36C25923R0040.pdf

PAGE 1 OF 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. UEI: EFT:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

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

36C25923R0040 01-30-2024

Patricia Toliver, Contract Specialist 303-712-5801 03-12-2024

10:00 AM MST

36C259

Department of Veterans Affairs

Network Contracting Office

NCO 19

6162 South Willow Drive, Suite 300

Greenwood Village CO 80111

X 100

X

621498

$25.5 Million

N/A

X

36C623

VA Eastern Oklahoma Health Care

Jack C. Montgomery VA Medical Center

1011 Honor Heights Dr.

Muskogee OK 74401

36C259

Department of Veterans Affairs

Network Contracting Office

NCO 19

6162 South Willow Drive, Suite 300

Greenwood Village CO 80111

36C623

Department of Veterans Affairs

Financial Service Center

PO Box 149971

Austin TX 78714-9971

See CONTINUATION Page

The Contractor shall provide Community-Based Outpatient

Clinic (CBOC) services within McCurtain County, Oklahoma, in accordance with the Performance Work Statement (PWS).

This requirement is being solicitated under the authority of

38 U.S. Code § 8153 - Sharing of health-care resources.

See Schedule of Services page 8 and Performance Work

Statement page 12 for complete listing of required services.

Period of Performance will be one (1) base year with nine

(9) twelve (12) month option periods.

See CONTINUATION Page

X X

X 1

Yomika Brock

Contracting Officer

36C25923R0040

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 SCHEDULE OF SERVICES

B.3 PERFORMANCE WORK STATEMENT

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES (NOV 2023)

C.2 52.203-13 CONTRACTOR CODE OF BUSINESS ETHICS AND CONDUCT (NOV

2021)

C.3 52.204-9 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR

PERSONNEL (JAN 2011)

C.4 52.204-13 SYSTEM FOR AWARD MANAGEMENT MAINTENANCE (OCT 2018)

C.5 52.204-18 COMMERCIAL AND GOVERNMENT ENTITY CODE MAINTENANCE

(AUG 2020)

C.6 52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR

INFORMATION SYSTEMS (NOV 2021)

C.7 52.216-18 ORDERING (AUG 2020)

C.8 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.9 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.10 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.11 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)141

C.12 52.219-14 LIMITATIONS ON SUBCONTRACTING (OCT 2022)

C.13 52.222-32 CONSTRUCTION WAGE RATE REQUIREMENTS—PRICE

ADJUSTMENT (ACTUAL METHOD) (AUG 2018)

C.14 52.228-5 INSURANCE—WORK ON A GOVERNMENT INSTALLATION (JAN

1997)

C.15 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.16 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR

1984)

C.17 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.18 VAAR 852.201-70 CONTRACTING OFFICER'S REPRESENTATIVE (DEC 2022)

C.19 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.20 VAAR 852.204-70 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR

PERSONNEL (MAY 2020)

C.21 VAAR 852.211-72 TECHNICAL INDUSTRY STANDARDS (NOV 2018)

C.22 VAAR 852.219-73 VA NOTICE OF TOTAL SET-ASIDE FOR CERTIFIED

SERVICE-DISABLED VETERAN-OWNED SMALL BUSINESSES (JAN 2023)

(DEVIATION)

C.23 VAAR 852.219-75 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING—

CERTIFICATE OF COMPLIANCE FOR SERVICES AND CONSTRUCTION (JAN 2023)

(DEVIATION)

C.24 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS

(NOV 2018)

C.25 VAAR 852.237-70 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE

(OCT 2019)

C.26 VAAR 852.237-74 NON-DISCRIMINATION IN SERVICE DELIVERY (OCT 2019)

C.27 VAAR 852.239-76 INFORMATION AND COMMUNICATION TECHNOLOGY

ACCESSIBILITY (FEB 2023)

C.28 VAAR 852.237-75 KEY PERSONNEL (OCT 2019)

C.29 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020) 157

C.30 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (DEC 2023)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

D.1 ANTICOAGULATION PROGRAM

D.2 11-108 MEDICATION RECONCILIATION PROCESS

D.3 PATIENT RIGHTS AND RESPONSIBILITIES

D.4 WOMEN’S HEALTH MAMMOGRAPHY AND CERVICAL SCREENING CARE

COORDINATION

D.5 SPECIMEN HANDLING AND TRANSPORTING FROM CBOCS

D.6 EO C2022

D.7 PRE-TREATMENT AND TRANSPORTATION OF SOLID CRITICAL AND SEMI-

CRITICAL AND SEMI-CRITICAL REUSABLE EQUIPMENT 1

D.8 PRE-TREATMENT AND TRANSPORTATION OF SOILED CRITICAL AND SEMI-

CRITICAL REUSABLE MEDICAL EQUIPMENT 2

D.9 INFORMATION SECURITY PROGRAM POLICY

D.10 COMMUNICATION TEST RESULTS TO PROVIDERS

D.11 SUICIDE PREVENTION

D.12 SCA 15-5333 WAGE DETERMINATION

D.13 DBA OK20230071 WAGE DETERMINATION

D.14 ORG CONFLICT OF INTEREST

D.15 CONTRACTOR RULES OF BEHAVIOR

D.16 IMMIGRATION CERTIFICATION

D.17 42 CFR PART 493- LABORATORY REQUIREMENTS

D.18 OUTPATIENT SCHEDULING PROCESSES AND PROCEDURES

D.19 DOCUMENT SCANNING POLICY

D.20 PAST PERFORMANCE REFERENCES

D.21 PAST PERFORMANCE QUESTIONNAIRE

D.22 QUALITY ASSURANCE SURVEILLANCE PLAN

D.23 EQM MEASUREMENTS FOR 2023

D.24 NO SHOW MINIMUM SCHEDULING EFFORT FOR OUTPATIENT

APPOINTMENTS SOP

D.25 DOCUMENTATION CHECKLIST

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (SEP 2023)

