36C25918R0563-001.docx

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1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

DUNS:

DUNS+4:

PHONE:

FAX:

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

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Only) 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) 30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

(REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

36C25918R0563 06-15-2018 Susan M. Protho 303-712-5801 06-26-2018

17:00 MST

36C259 Department of Veterans Affairs Network Contracting Office

NCO 19

6162 South Willow Drive, Suite 300 Greenwood Village

CO

80111 X X 621111 $11 Million Net 30 X N/A X Oklahoma City VA Healthcare System 921 NE 13th Street

OK

73104-5007 36C259 Department of Veterans Affairs Network Contracting Office

NCO 19

6162 South Willow Drive, Suite 300 Greenwood Village

CO

80111

Department of Veterans Affairs Financial Service Center PO Box 149971 Austin

TX

78714-9971 See CONTINUATION Page The Oklahoma City VA Healthcare System has a requirement for Radiation Oncology Physicist and Dosimetry support services:

Reference PWS and additional instructions included in the Solicitation document for full details.

Period of Performace is estimated to begin on 7/23/2018 for 1 year with (4) 1-year Options.

See CONTINUATION Page Terry W. Whitfield Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

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

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

a. CONTRACTOR:

b. GOVERNMENT:

Contract Specialist: Susan M. Protho Office: 303-712-5801 Cell: 719-623-9969 Email: susan.protho@va.gov Department of Veterans Affairs Network Contracting Office

NCO 19

6162 South Willow Drive, Suite 300 Greenwood Village CO 80111

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

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 Service Center PO Box 149971 Austin TX 78714-9971

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

B.2 PRICE/COST SCHEDULE

SCHEDULE OF SERVICES

The Contractor shall furnish all personnel to provide services necessary to perform onsite Radiation Oncology Physics and Dosimetry Support Services to eligible beneficiaries of the Department of Veterans Affairs Health Care System, Oklahoma City, OK (hereinafter referred to as VAHCS).

All VA Radiation Oncology Services are accredited by American College of Radiology (ACR) and follow the standards & guidelines set forth by ACR. As such, any Contractor providing on-site radiation oncology services must adhere to all the American College of Radiology Guidelines & Technical Standards for Radiation Oncology:

http://www.acr.org/Quality-Safety/Standards-Guidelines/Practice-Guidelines-by-Modality/Radiation-Oncology http://www.acr.org/Quality-Safety/Appropriateness-Criteria/New-and-Revised http://www.acr.org/Quality-Safety/Standards-Guidelines/Technical-Standards-by-Modality/Medical-Physics

Pricing Instructions:

The offeror is instructed to edit the number of sub-clins to correspond with the number of key personnel submitted for the contract line item number (CLIN). Affiliate Offerors shall include the “title” of the personnel submitted. Other commercial health care Offerors shall identify by title/position or level of experience the key personnel submitted. Also, renumber SUB-CLINs if adding or removing Key Personnel.

The offeror is instructed to include all other than price and cost information supporting the proposed price as directed in Instructions to Offerors addendum to 52.212-1 and/or Section D- Contract Documents, Exhibits, or attachments, VA Directive 1663 Appendix B. The Contractor shall propose the necessary key personnel to be credentialed and be available for scheduling to meet the requirements of the contract.

Place of Performance: Services shall be provided on site in Radiation Oncology Service, VAHCS, 921 NE 13th Street, Oklahoma City, OK 73104.

