36C25919R0014-001.docx

36C25919R0014

OF

1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL

BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

DUNS:

DUNS+4:

PHONE:

FAX:

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

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA

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

ARE

ARE NOT ATTACHED.

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

ARE

ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SI

GN 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. SIGN

ATURE 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

36C25919R0014 10-09-2018 Claudia Coria 303-712-5766 10-15-2018 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 X N/A X

DEPARTMENT OF VETERANS AFFAIRS

VA Salt Lake City Health Care System 500 Foothill Drive Salt Lake City UT 84148 36C259 Department of Veterans Affairs Network Contracting Office

NCO 19

6162 South Willow Drive, Suite 300 Greenwood Village CO 80111

INVOICES SUBMITTED ELECTRONICALLY

Department of Veterans Affairs Financial Service Center PO Box 149971 Austin TX 78714-9971 See CONTINUATION Page

SEE ATTAC

HED STATEMENT OF WORK pages 6-36 and SCHEDULE pages 38-42 Emergency Department Physician Services for the VA Salt Lake City Health Care System Questions pertaining to the solicitation are due by 4:00 p.m., Mountain Time on October 10, 2018 via email ONLY.

Fax and telephone questions are not acceptable.

Proposals are due by 4:00 p.m., Mountain Time on October 15, 2018 via email ONLY.

Faxed proposals will NOT be accepted.

$0.00 See CONTINUATION Page X X

ONE(1)

Leigh Ann Nunn Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

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

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 have trouble accessing the website, call the Hotline at 1-800-488-8244 for further instructions.

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

GOVERNMENT: Claudia Coria, Contracting Specialist 00259 Department of Veterans Affairs Rocky Mountain Network NCO 19 Contracting 6162 S. Willow Drive, Suite 300 Greenwood Village, CO 80111 Telephone: 303-712-5766

FAX: 303-712-5850

E-mail: Claudia.Coria@va.gov

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

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.

c. Other [MONTHLY IN ARREARS] GOVERNMENT INVOICE ADDRESS: All invoices from the contractor shall be submitted electronically to the VA Financial Services Center for payment processing, free of charge. For any questions about the e-invoicing program, please contact the FSC at the phone number or email address listed below:

1. Tungsten Support

2. Phone: 1-877-489-6135

3. Website: http://www.tungsten-network.com/uk/en/

4. Department of Veterans Affairs Financial Service Center

5. Phone: 1-877-353-9791 Email: vafscched@va.gov DUNS NUMBER: Please provide the Dun and Bradstreet Number assigned to your firm in the space provided: _____________.

TAX IDENTIFICATION NUMBER: Please provide the tax identification number to be utilized for this contract: ____________.

PERIOD OF PERFORMANCE: Services required herein shall be as follows:

ESTIMATED PERIOD OF PERFORMANCE (will adjust accordingly after award)

36C25918R0073

B.2 PERFORMANCE WORK SCHEDULE – ED Physician Services ***DO NOT CHANGE, MODIFY OR EDIT ANY PART OF THE SOLICITATION. DOING SO, WILL RESULT IN AN AUTOMATIC NON-RESPONSIVE PROPOSAL.***

1. GENERAL:

1.1. Services Provided: The Contractor shall furnish board certified or board eligible physician(s) to provide services necessary to perform onsite Emergency Department Physician Services to eligible beneficiaries of the Department of Veterans Affairs Medical Center, VA Salt Lake City Health Care System, (hereinafter referred to as VAMC).

1.2. 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/.

1.3. Place of Performance: Services shall be provided on site at the VAMC located at 500 Foothill Drive, Salt Lake City Utah, 84148. The Contractor Emergency Department physicians(s) shall be located within one (1) hour of the VAMC. The one (1) hour is approximately a 60-mile radius of the VAMC. The contractor shall respond to the VA within one (1) hour for emergencies.

