36C26021Q0116.docx

Contract Opportunity Special Notice

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* = Required Field Contract Opportunity Special Notice Q201 HIV Medical Case Management Oregon Counties: Multnomah, Clackamas, Columbia, Washington Yamhill 4/1/2021 - 3/31/2026 98327 36C26021Q0116 N 621999 Department of Veterans Affairs Network Contracting Office 20 1495 Wilmington Drive, Suite 360 DuPont WA 98327 The Department of Veterans Affairs, Network Contracting Office 20, in accordance with FAR 13.106-1(b)(1)(i) (the circumstances of the contract action deem only one source reasonably available) intends to award a sole source contract to Oregon Health & Science University for the following services: HIV Medical Case Management Services for the Portland VA Medical Center, Portland, Oregon, 4/1/2021 – 3/31/2026. NAICS 621999 All other Misc Ambulatory Health Care Services applies. This sole source contract will be for HIV medical case management services for VA patients who live in Oregon with a service area of Multnomah, Clackamas, Columbia, Washington, and Yamhill Counties. This will be on an as-needed basis, estimated at 540 visits per year. This notice of intent is not a solicitation or request for offers. No solicitation package is available. All responsible sources may submit a capability statement, proposal, or quotation which shall be considered. Any response to this notice must show clear and convincing evidence that the responding company already has the highly specialized and complex service of HIV Medical Case Management Services available for Multnomah, Clackamas, Columbia, Washington, and Yamhill Counties. Draft Performance Work Statement is attached. A determination not to compete is solely within the discretion of the Government. Responses must be received no later than 4:30 pm on December 16, 2020. All responses must be emailed to Darlene.Anderson4@va.gov .

HIV MEDICAL CASE MANAGEMENT

FOR THE

VA PORTLAND HEALTH CARE SYSTEM

3710 SW US VETERANS HOSPITAL ROAD

PORTLAND, OR 97239

1. GENERAL:

1.1 Authority:

This contract is entered into under the authority of Public Law 104-262 and U.S.C.8153 and under VAAR 873 the contractor agrees to provide Health Care Resources in accordance with the terms and conditions stated herein at the VA Portland Health Care System (VAPORHCS).

1.2 Services Required:

1.2.1 The Contractor agrees to furnish all personnel to provide HIV medical case management as outlined in the Performance Work Statement (PWS) and special contract requirements listed herein for the VAPORHCS. The contractor shall provide HIV case management services for the VAPORHCS. VAPORHCS needs to have a HIV case management service available. When staff physicians determine those services are clinically indicated, the patient will be referred for contract service. A contract is needed to make HIV case management available at the VAPORHCS. HIV case management is highly specialized and complex requiring qualified personnel.

1.2.2 Registered nurses and medical case managers social workers assigned by the Contractor to perform the services covered by this contract must have current, full and unrestricted state licenses. The qualifications of Contractor’s personnel must be approved in advance by the Chief of Staff or designee. Notice of any substitutions of key personnel must be provided to the Chief of Medicine or designee, and the qualifications of the substitutes must be supplied and approved in advance by the VAPORHCS Chief of Staff or designee. Ensure that all nursing staff performing the HIV case management has appropriate and current state licenses, CPR certification, and such annual health clearance as may be required by the appropriate state and federal regulatory agencies. Ensure the staff licenses are updated yearly and provided copies the medical center.

1.2.3 Perform HIV case management on an as-needed basis at the patient’s location between the hours of 8:00a.m. and 6:00p.m. on non-holiday weekdays. This will be awarded to one vendor. The offeror will need to determine the mix of labor required to provide services outlined in this document.

1.3 Place of Performance:

1.3.1 The Contractor agrees to provide Health Care Resources in accordance with the terms and conditions stated herein at prices specified in the Schedule of this contract. The case management staff (RN or medical case manager) will be assigned to work at the:

VA Portland Health Care System 3710 SW US Veterans Hospital Road Hospital and Specialty Care Division / Specialty Clinics Portland, OR 97239

1.3.2 Contractor will provide health care services to VA Portland Health Care System, remotely to the patient, and at the patient’s location, and as such, Contractor is considered part of the VA health activity for purposes of the following statutes and the VA regulations implementing these statues: the Privacy Act, 5. S.C. sec 552a, and 38 U.S. C. sections 5701, 7705, and 7332. Contractor will have access to VA patient medical records to the extent necessary for the Contractor to perform this contract.