Period of Performance: BASE YEAR: 07/23/2018 to 7/22/2019

Annual Cost

KEY PERSONNEL

TITLE/LEVEL OF EXPERIENCE: ____________

CLIN 0001 TOTAL FOR BASE TERM

Hours

Annual Cost

KEY PERSONNEL

TITLE/LEVEL OF

EXPERIENCE: ____________

Annual Cost

KEY PERSONNEL

TITLE/LEVEL OF EXPERIENCE: ____________

CLIN 0003 TOTAL FOR BASE TERM

Total for Base Year: $_______________

Period of Performance: OPTION YEAR 1: 7/23/2019 to 7/22/2020

Annual Cost

KEY PERSONNEL

TITLE/LEVEL OF EXPERIENCE: ____________

Annual Cost

TITLE/LEVEL OF EXPERIENCE: ____________

Annual Cost

KEY PERSONNEL

TITLE/LEVEL OF EXPERIENCE: ____________

CLIN 1003 TOTAL FOR BASE TERM

Total for Option Year 1: $_______________

Period of Performance: OPTION YEAR 2: 7/23/2020 to 7/22/2021

Annual Cost

KEY PERSONNEL

TITLE/LEVEL OF EXPERIENCE: ____________

Annual Cost

TITLE/LEVEL OF

EXPERIENCE: ____________

Annual Cost

KEY PERSONNEL

TITLE/LEVEL OF EXPERIENCE: ____________

CLIN 2003 TOTAL FOR BASE TERM

Total for Option Year 2: $______________

Period of Performance: OPTION YEAR 3: 7/23/2021 to 7/22/2022

Annual Cost

KEY PERSONNEL

TITLE/LEVEL OF EXPERIENCE: ____________

Annual Cost

TITLE/LEVEL OF EXPERIENCE: ____________

Annual Cost

KEY PERSONNEL

TITLE/LEVEL OF EXPERIENCE: ____________

CLIN 3003 TOTAL FOR BASE TERM

Total for Option Year Three: $_______________

Period of Performance: OPTION YEAR 4: 7/23/2022 to 7/22/2023

Annual Cost

KEY PERSONNEL

TITLE/LEVEL OF EXPERIENCE: ____________

Annual Cost

TITLE/LEVEL OF

EXPERIENCE: ____________

Annual Cost

KEY PERSONNEL

TITLE/LEVEL OF EXPERIENCE: ____________

CLIN 4003 TOTAL FOR BASE TERM

Total for Option Year Three: $_________________

GRAND TOTAL FOR BASE AND ALL OPTION PERIODS: $__________________

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B.3 PERFORMANCE WORK STATEMENT AND QUALITY ASSURANCE SURVEILLANCE PLAN

ONSITE THERAPEUTIC MEDICAL PHYSICIST SERVICES

PERFORMANCE WORK STATEMENT (PWS)

1. GENERAL

SERVICES REQUIRED: The VA Radiation Oncology Services are accredited by American College of Radiology (ACR) and follow the standards & guidelines set forth by ACR. As such, any Contractor providing on-site radiation oncology services must adhere to all the American College of Radiology Guidelines & Technical Standards for Radiation Oncology: A contractor providing on-site radiation oncology services must provide evidence the radiation oncology practice meets or exceeds the American College of Radiology Guidelines for Radiation Oncology.

http://www.acr.org/Quality-Safety/Standards-Guidelines/Practice-Guidelines-by-Modality/Radiation-Oncology http://www.acr.org/Quality-Safety/Appropriateness-Criteria/New-and-Revised http://www.acr.org/Quality-Safety/Standards-Guidelines/Technical-Standards-by-Modality/Medical-Physics

0. PLACE OF PERFORMANCE: 921 NE 13th Street Oklahoma City, Oklahoma 73104

0. AUTHORITY: Title 38 USC 8153, Health Care Resources (HCR) sharing Authority.

0. Policy/Handbooks:

2. VA Directive 1663: Health Care Resources Contracting - Buying http://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=347

2. VHA Directive 2006-041 “Veterans’ Health Care Service Standards” (expired but still in effect pending revision) https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443

2. VHA Handbook 1100.17: National Practitioner Data Bank Reports - http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135

2. VHA Handbook 1100.18 Reporting And Responding To State Licensing Boards - http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364

2. VHA Handbook 1100.19 Credentialing and Privileging - http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1806

2. VHA Directive 2012-030 Credentialing of Health Care Professionals – http://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=2815

2. VHA Handbook 1907.01 Health Information Management and Health Records: http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791

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

0. DEFINITIONS/ACRONYMS:

3. AAPM: American Association of Physics in Medicine

3. ACGME: Accreditation Council for Graduate Medical Education

3. ABR: American Board of Radiology

3. ACR: American College of Radiology (www.acr.org/)

3. ACO: Administrative Contracting Officer

3. AOA: American Osteopathic Association

3. BAA : Business Associate Agreement

3. CAMPEP: Commission on Accreditation of Medical Physics Educational Programs (http://www.campep.org/default.asp)

3. CDC: Centers for Disease Control and Prevention

3. CEU: Certified Education Unit

3. CME: Continuing Medical Education

3. CMS: Centers for Medicare and Medicaid Services

3. CO: Contracting Officer

3. COR: Contracting Officer’s Representative

3. COS: Chief of Staff

3. CPARS: Contractor Performance Assessment Reporting System

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

3. FSMB: Federation of State Medical Boards

3. Full Time Equivalent (FTE): VA’s definition for full time- working the equivalent of 80 hours every two weeks, 2080 hours per year. In calculating FTE, any hours not worked on national holidays shall not be included.