E.2 ADDENDUM to FAR 52.212-1

E.3 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

E.3 52.204-29 FEDERAL ACQUISITION SUPPLY CHAIN SECURITY ACT ORDERS-

REPRESENTATION AND DISCLOUSURES (DEC 2023)

E.4 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.5 52.216-1 TYPE OF CONTRACT (APR 1984)

E.6 52.222-5 CONSTRUCTION WAGE RATE REQUIREMENTS—SECONDARY SITE

OF THE WORK (MAY 2014)

E.7 52.229-11 TAX ON CERTAIN FOREIGN PROCUREMENTS—NOTICE AND

REPRESENTATION (JUN 2020)

E.8 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.9 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.10 VAAR 852.209-70 ORGANIZATIONAL CONFLICTS OF INTEREST (OCT 2020)

E.11 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE

RESOLUTION (OCT 2018)

E.12 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018)

E.13 VAAR 852.239-75 INFORMATION AND COMMUNICATION TECHNOLOGY

ACCESSIBILITY NOTICE (FEB 2023)

E.14 52.212-2 EVALUATION-COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES (NOV 2021)

E.15 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (NOV 2023)

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: (Please fill out information below):

Contractor Name:

Title:

Address:

Telephone:

Facsimile:

E-mail:

b. GOVERNMENT:

Yomika Brock Contracting Officer, Yomika.brock@va.gov

Patricia Toliver, Contract Specialist, patricia.toliver@va.gov

Department of Veterans Affairs

Veterans’ Health Administration

Network Contracting Office 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:

[X] 52.232-33, Payment by Electronic Funds Transfer—System for Award

Management, or

[] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Monthly in Arrears mailto:Yomika.brock@va.gov

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

Requests.

Department of Veterans Affairs

Financial Services Center

P.O. Box 149971

Austin, TX 78714-8972

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

AMENDMENT NO DATE

6. UNIQUE ENTITY IDENTIFIER (UEI): In accordance with FAR 52.204-6 Unique Entity

Identifier offerors must provide their UEI ID:

UEI # _______ _______ _______ _______ _______ _______ _______

If the UEI number is unknown, offerors may view the Quick Start Guide for Getting a Unique

Entity Identifier on sam.gov.

7. OFFEROR’s TAX ID NUMBER: ______________________________________

8. FEDERAL ACQUISITION REGULATIONS (FAR) require all contractors doing business with the Government to register and maintain registration in two separate and individual online databases:

a. CONTRACTOR PERFORMANCE ASSESSMENT REPORTING SYSTEM (CPARS) – as prescribed in FAR Part 42.15, the Department of Veterans Affairs (VA) evaluates contractor past performance on all contracts that exceeds the simplified acquisition threshold. Additional information is found in section 4.9 of the Performance Work Statement (PWS).

b. SYSTEM FOR AWARD MANAGEMENT (SAM) – all prospective awardees shall be registered and maintain active registration in the SAM database prior to award, during performance, and through final payment of any contract resulting from this solicitation. After initial registration, the contractor is required to update registration data as changes occur and must re-register annually. Noncompliance will preclude the exercising of any option periods that may be included herein and may be cause for termination of the contract. Refer to FAR Clause

52.212-4(t) for more details.

9. SECURE FAX:The following statement is required on all fax cover sheets; if it is determined the ordering process will include a fax: “This fax is intended only for the use of the person or office to which it is addressed and may contain information that is privileged, confidential or protected by law. All others are hereby notified that the receipt of this fax does not waive any applicable privilege or exemption for disclosure and that any dissemination, distribution or copying of this communication is prohibited. If you have received this fax in error, please notify this office immediately at the telephone number listed above.

10. MANDATORY WRITTEN DISCLOSURES: 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 OIG Hotline (va.gov) and clicking on "FAR clause 52.203-13 Reporting." If you experience difficulty accessing the website, call the Hotline at 1-800-488-8244 for further instructions.

11. POST AWARD ORIENTATION: The Contracting Officer will schedule a post award orientation conference for contract orientation purposes as required by VAAM M842.5 Post

Award Orientation.

(End of Contract Administration Data)

B.2 SCHEDULE OF SERVICES

The Department of Veterans Affairs has established a Deputy Under Secretary for Health for

Operations and Management (DUSHOM) approved Community Based Outpatient Clinic

(CBOC) in McCurtain County, Oklahoma. The Department of Veterans Affairs (VA) intends to award a contract to continue service in McCurtain County, Oklahoma, to provide primary care

(using the Patient Aligned Care Team, (PACT) model and mental health support services for eligible Veterans living in and around McCurtain County. The contractor shall furnish healthcare providers, medical facilities, equipment, supplies, and administrative functions to care for and support enrolled Veterans in a manner consistent with Department of Veterans Affairs Veterans

Health Administration (VHA) standards and meet the requirements set forth in the most recent edition of the Joint Commission accreditation manuals. Under the contract, the contractor shall utilize the VA Electronic Health Record (VA EHR) for documentation of all patient-related care, including clinical care provided, completion of clinical reminders, requests for consultation, ordering medications using the VHA formulary, requests for prosthetics, and any other functions related to patient care. The contractor shall be responsible for the administration and management of all aspects of this contract and the health plan covered there under, including responsibility for all employees, agents, subcontractors, and any other entity acting for or on behalf of the contractor.

