36C25623R0009_Final.docx

36C25623R0009

PAGE 1 OF

1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE

DATE/LOCAL

TIME

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a.

PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

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. SIGNAT

URE 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

36C25623R0009 03-13-2023 Troy Davis 713-770-5926 04-12-2023 12pm

CDT

36C256 Department of Veterans Affairs Network Contracting Office 16 5057 Westheimer Road, Suite 750 Houston TX 77056 X X 621111 $14 Million N/A X 36C586 Department of Veterans Affairs G.V. (Sonny) Montgomery VAMC 1500 E.

Woodrow Wilson Drive Jackson MS 39216-5116 36C256 Department of Veterans Affairs Network Contracting Office 16 5057 Westheimer Road, Suite 750 Houston TX 77056

FSC e-Invoice Payment http://www.fsc.va.gov/fsc/einvoice.asp Invoice Setup Information 1-877-489-6135 Invoice must be submitted electronically

877-353-9791 512-460-5429 See CONTINUATION Page Contractor to provide Onsite Emergency Room Physician Services, Jackson, MS.

For additional details reference schedule of services on page through page 1 and performance work statement on page 1 through page Reference page for Addendum to 52.212-1 Instructions to Offerors for solicitation submission requirements and reference page for 52.212-2 Evaluation-Commercial Items for solicitation award method.

This is a single award solicitation in accordance with Federal Acquisition Regulation (FAR) 12 and 15.

See CONTINUATION Page X X 1(one) Christopher D. Vu

VA-VHA-SAOC-2018-E8E15CC2

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: POC Name: _____________________

Network Contracting Office 16 5075 Westheimer Road, Suite 750 Houston TX 77056-5643 Phone: 713-770-2820 Email: christopher.vu2@va.gov

Troy Davis, Contract Specialist Department of Veterans Affairs Network Contracting Office 16 5075 Westheimer Road, Suite 750 Houston TX 77056-5643 Phone: 713-770-2659 E-mail: troy.davis@va.gov

Karla Thompson, Contracting Officer Representative Department of Veterans Affair G.V. (Sonny) Montgomery Veterans Affairs Medical Center 1500 E. Woodrow Wilson Drive Jackson, MS 39216-5116 Phone: 601-362-4471 ext 51354 Email: karla.thompson@va.gov

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

or

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [x] Monthly 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. Invoicing shall be in accordance with the requirements of The Department of Veterans Affairs (VA) Financial Services Center (VAFSC). The latest information shall be used for invoicing and payments and may change during the Period of Performance of this acquisition. Current Invoicing information is located at http://www.fsc.va.gov/einvoice.asp

5. MANDATORY WRITTEN DICLOSURES: Mandatory written disclosures required by FAR clause 52.203-13 to the Department of Veterans Affairs, Office of Inspector General (OIG) must be made electronically through the VA OIG Hotline at http://www.va.gov/oig/contacts/hotline.asp and clicking on "FAR clause 52.203-13 Reporting." If you experience difficulty accessing the website, call the Hotline at 1-800-488-8244 for further instruction.

6. Secure Fax – In accordance with VA Handbook 6500 the following statement on all fax cover sheets must be included: “This fax is intended only for the use of the person or office to which it is addressed and may contain information that is privileged, confidential, or protected by law. All others are hereby notified that the receipt of this fax does not waive any applicable privilege or exemption for disclosure and that any dissemination, distribution, or copying of this communication is prohibited. If you have received this fax in error, please notify this office immediately at the telephone number listed above.”

7. The Contracting Officer will issue a post award orientation letter (in lieu of a conference) for contract orientation purposes as required by VA Acquisition Manual, Part M842.502-70.

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

(End of B.1 Contract Administration Information)

B.2 SCHEDULE OF SERVICES

SCHEDULE OF SERVICES

The Contractor shall furnish all personnel to provide services necessary to perform onsite Emergency Department Physician Services to eligible beneficiaries of the Department of Veterans Affairs Medical Center, G.V. (Sonny) Montgomery VA Medical Center, Jackson, MS (hereinafter referred to as VAMC).