1.4. Authority: Title 38 USC 8153, Health Care Resources (HCR) Sharing Authority.

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

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

1.5.2. 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

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

1.5.4. - VHA Handbook 1100.18 Reporting and Responding to State Licensing Boards - http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364

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

1.5.6. - VHA Handbook 1400.01 Resident Supervision http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2847

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

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

1.6. Definitions/Acronyms- 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.

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

1.6.2. ACEP: American College of Emergency Physicians

1.6.3. ACGME: Accreditation Council for Graduate Medical Education

1.6.4. ACLS: Advanced Cardiac Life Support

1.6.5. ATLS: Advanced Trauma Life Support

1.6.6. AOD: Admitting Officer of the Day

1.6.7. BLS: Basic Life Support

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

1.6.9. CDC: Centers for Disease Control and Prevention

1.6.10. CR: Contract Discrepancy Report

1.6.11. CEU: Certified Education Unit

1.6.12. CME: Continuing Medical Education

1.6.13. CMS: Centers for Medicare and Medicaid Services

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

1.6.15. 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.

1.6.16. COS: Chief of Staff

1.6.17. CPARS: Contractor Performance Assessment Reporting System

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

1.6.19. 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.

1.6.20. DEA: Drug Enforcement Agency

1.6.21. ED: Emergency Department

1.6.22. FSMB: Federation of State Medical Boards

1.6.23. HHS: Department of Health and Human Services

1.6.24. HIPAA: Health Insurance Portability and Accountability Act

1.6.25. HR: Human Resources

1.6.26. ISO: Information Security Officer

1.6.27. 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.

1.6.28. MOD: Medical Officer of the Day

1.6.29. 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).

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

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

1.6.32. NP: Nurse Practitioner

1.6.33. NPPES: National Plan and Provider Enumeration System

1.6.34. PA: Physician Assistant

1.6.35. PALS: Pediatric Advanced Life Support

1.6.36. POP: Period of Performance

1.6.37. PPD: Purified Protein Derivative

1.6.38. PWS: Performance Work Statement

1.6.39. Privileging (Clinical Privileging): Privileging is the process by which a practitioner, licensed for 8independent 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.

1.6.40. QA/QI: Quality Assurance/Quality Improvement

1.6.41. QM/PI: Quality Management/Performance Improvement

1.6.42. QASP: Quality Assurance Surveillance Plan

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

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

1.6.45. 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.

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

1.6.47. 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 VAMC,500 Foothill Drive, Salt Lake City, UT 84148 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.

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.

2.1.1.2. All Contractor physician(s) shall have a current faculty appointment with the University of Utah School of Medicine, in the Department of Emergency Medicine.

2.1.2. Board Certification - All contractor’s physician(s) shall be board certified or board eligible in Emergency Medicine, shall be Board Certified or Board Eligible in Emergency Medicine, Internal Medicine, or Family Practice, and be currently certified in Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS) or equivalency. All continuing education courses required for maintaining certification must be kept up to date always. Documentation verifying current certification shall be provided by the Contractor to the VAMC COR on an annual basis for each year of contract performance.

2.1.3. Credentialing and Privileging –Credentialing and privileging shall be in accordance with the provisions of VHA Handbook 1100.19 referenced above. The Contractor shall propose key personnel to be credentialed and be available for scheduling to meet the requirements of the contract. The contractor shall be required to provide as a minimum, enough appropriately qualified physicians to be credentialed and privileged that meet or exceed twice the number of FTEE required to fulfill this contracts obligation. 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.

2.1.4. 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.

2.1.5. 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.

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

2.1.7. Training (ACLS, BLS, CPRS and VA MANDATORY): Contractor shall meet all VAMC educational requirements and mandatory course requirements defined herein; all training must be completed by the contractor’s physician (s) as required by the VAMC.

List all training required, frequency and associated time

2.1.8. 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.

2.1.8.1. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative reaction to PPD testing for all contractor’s physician (s). A negative chest radiographic report for active tuberculosis shall be provided in cases of positive PPD results. The PPD test shall be repeated annually.

2.1.8.2. RUBELLA TESTING: Contractor shall provide proof of immunization for all contractor’s physician (s) 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.