3. HHS: Department of Health and Human Services

3. HICPAC: Healthcare Infection Control Practices Advisory Committee- a federal advisory committee made up of 14 external infection control experts who provide advice and guidance to the CDC and the Secretary of HHS regarding the practice of health care infection control, strategies for surveillance and prevention and control of health care associated infections in United States health care facilities.

3. HIPAA: Health Insurance Portability and Accountability Act

3. IGRT: Image Guided Radiation Therapy is the process of frequent two and three-dimensional imaging, during a course of radiation treatment, used to direct radiation therapy utilizing the imaging coordinates of the actual radiation treatment plan.

3. IMRT: Intensity Modulated Radiation Therapy is the process of delivering highly conformal radiotherapy to the tumor while sparing the surrounding normal tissues by varying radiation intensity across treatment portals.

3. ISO: Information Security Officer

3. MU: Monitor Unit is a measure of machine output of a linear accelerator in radiation therapy.

3. NHPP: National Health Physics Program- NHPP provides regulatory oversight for the Nuclear Regulatory Commission master materials license issued to VHA to include permitting for use of materials, on-site inspections, and investigations of allegations, medical events, and incidents. In addition, we provide oversight for machine sources of ionizing radiation used for radiation therapy. Finally, we provide assistance and technical information for uses of ionizing radiation for healthcare diagnosis and treatment and non-human biomedical research. (http://www.patientcare.va.gov/NHPP.asp)

3. NROP: National Radiation Oncology Program

3. NRSC: National Radiation Safety Committee

3. OSL: Optically Stimulated Luminescence

3. POP: Period of Performance

3. PPD: Purified Protein Derivative

3. PWS: Performance Work Statement

3. QA/QI: Quality Assurance/Quality Improvement

3. QM/PI: Quality Management/Performance Improvement

3. QASP: Quality Assurance Surveillance Plan

3. QMP: Quality Management Program

3. IROC: Imaging and Radiation Oncology Core

3. SPE: Senior Procurement Executive

3. SRS: Stereotactic Radio Surgery: a minimally invasive form of surgical intervention which makes use of a three-dimensional coordinated system to locate small targets inside the body and to perform on them some action such as ablation, biopsy, lesion, injection, stimulation, implantation, radiosurgery (SRS) etc.

3. SRT: Stereotactic Radio Therapy

3. TJC: The Joint Commission

3. TLD: Thermoluminescent Dosimeter- a device that measures radiation dose

3. VA: Department of Veterans Affairs

3. VAHCS: Veterans Affairs Health Care System

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

3. VHA: Veterans Health Administration

1. QUALIFICATIONS:

1. Staff and Facility:

0. Board Certification - All Contractor’s Physicist(s) shall be Board Certified. All continuing education courses required for maintaining certification must be kept up to date. Documentation verifying current certification shall be provided by the Contractor to the VA COR on the award date for each year of contract performance.

0. Therapeutic Medical Physicist: The Contractor shall provide American Board of Radiology (ABR) Board Certified. Physicists in the area of Radiation Oncology and contractor’s Physicist(s) shall maintain certification throughout the period of performance. In the event a Contractor’s Therapeutic Medical Physicist(s) is/are not directly employed by the treating facility, documentation must be provided to ensure adequate certification.

0. Therapeutic Medical Physicists must be Board Certified in Medical Physics or Therapeutic Medical Physics by the ABR and maintain licensure with the Board of Licensure for Professional Medical Physicists, if applicable. Certification must be maintained throughout the contract POP. In the event a Contractor’s medical physicist(s) is/are not directly employed by the treating facility, documentation must be provided to ensure adequate certification.

0. Therapeutic Medical Physicist must be a graduate from a residency program and/or PH.D. in Medical Physics (Therapy Track) in the USA/Canada.