The VAMC Emergency Services are accredited by The Joint Commission (TJC)and follow the standards & guidelines set forth by American College of Emergency Physicians (ACEP). A contractor providing onsite emergency department physician services shall provide services that meet or exceed the ACEP Guidelines http://www.ACEP.org/ Place of Performance: Services shall be provided on site, VAMC 1500 East Woodrow Wilson Drive, Jackson, MS 39216-5116.

Pricing Instructions:

The Contractor shall propose at least the required number of qualified physicians in the line items to be credentialed and privileged and twice that number of FTE to ensure the fulfilment of the contract’s obligations.

NOTE: For purposes of award of this Contract, the Government intends to evaluate the option to extend services under FAR 52.217-8 as follows: The evaluation will consider the possibility that the option can be exercised at any time and can be exercised in increments of one to six months, but not for more than a total of six months during the life of the contract. The evaluation will assume that the prices for any option exercised under FAR 52.217-8 will be those rates in effect under the contract each time an option is exercised under this clause. The evaluation will therefore assume that the addition of the price or prices of any possible extension or extensions under FAR 52.217-8 to the total price for the basic requirement and the total price for the priced options has the same effect on the total price of all proposals relative to each other, and will not affect the ranking of proposals based on price, unless, after reviewing the proposals, the Government determines that there is a basis for finding otherwise. This evaluation will not obligate the Government to exercise any option under FAR 52.217-8.

Period of Performance: BASE YEAR: __June 1, 2023___ to ___May 31, 2024____

Annual Cost

KEY PERSONNEL

NAME:____________

TITLE:____________

Hours

NAME:____________

Hours

Annual Cost

KEY PERSONNEL

NAME:____________

Hours

NAME:____________

Hours

Total for Base Period: $ ___________________

OPTION YEAR ONE (1): __June 1, 2024___ to ___May 31, 2025____

Annual Cost

KEY PERSONNEL

NAME:____________

Hours

NAME:____________

Hours

Annual Cost

KEY PERSONNEL

NAME:____________

Hours

NAME:____________

Hours

Total for Option Year 1: $ ___________________

OPTION YEAR TWO (2): __June 1, 2025___ to ___May 31, 2026____

Annual Cost

KEY PERSONNEL

NAME:____________

Hours

NAME:____________

Hours

Annual Cost

KEY PERSONNEL

NAME:____________

Hours

NAME:____________

Hours

Total for Option Year 2: $ ___________________

OPTION YEAR THREE (3): __June 1, 2026___ to ___May 31, 2027____

Annual Cost

KEY PERSONNEL

NAME:____________

Hours

NAME:____________

Hours

Annual Cost

KEY PERSONNEL

NAME:____________

Hours

NAME:____________

Hours

Total for Option Year 3: $ ___________________

OPTION YEAR FOUR (4): __June 1, 2027___ to ___May 31, 2028____

Annual Cost

KEY PERSONNEL

NAME:____________

Hours

NAME:____________

Hours

Annual Cost

KEY PERSONNEL

NAME:____________

Hours

NAME:____________

Hours

Total for Option Year 4: $ ___________________

Total for base performance period and all option years: $_________________________

(END OF B.2 SCHEDULE OF SERVICES)

36C25623R0009

Page 1 of Page 1 of

B.3 PERFORMANCE WORK STATEMENT

Onsite Emergency Department Physician Services

1. GENERAL:

1.1. Services Provided: The Contractor shall provide Board Certified/Board Eligible Emergency Medicine Physician Services on site in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and the G.V. (Sonny) Montgomery VAMC, Jackson, MS. A contractor providing onsite emergency department physician services that meet or exceed the American College of Emergency Physician Guidelines http://www.ACEP.org/

1.2. Place of Performance: Contractor shall furnish services at the G.V. (Sonny) Montgomery VAMC, Jackson, MS, 1500 E. Woodrow Wilson Drive, Jackson, MS 39216.

1.3. Authority: Title 38 USC 8153, Health Care Resources (HCR) sharing Authority and Federal Acquisition Regulation (FAR) parts 12, and 15.