In accordance with FAR 16.504(a)(1), the guaranteed minimum contract amount of services the

Government will acquire under the contract is $50,000.00; and the maximum amount of services the Government will acquire under the contract is $17,100,000.00.

ORDERING PROCEDURES: This will be a fixed-priced Indefinite Delivery Indefinite Quantity

(IDIQ) contract. VA has the sole authority to assign Veterans treated by the Contractor into the

Primary Care Management Model (PCMM) software program used to track primary care clinic

Veteran rosters. Specific billable processes for issuing task orders under the resultant contract include: determining Veteran eligibility, enrollment eligibility, and at least one qualifying encounter by the Contractor's primary care provider (PCP) within the previous 12 months.

https://www.va.gov/oig/hotline/ https://dvagov.sharepoint.com/sites/VACOOALALF/ALFA/SitePages/VAAM.aspx?reg=M842 https://dvagov.sharepoint.com/sites/VACOOALALF/ALFA/SitePages/VAAM.aspx?reg=M842

The Contractor will be provided a list of all enrolled patients at the beginning of the contract and will be able to bill for these patients immediately. - In order to remain enrolled in the clinic, patients must have a qualifying visit within 12 months of their last visit. Qualifying encounters are further defined in Performance Work Statement (PWS) Section 6.2.1.1. Please review in detail to ensure compliance for issuance of subsequent task orders and payment processing.

Any services to be furnished under this contract shall be ordered by issuance of delivery orders or task orders by the Contracting Officer or Administrative Contracting Officer. Ordering procedures are monthly and based on Per Member Per Month (PMPM). Orders will be issued by electronic commerce methods.

*PMPM includes cost of unassigned patient visits. The contractor shall not bill separately or propose an additional LIN or bill separately for these costs.

BASE YEAR – October 1, 2024, through September 30, 2025

LINE

ITEM

NUMBER SERVICES

UNIT

EST

QTY

PER

UNIT

PRICE

TOTAL

EST

COST

PER

MONTH

TOTAL EST

COST PER

YEAR

Primary Care Services at Capitation Rates Per Member Per Month (PMPM).

within McCurtain County, OK

NAICS 621498

PSC Q201

PMPM

Total Estimate for Base Year

OPTION YEAR 1 – October 1, 2025, through September 30, 2026

LINE

QTY

PER

UNIT

PRICE

TOTAL

EST

COST

PER

MONTH

TOTAL EST

Capitation Rates Per Member Per Month (PMPM).

within McCurtain County, OK

Total Estimate for Option Year 1

OPTION YEAR 2 – October 1, 2026, through September 30, 2027

LINE

QTY

PER

UNIT

PRICE

TOTAL

EST

COST

TOTAL EST

PER

MONTH

Capitation Rates Per Member Per Month (PMPM).

within McCurtain County, OK

Total Estimate for Option Year 2

OPTION YEAR 3 - October 1, 2027, through September 30, 2028

LINE

QTY

PER

UNIT

PRICE

TOTAL

EST

COST

PER

MONTH

TOTAL EST

Capitation Rates Per Member Per Month (PMPM).

within McCurtain County, OK

Total Estimate for Option Year 3

OPTION YEAR 4 - October 1, 2028, through September 30, 2029

LINE

QTY

PER

UNIT

PRICE

TOTAL

EST

COST

PER

MONTH

TOTAL EST

Capitation Rates Per Member Per Month (PMPM).

within McCurtain County, OK

Total Estimate for Option Year 4

OPTION YEAR 5 - October 1, 2029, through September 30, 2030

LINE

QTY

PER

UNIT

PRICE

TOTAL

EST

COST

PER

MONTH

TOTAL EST

Capitation Rates Per Member Per Month (PMPM).

within McCurtain County, OK

NAICS 621498

PSC Q201

Total Estimate for Option Year 5

OPTION YEAR 6 - April 1, 2030, through September 30, 2031

LINE

QTY

PER

UNIT

PRICE

TOTAL

EST

COST

PER

MONTH

TOTAL EST

Capitation Rates Per Member Per Month (PMPM).

within McCurtain County, OK

Total Estimate for Option Year 6

OPTION YEAR 7 - October 1, 2031, through September 30, 2032

LINE

QTY

PER

UNIT

PRICE

TOTAL

EST COST

PER

MONTH

TOTAL

EST

COST

PER

Capitation Rates Per Member Per Month (PMPM).

within McCurtain County, OK

Total Estimate for Option Year 7

OPTION YEAR 8 - October 1, 2032, through September 30, 2033

LINE

QTY

PER

UNIT

PRICE

TOTAL

EST

COST

PER

MONTH

TOTAL EST

Capitation Rates Per Member Per Month (PMPM).

within McCurtain County, OK

Total Estimate for Option Year 8

OPTION YEAR 9 - October 1, 2033, through September 30, 2034

LINE

QTY

PER

UNIT

PRICE

TOTAL

EST

COST

PER

MONTH

TOTAL EST

Capitation Rates Per Member Per Month (PMPM).

within McCurtain County, OK

Total Estimate for Option Year 9

SUM TOTAL ESTIMATE FOR BASE AND OPTION YEARS $_________________________

This solicitation includes FAR 52.217-8 and will be evaluated. The evaluation will assume that the prices for any option exercised under FAR 52.217-8 will be at the same rates as those in effect under the contract at the time the option is exercised. The evaluation will therefore assume that the addition of the price or prices of any possible extension or extensions under

FAR 52.217-8 to the total price for the basic requirement and the total price for the priced options has the same effect on the total price of all proposals relative to each other, and will not affect the ranking of proposals based on price, unless, after reviewing the proposals, the

Government determines that there is a basis for finding otherwise. The evaluation will consider the possibility that the option can be exercised at any time and can be exercised in increments of one to six months, but not for more than a total of six months during the life of the contract.