1.4 Period of Performance:

1.4.1 The period of performance will be from time of award for five years.

1.5 Scope of Work:

a. This contract is only for the VA Portland Health Care System. It will be a fixed firm price contract.

b . Services outside the scope of work: any work, which the contractor determines to be outside the scope of this contract, shall not be performed unless and until specifically authorized by the contracting officer. Any work performed without this authorization, (whether written or verbal), will be at the expense of the contractor.

c. The HIV case management contract staff will generally be working independently and will consult with the Chief of Staff, VAPORHCS when unusual circumstances arise.

d. Standard of Care: Contract provider care shall cover the range of services as would be provided in any health care system and the standard of care be equal that provided by employees of VA Portland Health Care System.

e. Patients will be screened, triaged, and offered appropriate referrals to services needed. Patients with ongoing needs will be referred to appropriate staff for intake and ongoing case management services. Patients with needs that can be addressed by referrals will be offered appropriate referrals to services in the community.

g. Medical case management services will be provided to patients who live in Oregon. The service area is Multnomah, Clackamas, Columbia, Washington and Yamhill Counties. For patients outside of those counties referrals to HIV case management will be made to appropriate resources within those counties.

The contract staff will ask the Veteran to complete a release authorization VA form 10-5345 during intake. Contract staff are required to have a signed release authorization permitting disclosure of HIV information prior to transmission of any data to outside organizations. Any organizations receiving medical information from VA must be individually indicated on the release authorization form. A specific expiration date or condition must be entered on the form indicating when the authorization expires. The completed forms will be sent to the VAPORHCS to be scanned into the patient’s permanent electronic medical record.

Case management services will utilize a two-tiered model where patients with high needs shall receive more intensive services and patients with lower need shall receive less intensive services and or referral to other services that can be accessed in the community.

The less intense form of case management is for patients who have low acuity and short-term need for services, and shall include goal planning and short-term assistance such as, but not limited to, brief problem solving; assistance with insurance and benefits issues; assistance with accessing medications; and brief crisis intervention.

The more intense form of case management is for patients who have multiple needs and co-occurring disorders, and the contractor shall provide longer-term assistance including, but not limited to, goal planning, in conjunction with the patient; psychosocial and health assessments; case planning; case monitoring; short-term behavioral counseling; home visits with assessments; assistance in requesting community resources and medication assistance and management.

Provide individual case management services in a manner which increases patients’ self-sufficiency and ability to self-manage their disease and co-occurring conditions. Contract staff will refer and coordinate closely with services in the community that specialize in specific needs of the patients that can support the goal plans developed by the patient and case management staff.

Provide nursing case management services (NCM) to patients with documented medical needs. It is the responsibility of the ordering physician to define the scope of medical need for NCM services. Patients who receive NCM may be enrolled in other case management service.

One or more contract staff will regularly attend the multidisciplinary Infectious Disease clinic.

f . The contractors will be required to have the ability to perform HIV case management independently.

g. Provide direct patient care for HIV case management.

h . The quality of medical practice shall meet or exceed reasonable standards of professional practice for the required services as determined by the same authority that governs VA medical professionals and will be audited by the health care system for that purpose.

i. Document all patient care on the patient’s chart including replacement solutions administered, if any, fluid balance, medications given, and adverse reactions, if any, which occurred during the HIV case management. All documentation shall be completed in CPRS within 48 hours after care is delivered.

j. Contract personnel shall comply with the by-laws of VA Portland Health Care System. (See attachment 7)

k. Any conflicts that may arise regarding patient care shall be coordinated with the Chief of Medical Service.

l. The Chief of Medical Service will verify quality of patient care through the QASP.

m. The HIV case management staff will be required to coordinate the treatments at the VA Portland Health Care System as needed.

1.5.1 Duties and responsibilities shall include, but not be limited to the following:

a. The Contractor shall provide contract staff necessary to accomplish the services described in this PWS except as may otherwise be specified. Contractor will provide sufficient contract staff to ensure that all HIV case management requests will be met in a timely manner. All professionals providing services under the terms of this contract will be appropriately certified and licensed as described herein and possess the requisite skills and experience to perform the services defined in the contract.

b. The contractors agree to provide Health Care Resources in accordance with the terms and conditions stated herein, to furnish to and at the VA Portland Health Care System services at prices specified in the contract.

c. The contractor will be responsible for ensuring that the contract staff providing services under this contract are fully trained and completely competent to perform the required services covered by this contract. Full and unrestricted state licenses are required.

d. The Contractor will be responsible for any license and certification required, this includes American Heart Association Basic Life Support (BLS) certification and Advance Cardiac Life Support (ACLS).