1.4. Policy/Handbooks- The contractor shall be subject to the following policies, including any subsequent updates during the period of performance:

1.4.1. VHA Handbook 1100.17: National Practitioner Data Bank Reports: https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135

1.4.2. VHA Directive 1100.18: Reporting And Responding To State Licensing Boards:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9174

1.4.3. VHA Handbook 1100.19: Credentialing and Privileging: http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910

1.4.4. VHA Directive 1003.04: VHA Patient Advocacy:

https://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=5970

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

https://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=3148

1.4.6. VHA Directive 1101.05(02): Emergency Medicine:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3236

1.4.7. VHA Directive 1192.01: Seasonal Influenza Prevention Program:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=8948

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

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=8365

1.4.9. VA Directive 1663: Health Care Resources Contracting – Buying: https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2

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

1.4.11. VHA Directive 1100.20 Credentialing of Health Care Providers: https://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=9444

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

1.4.13. VHA Directive 1065: Productivity and Staffing Guidance for Specialty Provider Group Practice: https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9130

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

1.5. Definitions/Acronym: 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. ABEM: American Board of Emergency Medicine http://www.abem.org

1.5.2. ABIM: American Board of Internal Medicine http://www.abim.org/

1.5.3. ACEP: American College of Emergency Physicians

1.5.4. ACGME: Accreditation Council for Graduate Medical Education

1.5.5. ACLS: Advanced Cardiac Life Support

1.5.6. ATLS: Advanced Trauma Life Support

1.5.7. AOD: Admitting Officer of the Day

1.5.8. BLS: Basic Life Support

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

1.5.10. CDC: Centers for Disease Control and Prevention

1.5.11. CR: Contract Discrepancy Report

1.5.12. CEU: Certified Education Unit

1.5.13. CME: Continuing Medical Education

1.5.14. CMS: Centers for Medicare and Medicaid Services

1.5.15. 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.

1.5.16. 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.

1.5.17. COS: Chief of Staff

1.5.18. COVID-19: Coronavirus Disease 2019

1.5.19. CPARS: Contractor Performance Assessment Reporting System

1.5.20. 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.

1.5.21. DEA: Drug Enforcement Agency

1.5.22. ED: Emergency Department

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

1.5.24. FSMB: Federation of State Medical Boards

1.5.25. HHS: Department of Health and Human Services

1.5.26. HIPAA: Health Insurance Portability and Accountability Act

1.5.27. HR: Human Resources

1.5.28. ISO: Information Security Officer

1.5.29. 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.

1.5.30. MOD: Medical Officer of the Day

1.5.31. 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).

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

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

1.5.34. NP: Nurse Practitioner

1.5.35. NPPES: National Plan and Provider Enumeration System

1.5.36. PA: Physician Assistant

1.5.37. PALS: Pediatric Advanced Life Support

1.5.38. POP: Period of Performance

1.5.39. PPD: Purified Protein Derivative

1.5.40. PWS: Performance Work Statement

1.5.41. 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.

1.5.42. QA/QI: Quality Assurance/Quality Improvement

1.5.43. QM/PI: Quality Management/Performance Improvement

1.5.44. QASP: Quality Assurance Surveillance Plan

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 the G.V. (Sonny) Montgomery VA Medical Center.

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 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’s physician(s) shall be Board Certified/Board Eligible in Emergency Medicine. All contractor’s physician(s) are strongly encouraged, but not required to be certified in Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) if Board Certified/Board Eligible in Emergency Medicine unless required by facility policy.

2.1.3. Credentialing and Privileging: Credentialing and privileging is to be done in accordance with the provisions of VHA Handbook 1100.19 and VHA Directive 1100.20 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 VAMC Professional Standards Board, Medical Executive Board and Medical Center Director.

2.1.3.1 If a contractor’s physician(s) is 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 shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contractor’s physician(s) and 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 credentialing 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. For Emergency Departments, physicians Board Certified/Board Eligible in Emergency Medicine are strongly encouraged, but not required, to have current BLS and ACLS certification. Physicians Board Certified/Board Eligible in Internal Medicine or Family Practice must be certified in BLS and ACLS. However, PLEASE KNOW THAT YOU MUST FOLLOW YOUR LOCAL FACILITY’S POLICY. Other training may become required. VA will communicate any changes to the training requirement to the contractor.

Training (The following training is mandatory per VHACO for Contracted Physicians) Frequency (once a year, etc) Annual Hours

2.1.7. Standard Personnel Testing (PPD, etc.): Contractor shall provide proof of the following tests 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 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.

2.1.8. 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 proposal.