This evaluation will not obligate the Government to exercise any option under FAR 52.217-8.

B.3 PERFORMANCE WORK STATEMENT

1 GENERAL

1.1 SERVICES REQUIRED: The Eastern Oklahoma VA Health Care System (EOVAHCS) requires the following services to be provided in a private hospital, office or clinic environment to Veterans, primarily residing in McCurtain County, Oklahoma

1.1.1 [X] Primary Care CBOC: offers both medical and mental health care and may offer support services such as pharmacy, laboratory, and x-ray. Primary Care CBOCs are required to provide both primary care and mental health services. Mental

Health services will be provided by VA staff via telehealth.

1.2 PLACE OF PERFORMANCE: Within McCurtain County, Oklahoma catchment area.

1.3 AUTHORITY: In accordance with Federal Acquisition Regulation 12 and 15 and Title 38

United States Code (USC) 8153 to be furnished by the contractor on behalf of

EOVAHCS, 1011 Honor Heights Drive Muskogee, OK 74404-1318.

1.4 POLICY AND REGULATIONS: The Contractor is required to meet VHA performance and quality criteria and standards including, but not limited to, access, customer satisfaction, prevention index, chronic disease index, and clinical guidelines.

Performance and quality standards may change during the contract. New or revised quality/performance criteria or standards will be provided to the Contractor before implementation date and throughout the life of the contract through unilateral or bi-lateral modifications, as applicable. Copies of current VA and VHA publications can be located at http://www.va.gov/vhapublications/ or at http://www.va.gov/vapubs/. Compliance with mandated performance is required as a condition of this contract. Contractor shall comply with all relevant VA policies and procedures, including those related to quality, access, patient safety and performance, including, but not limited to the policies listed on the Contracted Clinic Policy Document located at https://www.patientcare.va.gov/primarycare/Resources.asp.

1.5 DEFINITIONS/ACRONYMS:

1.5.1. ABMS: American Board of Medical Specialties

1.5.2. ACLS: Advanced Cardiac Life Support

1.5.3. ACGME: Accreditation Council for Graduate Medical Education

1.5.4. ACPE: American Council on Pharmaceutical Education

1.5.5. ACO: Administrative Contracting Officer

1.5.6. ADE: Adverse Drug Events

1.5.7. AED: Automatic External Defibrillator

1.5.8. AIS: Automated Information Security

1.5.9. ANA: American Nurses Association

1.5.10. AOA: American Osteopathic Association

1.5.11. ARRT: American Registry of Radiologic Technology

1.5.12. ASC: Ambulatory Surgery Center

1.5.13. Assigned: A Veteran is “assigned” to an outpatient clinic via PCMM (i.e., CBOC) where the patient receives their primary care after the patient’s eligibility is determined through registration and enrollment.

1.5.14. ASYNCHRONOUS CARE: Care provided outside of bookable time and includes but is not limited to the following activities: refilling prescriptions, reviewing outside records, huddles and case management, team meetings, processing view alerts, secure messaging and training.

1.5.15. BAA: Business Associate Agreement

1.5.16. BI-RADS: Breast Imaging-Reporting and Data System; a quality assurance tool designed to standardize mammography reporting

1.5.17. BLS: Basic Life Support

1.5.18. BOS: Bureau of Osteopathic Specialists

1.5.19. CAHEA: Committee on Allied Health Education and Accreditation

1.5.20. CAP: College of American Pathologists

1.5.21. CARF: Commission on Accreditation of Rehabilitation Facilities

1.5.22. CBO: VA Central Billing Office.

1.5.23. CDC: Centers for Disease Control and Prevention

1.5.24. CEU: Certified Education Unit

1.5.25. CLIA: Clinical Laboratory Improvement Amendments

1.5.26. CME: Continuing Medical Education

1.5.27. CMS: Center for Medicare and Medicaid Services

http://www.va.gov/vhapublications/ http://www.va.gov/vapubs/ https://www.patientcare.va.gov/primarycare/Resources.asp

1.5.28. CO: Contracting Officer

1.5.29. COPD: chronic obstructive pulmonary disease

1.5.30. COR: Contracting Officer’s Representative

1.5.31. COS: Chief of Staff

1.5.32. CPA: Collaborative Practice Agreement

1.5.33. CPS: Clinical Pharmacy Specialist

1.5.34. CPT: Current Procedural Terminology

1.5.35. CRNP: Certified Registered Nurse Practitioners

1.5.36. CSWE: The Council on Social Work Education the CSWE website is http://www.cswe.org/

1.5.37. CPARS: Contractor Performance Assessment Reporting System

1.5.38. CVT: Clinical Video Telehealth

1.5.39. DICOM: Digital Image and Communication in Medicine

1.5.40. DIGMA: Drop in Group Medical Appointment

1.5.41. DRG: Diagnostic Related Group

1.5.42. DSS: Decision Support System

1.5.43. ECC Extended Care Center

1.5.44. Enrollment: The process of establishing eligibility for VA’s “Medical Benefits

Package.” Most Veterans are required to “enroll” into the VA Health Care System to be eligible for VA health care and to be assigned to an outpatient clinic like a

CBOC, however some can still receive care without enrolling. Applicants are only required to “enroll” once for VA health care unless they are determined ineligible for care at time of application or they have disenrolled.

