RFQ_36C25921Q0085 0001.docx

5. PROJECT NUMBER (if applicable)

CODE

7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office.

is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER

16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30

PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer)

660-21-1-052-0003

36C259 Department of Veterans Affairs Network Contracting Office

NCO 19

6162 South Willow Drive, Suite 300 Greenwood Village CO 80111

36C259 Department of Veterans Affairs Network Contracting Office

NCO 19

6162 South Willow Drive, Suite 300 Greenwood Village CO 80111 To all Offerors/Bidders

36C25921Q0085

X

X 11/30/2020 at 12pm MDT See CONTINUATION Page

The purpose of this Amendment is to:

1) Update Section B.2 Statement of Work - Special Compensation paragraph a)

2) Update Section B.4 Price/Cost Schedule CLIN 0002 Description based on the Statement of Work update.

3) Provide an Answer to Vendor Questions under file name: Questions and Answers to 36C25921Q0085

4) To inform that the Amendment does not change the solicitation close date and time of: 11/30/2020 at 12pm MDT.

**Submit all solicitation offers to John Cheng via email at: john.cheng2@va.gov **

CONTINUATION PAGE

B.2 Statement of Work General:

Scope of Required Service:

The Salt Lake City Veterans Affairs Medical Center, 500 Foothill Drive, Salt Lake City, UT 84148, has a requirement for a Contractor to supply staffing services for up to Ten (10) positions of General Administrative Clerks. The parties agree that this Vendor’s contract shall apply solely to the staffing services. The contractor shall begin providing staffers for the, fingerprinting, and badging, on or about December 8, 2020. Contractor staff shall report 15 minutes prior to their appointment time to the assigned VA in-processing representative. The assigned VA in-processing representative will supply the information on where to report for fingerprinting/badging. The location of the mandatory 10-day VA Scheduler training will be determined on a per group basis once the badges are acquired. Contractor staff shall be given a schedule and assigned facility during the mandatory 10-day VA Scheduler training.

Place of Performance:

The Veteran Affairs Salt Lake City Healthcare System (VASLCHCS) services performed under this contract will be performed at: George E. Wahlen, Salt Lake City, UT, VA Medical Center – 500 Foothill Drive, Salt Lake City, UT 84148

Staffing Requirements:

The Contractor shall have the following staff available at any given time:

General Administrative Staff herein referred to as Clerks with assignments of 6 months with a Government option to extend services for up to 6 months.

Clerk Qualification:

Credentialing and Privileging: The Contractor shall run a background investigation on all prior to submitting them for consideration of a contract at VASLCHCS and submit the results with the applicant’s profile. The contractor will be responsible for the actions of those individuals they provide to perform work for VA.

Position Sensitivity – The position sensitivity has been designated as Low Risk.

Must be authorized to work in the United States.

The contractor shall bear the expense of obtaining background investigation.

The dress code will comply with standards in accordance with VASLCHCS policy.

The contractor, when notified of an unfavorable determination by the Government, shall withdraw the employee from consideration from working under the contract. Failure to comply with the contractor personnel security requirements may result in termination of the contract for default.

Contractor Services:

The Contractor shall be responsible for providing contract Clerks, defined in Section 4, to perform work on a temporary staffing basis under the guidance of the Government, and that Government will establish the details of the work but the contractor will be responsible for the work product of the Providers.

The Contractor shall provide requested profiles for new staff within five business days to the Contracting Officer’s Representative (COR) with required information as described in section 4.

The contactor shall provide staffing specialist(s) to work directly with VASLCHCS managers to meet VASLCHCS staffing needs and address disciplinary issues. The staffing specialist(s) will be responsible for entering workload data into VASLCHCS designated databases and address staffing programs. The Contractor is required to have on site up to date files on all Contract staff with the following information in the files:

A) Social Security Number.

B) Completion of VA Personal Identification Verification (PIV). The PIV and must be typed with accurate information and legal names on the forms.

C) In accordance with VA Directive 0735, all contractor staff must be issued a PIV, Non-PIV, or Flash Pass badge based on access requirements. The badge must be kept current/non-expired. A copy of the badge must be kept on file.