1.5.2 The Contractor:

a. Must provide HIV case management to VA patients.

b. Must meet medical staff criteria for initial appointment and reappraisal in accordance with VHA Handbook 1100.19, entitled Credentialing and Privileging (see http://vaww1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910 to practice medicine at VA Portland Health Care System prior to beginning work. See Memorandum 3307, provided as an attachment to QASP.

c. Must be performing the required services identified in the Work Statement or the cost will be decreased accordingly during each billing cycle. The payments for holiday time (for work performed in the case of an emergency) and for any leave, including sick leave or vacation time, are the responsibilities of the contractor.

d. Must be fluent in written and spoken English;

e. Will be required to provide HIV case management services.

f. Must provide evidence of current clinical experience appropriate to a HIV case manager.

g. Must be a US citizen or provide evidence of eligibility to work in the US including an e-verify report.

h. Must provide current professional liability insurance certificate that covers work at the VA;

i. Must provide names of most current employer(s) and two peer reference contacts;

j. Must be able to work effectively in a collaborative environment, but also be able to function safely in an autonomous role;

k. Must be computer literate and have moderate typing skills, as the VA utilizes computerized patient medical records;

l. Must be a team player;

m. Must be able to work without direct supervision.

n. Must provide services in accordance with VA policies and procedures and the regulations of the medical staff by laws of the VA facility;

o. Must practice within guidelines established by Federal, State, Department of Veterans Affairs, the Medical Director (or designee), and the Service Chief.

p. Relationship with management, co-workers, patients, and the general public are consistently courteous, respectful, and cooperative in nature. The contractor will display a cooperative attitude and will effectively work together to implement the organization’s mission and goals. They will ensure productivity is maintained at the established level for the program for which he/she is responsible

q. Will provide input to any Peer Review or Process Review directly relating to a patient treatment or incident resulting from actions taken as a result of the consultation.

r. Will maintain familiarity and comply with facility infection control policies and procedures.

s. Must ensure a safe work environment and safe work habits

t. Will maintain familiarity and comply with all Federal, State, Department of Veterans Affairs, VA Portland Health Care System and departmental regulation and requirements.

1.6. Definitions:

AQL: Acceptable Quality Level CEU: Certified Education Unit CME: Continuing Medical Education COR: Contracting Officer’s Representative CPRS: Computerized Patient Record System FPPE: “Focused” Professional Practice Evaluation H&P: History and Physical HCS: Health Care System HHS: Department of Health and Human Services HIPAA: Public Law 104-191 JC: Joint Commission NPI: National Provider Identification OPPE: Ongoing” Professional Practice Evaluation OIG: Office of Inspector General PATS: Patient Advocate Tracking System PTSD: Post Traumatic Stress Disorder PWS: Performance Work Statement QASP: Quality Assurance Surveillance Plan TBI: Traumatic Brain Injury VA: Department of Veterans Affairs VAAR: Veterans Affairs Acquisition Regulations VHA: Veterans Health Administration

2.0. PERSONNEL:

2.1. Qualifications:

2.1.1 The qualifications of the HIV case management staff assigned to perform the services covered by this contract shall be subject to review by VA Portland Health Care System.

2.1.2 The contractor will perform his/her work independently and with minimum direction. The contractor will work independently and is self-directed in that he/she is able to judge what activities are of highest priority, and accomplishes the necessary tasks without the necessity of supervisory direction.

2.1.3 Certification/Eligibility: Personnel must be licensed in a state, territory, or commonwealth of the United States or the District of Columbia. The Contractor will be responsible for any license and certification required to perform under this contract. The Contractor will be responsible for ensuring that the HIV case management staff providing services under this contract is/are fully trained and completely competent to perform the required services covered by this contract.

2.1.4 Credentialing and Privileging:

Contractors must be credentialed in accordance with policies and procedures set forth in VA Directive 1663 https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2 and Veterans Health Administration (VHA) 1100.19 http://vaww1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910 to include submission into VetPro, VHA’s credentialing internet software.

2.1.5 Technical Proficiency:

a. All care provided to Veterans is expected to be of the highest quality and is subject to peer review, focused professional practice review, ongoing professional practice review, and quality assurance activities. In addition, the VA Portland Health Care System reserves the right to survey Veterans and families for patient satisfaction, evaluate and coordinate action through the contractor to address satisfaction concerns.

b. Patient or staff complaints about the quality of care will be considered in the evaluation of the HIV case management contract. All Veterans, family members, VA employees and other customers of the VA Portland Health Care System will be treated professionally and courteously. The contractor shall provide satisfactory customer service. Patient or staff complaints about the quality of care will be considered in the evaluation of the HIV case management contract. The contractor must report all patient complaints immediately (within 24 hours) and resolved them within 7 days.

c. The services to be performed: shall be performed in accordance with VA policies, procedures, and the regulations of the Medical staff by-laws of the VA Portland Health Care System, see attached document.

The Government may evaluate the quality of professional and administrative service provided, but retains no control over the medical, professional aspects of services rendered (e.g., professional judgments, and/or diagnosis for specific medical treatment). An contractor provided by this contract carries the same responsibility for patient care as a VA staff appointed under Title 38 U.S.C. 7405.