1.5.45. EPRP: External Peer Review Program

1.5.46. FDA: Food and Drug Administration

1.5.47. FSMB: Federation of State Medical Boards

1.5.48. HCC: Health Care Center A HCC is a VA-owned, VA-leased, contract, or shared clinic operated at least 5 days per week that provides primary care, mental health care, on site specialty services, and performs ambulatory surgery and/or invasive procedures which may require moderate sedation or general anesthesia.

1.5.49. HHS: Department of Health and Human Services

1.5.50. HCFA: HealthCare Financing Administration

1.5.51. HICPAC: Healthcare Infection Control Practices Advisory Committee. – A

HICPAC is 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.

1.5.52. HT: Home Telehealth

1.5.53. ICAVL: Intersocietal Commission for the Accreditation of Vascular Laboratories

1.5.54. ICD 10: International Classification of Diseases 10th edition

1.5.55. iMED: Software used by VA for informed consent

1.5.56. INR: International Normalized Ratio

1.5.57. ISO: Information Security Officer

1.5.58. LIP: licensed independent practitioner

1.5.59. MCCR: Medical Care Cost Recovery

http://www.cswe.org/

1.5.60. Mental Health Services: Per VHA Handbook 1160.01(1) is meant to include services for the evaluation, diagnosis, treatment, and rehabilitation of both substance use disorders and other mental disorders.

General mental health services include:

(a) Diagnostic and treatment planning evaluations for the full range of mental health problems;

(b) Treatment services using evidence-based pharmacotherapy, or primary evidence-based psychotherapy for patients with mental health conditions and substance use disorders;

(c) Patient education;

(d) Family education when it is associated with benefits to the Veterans;

(e) Referrals as needed to inpatient and residential care programs; and

(f) Consultation about special emphasis problems including Post Traumatic Stress

Disorder (PTSD) and Military Sexual Trauma (MST).

Specialty mental health services include:

(a) Consultation and treatment services for the full range of mental health conditions;

(b) Evidence-based psychotherapy;

(c) Mental Health Intensive Case Management (MHICM);

(d) Psychosocial Rehabilitation Services, including: PRRCs, family psycho-education, family education, skills training, peer support, and Compensated Work Therapy

(CWT) and supported employment;

(e) PTSD teams or specialists;

(f) MST special clinics;

(g) Homeless programs; and

(h) Specialty substance abuse treatment services.

1.5.61. MQSA: Mammography Quality Standards Act

1.5.62. MSN: Master of Science in Nursing

1.5.63. NLN: National League for Nursing

1.5.64. NSQIP/CICSP: National Surgical Quality Improvement Program/Continuous

Improvement in Cardiac Surgical Program

1.5.65. OTC: Over the Counter

1.5.66. PA: Physician Assistant

1.5.67. PACS: Picture Archiving and Communications System

1.5.68. PACT: Patient Aligned Care Team Background & Introduction: VA has implemented a PCMH model at all VA Primary Care sites which is referred to as

PACT. This initiative supports VHA’s Universal Health Care Services Plan to redesign VHA healthcare delivery through increasing access, coordination, communication, and continuity of care. PACT provides accessible, coordinated, comprehensive, patient-centered care, in team based environment including the active involvement of other clinical and non-clinical staff. PACT allows patients to have a more active role in their health care and is associated with increased quality improvement, patient satisfaction, and a decrease in hospital costs due to fewer hospital visits and readmissions.

1.5.69. Parent Facility: VAMC responsible for performance monitoring and payment for contracted Outpatient Site of Care services.

1.5.70. PCMH: Patient-Centered Medical Home

1.5.71. PCMM: Patient Centered Management Module - a software program used to track Primary Care Clinic Veteran rosters

1.5.72. PCP: Primary Care Provider

1.5.73. Phar.D.: Doctor of Pharmacy

1.5.74. POC: Point of Care Testing

1.5.75. PRIMARY CARE VISIT: An episode of care furnished in a clinic or virtually that provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. Primary care includes, but is not limited to, diagnosis and management of acute and chronic biopsychosocial conditions, health promotion, disease prevention, overall care management, and patient and caregiver education. The VHA site classification defines primary care as those encounters that occur within the primary care class of encounters

1.5.76. PCMHI: Primary Care-Mental Health Integration

1.5.77. PWS: Performance Work Statement

1.5.78. QAPI: Quality Assessment and Performance Improvement

1.5.79. QASP: Quality Assurance Surveillance Plan

1.5.80. RME: reusable medical equipment

1.5.81. SOP (Clinical): Scope of Practice

1.5.82. SFT: Store and Forward Telehealth

1.5.83. SMA: Shared Medical Appointments

1.5.84. SPD: Sterile Processing Division

1.5.85. SPE: Senior Procurement Executive

1.5.86. SPECIALTY CARE VISIT: The VHA site classification defines specialty care as those encounters that occur within the geriatric medicine; allergy; cardiology;

dermatology; emergency; employee health; endocrinology; gastroenterology;

general medicine; hematology or oncology; infectious disease; nephrology;

neurology; outreach; pulmonary or respiratory disease; rheumatology; amputation follow-up; amputation; anesthesia; cardio-thoracic; ear, nose, and throat (ENT);

eye; general surgery; gynecology (GYN); neurosurgery; orthopedics; plastic surgery; urology; or vascular clinic stops.