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

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

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

2.1.8.6. 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.

2.1.8.7. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO BLOODBORNE PATHOGENS: Contractor shall provide generic self-study training for all contractor’s physician (s); provide their own Hepatitis B vaccination series at no cost to the VAMC 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. 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.

2.1.10. DEA - Contractor shall provide copy of current DEA certificate.

2.1.11. 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.

2.1.12. Citizenship related Requirements:

2.1.12.1. The Contractor certifies that the Contractor shall comply with 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, because 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 offerors response to the RFP using the subject attachment 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 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 contracts with excluded individuals to provide items or services to Federal program beneficiaries.

2.1.13.2. 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. 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) for the services required is 5.63 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 Department physicians that are required to be on site daily is two (2) as defined in paragraph Hours of Operation in Section 3, page 15.

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 two (2) hours and notify the Contracting Office Representative (COR) at the (VAMC) immediately of the schedule change.

2.9.4. Section Chief and Associate Section Chief: Contractor shall designate (with the concurrence of the VAMC Chief of Medicine) a Section Chief of Emergency Medicine who will serve as the key administrative contact. Associate Chief (s) are also to be designated to fulfil the obligations when the Section Chief of Emergency Medicine is not available. The Section Chief of Emergency Medicine serves at the discretion of the VAMC Chief of Staff or his/her designee. On the event that a section chief is not successful in completing the job of Section Chief, the contractor shall nominate a replacement within 10 calendar days of notification by the Chief of Staff or his/her Designee. The appointment of the Section Chief of Emergency Medicine shall be with the concurrence of the Chief of Staff. The Section Chief shall have experience in leadership and, administrative medicine, and quality improvement. The Section Chief shall be responsible for the oversight and supervision of the physicians provided within this contract. The Contracted Section Chief shall not supervise VA employees.

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 three (3) business 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.

2.9.5.1. 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 seven (7) 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. Physician substitutions shall meet all credentialing, privileging, and have a faculty appointment at the University of Utah School of Medicine, Department of Emergency Medicine.

2.9.5.2. For temporary substitutions where the key person will 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 comparable qualifications to the key person. Any period exceeding two weeks will require the procedure as stated above.

2.9.5.3. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. 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.

2.9.5.4. 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 the Emergency Department (ED) is open 24 hrs. per day, 7 days per week, including federal holidays.

3.1. VAMC ED Business Hours: 24 hours day/ seven days a week (24/7).

3.1.1. Patients must be seen by a contractor’s physician (s) on-site at the 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. Peak hours schedule will be determined by the Section Chief. Contractor will be given 30 days’ notice for any type of change in schedule.

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 leading 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 ACEP. SAEM, AAEM American College of Emergency Physicians: http://www.acep.org

4.2.4. The American Board of Internal Medicine http://www.abim.org/

4.2.5. 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

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

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

4.2.8. The requirements contained in this PWS

4.3. Resident Supervision and Teaching:

4.3.1. Emergency Services physicians shall meet necessary appointment standards, and have experience with resident supervision and teaching for trainees in the Emergency Care Unit during their assigned duties as required by Accreditation Council for Graduate Medical Education (ACGME) standards including a faculty appointment at the University of Utah School of Medicine.

4.3.2. Resident Supervision/Teaching: Per the guidelines dictated by the Residency Review Committee (RRC) of Accreditation Council for Graduate Medical Education (ACGME), the contractor’s physician(s) performing the services shall be responsible for residents. Contractor’s physician(s) shall be responsible for:

4.3.2.1. Academic environment: Provide for an academic environment conducive to the training and professional development for residents rotating through the Emergency Department Service.

4.3.2.2. Emergency Services physicians must provide resident supervision and teaching for trainees in the Emergency Care Unit during their assigned duties as required by ACGME standards. https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/110_emergency_medicine_2017-07-01.pdf?ver=2017-05-25-084936-193

4.3.2.3. Resident patient care documentation: Contractor’s physician(s) shall be responsible for complying with the Residency review documentation and insuring that all notes and encounters are completed and shall appropriately document medical records in accordance with VAMC standards, equivalent to TJC compliance guidelines, standard commercial practice and guidelines established by VAMC .The Contractor shall also perform any administrative duties relative to documentation of resident training, as required and directed by the VAMC COS or designated representative.