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 proposal and during the entirety of contract performance. At the time of proposal, 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 (Jan 2008) 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 proposal, 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 and VHA Directive 1100.20. Clinical/Professional performance monitoring and review of all clinical personnel covered by this contract for quality purposes will be provided by the VAMC COS and/or the Chief of the Service or his designee. A clinical COR may be appointed, however, only the CO is authorized to consider any contract modification request and/or make changes to the contract during the administration of the resultant contract.

2.3. Non Personal Healthcare Services: The parties agree that the 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 physician(s). When a Contractor or contractor’s physician(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): FTE is defined by VA as a minimum of 80 hours every two weeks and does not include holidays.

2.9.2. The minimum number of Board Certified /Board Eligible Emergency Medicine physicians to be on site on a daily basis is at least 2 physicians at all times.

2.9.3. It is essential that continuity of services is maintained to the maximum degree possible hence, substitution of contractor provided Physicians shall be limited to urgent/emergent absences of approved, assigned providers. 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 begin or complete an assigned shift, the contractor shall provide replacement physician coverage within 2 hours and notify the Contracting Office Representative (COR) at the VAMC immediately of the schedule change. At no time must the ED be left without qualified physicians (as defined in Section 2 above) to provide clinical care in the ED.

2.9.4. Contract Manager (CM): The contactor shall designate a CM to act as the contractor's authorized representative and manage the provision of contract services. The name of the CM, and an alternate who shall act for the contractor when the CM is absent, shall be designated in writing to the CO. The CM and alternate shall both be employees of the contractor and have full authority to act for the contractor on all contract matters relating to daily operation of this contract. The CM shall work with the COR to resolve issues; receive and relay technical instructions; and ensure adequate performance of contract services. The CM is responsible for the overall management of contract employees and/or subcontractors performing services under this contract. The CM shall ensure that the contractor’s employees and/or subcontractors do not perform any services outside the scope of the contract without an official modification issued by the CO. The CM shall ensure that the contractor’s employees and/or subcontractors understand that services performed outside the scope of the contract are performed wholly at contractor’s expense. Any changes to the CM will be subject to the prior written consent of the CO, which shall not be unreasonably withheld. Contractor agrees that any proposed replacement will have the required experience and qualifications to perform the role satisfactorily and professionally.

2.9.5. 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 7 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 15 calendar days after receipt of all required information of the decision on the proposed substitutes. The contract will be modified to reflect any approved changes of key personnel.

2.9.4.2 For temporary substitutions where the key person shall not be reporting to work for three (3) consecutive 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 VAMC’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. HOURS OF OPERATION

3.1. VA Business Hours: The Emergency Department at VAMC operates twenty-four (24) per day, seven (7) days per week, including Federal Holidays. The shift structure/length may change at the discretion of ED or facility leadership and the following current shifts are:

Monday through Friday:

7:00 am - 7:00 pm

9:30 am – 6:00 pm

5:30 pm – 12:00 am

6:00 pm – 7:00 am

Saturday and Sunday:

7:00 am - 7:00 pm

10:00 am – 10:00 pm

12:00 pm – 4:00 pm

7:00 pm – 7:00 am

*Holiday staffing (on holidays that fall on weekday)

7:00 am - 7:00 pm

9:30 am – 6:00 pm

5:30 pm – 12:00 am

6:00 pm – 7:00 am

3.1.1. Patients must be seen by a contractor’s physician(s) on-site at VAMC 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 to be scheduled to work during all hours of operation of the ED or as required by the facility Chief of Staff or designee. The ED operates 24 hours a day, 7 days a week, 365 days a year including Federal Holidays.

3.1.3. FEDERAL HOLIDAYS:

The following holidays are observed by the VA:

Any day specially declared by the President of the United Sates to be a national holiday.

3.1.4. There are no on-call requirements for these services.

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 Emergency services as would be provided in a state-of-the-art health care treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards as established by:

4.2.1. The American Board of Emergency Medicine

4.2.2. American Board of Osteopathic Emergency Medicine

4.2.3. Relevant professional societies including American College of Emergency Physicians (ACEP), Society of Academic Emergency Medicine (SAEM), and American Academy of Emergency Medicine (AAEM)

4.2.4. The professional standards of The Joint Commission (TJC): http://www.jointcommission.org/emergency_department/

4.2…