2.1.6 Continuing Medical Education (CME)/ Certified Education Unit (CEU) Certified Education Unit (CEU) Requirements: All staff providing care to Veterans are expected to maintain all required training consistent with their licensure and with the Contracting agency’s medical bylaws. It is highly preferred that contract staff will undergo Veteran-specific training to manage patients with special needs such as those patients with Post-Traumatic Stress Disorder, Traumatic Brain Injury, Military Sexual Trauma, and Suicidal Ideation and other programs that may assist with an understanding of the cultural needs and unique population specific issues associated with military service, if it is determined to be required.

2.1.7 Training:

a. The contractor shall maintain their licensure. If the contractor’s certifications and or licensure status changes they shall inform the Contracting Officer immediately.

b. The contractor shall complete any training required by the VA.

c. All contract employees and subcontractors requiring access to VA computer network are required to complete VA's Information Security and Privacy Awareness Training (ISPAT) training annually. The courses required are Privacy Policy (HIPPA), TMS module #10203 and VA Privacy and Information Security Awareness and Rules of Behavior Training TMS module #10176 can be obtained from the Talent Management System at https://www.tms.va.gov/SecureAuth35/. The COR can assist in enrollment in the system. Documented proof in the form of a certificate must be provided to the Contracting Officer.

d. When notified of an unfavorable determination of the background investigation or credentialing, the contractor shall withdraw the employee from working under the contract, and at the request of the VA, submit another employee for consideration.

2.1.8 Standard Personnel Testing: N/A

2.1.9 Conflict of Interest:

See VHA Handbook 1660.3, Conflict of Interest; Aspects of Contracting for Scarce Medical Specialist Services; Enhanced Use Leases; Health Care Resource Sharing; Non-VA Purchased Care (Fee Basis); and Intergovernmental Personnel Action Agreements (IPAS). These publications and handbooks are available at: http://www1.va.gov/vhapublications/index.cfm

2.1.10 Citizenship Related Requirements:

A technically qualified United States Citizens will be given preference over non-citizens in accordance with current regulations. Non-citizens must provide proof of eligibility to work and an e-verify printout.

2.1.11 Office of Inspector General (OIG) Statement:

The contractor is required to check the HHS Office of Inspector General List of excluded individuals/entities on the OIG Website (https://oig.hhs.gov/) for each person providing services under this contract to ensure that the individuals providing services under the contract have not engaged in fraud or abuse regarding Sections 1128 and 1128A of the Social Security Act regarding federal health care programs. Further, the contractor is required to certify in its proposal that all persons listed in the contractor’s proposal have been verified as not appearing on the OIG list. During the performance of this contract, the Contractor is prohibited from using any individual or business listed on the List of Excluded Individuals/Entities.

2.2 Technical Direction:

2.2.1 Submission: As part of the pre-award Contractor Responsibility determination and during the performance of the contract for the purpose of on-going Contractor competency evaluation, the VA will perform or require for evaluation, from the Offeror/Contractor one or more of the following:

a. Submission of information to allow evaluation of their qualifications and past performance. This information should be specific, concise, and complete and provide sufficient information to demonstrate the offeror’s capacity to meet or exceed the requirements of the contract.

b. Submission of evidence of accomplishment of training and education that is required by the terms of the contract.

c. Submission of evidence of experience and achievements in work similar to that required by the contract.

d. Licensure that meets or exceeds standards relative to the industry being contracted.

2.2.2 Contractor must not have had a terminated license, registration or certification for cause, or if the provider voluntarily relinquished such license, registration or certification in any state after being notified in writing by a state of potential termination for cause. (The definition for “cause” is “substandard care, professional misconduct, or professional incompetence.”) All contractors shall have a current, full and unrestricted license to practice medicine in any State, Territory, or Commonwealth of the United States or in the District of Columbia. If required by the State of Licensure, current registration shall also be maintained.

2.2.3 Invoices will be billed as individual line items as they are listed in the price schedule.

Monthly invoice(s) will contain only the visits for that month. Previous invoiced procedures shall not be intermingled with current invoice. Invoices not received in proper format will be returned. Invoices: Invoices shall be submitted monthly in arrears with the following information

a. Contract number and purchase order number.

b. Station ID (648)

c. Dates and hours worked

d. Price

2.2.4 The VA Portland Health Care System will not pay any hiring fees if the contractor is hired for a permanent position.

2.2.5 Service Contract Act (SCA) is applicable to this contract.

2.2.6 Marketing: Contractor shall not advertise or use any marketing material, logos, trade names, service marks, or other material belonging to the VA Portland Health Care System without consent.

2.2.7 Safety requirements: in the performance of this contract, the contractor shall take such safety precautions as the COR may determine to be reasonable and necessary to protect the lives and health of occupants of the building. The contracting officer or his designee will notify the contactor of any non-compliance with the foregoing provisions and the action to be taken. The contractor shall after receipt of such notice, immediately correct the condition. Such notice, when served on the contractor or his representative at the site of the work, shall be deemed sufficient for the purpose aforesaid. If the contractor fails or refuses to comply promptly, the contracting officer may issue an order stopping all or any part of the work and hold the contractor in default.

