security Officer

1.5.26. 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.

1.5.27. MOD: Medical Officer of the Day

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

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

1.5.30. NP Nurse Practitioner

1.5.31. NPPES: National Plan and Provider Enumeration System

1.5.32. NMEP: Neurogenic motor evoked potential

1.5.33. PA: Physician Assistant

1.5.34. POP: Period of Performance

1.5.35. PWS: Performance Work Statement

1.5.36. Privileging (Clinical Privileging): 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.

1.5.37. Providers of Care: any providers or servicing individuals who enter the VA under the contract, including onsite Technologist.

1.5.38. QA/QI: Quality Assurance/Quality Improvement

1.5.39. QM/PI: Quality Management/Performance Improvement

1.5.40. QASP: Quality Assurance Surveillance Plan

1.5.41. S-EMG: Stimulus Evoked Electromyograph

1.5.42. SSEPS: Somatosensory evoked potential

1.5.43. TcMEP: Transcranial motor evoked potential

1.5.44. T-EMG: Triggered Electromyograph

1.5.45. Veterans’ Health Administration (VHA): The central office for administration of the VA medical centers through throughout the United States. The VHA is located in Washington, D.C.

1.5.46. Veterans Integrated Services Network (VISN): The regional oversight for the VA medical centers.

1.5.47. VISTA (Veterans Integrated Systems Technology Architecture): A PC based system that will capture and store clinical imagery, scanned documents and other non-textual data files and integrates them into patient’s medical record and with the hospital information system.

1.5.48. VetPro: a federal web-based credentialing program for healthcare providers.

1.5.49. Veterans Affairs Medical Center (VAMC): Unless identified with the name of a different VA Medical Center, for purposes of this contract, this term shall mean Harry S. Truman Memorial Veterans' Hospital, in Columbia, MO.

2. QUALIFICATIONS:

2.1. Staff/Facility

2.1.1. License: Neurologists assigned by the Contractor to perform the services covered by this contract shall have a current license to practice medicine in the state of Missouri. All licenses held by the personnel working on this contract shall be full and unrestricted licenses. Contractor’s Neurologists who have current, full, and unrestricted Missouri licenses, but who have, or ever had, a license restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending action or denied upon application may not be considered for the purposes of this contract.

2.1.1.1. All licenses held by the 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 Contractor-provided Neurologists must be Board Certified or Board Eligible by the American Board of Psychiatry and Neurology (ABPN). Documentation verifying current certification must be submitted to the VA Contracting Officer’s Representative (COR) annually throughout the contract period. All continuing education requirements necessary to maintain certification must remain current at all times.

2.1.2.1. All Contractor-provided Electro Neurophysiologic Technologists performing on-site IONM services must have a Certification Neurophysiologic Intraoperative Monitoring(CNIM),through the American Board of Registered Electroencephalographic and Evoked Potential Technologists (ABRET) (http://www.abret.org). This certification is intended for Technologists who work under supervision by a Neurophysiologist or Neurologist. All continuing education requirements necessary to maintain certification must be kept up to date at all times. Documentation verifying current certification shall be provided by the Contractor to the VA Contracting Officer’s Representative (COR) within thirty (30) days of contract award and annually thereafter for each year of contract performance

2.1.3. Credentialing and Privileging: Credentialing and privileging shall be conducted in accordance with VHA Directive 1100.19, VHA Handbook 1100.19, and all applicable VA policies. The Contractor is responsible for ensuring that all proposed personnel meet credentialing requirements prior to performing any services.

2.1.3.1. On-Site Contract Technologists: All Electro Neurophysiologic Technologists performing services on VA premises must complete VA credentialing requirements through VetPro, the VA’s credentialing system. No services shall be provided until credentialing has been approved by the KCVAMC VAMC Medical Center Director. The Contractor shall ensure timely submission of all required documentation into VetPro, including verification of education and training, current unrestricted licensure or certification, background checks, and health requirements. The Contractor shall maintain compliance with VA re-credentialing schedules and promptly report any changes in status. The VAMC has determined that Flash/PIV is required for on-site IONM Technologist.