D) Evidence of High School Diploma or GED.

E) Must have at least 6 months of customer service experience in a business setting.

The contractor shall provide individual(s) to provide offsite supervision/guidance for their employees. These individuals shall be available to contractor staff via phone/email whenever contractor staff are working in a VA facility.

The contractor shall adhere/comply to all Federal/State/ VASLCHCS guidelines, regulations, laws, policies, and procedures always. Prior to terminating long term contract employees, (see paragraph 1.3.) the Contractor shall notify the CO and the COR in advance in a reasonable timeframe. The Contractor shall submit justification (including proposed substitutions) in enough detail to permit evaluation of newly assigned contract-staff healthcare provider.

The contracted positions shall log into a VA computer at least monthly to keep his/her computer account in an “active” status. If the contracted providers fail to keep his/her computer accounts from being deactivated, it is the contractor’s responsibility to submit another PIV form with accurate information and the contractor’s legal name to VASLCHCS designated staff to reactivate the computer account.

Dress Attire: The Contractor personnel shall wear VA furnished badges always. The Contractor employee must wear this badge in accordance with regulation, and always while performing services under this agreement. Contract personnel will adhere to the VASLCHCS Dress Code Policy.

The Government reserves the right to accept or not accept the contractor provided personnel. If any contract-staff healthcare providers are determined unacceptable by the designated Government contact at any time during the agreement period, the Contracting Officer will determine whether the personnel shall be released from duty and will notify the contractor’s point of contact that such individual shall not be resubmitted to provide service under this agreement.

Non-acceptance of a contract-staff healthcare provider does not relieve the contractor from fulfilling the terms and conditions of this contract. In the event of a dispute between the designated contacts, the CO’s decision is final.

In the event the independent contractor becomes ill or cannot work for any other reason, it is the contractors’ responsibility to immediately provide another candidate, who is appropriately certified to work in the area the previous candidate was scheduled to work.

The parties agree that such personnel shall not be considered VA employees for any purpose and shall be considered employees of the Contractor. The designated contractor point of contact shall be available 24 hours a day 7 days a week to supply services.

Training:

A 10-day mandatory VA Scheduler training will be provided by VHA to all contractors. Keys for scheduling will not be assigned to the contractor staff until all requirements are completed for the mandatory VA Scheduler training.

Failure to complete the VA Scheduler 10-day mandatory training within the timeframe required, is grounds for termination of all physical or electronic access privileges and removal from work on the contract. Contractors will only be given two opportunities to complete all requirements of the training assigned (or reasonable delays as determined by Contracting Representative).

The following Talent Management System (TMS) modules shall be completed during initial orientation:

a) Privacy and Information Security Awareness

b) Privacy and HIPAA Focused Training

c) VHS Compliance and Business Integrity (CBI) Awareness Training

d) Scheduling Training-Business Rules

e) Scheduling Training-Make Appointment

f) Scheduling Training-Recall Reminder The remaining TMS modules must be completed within 15 days of completion of the mandatory VA Scheduler training. They include:

a) Fire Safety and Prevention

b) Culture of Safety and Patient Care

c) Blood-borne Pathogens Awareness

d) VASLCHCS Environment of Care

e) VASLCHCS Infection Prevention and Control

f) VASLCHCS Falls Prevention

g) Prevention of Workplace Harassment/No Fear

h) Prevention and Management of Disruptive Behavior Web Course The contractor shall provide to the contracting officer and/or the COR a copy of the training certificates for each applicable employee. Note: completion of TMS course “VA Privacy and Information Security Awareness and Rules of Behavior” satisfies the requirement for certifying and signing the Contractor Rules of Behavior for each applicable employee.

Failure to complete the mandatory training (including completion of TMS course “VA Privacy and Information Security Awareness and Rules of Behavior” which satisfies the requirement for certifying and signing the Contractor Rules of Behavior for each applicable employee) within the timeframe required, is grounds for suspension or termination of all physical or electronic access privileges and removal from work on the contract until the training and documents are complete.

