36C26026Q0422.pdf

Sources Sought Notice

Sources Sought Notice 36C26026Q0422

SUBJECT* Lincoln County, OR Community Based Outpatient Clinic Estimated POP: 12/01/2026 - 11/30/2036

GENERAL INFORMATION

CONTRACTING OFFICE’S ZIP CODE* 98661

SOLICITATION NUMBER* 36C26026Q0422

RESPONSE DATE/TIME/ZONE 03-17-2026 12:00 PACIFIC TIME, LOS ANGELES, USA

ARCHIVE 30 DAYS AFTER THE RESPONSE DATE

RECOVERY ACT FUNDS N

SET-ASIDE N

PRODUCT SERVICE CODE* Q201

NAICS CODE* 621498

CONTRACTING OFFICE ADDRESS NCO 20 Network Contracting Office

ATTN: V4CONT

1601 E. Fourth Plain Blvd Bldg.17, Suite B428 Vancouver WA 98661

POINT OF CONTACT* Senior Contract Specialist Scott Reed scott.reed2@va.gov

NO PHONE CALLS ACCEPTED

PLACE OF PERFORMANCE

ADDRESS See attached document: Sources Sought Notice

POSTAL CODE

COUNTRY

ADDITIONAL INFORMATION

AGENCY’S URL

URL DESCRIPTION

AGENCY CONTACT’S EMAIL ADDRESS

EMAIL DESCRIPTION

Sources Sought Notice

Sources Sought Notice 36C26026Q0422

DISCLAIMER

This RFI is issued solely for information and planning purposes only and does not constitute a solicitation. All information received in response to this RFI that is marked as proprietary will be handled accordingly. In accordance with FAR 15.201(e), responses to this notice are not offers and cannot be accepted by the Government to form a binding contract. Responders are solely responsible for all expenses associated with responding to this RFI.

DESCRIPTION

The U.S. Department of Veterans Affairs, Network Contracting Office 20, in support of the VISN 20 Northwest Network, is currently requesting information to determine the existence of vendors capable of providing Community Based Outpatient Clinic (CBOC) services to the VA Portland Health Care System (VAPORHCS).

It is anticipated that a single Indefinite-Delivery Indefinite-Quantity (IDIQ) contract will result from the solicitation.

The intended period of performance is 10 years.

Description of Services

VAPORHCS requires clinic space, equipment, supplies and staff as detailed in the Performance Work Statement (PWS) for Primary Care services for up to 1600 patients in the Lincoln County, OR area. The requirement is a physical location within Lincoln County, OR. Mental Health services will be provided physically on site at the Salem CBOC, or virtually from the coastal clinics if Veterans have no other means of communication.

Contractor performing services under a resultant contract shall provide a continuum of care from prevention to diagnosis and treatment, and to appropriate referral and follow-up. Contractor’s outpatient site of care shall have the necessary professional medical staff, diagnostic testing and treatment capability, and referral arrangements needed to ensure continuity of health care. The contractor shall provide services solely dedicated to Veterans regardless of gender or age. Those patients needing specialty care shall be referred to VA.

Alternatively, the contractor may provide clinic space, equipment, supplies and staff, except physicians, which may be provided by VAPORHCS.

The NAICS code assigned is: 621498, All Other Outpatient Care Centers the small business size standard for this NAICS code is $25.5 million.

The Government is not currently soliciting offers. This is a Sources Sought Notice to gain knowledge of potential qualified sources. A solicitation is not currently available.

Responses to this request will be considered for the purpose of determining how the requirements will be stated and how the procurement will be conducted. This Sources Sought Notice is not to be construed as a commitment by the Government, implied or otherwise, to issue a solicitation or to award a contract. No reimbursement will be made for any costs associated with providing information in response to this notice or any follow-up information requests.

If your business is interested and capable of providing the required services, please complete the Sources Sought Questionnaire following the PWS and email your response to scott.reed2@va.gov no later than 12:00 PM PT on March 16, 2026. Please include a Capabilities Statement. Phone calls will not be accepted. Include any comments or questions you may have.

PERFORMANCE WORK STATEMENT (PWS)

1. GENERAL:

1.1 Services Required: The VA Portland Health Care System; requires the following services to be provided in a private hospital, office or clinic environment to Veterans, primarily residing in Lincoln County, Oregon area.