1.5.87. PACT SUPPORT STAFF: PACT staff assisting providers in the actual delivery of care to patients. It consists of RNCMs, clinical associates, and administrative associates

1.5.88. SYNCHRONOUS CARE: Bookable, real-time care provided in person or virtually

(VA Video Connect, CVT, telephone) with a Veteran and involves clinical decision-making in a two way conversation.

1.5.89. TJC: The Joint Commission

1.5.90. TIU: Text Integration Utility

1.5.91. TCT: Telehealth Clinical Technicians

1.5.92. TMS: Talent Management System

1.5.93. VA: Veterans Affairs

1.5.94. VA ECHO: VA Extension for Community Health Outcomes

1.5.95. VA EHR: VA electronic health record

1.5.96. VAMC: Veterans Affairs Medical Center

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

1.5.98. VHA: Veterans Health Administration

1.5.99. VVC: VA Video Connect

1.5.100. VSSC: VHA Support Service Center

1.5.101. WHEN: Weekend- Holiday- Every Night

2. STAFFING AND QUALIFICATIONS

2.1 MINIMUM PATIENT ALIGNED CARE TEAM (PACT) STAFFING REQUIREMENTS

PACTs comprise the patients, the patients’ personal support persons, teamlets (Primary

Care Providers (PCPs), Registered Nurse Care Managers (RNCMs), Clinical

Associates, Administrative Associates), and discipline specific team members (Clinical

Pharmacy Specialists (CPSs) , Licensed Clinical Social Workers (LCSWs), Registered

Dietician/Nutritionists, and Primary Care-Mental Health Integration (PCMHI) staff). The

Contractor shall provide PACT staffing in numbers and qualifications capable of fulfilling the standards outlined in the resultant contract. The Contractor shall provide a sufficient number of primary care providers so that each primary care provider has a caseload ratio to meet VA standards. Current standards are 1200 active patients per full time physician and 900 active patients per full time midlevel provider. Actual panel sizes can be determined by the VA in accordance with VHA Directive 1406 Patient Centered

Management Module (PCMM) for Primary Care. The staffing standard for support staff shall be at least three full time equivalent (FTE) support staff (1 FTE RNCM, 1 FTE

Clinical Associate, 1 FTE Administrative Associate) for each FTE Primary Care Provider.

The Clinical Pharmacy Specialist (CPS) shall be provided the same support staffing given to other providers on the team when they are working in the capacity of a mid-level provider. The Contractor shall provide personnel in numbers and qualifications capable of fulfilling the standards outlined in the resultant contract. The Contractor must establish and implement contingency plans for ensuring patients receive continuity of and access to appropriate primary care during periods of inadequate resources, extended staff absences, staff turnover, understaffing, and nature-related events (e.g., extreme weather conditions, natural disasters). If the number of patients reaches 90% of maximum panel size assigned by the facility the Contractor shall communicate to the VA the Contractor’s future staffing plan to ensure staffing ratio standards remain in accordance with PCMM staffing standards. Total Estimated Patients enrolled/assigned to site: 980.

PHYSICIAN DIRECTOR (MANDATORY FOR ALL SITES): FTE Ratio Performance

Standard: 0.05 FTE per PACT Responsible Party: Shall be provided by Contractor.

Qualifications: Contractor’s Physicians (including subcontractors) providing physician director services under the resultant contract shall demonstrate evidence of education, training, and experience in Internal Medicine or Family Practice. Contactor’s Physicians performing under this contract shall be board certified by the ABMS in Internal Medicine and/or Family Practice or the BOS in Internal Medicine and/or Family Practice. If proposed staff do not meet VA credentialing requirements, the Contractor shall propose substitute acceptable personnel within five (5) calendar days. The physician director may also be credentialed and privileged to function as a PCP. (If so, authorization for prescriptive authority is required). Physicians shall be licensed in the state in which the

Outpatient Site of Care (i.e., CBOC) is located; otherwise qualifications as per VA

Handbook 5005, Appendix G2.

Position Responsibilities: Serves as medical director to oversee and be responsible for the provision of covered services to enrolled and unassigned patients presenting for care at the site.

2.2 PRIMARY CARE TEAMLET STAFFING (MANDATORY FOR ALL SITES): All primary care teamlet staffing shall be provided by Contractor and all staff will be on site.

2.2.1 TEAMLET MEMBER 1: Primary Care Provider (PCP): FTE Ratio Performance

Standard: Current standards are 1200 active patients per full time physician and

900 active patients per full time midlevel provider. Contractor shall propose quantity of FTE to meet Standard FTE ratio to panel size. Contractor to propose mix of PCP from the options below. At least one of the PACT PCPs must be a physician.