0. Experience – Contractor’s Physicist(s) will have a minimum of 3 years of experience after board certification in the following areas:

1. ARIA record and verify system

1. Eclipse Treatment Planning System (TPS)

1. BrainLab (SRS) (experience in iPlan TPS will be a plus but not mandatory)

1. SBRT

1. 4D-CT Imaging & Treatment Planning

1. Varian RPM Gating System

1. Patient Treatment Planning

1. Varian LINAC & Treatment Planning System (TPS) Acceptance and Commissioning (experience in Electron Monte Carlo Commissioning and Clinical Implementation will be a plus but mandatory).

0. Credentialing of Health Care Professionals other than physicians. In accordance with VHA Directive 2012-030, all health care professional who claim licensure, certification, or registration, as applicable to the position (this applies to all who are appointed or utilized on a full-time, part-time, intermittent, consultant , without compensation, on-station fee-basis, on-station contract, or on-station sharing agreement basis) and who are not currently credentialed in accordance with VHA Handbook 1100.19, must be credentialed in accordance with this directive. NOTE: The credentialing requirements are found in Attachment A of this Directive.

0. Technical Proficiency - Contractor’s Physicist (s) and other contract provider (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 Physicist (s) and other contract provider (s) shall have knowledge of professional care theories, principles, practices, and procedures to serve radiation oncology patient population. Contractor’s Physicist (s) and other contract provider (s) shall demonstrate knowledge of growth and development, and pathophysiology of disease processes specific radiation oncology patient population. Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contractor’s Physicist(s) and other contract provider (s) shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior.

0. Continuing CME/CEU Requirements: Contractor shall provide the COR copies of current CMEs as required or requested by the VAHCS. Contractors registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. CME hours shall be reported to the credentials office for tracking. These documents are required for initial and renewal privileging. Failure to provide shall result in loss of privileges.

0. Training (CPRS and VA MANDATORY): Contractor’s Physicist (s) and other contract provider(s) shall meet all VA educational requirements. All training must be completed by the contractor’s Physicist (s) and other contract provider (s) as required by the VA. Contractor’s Physicist (s) shall complete the orientation process for contractors. A total of 13 hours is represented in the table below.

.25

0. Standard Personnel Testing/Infection Control: Contractor shall provide statement that all required infection control testing is current and that the contractor is compliant with OSHA regulations concerning occupational exposure to blood borne pathogens. Contractor shall provide proof of the following tests for their staff 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. Up to date certifications will be sent to the CO and COR on the award date for each year of contract performance.

6. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative reaction to PPD testing for all Contractor staff.

A negative chest radiographic report for active tuberculosis shall be provided in cases of positive PPD results. The PPD test shall be repeated annually.

6. RUBELLA TESTING: Contractor shall provide proof of immunization for all Contractor staff 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.

6. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO BLOODBORNE PATHOGENS: Contractors shall provide generic self-study training for all Contractor staff; 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.

6. The VAHCS shall notify the Contractor of any significant communicable disease exposures as appropriate. Contractors 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. Contractors shall provide follow up documentation of clearance to return to the workplace prior to their return.

0. Conflict of Interest: The Contractor and all contractor’s Physicist (s) and other contract provider (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.

0. Citizenship related Requirements:

8. 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;

8. 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.

8. 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.

8. 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.

8. 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.

0. 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.

9. 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 Physicist (s) is 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.

9. 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.

1. 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 VAHCS 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.

1. Non Personal Healthcare Services: The parties agree that the Contractor and all contractor’s Physicist (s) and other contract provider (s) shall not be considered VA employees for any purpose.

1. 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.

1. Prohibition Against Self-Referral: Contractor’s Physicists are prohibited from referring VA patients to contractor’s or their own practice(s)

1. Inherent Government Functions: Contractor and Contractor’s Physicist (s) and other contract provider (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.

1. No Employee status: The Contractor shall be responsible for protecting Contractor’s Physicist (s) and other contract provider (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:

6. Workers’ compensation

6. Professional liability insurance

6. Health examinations

6. Income tax withholding, and

6. Social security payments.

1. Tort Liability: The Federal Tort Claims Act does not cover Contractor or contractor’s Physicist (s) and other contract provider (s). When a Contractor or contractor’s Physicist (s) and/or other 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 contractor’s Physicist (s) or other contract provider (s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

1. Key Personnel:

Contractor shall provide the number of qualified staff as is necessary to perform the services required under this contract, at the staffing level determined to be professionally acceptable by any of the following OKC VAHCS staff, Chief of Staff, Chief Therapeutic Medical Physicist, Chief of Medicine Service, or Section Chief of Radiation Oncology, in accordance with American College of Radiology staffing guidelines.