4.3.2.4. Clinical Direction and Oversight: Contractor’s physician(s) shall provide clinical direction to and oversight of residents/fellows consistent with current accreditation guidelines, clinical research, protocol development, data management of protocols, quality assurance conferences and meetings, and affiliate/VAMC staff meetings. Ensure on-site resident supervision in accordance with the national VHA Handbook 1400.01, Resident Supervision, dated December 19, 2012. http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2847

4.3.3. Attending Physician: Emergency Department procedures shall not be conducted by residents in the absence of an attending physician. All procedures, inpatient admissions and consults shall be the responsibility of an attending Emergency Medicine physician.

4.4. MEDICAL RECORDS

4.4.1. Authorities: Contractor’s physician (s) providing healthcare services to VAMC 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).

4.4.2. HIPAA: This contract and its requirements meet exception in 45 CFR 164.502(e), and do not require a Business Associate Agreement (BAA) 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 VAMC system of records entitled ‘Patient Medical Records-VA’ (24VA19). Contractor generated VAMC Patient records are the property of the VAMC 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 VAMC 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 VAMC within twenty-one (21) calendar days after the contract expiration date.

4.4.3. Disclosure: Contractor’s physician (s) may have access to patient medical records: however, Contractor shall obtain permission from the VAMC 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.

4.4.4. Professional Standards for Documenting Care: Care shall be appropriately documented in medical records in accordance with standard commercial practice and guidelines established by VHA 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 VAMC.

4.4.5. 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 VAMC Privacy Officer at the following address:

Robert Janes 500 Foothill Drive Salt Lake City, UT 84148

4.5. Direct Patient Care: estimated 85% of the contracted time will be in direct patient care.

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

4.5.1.1. Board Certified /Board Eligible Emergency Department Physicians

4.5.1.2. Administrative Support for scheduling and other administrative functions that are needed to complete the various duties contained herein.

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

4.5.2.1. Evaluation, Emergent Treatment and Management: Employment of the principles of emergency care for life/limb threats, resuscitation and stabilization, triage, diagnosis and disposition.

4.5.2.1.1. Initial evaluation, emergent treatment and management of minor wound care, respiratory illness, gastrointestinal illness, burns, musculoskeletal trauma, dermatological illness, ENT, eye and urological problems.

4.5.2.1.2. Initial evaluation, emergent treatment and management of minor procedures such as local infiltration anesthesia, incision and drainage, simple laceration repair, nail trephination, electro-coagulation, nasal cautery, gastric lavage, bladder catheterization, peripheral venous line insertion, and spinal immobilization.

4.5.2.1.3. Initial evaluation, emergent treatment and management of abdominal and gastrointestinal disorders (including trauma) of the esophagus, stomach, small bowel and colon rectum and anus, liver and biliary tree and pancreas.

4.5.2.1.4. Initial evaluation, emergent treatment and management of cardiovascular disorders (including trauma) involving cardiac failure, differential diagnosis of chest pain, cardiac structural disorders, cardiac rhythm and conduction defects, pericardial disorders, disease of peripheral arteries and veins, shock, and cutaneous disorders.

4.5.2.1.5. Initial evaluation, emergent treatment and management of emergent disorders caused by antigens, organisms and other foreign substances such as reactions of hypersensitivity; reactions from venoms, bites and stings; reactions caused by infectious agents; disorders due to chemical, drug and physical agents; and disorders associated with the environment to include barotraumas, near drowning, electrical injury, hypothermia and radiation injury.

4.5.2.1.6. Initial evaluation, emergent treatment and management of emergent disorders of the hematopoietic system such as anemia, coagulopathy and management of acute neoplastic disease complication.

4.5.2.1.7. Initial…