OPTION 1: Physician (MD/DO): Qualifications: Physicians shall demonstrate evidence of education, training, and experience in Internal Medicine or Family

Practice. Physicians performing under this contract shall be board certified by the

ABMS in Internal Medicine and/or Family Practice or the BOS in Internal

Medicine and/or Family Practice. Authorization for prescriptive authority is required. If proposed staff do not meet VA credentialing requirements, the

Contractor shall propose substitute acceptable personnel within five (5) calendar days. Physicians shall be licensed in the state in which the Outpatient Site of

Care (i.e., CBOC) is located; otherwise qualifications as per VA Handbook 5005.

Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care, providing health care commensurate to the PCP’s licensure and clinical privileges or scope of practice, ensuring the patient’s care plan contains medical recommendations for clinically indicated care, offering clinically indicated health care services to patients assigned to the PACT, and providing or arranging for care to which patients consent, providing leadership to the team including shared delegation of appropriate care and care processes to appropriate team members, reviewing available clinical and performance data with the team, and focusing on continuous improvement of critical team processes, ensuring the patient has same-day access for face-to-face and virtual care visits during regular clinic hours, and collaborating with PACT staff to develop personal health plans that incorporate care management and care coordination appropriate to the patient’s needs.

OPTION 2: Certified Registered Nurse Practitioner (CRNP): Qualifications:

CRNP’s (including subcontractors) must possess a master’s degree from a program accredited by the NLNAC or CCNE, and maintain full and current certification as a nurse practitioner from the American Nurses Association or another nationally recognized certifying body as a Nurse Practitioner in either

Adult Health or Family Practice. Authorization for prescriptive authority is required. CRNPs shall prescribe controlled substances in accordance with limitations imposed by the Controlled Substances Act and the CRNP’s State licensure on the authority to prescribe, or administer controlled substances.

Three years of clinical nursing experience is required. A minimum of one (1) year clinical experience as a CRNP is required (three (3) years preferred). Experience in outpatient care in a Family Medicine or Internal Medicine environment is preferred. CRNP shall have current, full, active, and unrestricted license and registration as a graduate professional nurse in the state in which the Outpatient

Site of Care (i.e., CBOC) is located; otherwise, qualifications as per VA

Handbook 5005, Appendix G6.

Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care, providing health care commensurate to the PCP’s licensure and clinical privileges or scope of practice, ensuring the patient’s care plan contains medical recommendations for clinically indicated care, offering clinically indicated health care services to patients assigned to the PACT, and providing or arranging for care to which patients consent, providing leadership to the team including shared delegation of appropriate care and care processes to appropriate team members, reviewing available clinical and performance data with the team, and focusing on continuous improvement of critical team processes, ensuring the patient has same-day access for face-to-face and virtual care visits during regular clinic hours, and collaborating with PACT staff to develop personal health plans that incorporate care management and care coordination appropriate to the patient’s needs.

OPTION 3: Physician Assistant (PA):Qualifications: PA’s (including subcontractors) must be a graduate of a training program which is accredited by the Accreditation Review Commission on Education of PA (ARC-PA) or one of its predecessor organizations. Additionally, PAs must have a Master’s degree in any discipline or a Bachelor’s degree in any discipline with one year of experience as a PA. PAs must have successfully passed the PA National Certifying Exam

(PANCE). Authorization for prescriptive authority is required. PA shall have current, full, active, and unrestricted license and registration in the state in which the Outpatient Site of Care (i.e., CBOC) is located; otherwise qualifications as per VA HANDBOOK 5005 APPENDIX G8.

Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care, providing health care commensurate to the PCP’s licensure and clinical privileges or scope of practice, ensuring the patient’s care plan contains medical recommendations for clinically indicated care, offering clinically indicated health care services to patients assigned to the PACT, and providing or arranging for care to which patients consent, providing leadership to the team including shared delegation of appropriate care and care processes to appropriate team members, reviewing available clinical and performance data with the team, and focusing on continuous improvement of critical team processes, ensuring the patient has same-day access for ace-to-face and virtual care visits during regular clinic hours, and collaborating with PACT staff to develop personal health plans that incorporate care management and care coordination appropriate to the patient’s needs.

2.2.2 TEAMLET MEMBER 2: Registered Nurse (RN) Care Manager: FTE Ratio

Performance Standard: Current standard is 1.0 FTE RNCM per 1.0 FTE PCP

Qualifications: Graduate of a school of professional nursing accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The accreditation Commission for Education in Nursing (ACEN) or The commission on Collegiate Nursing Education (CCNE). Current, full, active, and unrestricted registration as a graduate professional nurse in the state in which the

Outpatient Site of Care (i.e., CBOC) is located; otherwise qualifications as per VA

Handbook 5005, Appendix G6.

Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care at the site, providing all aspects of professional nursing services consistent with licensure, certification, nursing professional standards of practice, and the clinician’s Functional Statement with elements of practice, enhancing patient safety and quality of care by collaborating with PACT staff to develop, oversee, and manage care management plans and care coordination for patients assigned to PACTs, participating in modes of communication and care delivery including, but not limited to, secure messaging, virtual care, view alerts management, shared medical appointments, face to face visits, etc., as part of care management, identifying patient needs for involvement of discipline-specific team members and discussing nursing recommendations with the PCP, engaging relevant PACT staff to support nursing care, according to locally established informal and formal communication processes, including entering consultation requests to discipline-specific PACT members, if required for formal communications, assuming full accountability for the appropriateness of assignments made by the RNCM to clinical associates or administrative associates related to care management, care coordination, nursing services, and outcomes of care, entering orders in the VA EHR for tests per approved standardized RN care management protocols or PCP orders, ensuring the RNCM has same-day access for face-to-face and virtual care visits, using nursing expertise, evidence-based guidelines, standardized nursing protocols, and professionally accepted practice standards to promote patient engagement, self-care and wellness, and provide care to patients and determine care management requirements for individual patients or cohorts of patients. The RN collaborates for the improvement of patient care outcomes in the Patient Aligned Care Team. Promotes systems to improve access and continuity of care, uses advanced clinical knowledge and critical thinking skills to mentor staff in planning, implementing and evaluating interventions that improve patient outcomes, designs and provides age and population specific health promotion and risk reduction strategies, translates evidence-based research into practice to ensure that patients benefit from the latest innovations in nursing science, manages patients in transition between levels of care, serves as an expert resource to implement and teach skills, including motivational interviewing to promote patient self-management toward patient-driven holistic care plan for life.