1.2 Site Classification: This site is classified as a [X ] Primary Care CBOC. VA Portland Health Care System (VAPORHCS) requires clinic space, equipment, supplies, and staff as detailed in this solicitation Primary Care services to up to 1600 patients in the Lincoln County area. The requirement to be met is a physical location within Lincoln County, Oregon. Mental Health services will be provided physically onsite at the Salem CBOC, or virtually from the coastal clinics if Veterans have no other means of communication.

1.3 Place of Performance: Services shall be performed by contractor at a facility in Lincoln County on behalf of the VA Portland Health Care System 3710 SW US Veterans Hospital Rd. Portland, OR 97239

1.4 Authority: Title 38 United States Code (USC) 8153 and FAR 12 in combination with 15 and/or VAAR 873.

1.5 Policy and Regulations: The contractor is required to meet VHA performance and quality criteria, policy and standards including, but not limited to, access, quality of care, Veteran satisfaction, coordination of care, 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/vapubs/ or at http://www.va.gov/vhapublications/. Some VA policy documents include Standard Operating Procedures (SOPs) located on internal VA websites that are not available to the public. SOPs relevant to this requirement are provided as attachments under Section D. 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/docs/List-of-contracted-clinic-policy-documents.xlsx#. A link to the VA Qualifications Standards is also included in this document.

1.6 Acronyms/Definitions:

ABMS: American Board of Medical Specialties ACGME: Accreditation Council for Graduate Medical Education ACIP: Advisory Committee on Immunization Practices ACLS: Advanced Cardiac Life Support ACO: Administrative Contracting Officer ACPE: American Council on Pharmaceutical Education ADE: Adverse Drug Events AED: Automatic External Defibrillator AIS: Automated Information Security ANA: American Nurses Association AOA: American Osteopathic Association APRN: Advanced Practice Registered Nurse ARRT: American Registry of Radiologic Technology ASC: Ambulatory Surgery Center 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.

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.

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

BLS: Basic Life Support

BOS: Bureau of Osteopathic Specialists CAHEA: Committee on Allied Health Education and Accreditation CAP: College of American Pathologists CARF: Commission on Accreditation of Rehabilitation Facilities CBO: VA Central Billing Office.

CCNE: Commission on Collegiate Nursing Education CDC: Centers for Disease Control and Prevention CEU: Certified Education Unit CLIA: Clinical Laboratory Improvement Amendments CME: Continuing Medical Education CMS: Center for Medicare and Medicaid Services CNP: Certified Nurse Practitioner CNS: Clinical Nurse Specialist CO: Contracting Officer COPD: Chronic Obstructive Pulmonary Disease COR: Contracting Officer’s Representative COS: Chief of Staff CPA: Collaborative Practice Agreement CPARS: Contractor Performance Assessment Reporting System CPP: Clinical Pharmacist Practitioner CPT: Current Procedural Terminology CSWE: The Council on Social Work Education the CSWE website is http://www.cswe.org.

CVT: Clinical Video Telehealth DICOM: Digital Image and Communication in Medicine DIGMA: Drop-in Group Medical Appointment DRG: Diagnostic Related Group DSS: Decision Support System ECC: Extended Care Center 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.

EPRP: External Peer Review Program FDA: Food and Drug Administration FSMB: Federation of State Medical Boards FTE: Full Time Equivalent 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.

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

HPE: Health Professions Education HPT: Health Professions Trainee HT: Home Telehealth ICAVL: Intersocietal Commission for the Accreditation of Vascular Laboratories ICD: International Classification of Diseases iMED: software used by VA for informed consent.

INR: International Normalized Ratio LIP: Licensed Independent Practitioner MCCR: Medical Care Cost Recovery Mental Health Services: per VHA Directive 1160.01 is meant to include services for the evaluation, diagnosis, treatment, rehabilitation, suicide prevention and crisis intervention, and coordination of care for 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, including SUD

(b) Treatment services using evidence-based pharmacotherapy, somatic treatments, or primary evidence-based Psychotherapy (EBP) for patients with mental health conditions and substance use disorders

(c) Patient education

(d) Family education, family consultation, family psychoeducation and couples/marriage and family counseling 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)

(g) Suicide Prevention

(h) Referrals and coordination of care between other levels of care and community treatment programs.

Specialty mental health services include:

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

(b) Evidence-based psychotherapy

(c) Intensive Community Mental Health Integration (ICMHR)

(d) Psychosocial Rehabilitation Services, including: PRRCs, family psycho-education, family education, skills training, peer support, and Compensated Work Therapy (CWT), supported employment and vocational assistance.