2.2.8 Contractors are required to use universal precautions to guard against possibility of accidental exposure to blood-borne pathogens. VA Portland Health Care System will provide appropriate Personal Protective Equipment (PPE). Contractors will follow the guidance provided in the VA Portland Health Care System SOPs regarding Infection Control, Safety, and Hazardous Waste Management.

2.3 Non Personal Services:

2.3.1 It is expressly agreed and understood that this is a non-personal services contract, as defined in Federal Acquisition Regulation (FAR) 37.101, under which the professional services rendered by the Contractor or its health-care providers are rendered in its capacity as an independent contractor. The Contractor shall be liable for their liability-producing acts or omissions. The Contractor shall maintain or require all health-care providers performing under this contract to maintain, during the term of this contract, professional liability insurance issued by a responsible insurance carrier. However, if the Contractor is an entity or a subdivision of a State that either provides for self-insurance or limits the liability or the amount of insurance purchased by State entities, then the insurance requirement of this contract shall be fulfilled by incorporating the provisions of the applicable State law.

2.3.2 An apparently successful offeror, upon request of the Contracting Officer, shall, prior to contract award, furnish evidence of the insurability of the offeror and/or of all health-care providers who will perform under this contract. The submission shall provide evidence of insurability concerning the medical liability insurance required by paragraph (a) of this clause or the provisions of State law as to self-insurance, or limitations on liability or insurance.

2.3.3 The Contractor shall, prior to commencement of services under the contract, provide to the Contracting Officer Certificates of Insurance or insurance policies evidencing the required insurance coverage and an endorsement stating that any cancellation or material change adversely affecting the Government.

2.3.4 The Contractor shall notify the Contracting Officer if it, or any of the health-care providers performing under this contract, change insurance providers during the performance period of this contract. The notification shall provide evidence that the Contractor and/or health-care providers will meet all the requirements of this clause, including those concerning liability insurance and endorsements. These requirements may be met under either the new policy, or a combination of old and new policies, if applicable.

2.3.5 No Employee status:

The parties agree that such personnel working under this contract shall not be considered VA employees for any purpose and shall be considered employees of the Contractor. The relationship of the parties is not and shall not be construed or interpreted to be a partnership, joint venture or agency. The relationship of the Parties is an independent contractor relationship.

2.3.6 TORT:

Contractor employees are not covered by the Federal Tort Claims Act. When the Contractor or its employee has been identified as a provider in a tort claim, the Contractor is responsible for notifying the Contractor’s legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor or employee’s action or non-action is the responsibility of the Contractor and/or insurance carrier. The contractor shall provide a copy of current license and malpractice insurance certificate.

2.4 Key Personnel and Emergency Substitutions:

2.4.1 Key personnel on this contract shall include the contractor’s point of contact on this contract.

2.4.2 The provider assigned by the contractor shall fall under all the existing VA Portland Health Care System quality monitors relating to services provided such as, medical records review, Peer Review, Incident reporting, Infection Control, etc.

2.4.3 The Government reserves the right to refuse acceptance of a contractor, 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. The Contracting Officer, Administrative Contracting Officer and Contracting Officer's Representative shall deal with issues raised concerning contract personnel's conduct. The final arbiter is the Contracting Officer.

2.4.4 The Contracting Officer Representative shall resolve complaints concerning Contractor relations with the Government employees or patients. In the event that the Contractor is involved and named in a validated patient complaint, and the Government is unable to resolve the issue the Government reserves the right to refuse acceptance of the services of such personnel. In the event of incidents involving physical or verbal abuse the contractor will be immediately removed from the facility and will not return until clearance is given by the Contracting Officer and the Facility Director. In the event any issues cannot be resolved the Contracting Officer is the final authority on validating complaints.

2.4.5 VA Portland Health Care System personnel shall brief the Contractor on VAPORHCS policies and procedures on the first scheduled duty day.

3.0 HOURS OF OPERATION:

3.1.1 Normal Clinical Hours: The normal clinical hours shall be defined as those in which HIV case management are performed, generally between the hours of 8:00a.m. and 6:00p.m. on non-holiday weekdays. VA Portland Health Care System retains the right to adjust scheduling as needed to best serve VA patients.

3.1.2 Contractor’s employee must be performing the required services identified in the Performance Work Statement to invoice for hours worked. The payments for holiday time (for work performed in the case of an emergency) and for any leave, including sick leave or vacation time is the responsibility of the contractor The services covered by this contract shall be furnished by the Contractor during work hours as defined herein.

3.1.3 Any hours worked beyond the normally scheduled shifts shall be reviewed by the Chief of Staff, and approved by the COR to determine appropriateness. Any time worked deemed unnecessary by the Chief of Staff will not be paid by the VA.