2.1.3.2. Off-Site Contract Neurologists: VA privileging is not required for off-site Neurologists, as their work is technical in nature, does not involve clinical decision-making, and does not include direct patient care. Remote Neurologists shall be board-certified with unrestricted licenses and credentialed and privileged through the Contractor or its affiliate location. The Contractor shall provide written verification that each Neurologist is licensed, credentialed, and privileged in accordance with applicable standards. All services shall comply with HIPAA, HITECH, and VA privacy and security requirements. VA reserves the right to audit credentialing documentation at any time. The VAMC has determined that Flash/PIV is NOT required for off-site Neurologists.

2.1.4. Technical Proficiency: The Contractor must be capable of providing real-time data and shall utilize the most recent technology and hardware. The Contractor will work closely with surgeons, nursing staff, schedulers, Clinical Engineering, and Sterilization and Processing Service to support surgical procedures. All equipment provided must function with the current electrical power supply at KCVAMC VAMC. Remote Neurologists will provide real-time monitoring via HIPAA- and HITECH-compliant telemedicine platforms. The Contractor shall provide scheduled services throughout the contract period and ensure qualified replacement personnel at no additional cost to the Government in the event of absence. All replacement personnel must meet VA credentialing and technical requirements prior to performing services The Contractor shall implement a comprehensive Quality Assurance (QA) program that monitors and tracks performance, successes, and complications. QA reports shall be submitted to the COR no later than the 10th day of the month following the end of each quarter.

2.1.4.1. Intraoperative Neurophysiologic Monitoring (IONM): The Contractor shall provide qualified Electro Neurophysiologic Technologists to perform on-site intraoperative neurophysiologic monitoring (IONM) services. Monitoring shall include, but is not limited to: Somatosensory Evoke Potential (SSEPS), Transcranial motor evoked potential (TcMEP), Stimulus Evoked Electromyograph (S-EMG), Triggered Electromyograph (T-EMG), spinal cord mapping including D- Waves, Descending neurogenic evoked potential (DNEPs), Neurogenic motor evoked potential (NMEPs), Cortical, motor, sensory, language mapping, white matter tract and brainstem nuclei mapping, brainstem auditory evoked responses, visual evoked potentials, cranial nerve monitoring, and intraoperative EEG. All monitoring shall be performed in real time with continuous communication to the surgical team.

2.1.4.2. Electro Neurophysiologic Technologists shall possess the necessary skills to meet Government requirements to speak, understand, read and write fluently in English. They will test and adjust equipment as needed, select appropriate electrode combinations, obtain standard recordings, and report the patient’s nervous system status to the surgeon during procedures. After each procedure, they will remove electrodes and return or remove equipment in accordance with VAMC or contractor guidelines.

2.1.4.3. Data Integrity and Communication: Technologists shall recognize artifacts in the data, differentiate them from evoked potential patterns, and take appropriate steps to eliminate them. They shall translate test results from computer files into hard copy reports for interpretation by the Neurologist and immediately notify the attending surgeon if there is any indication that possible damage may occur to the patient.

2.1.4.4. Contractor shall provide documents upon request of the COR to verify current and ongoing competency and skills upon completion. Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all Electro Neurophysiologic Technologists. Electro Neurophysiologic Technologists shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern staff behavior.

2.1.4.5. The Electro Neurophysiologic Technologist will recognize artifacts in the data, differentiate them from evoked potential patterns and take appropriate steps to eliminate them. They will obtain patient medical information when requested and will translate test results from computer files to a hard copy report for Neurologists interpretation

2.1.4.6. Contractor’s personnel shall be capable of providing technical and professional direction during surgical procedures and notify the attending surgeon immediately in the event possible damage may occur to the patient.

2.1.5. All Contractor provided Electro Neurophysiologic Technologists who perform on-site IONM services shall be accredited and registered through the American Board of Registered Electro Neurophysiologic Technologist (http://www.abret.org). This technical certification is intended for Technologists who work under supervision by a Neurophysiologist or Neurologist. All continuing education courses required for maintaining certification must be always kept up to date. Documentation verifying current certification shall be provided by the Contractor to the VA Contracting Officer Representative (COR) within the first thirty (30) days of contract award and shall provide on an annual basis for each year of contract performance.