(e) PTSD teams or specialists

(f) MST special clinics

(g) Homeless programs; and

(h) Specialty substance abuse treatment services.

MQSA: Mammography Quality Standards Act MSN: Master of Science in Nursing NLN: National League for Nursing NLNAC: National League for Nursing Accreditation Commission NP: Nurse Practitioner NSQIP/CICSP: National Surgical Quality Improvement Program/Continuous Improvement in Cardiac Surgical Program OTC: Over the Counter PA: Physician Assistant PACS: Picture Archiving and Communications System 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.

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

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.

Parent Facility: VAMC responsible for performance monitoring and payment for contracted outpatient site of care services.

PBM: Pharmacy Benefits Management PCMH: Patient-Centered Medical Home PCMHI: Primary Care-Mental Health Integration PCMM: Patient Centered Management Module - is an enterprise application that enables users to (1) set up and define health care teams, (2) assign staff and their associated full-time equivalent (FTE) staff to positions within each team, (3) assign patients to the team, and (4) assign patients to specific team members.

PCP: Primary Care Provider Phar.D.: Doctor of Pharmacy

PMPM: Per Member Per Month-reimbursement methodology for services provided under the PC and MH LINs based on all-inclusive monthly rate per Veteran that meets qualifying encounter criteria in the previous twelve months of the contract period. This methodology also accounts for costs of unassigned/unenrolled visits based on estimates provided to contractors and it supports the PACT model in increasing coordination, quality, and continuity of care of Veterans receiving services at the Outpatient Site of Care.

POC: Point of Care Testing 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.

PWS: Performance Work Statement QAPI: Quality Assessment and Performance Improvement QASP: Quality Assurance Surveillance Plan REACH VET: Recovery Engagement and Coordination for Health Veterans Enhanced Treatment- REACH VET summarizes information from the Veterans Health Record and uses predictive modeling to identify Veterans at statistical risk for suicide and other negative outcomes. This tool supplements clinical strategies used to identify at-risk Veterans and may help providers intervene prior to these negative outcomes occurring.

RME: Reusable Medical Equipment SFT: Store and Forward Telehealth SMA: Shared Medical Appointments SOP (Clinical): Scope of Practice SPD: Sterile Processing Division SPE: Senior Procurement Executive 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.

STORM: Stratification Tool for Opioid Risk Monitoring 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.

TCT: Telehealth Clinical Technician TIU: Text Integration Utility TJC: The Joint Commission TMS: Talent Management System VA: Veterans Affairs VA ECHO: VA Extension for Community Health Outcomes VA EHR: VA electronic health record VAMC: Veterans Affairs Medical Center VAST: VHA Site Tracking database VetPro: a federal web-based credentialing program for healthcare providers.

VHA: Veterans Health Administration VSSC: VHA Support Service Center VVC: VA Video Connect 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), discipline specific team members. The VA will be providing (Clinical Pharmacist Practitioners (CPPs), Licensed Social Workers, Registered Dietitian/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, panel numbers may increase or decrease depending on the need of Primary Care Services within Lincoln County. 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 contractor shall provide personnel in numbers and qualifications capable of fulfilling the standards outlined in the resultant contract. The contractor shall 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. The total estimated patients assigned to site is: 1,345 for Lincoln County.

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. Contractor’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 qualification standards for Physician located in the VA Qualification Standards. See the Policy and Regulations section of this PWS for VA Qualification Standards access information. Position Responsibilities: Serves as medical director to oversee and be responsible for the provision of covered services to assigned 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.

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 mid-level provider. Contractor shall propose quantity of FTE to meet standard FTE ratio to panel size. Actual panel sizes can be determined by the VA in accordance with VHA Directive 1406 Patient Centered Management Module (PCMM) for Primary Care. Contractor to propose mix of PCP from the options below.

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 or board eligible 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 qualification standards for Physician located in the VA Qualification Standards. See the Policy and Regulations section of this PWS for VA Qualification Standards access information. Position Responsibilities: Responsible for the provision of covered services to assigned 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. Responsible for meeting all clinical performance metrics.

Option 2: Advanced Practice Registered Nurse (APRN): Qualifications: APRN’s (including subcontractors) shall possess a master’s degree from a program accredited by the National League for Nursing Accreditation Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE) and maintain full and current certification as a Certified Nurse Practitioner (CNP) from the American Nurses Association or another nationally recognized certifying body in either Adult Health or Family Practice. Authorization for prescriptive authority is required. CNPs shall prescribe controlled substances in accordance with limitations imposed by the Controlled Substances Act and the CNP’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 CNP is required (three (3) years preferred). Experience in outpatient care in a Family Medicine or Internal Medicine environment is preferred. CNP 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 qualification standards for Advanced Practice Nurse located in the VA Qualification Standards. See the Policy and Regulations section of this PWS for VA Qualification Standards access information. Position Responsibilities: Responsible for the provision of covered services to assigned 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.