3.1.4. Work Schedule:

a. Coverage. Contractor shall schedule a sufficient number of qualified staff, to be immediately available to provide all HIV case management services required. Contractors shall not be scheduled or work performed until the COR has received clearance from the contracting officer and credentialing.

b. Staff Lead Time : Any new staff will require a minimum of 8-weeks lead-time for credentialing and background investigations after submission of all of the paperwork. Contractor will work with the COR and VAPORHCS Medical Staff Coordinator to credential personnel through VetPro. VetPro is a software program to support the credentialing activities for the appointment of health care professionals to VA medical facilities.

4.0 CONTRACTOR RESPONSIBILITIES:

4.1. Services Required: Provide direct patient care in all aspects of HIV case management. Provide strong support for nursing and ancillary staff as they care for the patient.

4.2. Standards of Practice:

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

4.2.2 By signing this solicitation, the contractor hereby acknowledges that it is and will continue to comply with State workers compensation laws that are applicable to the contractor. While it is understood by the Federal government that workers compensation laws may not apply to a contractor with respect to that contractor’s independent contractors and as such that contractor will not be required to make workers compensation premium payments for such independent contractors, it is wholly the burden and responsibility of the contractor to make such a determination pursuant to State workers compensation laws. The Federal government does not offer any legal advice on such a determination and contractors are encouraged to seek independent legal advice when making such a determination.

4.2.3 The contractor shall comply with all current VHA policies. The contractor is required to meet VHA performance and quality criteria and standards including, but not limited to, customer satisfaction, preventative index, chronic disease index and clinical guidelines. Performance and quality standards may change during the course of the contract. New or revised quality/performance criteria or standards will be provided to the contractor before their implementation date. Compliance with mandated performance is required as a condition of this contract.

4.2.4 The services required in this agreement shall be performed in accordance with established principles and ethics of the medical profession. The quality of healthcare provided shall meet or exceed the current recognized standards established by the American Board Certification, The Joint Commission (TJC), Veterans Health Administration regulations and medical staff by-laws and those of other professional associations that specify standards of performance for the medical profession.

4.2.5 The Contractor shall be responsible for providing responsible management of medical care. Care provided will respect and integrate the patient’s beliefs, values and cultural influences. The Contractor shall involve the patient in care decisions by keeping him/her fully informed about the diagnosis, plan of care and treatment goals, risks and benefits of proposed treatment, and prognosis; shared decision-making shall be pursued.

4.2.6 VA will provide the contractor with access to the VISTA (Veterans Health Information System Technology Architecture), VA’s patient record computer system, Computerized Patient Record System (CPRS) that contains: patient medical records, medication profiles, laboratory and radiology data, and other diagnostic test results. Access will be for the purpose of: obtaining patient specific information, and communicating with VA Staff about patient care issues.

4.2.7 The contractor will also be responsible for reviewing patient information via the computerized patient record system. The COR will be responsible for ensuring and documenting that these requirements are satisfied. If patient records are not properly documented within CPRS, VA reserves the right to withhold payment to the Contractor until such records are properly documented.

4.2.8 Any changes in the laws, regulations, or VA/VHA policies or procedures governing the information covered by this section of the contract, during the term of this contract, shall be deemed to be incorporated into this contract.

4.2.9 In the event there are concerns with the contractor’s performance, the following process will be followed:

a. Facility identifies the concern and submits an incident report to the Contracting Officer.

b. Vendor will have 24 hours to interact with the staff member and communicate the issue.

c. Vendor will reply back to the Contracting Officer within 48 hours with a response from the contract staff in writing.

d. The Contracting Officer will respond back to the facility about the issue to the facility with the contractor’s response.

e. If the issue continues a conference call will be set up with the contractor, Medical Director, Chief of Staff, Contracting and vendor to discuss a performance improvement plan. Facility will outline the expectation and steps on how contract staff will need to improve. At that time an evaluation date will be set up to verify closing the concern or moving on to the next step. This date will depend on when the provider is scheduled at the facility.

f. If the issue continues, a conference call will be set up with the contractor, Medical Director, Chief of Staff, Contracting and vendor to discuss the removal of the contractor. In the event that it is decided that removal is the best option, the CO and facility will discuss with the vendor about either transitioning to new contract staff in or immediately requesting the contract staff turn in badges and VA equipment and be escorted from the facility. If the contract staff is not at the VA, the vendor will return the badges and any VA equipment to the facility.

4.3. Resident Supervision and Teaching: N/A

4.3.1. Resident Supervision/Teaching: N/A

4.3.2 Academic Environment: N/A

4.3.3 Resident Patient Care Documentation: N/A

4.3.4 Technical Direction and Oversight: The COR shall be the VA official responsible for verifying purchase order compliance. After purchase order award, any incidents of contractor noncompliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer.