8. 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 Physicist requires an unscheduled absence, the Contractor shall provide a replacement for the next full shift within 24-hours and notify the Contracting Office Representative (COR) at the OKC VAHCS immediately of the schedule change.

8. 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 15 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 15 calendar days prior to making any permanent substitutions.

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.

1. For temporary substitutions where the key person shall not be reporting to work for three 3 consecutive work days or more, the Contractor shall provide a qualified replacement for the key person. The substitute shall have qualifications as defined in this PWS. Any period exceeding two weeks will require the procedure as stated above.

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

1. Contingency Plan: Because continuity of care is an essential part of OKC VAHCS’s medical services, the Contractor shall have a contingency plan in place to be utilized if the Contractor’s Physicist (s) leaves Contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract. The replacement Therapeutic Medical Physicist must be credentialed and have a security clearance through VSC prior to the unplanned absence of the key personnel.

1. Continuity of Care: To maintain continuity of care, the Contractor’s Physicist must be on a minimum of a 6-month continuous rotation at the OKC VAHCS.

1. VA HOURS OF OPERATION/SCHEDULING:

2. VA Radiation Oncology Business Hours: Monday through Friday 8:00 AM to 4:30 PM

0. Contractor’s Physicist(s) will be available, as required, during the hours written in section 3.1. These hours may be revised, in writing, as deemed appropriate, for patient care by the Chief of Staff, Chief of Medicine, Chief of Radiation Oncology or Chief Therapeutic Medical Physicist.

0. The TMP may be required to perform work after normal business hours to complete calibrations, measurements, and/or quality assurance.

2. On-call: The Contractor will cover on-call coverage as assigned by the Chief Therapeutic Medical Physicist.

1. On-call hours are defined as hours outside of normal business hours as specified in section 3.1 but exclude all items stated in section 3.1.2.

1. On-call: Contractor’s Physicist shall be physically on-site at the OKC VAHCS Radiation Oncology Department within 60 minutes of an emergency phone call, when medically necessary.

2. Federal Holidays: The following holidays are observed by the Department of Veterans Affairs:

1. New Year’s Day

1. President’s Day

1. Martin Luther King’s Birthday

1. Memorial Day

1. Independence Day

1. Labor Day

1. Columbus Day

1. Veterans Day

1. Thanksgiving

1. Christmas

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

1. CONTRACTOR RESPONSIBILITIES

3. SERVICES REQUIRED: Board Certified Therapeutic Medical Physicist Services

3. Standards of Practice: The medical practice and patient care provided by Contractor shall be evidence based best practices that meet or exceed all standards of professional practice and performance measures applicable to OKC VAHCS medical professionals, including, but not limited to, NHPP, AAPM and TJC standards and ACR current practice guidelines in radiation oncology.

3. Contractor’s care shall cover the range of services as would be provided in a state-of-the-art civilian medical treatment facility. Contractor shall provide evidence the Contractor’s radiation oncology standard of care is of a quality that meets or exceeds currently recognized VA and ACR national standards as established by:

2. The American College of Radiology (ACR) Guidelines for Radiation Oncology. http://www.acr.org/Quality-Safety/Standards-Guidelines/Practice-Guidelines-by-Modality/Radiation-Oncology http://www.acr.org/Quality-Safety/Appropriateness-Criteria/New-and-Revised http://www.acr.org/Quality-Safety/Standards-Guidelines/Technical-Standards-by-Modality/Medical-Physics

2. The professional standards of the TJC or equivalent accreditation http://www.jointcommission.org/standards_information/hap_requirements.aspx .

2. VA Standards: VHA Directive 2006-041 “Veterans’ Health Care Service Standards” (expired but still in effect pending revision) https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443

2. The standards of the American Hospital Association http://www.hpoe.org/resources?show=100&type=8 and;

2. The requirements contained in this PWS

3. MEDICAL RECORDS

3. Authorities: Contractor’s Physicist (s) providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the U.S.C.551a (Privacy Act), 38 U.S.C. 5701 (Confidentiality of claimants records), 5 U.S.C. 552 (FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332 (Confidentiality of certain medical records), Title 5 U.S.C. § 522a (Records Maintained on Individuals) as well as 45 C.F.R. Parts 160, 162, and 164 (HIPAA).