2.1.5.1. All On-site Contractor provided personnel shall be certified in Basic Life Support (BLS). All continuing education courses required for maintaining certification must be always 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.

2.1.6. Continuing Medical Education (CME)/ Certified Education Unit (CEU) Requirements: Contracted Neurologists shall provide the COR copies of current CMEs as required or requested by the VAMC. Contractor’s Neurologists 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 credential’s office for tracking. These documents are required for both privileging and re-privileging. Failure to provide shall result in loss of privileges for Contractor’s Neurologists.

2.1.7. 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:

*Additional training may be required during the contract period. VA will communicate any changes to the Contractor. Completion of all mandatory training is required prior to performing services and must be documented for compliance.

2.1.8. All On-site Contractor provided personnel shall be certified in Basic Life Support (BLS). All continuing education courses required for maintaining certification must be always kept up to date. Documentation verifying current certification shall be provided by the Contractor to the VA COR every two (2) years.

2.1.9. 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.

2.1.9.1. Standard Personnel Testing (PPD, etc.): Contractor shall provide proof of the following tests for on-site personnel of care entering the facility 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.

2.1.9.2. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative reaction to PPD testing for all on-site contractor’s providers of care. A negative chest radiographic report for active tuberculosis shall be provided in cases of positive PPD results. The PPD test shall be repeated annually.

2.1.9.3. RUBELLA TESTING: Contractor shall provide proof of immunization for all on-site contract providers of care for measles, mumps, rubella or a rubella titer of 1.8 or greater. If the titer is less than 1.8, a rubella immunization shall be administered with follow-up documentation to the COR.

2.1.9.4. VARICELLA: Contractors shall provide proof of immunity for all on-site Contractors.

2.1.9.5. ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of Tdap vaccination for all on-site Contractors.

2.1.9.6. INFLUENZA: Contractors shall provide proof that all on-site contractor’s providers of care have received the annual Influenza vaccine unless it is contraindicated. If the contractor’s providers of care have a medical contraindication to the vaccine, they shall be required to wear a mask during the Influenza season. {This is applicable to all health care workers}.

2.1.9.7. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO BLOODBORNE PATHOGENS: Contractor shall provide generic self-study training for all contractor’s providers of care; provide their own Hepatitis B vaccination series at no cost to the VA if they elect to receive it; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident. The VAMC 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.

2.1.9.8. KCVAMC VAMC 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.

2.1.10. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. This is applicable to contracted Neurologists providing services. 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 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). NPI’s must be provided to the Contracting Officer with the quote.

2.1.11. Conflict of Interest: The Contractor and all contractor’s personnel of care are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of quote and during the entirety of contract performance. At the time of quote, 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 its organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest. These statements shall be in response to the VAAR provision 852.209-70 Organizational Conflicts of Interest (Jan 2008) and fully outlined in response to the subject Attachment 5 in Section D of the solicitation document.

2.1.12. Citizenship related Requirements:

2.1.12.1. 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;

2.1.12.2. 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.

2.1.12.3. 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.

2.1.12.4. 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.

2.1.12.5. The contractor agrees to obtain a similar certification from its subcontractors. The certification shall be made as part of the Contractors response to the RFQ using the subject Attachment 7 in Section D of the solicitation document.

2.1.13. 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.

2.1.13.1. 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 personnel of care 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.

2.1.13.2. By submitting their quote, 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 Handbook 1100.19. Clinical/Professional performance monitoring and review of all clinical personnel covered by this contract for quality purposes will be provided by the VAMC COS and/or the Chief of the Service or his designee.

2.3. Non-Personal Healthcare Services: The parties agree that the contractor and all contractor’s Neurologists and Electro Neurophysiologic Technologist 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: Contracted personnel are prohibited from referring VA patients to contractor’s or their own practice(s)

2.6. Inherent Government Functions: Contractor and contractor’s personnel of care 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 their personnel furnishing services under this contract. 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:

· Workers’ compensation

· Professional liability insurance

· Health examinations

· Income tax withholding, and

· Social security payments.