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 qualification standards for Nurse located in the VA Qualification Standards. See the Policy and Regulations section of this PWS for VA Qualification Standards access information. Position Responsibilities: Responsible for the provision of covered services to assigned 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.

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 qualification standards for Licensed Practical or Vocation nurse located in the VA Qualification Standards. See the Policy and Regulations section of this PWS for VA Qualification Standards access information. Position Responsibilities: Responsible for the provision of covered services to assigned 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.

Option 2: Unlicensed Assistive Personnel (Health Technician, Nursing Assistant). This staffing is part of the PACT Teamlet, not the primary telehealth clinical technician (TCT): Qualifications: Nursing Assistant qualifications per VA qualification standards for Nursing Assistant located in the VA Qualification Standards.

See the Policy and Regulations section of this PWS for VA Qualification Standards access information. Health Technician qualifications per Health Aid and Technician Series 0640 located at: Health Aid and Technician Series 0640 (opm.gov). Position Responsibilities: Responsible for the provision of covered services to assigned 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.

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 provide clerical support and administrative functions to support site operations. Completion of scheduling training per VA policies and guidance. See VA qualification standards for Medical Support Assistant located in the VA Qualification Standards for additional qualifications. See the Policy and Regulations section of this PWS for VA Qualification Standards access information. Position Responsibilities: Responsible for the provision of covered services to assigned and unassigned patients presenting for care. Provide clerical support and administrative functions to PACT staff and collaborate with PACT staff to incorporate the logistical elements of care coordination into comprehensive care management plans. Provide guidance and direction to patients and personal support persons for navigating the VA health care system and administrative functions in VA. Provide scheduling services in accordance with VA policies and guidance.

2.3 Discipline Specific PACT Team Member (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.

The contractor shall place consults for the following disciplines referring the Veterans to the VA for Clinical Pharmacist Practitioner (CPP) Anti-Coagulation, registered Dietitian/Nutritionist, Primary Care Mental Health Integration (PCMHI), and Social Work Services if the services are required.

2.5 General and Specialty Mental Health Staffing Requirements and Options: VA will provide by referral or by telehealth as needed. If telehealth or VVC is needed, Veterans can report to Lincoln County CBOC to be seen one of the telehealth rooms by the VA virtually.

2.6 Telehealth Services Clinical Staff: Contractor will not be required to provide Teleheath staff. However, contract staff may be expected to perform some Teleheath support. All contractor staff who support and manage telehealth services must be working within permitted licensure and scope of practice. The only contracted roles at clinic are RN, LPN, and MSA.

License and Accreditation: All contract licensed providers assigned by the Contractor to perform the services covered by this contract shall have a current license to practice in the state where the outpatient clinic is located. If the state where the outpatient clinic is located recognizes multistate licensure through a compact and a contract licensed provider’s home state is a party to such compact, and no other restrictions apply, then the provider’s compact licensure status in the state where the outpatient clinic is located may be acceptable as long as the provider complies with all licensure requirements of the multistate compact for the entirety of the provider’s performance of services under the contract.

All licenses held by the personnel working on this contract shall be full and unrestricted licenses. Contract providers who have current, full, and unrestricted licenses in one or more states, but who have, or ever had, a license restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending action, or denied upon application will not be considered for the purposes of this contract.

Contractor staff shall be technically proficient in the skills necessary to fulfill the government’s requirements, including the ability to speak, understand, read, and write English fluently.

The contractor shall ensure that all individuals who provide services and/or supervise services at the contractor’s outpatient site of care, including individuals furnishing services under contract are qualified to provide or supervise such services.

Position specific competencies shall be completed for all staff annually.

Contractor staff qualifications, licenses, certifications shall be maintained throughout the contract period of performance. If contractor’s staff is not directly employed by the treating facility, documentation shall be provided to the COR to ensure adequate certification. All actions required for maintaining certification shall be kept up to date always. Documentation verifying current licenses and certifications shall be provided by the contractor on an annual basis.