Contractor Responsibilities:

a) The Contractor shall provide all necessary contractors upon request of VASLCHCS to include:

b) Find sources for requested positions and shifts.

c) Provide contract-staff selection choices to Government

d) On-board the selected contract-staff

e) Maintain required documents

f) Off-board contract-staff when no longer needed

g) Pay the contract-staff agencies for the providers who performed services

h) Contractor shall be responsible for meeting VA and Joint Commission (or equivalent) standards.

i) Contractors shall be responsible for maintaining the integrity of this contract in relationships with subcontractors and professional liability insurance. Subcontracting, corporate partners and/or teaming

j) Arrangements are permitted under this contract. Any subcontractors utilized during this contract shall maintain the qualifications as required by the prime contractor.

k) In the event of any sentinel event of actual or threatened claim arising out of or relating to the acts or omissions of Provider, Government shall provide the contractor written notice of such claim immediately and, in no event, 30 days after Government knew, or reasonably should have known of such claim. Government shall make available to the contractor copies of all non-privileged documentation about problems or incidents in which Providers are involved.

l) Provide a time clock system to track agency hours, payroll, and schedules.

m) The contractor shall ensure that all contract personnel participate in VA defined orientation procedures applicable for newly assigned contract personnel to include regulations specific to the profession or class to which he/she belongs, local VA policy and procedures, and VHA policy and procedures. Orientation may consist of self-paced written/on-line education, classroom hours and/or unit orientation and hands-on skill validation.

n) The Contractor shall prescreen all personnel requiring access to the computer system to ensure they are eligible for employment, and can read, write, speak and understand the English language.

o) Invoicing: The contractor shall submit invoices bi-weekly or monthly in arrears for the shifts worked. All time slips are to be submitted with the invoice for shift verification. The invoice must include: 1) Name of contractor staff; 2) Date worked; 3) Area worked (must match time slip); 4) Hours worked; 5) Rate of pay; and 6) Amount billed for shift. The invoice should be for the entire week for the entire facility. The Contractor is required to utilize and submit VASLCHCS time slips.

p) All patient safety incidences shall be reported immediately to the supervisor, the COR, and the Contractor.

Contractor Employee Responsibilities:

a) Requirements For: General Administrative Clerk/Qualifications.

b) High School education or GED equivalent.

c) Oral and written proficiency with English.

d) Basic computer skills.

e) Have no health or physical disability restrictions that interfere with the performance of assigned duties.

f) Have documented training and skills verification.

g) Familiarity with Medical Terminology preferred

Duties and Responsibilities. The Clerk shall:

a) Follow all scheduling directives, handbooks, and laws applicable to the scheduling duties.

b) Performs receptionist and customer service duties.

c) Maintains appointment schedules for one or more outpatient clinics. Schedule appointments per VA rules and regulations. All appointments will be made with the patient’s input, either in person or by phone. This may require a high level of coordination to avoid patients having to make multiple trips to the medical center or clinic whenever possible.

d) Assists with clinic access contingency plans by adjusting appointment times, location, or dates. Shifts patients to other healthcare providers as conflict with staffing and/or coverage occurs.

e) Supports patient safety standards using the correct Veterans Affairs identification of all patients using two forms of identification.

f) Communicates with internal medical providers on rules and regulations for VA Community Care and advises on appropriate processes.

g) Coordinates and authorizes Veteran care with community providers that the VA does not supply or cannot supply timely.

h) Validates and update patient demographic information.

i) Collects, scans, and updates health insurance information.

j) Collects and scans medical records and medical documentation upon receipt.

k) Prepares and distributes documentation per VA release of information rules and regulations.

l) Screens/receives phone calls in a courteous and timely manner.

m) Demonstrates sensitivity to cultural diversity, race, gender, and others individual differences in the workforce, in the Veteran population and in the Community.

n) Other duties, as assigned.