2.8. Tort Liability: The Federal Tort Claims Act does not cover the contractor’s providers of care. When a contractor or contractor’s contracted personnel have 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 contractor’s Neurologists or Electro Neurophysiologic Technologist) action or non-action shall be the responsibility of the contractor and/or insurance carrier.

2.9. Key Personnel:

2.9.1. Clinical Personnel Required: The contractor shall provide contracted Neurologists who are competent, qualified per this Performance Work Statement and adequately trained to perform assigned duties. Required to be available daily will be two (2) as defined in Section 3: Hours of Operation section.

2.9.2. Clinical Personnel Required: The minimum number of Board Eligible Electro Neurophysiologic Technologist required to be available daily will be two (2) as defined in the Hours of Operation section.

2.9.3. At all times during procedures in the operating room, the ratio of contracted staff to patient will be at a minimum, 1 to 1.

2.10. 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 three (3) 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.

2.10.1. 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 ten (10) 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.

2.10.2. For temporary substitutions where the key person shall not be reporting to work for three 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.

2.10.2.1. 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 Neurologist(s) or Technologist(s), s/he may request, without cause, immediate replacement of said Contractor’s Neurologist(s) or Technologist(s). The CO and COR shall deal with issues raised concerning Contractor’s Neurologist(s) or Technologist(s) conduct. The final arbiter on questions of acceptability is the CO.

2.10.2.2. Contingency Plan: Because continuity of care is an essential part of VAMC’s medical services, The contractor shall have a contingency plan in place to be utilized if the Contractor’s Neurologist(s) or Technologist(s) leaves contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract.

3. HOURS OF OPERATION

3.1. VA Business Hours: Normal hours of operations are 7:30 am – 5:00 pm, Monday through Friday. The operating room is open 24 hours/day and a contractor shall be available for procedures 365 days/year, 24/7.

3.1.1. Contractor’s services shall be available and present for all hours of possible scheduled operations, which will be established, and may be revised, as deemed appropriate for patient care by the Chief of Staff. Currently normal operating room hours are 7:30 am – 5:00 pm, Monday through Friday.

3.1.1.1. During normal business hours of operation, contracted staff shall be onsite and ready to perform services 45 minutes prior to the start of surgery. Equipment and Technologist shall be cleared through biomed and SPS 45 minutes prior to surgical procedure.

3.1.2. Contracted personnel shall be available for procedures outside of normal hours of operations, including evenings, weekends and holidays.

3.1.2.1. Outside of normal business hours, contracted staff should report to the operating room within 60 minutes of being called for surgery.

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 by the President of the United States to be a national holiday.

3.3 Cancellations: contractor will not cancel service for any reason.

3.3.1. Unless a state of emergency has been declared or clinics are otherwise cancelled by the VAMC, the contractor shall be responsible for providing services.

4. CONTRACTOR RESPONSIBILITIES

4.1. The Contractor shall furnish all supplies, accessories, equipment, consumables, transportation, delivery, training, and services. The Contractor shall provide 24/7 case coverage and scheduling 365 days/year by Key Personnel who are on the key personnel roster. Electro Neurophysiologic Technologists must be available for onsite coverage before and during surgery. Contractor shall coordinate provision of services with the attending surgeon or designee. Contractor shall complete all administrative tasks and required documentation immediately following the procedures.

4.2. Contractors will comply with appropriate and applicable policies, procedures and regulations of the KCVAMC as well as with centers for Medicare and Medicaid services (CMS) requirements and complete medical record deficiencies within policy guidelines. Services must meet Joint Commission clinical quality standards for intraoperative monitoring and be FPIS compliant. Quality reports required for quality assurance need to be JHACO certified.

4.3. The Contractor shall provide, transport, install, participate in the simulations, be available in live surgical cases and test the medical equipment prior to utilization.