2.2.3 TEAMLET MEMBER 3: CLINICAL ASSOCIATE FTE Ratio Performance

Standard: Current standard is 1.0 FTE clinical associate per 1.0 FTE PCP.

Contractor to propose the mix of Clinical Associates from the options below.

OPTION 1: Licensed Practical Nurse (LPN) or Licensed Vocational Nurse

(LVN): Qualifications: Current, full, active, and unrestricted license in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise qualifications as per VA HANDBOOK 5005 APPENDIX G13. Position Responsibilities:

Responsible for the provision of covered services to enrolled and unassigned patients presenting for care at the site, providing evaluation and care consistent with licensure, certification, and functional statement with elements of practice, to patients assigned PACTs, collaborating with PACT staff to develop comprehensive health care plans and care management plans for patients assigned to patient panels, managing clinic workflow, ensuring patients are placed in examination rooms in a timely manner, and providing direction to patients as they move through the clinic environment. Duties include but are not limited to the ability to perform a variety of specialized clinical support skills, ability to perform basic patient care service, have knowledge of medical terminology, demonstrate skills in interpersonal communication, demonstrate knowledge of aseptic technique and infection control and knowledge of patient confidentiality, policies and procedures.

Shall assist all health care providers in performing patient care services and duties pertaining to the effective and efficient delivery of patient centered care in all clinical areas. Staff member will receive training as back-up for telehealth services

(e.g. S&F, CVT).

OPTION 2: Health Technician (Medical Assistant) This staffing is part of the

PACT Teamlet, not the primary telehealth clinical technician (TCT):Qualifications:

Completion of an approved medical assistant training program accredited by the

Commission on Accreditation of Allied Health Education Programs (CAAHEP) or the Accrediting Bureau of Health Education Schools (ABHES), or by any accrediting agency recognized by the United States Department of Education or a current and active Certified Medical Assistant (CMA) or Registered Medical

Assistant (RMA) from The American Association of Medical Assistants (AAMA) or the American Medical Technologists (AMT). Other credentials such as completion of a medical services training program of the Armed Forces of the United States may be accepted based on VA Chief of Staff determination. Position

Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care at the site, providing evaluation and care consistent with licensure, certification, and functional statement with elements of practice, to patients assigned PACTs, collaborating with PACT staff to develop comprehensive health care plans and care management plans for patients assigned to patient panels, managing clinic workflow, ensuring patients are placed in examination rooms in a timely manner, and providing direction to patients as they move through the clinic environment. Duties include but are not limited to the ability to perform a variety of specialized clinical support skills, ability to perform basic patient care service, have knowledge of medical terminology, demonstrate skills in interpersonal communication, demonstrate knowledge of aseptic technique and infection control and knowledge of patient confidentiality, policies and procedures. Shall assist all health care providers in performing patient care services and duties pertaining to the effective and efficient delivery of patient centered care in all clinical areas. Staff member will receive training as back-up for telehealth services (e.g. S&F, CVT).

2.2.4 TEAMLET MEMBER 4: ADMINISTRATIVE ASSOCIATE: FTE Ratio

Performance Standard: Current standard is 1.0 FTE administrative associate per

1.0 FTE PCP. Qualifications: Required education and experience demonstrating skills and abilities to perform duties ensuring smooth site operations. Position

Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care, providing clerical support and administrative functions to PACT staff, collaborating with PACT staff to incorporate the logistical elements of care coordination into comprehensive care management plans, providing guidance and direction to patients and personal support persons for navigating the VA health care system and administrative functions in VA, and coordinating care for patients assigned to the PACT.

2.3 DISCIPLINE SPECIFIC PACT TEAM MEMBERS (REQUIRED FOR ALL SITES):

Discipline-specific team members are designated in PCMM for one or more PACT(s).

Discipline-specific team members provide continuity of direct discipline-specific care to all patients assigned to PACT(s) for which the team member is designated.

2.3.1 DISCIPLINE SPECIFIC 1: CLINICAL PHARMACY SPECIALIST (CPS):

Contractor will make referral to VHA provider on as need basis.

2.3.2 DISCIPLINE SPECIFIC 2: CLINICAL PHARMACY SPECIALIST (CPS) ANTI-

COAGULATION: Contractor will make referral to VHA provider on as need basis.

1.1.1 2.3.3 DISCIPLINE SPECIFIC 3: LICENSED CLINICAL SOCIAL WORKER (this position provides general/medical social work services): FTE Ratio Performance

Standard: 1 FTE per 2 PACTs. Qualifications: Social Workers providing general social work services under this contract must have a Master’s degree in Social Work (MSW) from a school accredited by Council on Social Work Education (CSWE).