Government Responsibilities:

a) Government will provide enough information about its specific needs so that the contractor can match the skills and experience of Provider to those needs.

b) Government will be responsible for compliance with all relevant safety and health laws and regulations during the period of a Clerk’s assignment under Government supervision, including but not limited to Joint Commission regulations relating to orientation and evaluation and HIPAA regulations. The Government will provide each Clerk with all necessary site-specific training, orientation, equipment and evaluation required by federal, state or local occupational safety laws or rules, including Joint Commission and HIPAA for member of the Government’s workforce. Other training required includes: 1) Occupational Exposure to Blood borne Pathogens; 2) Infection Control; 3) Blood Borne Pathogens; 4) Hazard Communication; 5) Fire Safety; 6) Emergency Preparedness; 7) Information Security (contains Rules of Behavior); 8) Code of Organizational Ethics; 9) Security Management; 10) VHA Privacy Policy Training (HIPAA); 11) BLS; 12) Fall Prevention; and 13) Other learning modules assigned. Further, Government will only utilize Providers for the need requested and will only assign Providers to work in the clinical specialty areas in which they are professionally qualified and oriented to work. Orientation/assessment time will be billable to Government as the regular hourly bill rate as set forth in the contract price schedule.

c) Both Government and Contractor will designate a contact that shall be the parties’ primary liaisons about the Services.

d) VA Support Personnel, Services or Equipment: The Salt Lake City VAMC will provide all medical supplies and equipment to provide these services except for uniforms and any other personal items.

e) The Government will be responsible for the cost of fingerprinting.

f) The Government may require that the contractor staff shall be immunized annually with the influenza vaccine. The Government may provide this vaccine. Although the Government may provide this vaccine, it may be obtained at other facilities with the cost being borne by the contractor. Unless vaccinated by the Government, the contractor shall be required to show proof of the vaccination. If the contractor worker declines the immunization, they must provide documentation of the waiver, which declines the influenza vaccine (declination based on religious convictions or medical contraindications only).

Hours of Operation:

a) Work Schedule: Contractor staff shall be available from 07:00 AM to 5:00 PM hours, Monday through Friday.

b) Federal Holidays include: New Year’s Day, Martin Luther King Day, Presidents Day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans Day, Thanksgiving Day, and Christmas Day and any other day declared as a national holiday by the President of the United States.

c) The government reserves the right to schedule or reschedule the duty hours during the agreement to meet staffing and patient care needs. The government shall provide a 24-hour notice of any schedule changes. Contractor will be responsible for the overall provision of coverage within the timeframes annotated above without exception.

d) Contractor’s employee shall be present at the facility and must be performing the required services to receive payment for services. Contractor shall only receive payment for the actual number of hours worked on-site at the specified facility.

Special Compensation:

a) Shift Differentials. Government agrees to pay an additional 10% amount for all Saturday and Sunday shift as well as all hours worked after 6:00 p.m. Monday- Friday. Shift differentials will be invoiced for the entire shift in which most the hours worked is during the shift differential period.

b) Overtime. Government agrees to pay for all hours worked more than forty (40) hours per week and in accordance with the Service Contract Act wage determination. If any applicable law requires Contractor to pay Provider daily overtime, Government shall pay Contractor in accordance with the Service Contract Act.

c) Holidays. Government shall pay in accordance with the Service Contract Act for time worked by Providers on the following holidays: New Year’s Day, Memorial Day, Independence Day, Labor Day, Thanksgiving, and Christmas Day. A holiday shift is defined as any shift in which a portion of the hours worked is during the holiday.

d) Performance Evaluations. Government reserves the right to complete an evaluation regarding the performance of each contractor staff if performance is questionable.

Performance Standards: The following outlines required standards and will be a part of the resultant contract.

B.4 PRICE/COST SCHEDULE

ITEM INFORMATION

Provide General Administrator Clerk Staffing Services for the Health Administration Services' Centralized Scheduling Unit. In Accordance With the Statement of Work.

Contract Period: Base POP Begin: 12-08-2020 POP End: 06-08-2021

The following Overtime, Saturday, Sunday, and Holiday rate will only be in effect when contractor staff with prior approval from the COR/designee in accordance with the Statement of Work.

Contract Period: Base POP Begin: 12-08-2020 POP End: 06-08-2021

C-12 Page 1 of