4.4 Medical Records:

a. All records will be completed within 24 hours

b. Verify and sign reports within the contractor’s area of assignment within 24 hours of availability of report.

c. Adhere to policy and procedure relative to informed consent, patient assessment and reassessment and communication with referring provider to ensure coordination of care.

d. Must adhere to the documentation guidelines set forth in the Department of Veterans Affairs, VA Portland Health Care System Medical Center Memorandums and Documentation Requirements. See attached documents.

4.4.1. Authorities:

By performing services under this contract, the Contractor is considered part of the VA healthcare activity for purposes of the following statutes and respective regulations implementing these statutes: Title 5 U.S.C Section 552a (Privacy Act), Title 38 U.S.C. Section 5701, Title 38 U.S.C. Section 5705, Title 38 U.S.C Section 7332, and Public Law 104-191 (HIPAA).

4.4.2. HIPAA:

Contractor and any subcontractors must adhere to the provisions of HIPAA. This includes both Privacy and Security Rules published by HHS.

4.4.3. Disclosure:

a. As required by Public Law 104-191, Health Insurance Portability and Accountability Act (HIPAA) of 1996, the Department of Health and Human Services (HHS) has promulgated rules governing the use and disclosure of protected health information by covered entities. The covered entity component of the Department of Veterans Affairs is the Veterans Health Administration (VHA). In accordance with HIPAA, the contractor is required to enter into a Business Associate Contract (BAA) with VHA.

b. Any contract resulting from this solicitation will be subject to the Privacy Act of 1974. Federal Acquisition Regulations 52.224-1 Privacy Act Notification and 52.224-2 Privacy Act are incorporated by reference.

4.4.4. Professional standards for documenting care:

Contract personnel are responsible for ensuring that their documentation practices are in accordance with all applicable VA, state, and federal regulations. SEE VHA HANDBOOK 1907.01, HEALTH INFORMATION MANAGEMENT AND HEALTH RECORDS. http://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=3088

4.4.5 Release of Information:

a. Contract personnel shall have access to patient medical records/information and general files only to the extent necessary to perform their contractual duties. Contract personnel shall only release medical information obtained during the course of this contract to those VA medical staff members involved in the necessary care and treatment of the individual patient to which the information pertains. Notwithstanding any other clause and/or provision of this contract, if a request for release or disclosure of information is not necessary for the care and treatment of an individual patient, the Contractor and contract personnel shall not disclose any information contained in general files, patient records, and/or any other individually identifiable health information, including information and records generated by the Contractor in performance of this contract, except pursuant to explicit instruction and written approval from VA. For the purposes of this paragraph, instruction to disclose or copy such records and/or information may be provided by the following only: VA Regional Counsel, Chief, Health Information Management Services, or Privacy Officer through the VA Contracting Officer. Violation of the aforementioned statutes may result in criminal and/or civil penalties.

b. Contract personnel who obtain access to hardware or media that may manipulate or store drug or alcohol abuse data, sickle cell anemia treatment records, records or tests or treatment for or infection with HIV, medical quality assurance records, or any other sensitive information protected under the statues and implementing regulations previously mentioned shall not have access to the records unless absolutely necessary to perform their contractual duties. Any contract person who has access to the previously mentioned data and/or information must not disclose it to anyone, including other contract personnel not involved in the performance of the particular contractual duty for which access to this data and/or information was obtained.

c. Information or records accessed and/or created by the Contractor in the course of performing services under this contract are the property of the VA and shall not be accessed, released, transferred, or destroyed except in accordance with applicable federal law, regulations, and/or VA/VHA policy. The Contractor will not copy information contained in VA information systems, either by printing to paper or by copying to another digital format, without the explicit instruction and written approval from of the VA officials, except as is necessary to make single copies in the ordinary course of providing patient care. The Contractor will not commingle the data from VA information systems with information from other sources. Contractor shall report any unauthorized disclosure of VA information to the VA officials.

d. If this contract is terminated for any reason, the Contractor will provide VA with all individually identifiable VA patient treatment records or other information in its possession, and any copies made pursuant to paragraph 6 above, within seven (7) calendar days of the termination of this contract.

e. The Contractor shall follow all VA policies regarding the retention of records. As an alternative, the Contractor may deliver the records to VA for retention.

f. The Contractor shall follow all of the previously mentioned statutes and respective regulations implementing these statutes and VHA Handbook 1605.1 - Privacy and Release of Information and any other VA/VHA policies and procedures governing the information discussed in this section of the contract. Copies of the information discussed in the aforementioned paragraphs may be viewed by contract personnel in the Office of Health Information Management. All contract personnel with access to any of the previously mentioned records (electronic or paper) will be required to complete VHA Privacy Policy Training before accessing such record systems. This training must also be completed annually. The COR will be responsible for ensuring and documenting that this requirement is satisfied.

g. Any changes in the laws, regulations, or VA/VHA policies or procedures governing the information covered by this section of the contract, during the term of this contract, shall be deemed to be incorporated into this contract.

h. VA has unrestricted access to the records generated by the contractor pursuant to this contract.