4.4. Intraoperative Neuromonitoring (neurophysiology) services: The Electro Neurophysiologic Technologist shall be under direction of the OR Surgeon and shall perform multiple modality evoked potentials on patients in the operating room at the KCVAMC. Procedures may include stimulate screws and stimulate nerves. The Electro Neurophysiologic Technologist will be responsible for setting up all necessary OR equipment and supplies necessary for neurophysiological intraoperative monitoring and the placement of suitable electrodes on predetermined measured positions on the patient’s body. Technologist must accurately apply all recording and stimulating electrodes. Once connected to the machine in the operating room, data can be interpreted by the Neurophysiologist (on-site) or remotely where the data is transmitted using a secure HIPAA compliant internet connection.

4.5. Intraoperative monitoring modalities needed include: SSEPS, TcMEP, S-EMG, T- EMG, spinal cord mapping including D-Waves, DNEPs, NMEPs, Cortical, motor, sensory, language mapping, white matter tract and brainstem nuclei mapping, brainstem auditory evoked responses, visual evoked potentials, cranial nerve monitoring, and intraoperative EEG. Specialized cases are procedures requiring advanced IONM techniques or advanced skills including the following: cortical SSEP mapping, direct cortical stimulation mapping of motor cortex, language mapping, brainstem nuclear mapping, cerebral white matter mapping, cases requiring measurement of lateral spread, brachial plexus cases and selective dorsal root rhizotomies.

4.6. Communication Protocols: The Contractor Technologist will establish communication protocols with the surgical team and remote Contractor Neurologist to report monitoring activity. The neuromonitoring team shall provide all resources required to ensure seamless integration with surgical workflows.

4.7. Data Integrity, Reporting, and Post‑Procedure Duties: The Contractor Electro Neurophysiologic Technologist, shall recognize artifacts in the data, differentiate artifacts from evoked potential patterns, and take appropriate steps to eliminate them. The Technologist shall obtain patient medical information when requested and translate test results from computer files into hard‑copy reports for Neurologist interpretation. Technologists are responsible for removing electrodes post‑procedure and returning equipment to specified KCVAMC locations or removing contractor‑supplied equipment from the operating room upon completion. Technologist case documentation and printouts shall be provided to the remote Neurologist and recorded in accordance with facility policy no later than the end of the surgical day.

4.8. Attendance and Verification: On‑site contracted personnel shall sign in and out when in attendance in the operating room. Attendance rosters shall be used by the COR to verify work performed, consistent with the Quality Assurance Surveillance Plan (QASP). Failure to sign in and out on the attendance log may delay payment for services rendered.

4.9. Remote Contractor Neurologist Responsibilities: The Contractor shall provide qualified Remote Neurologists to perform real-time technical interpretation of intraoperative neurophysiologic monitoring (IONM) data via secure, HIPAA- and HITECH-compliant telemedicine platforms. Remote Neurologists shall ensure accurate interpretation of monitoring recordings, promptly communicate technical recommendations regarding neurophysiologic trends to the attending surgeon, and maintain continuous communication with the surgical team throughout each procedure. Neurologists shall complete all required documentation pertaining to procedures, complications, and outcomes within 24 hours following each case and submit reports via secure, encrypted channels in compliance with FIPS 140-2 standards. They shall adhere to all established patient safety and infection control standards, make every effort to prevent surgical complications or omissions in care, and report any patient injury, medication error, or breach of safety to the COR within 24 hours, including submission of a patient safety report and follow-up as required. Remote Neurologists must hold a current, unrestricted medical license in a U.S. state or territory, be Board Certified or Board Eligible by the American Board of Psychiatry and Neurology (ABPN), maintain continuing education requirements, and provide CME documentation to the COR as requested. All services shall meet or exceed nationally recognized standards, including those of ABPN, The Joint Commission (TJC), and the American Hospital Association (AHA), and comply with all requirements contained in this Performance Work Statement. Remote Neurologists shall be available 24 hours a day, seven days a week, 365 days a year, respond within 60 minutes for urgent or emergent cases, and participate in the Contractor’s Quality Assurance program, including timely submission of QA reports. Remote Neurologists shall not engage in direct patient care or clinical decision-making; their role is limited to technical interpretation and monitoring.

4.10. QA/QI documentation: The contractor’s Neurologists shall complete all required documentation pertaining to procedures,…