3. HIPAA: This contract and its requirements meet exception in 45 CFR 164.502(e), and do not require a BAA in order for Covered Entity to disclose Protected Health Information to: a health care provider for treatment. Based on this exception, a BAA is not required for this contract. Treatment and administrative patient records generated by this contract or provided to the Contractors by the VA are covered by the VA system of records entitled ‘Patient Medical Records-VA’ (24VA19). 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 are available for immediate transmission when requested by the VA. Records identified for review, audit, or evaluation by VA representatives and authorized federal and state officials, shall be accessed on-site during normal business hours or mailed by the Contractor at his expense. Contractor shall deliver all final patient records, correspondence, and notes to the VA within twenty-one (21) calendar days after the contract expiration date.

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

3. Professional Standards for Documenting Care: Care shall be appropriately documented in medical records in accordance with standard commercial practice and guidelines established by VHA Handbook 1907.01 Health Information Management and Health Records: http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791 and all guidelines provided by the VAHCS.

3. Release of Information: The VA shall maintain control of releasing any patient medical information and will follow policies and standards as defined, but not limited to Privacy Act requirements. In the case of the VA authorizing the Contractor to release patient information, the Contractor in compliance with VA regulations, and at his/her own expense, shall use VA Form 3288, Request for and Consent to Release of Information from Individual’s Records, to process “Release of Information Requests.” In addition, the Contractor shall be responsible for locating and forwarding records not kept at their facility. The VA’s Release of Information Section shall provide the Contractor with assistance in completing forms. Additionally, the Contractor shall use VA Form 10-5345, Request for and Authorization to Release Medical Records or Health Information, when releasing records protected by 38 U.S.C. 7332. Treatment and release records shall include the patient’s consent form. Completed Release of Information requests will be forwarded to the VA Privacy Officer at the following address: Sharron Schaefer, 921 NE 13th Street, Oklahoma City, OK 73104, Sharron.Schaefer@va.gov, 405-456-5761.

3. DIRECT PATIENT CARE: 95% of the time involved in direct patient care.

4. Board Certified Therapeutic Medical Physicist Services: Contractor shall provide, at a minimum, the following Therapeutic Medical Physicist services for Veteran patients in accordance with the terms and standards specified herein

0. Services shall include evaluation and treatment of transported inpatient and outpatient clinical services for both palliative and curative cancer patients; follow-up, re-evaluation and treatment visit.

Conventional Radiation Treatment: Use of the following modalities IMRT, IGRT, Stereotactic Radiosurgery, and Stereotactic Radiotherapy shall be fully justified in accordance with the appropriateness criteria of the American College of Radiology (ACR). ACR Quality-Safety Appropriateness Criteria may be accessed at:

http://www.acr.org/Quality-Safety/Appropriateness-Criteria/New-and-Revised

4.5.1.10. Documentation Requirements All patient care documentation including, but not limited to consultations, encounters, weekly progress notes, treatment discharge notes, follow-up notes, continuing physics consultation which covers weekly chart review checks, special physics consultation notes, and other required documentation, shall be recorded in CPRS in accordance with VA Rules and Regulations (see Section D, page 83 for CPRS User Guide and By-Laws and Rules of the Medical Staff of the VA RADIATION ONCOLOGY), including, but not limited to:

4.5.1.10.1. Inclusion of correct Current Procedural Terminology (CPT) and diagnoses codes, and service connection of condition being treated on encounters;

4.5.1.10.3. Electronic signature on all entries; timeframes for electronic signing, completion and closing of entries and encounters.

4. Medical Physics Support: Contractor shall provide medical physics support to perform the requirements of this contract in the following manner:

1. Contractor’s Medical Physicists are primarily and professionally engaged in the design, optimization, and technical evaluation of radiation treatment plans as well as ensuring precise and accurate radiation dose delivery.

Contractor’s Medical Physicists are responsible for radiation protection of patients and staff. The responsibilities of Contractor’s Medical Physicists are defined as follows:

1. Availability - Contractor’s Medical Physicists shall be available, when necessary, for consultation with the Radiation Oncologist and to provide advice or direction to technical staff when…