The contractor is responsible for assuring that all persons, whether they be staff, agents, subcontractors, providers, or anyone acting for or on behalf of the contractor, are properly licensed always under the applicable state law and/or regulations of the provider’s license, and shall be subject to credentialing and privileging requirements by VA.

The contractor shall not permit any staff to begin work at an outpatient site of care prior to confirmation from the VA that the individual’s background investigation has been reviewed and released to the Office of Personnel Management (OPM), by the Security and Investigations Center (SIC), and that credentialing and privileging requirements have been met. A copy of licenses shall be provided with offer and will be updated annually. Any changes related to the providers' licensing or credentials will be reported immediately to the VA Credentialing Office. In accordance with FAR 52.212-4 Contract Terms and Conditions – Commercial Products and Commercial Services failure to comply with these terms and conditions may result in all rights and remedies provided by law.

The contractor shall notify COR, CO, and the VA Chief of Staff when any provider furnishing services under this contract is reported to the National Practitioner Data Bank. This notification shall include the name, title, and specialty of the provider.

The contracted facility shall meet all or exceed VA health care accreditation requirements in VHA Directive

1100.16. Documentation verifying accreditation requirements shall be provided by the contractor on an annual basis.

2.9 Credentialing and Privileging: Credentialing and privileging of all health care providers who are permitted by law and the facility to practice independently will be done in accordance with the provisions of VHA Directive 1100.21, Privileging. Credentialing for all health care professionals who claim licensure, certification, or registration, as applicable to the position and who are not currently credentialed in accordance with VHA Directive 1100.21, Privileging, shall be credentialed in accordance with VHA Directive 1100.20, Credentialing of Health Care Providers. VHA Credentialing and Privileging Office Standard Operating Procedures (SOPs) define processes from VHA Directives 1100.20 and 1100.21, to include: VHA policy concerning VetPro; the Temporary Appointment Process; credentialing during activation of the Facility Disaster Plan; requirements for querying the FSMB; credentialing and privileging requirements for telemedicine and remote health care; clarifications for the Summary Suspension of Privileges process in order to ensure both patient safety and practitioner rights; and the credentialing requirements for other required providers.

Contractor shall ensure that all health care professionals who are permitted by law and the facility to practice independently participate in the credentialing and privileging process through VHA’s electronic credentialing system, “VetPro”. No services are to be provided by any contract provider requiring credentialing and privileging until the parent VA facility Medical Executive Board and Medical Center Director (or designee) have granted approval. The contractor shall be provided copies of current requirements and updates as they are published.

Credentials and privileges shall require renewal annually in accordance with VA policies. Credentialed providers assigned by the contractor to work at the site shall be required to report specific patient outcome information, such as complications, to the VA. Quality improvement data provided by the contractor and/or collected by the VA will be used to analyze individual practice patterns. The Service Chief, Primary Care Service Line will utilize the data to formulate recommendations to the Medical Executive Board when clinical privileges are being considered for renewal.

Contractor shall ensure that all health care professionals who claim licensure, certification, or registration, as applicable to the position and who are not currently credentialed in accordance with VHA Directive 1100.21 participate in the credentialing process through VA’s “VetPro,” in accordance with VHA Directive 1100.20 and 1100.21. No services are to be provided by any contract provider requiring credentialing until the VA parent facility has granted approval. The contractor shall be provided copies of current requirements and updates as they are published. Since contracted nurse practitioners, clinical pharmacist practitioners, and physician assistants are not recognized by the VA as independent practitioners, they function under a VA Scope of Practice (not Clinical Privileges). The VA Scope of Practice shall adhere to applicable practice acts within that state. The credentials and scope of practice for nurse practitioners, clinical pharmacist practitioners, and physician assistants are reviewed at the time of the initial appointment and at least every three years thereafter by an appropriate VA discipline-specific Professional Standards Board.

2.10 Continuing Medical Education (CME)/Certified Education Unit (CEU): Contractor staff registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. CME hours shall be reported to the credentialing office for tracking. These documents are required for both privileging and re privileging. Failure to provide will result in loss of privileges.

2.11 Training (VA Mandatory/ACLS/BLS): Contractor staff shall complete VA mandatory training as requested and complete ACLS/BLS training and keep ACLS/BLS certifications current throughout the life of the contract. Certification refers to the successful completion of an American Heart Association (AHA) or Military Training Network (MTN) approved BLS or ACLS course. The AHA and MTN are the only programs acceptable by VA for obtaining required certification. Copies of current certifications shall be provided to the COR. ACLS certification is required for health care personnel that order, administer, monitor, or supervise moderate sedation, monitored anesthesia care, or general anesthesia, according to current VHA policy. The contractor shall coordinate, and cover contract staff travel expenses in accordance with General Services Administration (GSA) rates.