5.0. DIRECT PATIENT CARE:

5.1. Contractor shall be responsible for the following tasks:

5.1.1. Task 1: Provide direct patient care in all aspects of HIV case management. Provide strong support for nursing and ancillary staff as they care for the patient.

6.0 ADMINISTRATIVE

6.1 Contractor Shall be Responsible For:

6.1.1 Task 1: Provide direct patient care in all aspects of HIV case management. Provide strong support for nursing and ancillary staff as they care for the patient.

7.0 GOVERNMENT RESPONSIBILITIES:

7.1 Oversight of Service/Performance Monitoring:

a. Oversight and performance monitoring will be accomplished by following the attached QASP. Services rendered will be verified by a record keeping system, maintained by the Chief of Staff or designee, which assures the VA pays for only those services actually requested.

b. The services specified in this contract may be changed by written modification to this contract. The modification will be prepared and approved by the VA contracting officer prior to becoming effective.

c. ORDER OF PRECEDENCE: The terms, conditions, and attachments referenced herein, including any formal written modifications thereto, constitute the complete agreement between the parties and take precedence over any other language, oral or written.

d. Contracting Officer: The Contracting Officer (CO) is responsible for the overall administration of this contract. Contractor is advised that only the Contracting Officer, acting within the scope of his/her duties and responsibilities, has the authority to make changes to the contract, which affect contract prices, terms and conditions of this contract:

e. Governing Law: This contract shall be governed, construed and enforced in accordance with Federal Law.

8.0 Performance Standards, Quality Assurance, and Quality Improvement:

The Government may evaluate the quality of professional and administrative services provided, but retains no control over the medical, professional aspects of services rendered (e.g., professional judgments, diagnosis for specific medical treatment).

8.1 Methods of Surveillance:

In accordance with the QASP.

· DIRECT OBSERVATION. 100% survey: Patients who are treated at the VA Portland HCS outpatient clinics will be observed by VAPORHCS staff.

· VALIDATED USER/CUSTOMER COMPLAINTS: Patient complaints or concerns while receiving treatment from the contractor’s staff will be documented in writing. Examples of these complaints include but are not limited to Vista Reports and EPRP Reports. These documents will then be provided to the Chief Medical Director of the contractor for review.

· Verification and/or documentation provided by Contractor. Contractor’s staff will provide an invoice of HIV case management services, and the clinical documentation for each patient to be scanned into the patient’s medical record.

8.2 Performance Standards:

Contract personnel shall be subject to the following standards and acceptable quality levels.

8.2.1 Standard 1: Provide required medical service as specified in the requirements.

Standard 1 - AQL: 1 100%

8.2.2 Standard 2: Patient safety incidents must be reported using Patient Safety Report.

Standard 2- AQL: 100%

8.2.3 Standard 3: Updated licensing, registration and certification shall be provided as they are renewed.

Standard 3 - AQL: 100%

8.2.4 Standard 4: Contractor completes all mandatory required training per VAPORHCS policy.

Standard 4 – 100%

8.2.5 Standard 5: Contractor is aware of all laws, regulation, policies and procedures relating to Privacy, Confidentiality and HIPPA and complies with all standards.

Standard 5 – 100%

8.2.6 Standard 6: Within 30 days of the end of each month services were provided as described above, the Contractor shall provide itemized invoicing.

Standard 6 – 80%

8.2.7 Standard 7: Contractor will enter notes for each patient visit within 7 days either in CPRS or by sending the note to VAPORHCS.

Standard 7 – 100%

8.2.8 Standard 8: Patient complaints about the quality of care are reported to the VISN Patient Advocate, the COR, and the Contractor Patient for resolution.

Standard 8 – 100%

8.3 See QASP Section D

9.0. Special Contract Requirements:

9.1 Contract employees shall wear agency identification badge as well as VA badge at all times while on the premises of the VA Portland Health Care System.

9.2 Contractor Security Requirements: Contractors, contractor personnel, subcontractors, and subcontractor personnel shall be subject to the same Federal laws, regulations, standards, and VA Directives and Handbooks as VA and VA personnel regarding information and information system security.

9.3 Contractor Security Investigation Requirements: Background Investigations (BI) that are required to give contractor personnel routine access to a facility and to authorize access to VA/Federally owned information systems. This is required of all contractor personnel performing services for the facility, including CBOC’s (Community Based Outpatient Care). This must be completed prior to the start date.

a. This is a federal law and is established under HSPD-12, FIPS Pub-201-1, EO 10450, and VA Directive 0710. This process is specific and required beyond any additional agency credentialing and vetting processes.

b. Prior to commencing work, each contract employee, including any subcontract employees, must complete the following within five (5) business days of receiving this letter:

1. From the VHA Service Center (VSC) Human…