2.12 Access to Patient Information: In performance of official duties, contractor’s provider(s) have regular access to printed and electronic files containing sensitive data, which shall be protected under the provisions of the Privacy Act of 1974 (5 U.S.C. 552a), Health Insurance Portability and Accountability Act (HIPAA) of 1996 (45 CFR Part 160 and 164) and other applicable laws, federal regulations, Veterans Affairs statutes, and policies. Contractor’s provider(s) are responsible for (1) protecting that data from unauthorized use, release/disclosure or from loss, alteration, or unauthorized deletion and (2) following all applicable regulations and instructions regarding access to computerized files, release of access codes, etc., as set out in VA Rules of Behavior which contract provider(s) signs.

Contractor staff shall complete required VA Information Security and Privacy training, review and sign the VA Rules of Behavior prior to having access to the VA computer system. Contractor staff who have access to PHI and PII shall also complete VHA Privacy and HIPAA Focused training prior to having access to PHI and PHI. Both VA Information Security and Privacy training and VHA Privacy and HIPAA Focused training will be completed annually. Upon completion of the training(s), contractor shall email or fax training certificates to the CO at

In addition, if providing clinical services, contractor staff will attend VA EHR training prior to providing any patient care services. Contractor staff shall document patient care in the VA EHR to comply with all VA policies.

All contractor staff requiring access to PHI / Encrypted information shall obtain a PIV card to ensure secure communications to and from the VA (e.g., Clinical staff, contract billing staff requiring patient lists with PHI/PII and Contract management personnel requiring PHI/PII information).

2.13 Rules of Behavior for Automated Information Systems: Contractor staff having access to VA Information Systems are required to read and sign a Rules of Behavior statement which outlines rules of behavior related to VA Automated Information Systems. The COR will provide, through the facility information security officer, the Rules of Behavior to the contractor for the respective facility. A copy of the Rules of Behavior may also be found in the attachments section.

2.14 Standard Infection Control Measures (PPD, immunizations, etc.): Contractor shall adhere to current CDC Guidelines for Infection Prevention and Control in Health Care Settings (located at: Guidelines and Guidance Library | Infection Control | CDC). Contractor shall provide statement that all required infection control testing and immunizations for their personnel are current, and that the contractor is compliant with OSHA regulations concerning occupational exposure to blood borne pathogens and Tuberculosis . All clinic staff are required to receive annual influenza vaccination or obtain an exemption for medical or religious reasons. Staff who are granted an exemption are required to wear a face mask throughout the influenza season. (See VHA Directive

1192.01 Seasonal Influenza Vaccination Program for VHA Health Care Personnel for more information). The contractor shall also notify the VA of any significant communicable disease exposures and the VA will also notify the contractor of the same, as appropriate. Contractor shall adhere to CDC Hand Hygiene Guidelines for Healthcare settings (located at: About Hand Hygiene for Patients in Healthcare Settings | Clean Hands | CDC ); and provide antimicrobial hand soap and alcohol rub that is at least 60% ethyl alcohol (ethanol) or 70% isopropanol for Hand hygiene.

2.15 National Provider Identification (NPI): All contractors who provide billable healthcare services to VA or VHA, shall obtain a NPI as required by the Health Insurance Portability and Accountability Act (HIPAA) National Provider Identifier Final Rule, administered by the CMS. This rule establishes assignment of a 10-digit numeric identifier for contractor staff, intended to replace the many identifiers currently assigned by various health plans. Contractor staff needs only one NPI, valid for all employers and health plans. Contractor staff shall also designate their specialties/subspecialties by means of taxonomy codes on the NPI application.

The NPI may be obtained via a secure website at: https://nppes.cms.hhs.gov/NPPES

2.16 Prescription Drug Monitoring Program: Contractor’s providers shall register with the state prescription drug monitoring program in accordance with VHA Directive 1306, Querying State Prescription Drug Monitoring Programs (PDMP).

2.17 Conflict of Interest: The contractor and all contractor’s personnel are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of proposal and during the entirety of contract performance. At the time of proposal, the contractor shall provide a statement which describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided. The contractor shall also provide statements containing the same information for any identified consultants or subcontractors who shall provide services. The contractor shall also provide relevant facts that show how its organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest.