36C26118Q0002-003.docx

36C26118Q0002

PAGE 1 OF

1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

DUNS:

DUNS+4:

PHONE:

FAX:

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

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA

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

ARE

ARE NOT ATTACHED.

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

ARE

ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) 30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

(REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

654-18-3-070-0005 36C26118Q0002 11-2 -2017 Nandini Johnson 916-923-4575 12-29-2017 12:00

612MCP

Department of Veterans Affairs VA Sierra Pacific Network (VISN 21) VA Northern California HealthCare System 5342 Dudley Blvd. Bldg 98 (NCO 21) McClellan CA 95652-1012 X 621492 $38.5 Million N/A X Reference Schedule.

612MCP

Department of Veterans Affairs Department of Veterans Affairs VA Northern California HealthCare System 5342 Dudley Blvd. Bldg 98 (NCO 21) McClellan CA 95652-1012

Department of Veterans Affairs FMS VA-9(101) Financial Services Center PO Box 149971 Austin TX 78714-9971 See CONTINUATION Page Contractor shall provide Inpatient Hemodialysis and Outpatie nt Peritoneal Dialysis Services for the VA Sierra Nevada Health Care System in accordance with the Performance Work Statemen contained herein.

Refer e nce Price/Cost Schedule Please carefully read FAR 52.212-1 Instructions to Offerors and VAAR 852.273-73 Evaluation – Health-Care Resources in order to respond to this RFQ. Failure to do so may eliminate your response from being considered for award.

See CONTINUATION Page 654-3680160-070-820100-2560 010020160 X X Nandini C. Johnson Contracting Officer Table of Contents

B.1 CONTRACT ADMINSTRATION……………………………………………………………4

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

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

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

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C261 Department of Veterans Affairs VA Sierra Pacific Network (VISN 21) VA Northern California HealthCare System 5342 Dudley Blvd, Bldg 209 McClellan CA 95652-2609

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

3. INVOICES: Invoices shall be submitted in arrears:

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests. Invoices shall be in accordance with the requirements of The Department of Veterans Affairs (VA) Financial Services Center (VAFSC). The latest information shall be used for invoicing and payments and may be changed during the Period of Performance of this acquisition. Current invoicing information is located at https://www.fsc.va.gov/einvoice.asp Vendor e-Invoice Set-Up Information:

Please contact Tungsten at the phone number or email address listed below to begin submitting your electronic invoices to the VA Financial Services Center for payment processing, free of charge. If you have question about the e-invoicing program or Tungsten, please contact the FSC at the phone number or email address listed below:

· Tungsten e-Invoice Setup Information: 1-877-489-6135

· Tungsten e-Invoice email: VA.Registration@Tungsten-Network.com

· FSC e-Invoice Contact Information: 1-877-353-9791

· FSC e-invoice email: vafsccshd@va.gov

B.2 SUBCONTRACTING COMMITMENTS--MONITORING AND COMPLIANCE (JUN 2011)

This solicitation includes VAAR 852.215-70, Service-Disabled Veteran-Owned and Veteran-Owned Small Business Evaluation Factors, and VAAR 852.215-71, Evaluation Factor Commitments. Accordingly, any contract resulting from this solicitation will include these clauses. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) to assist in assessing contractor compliance with the subcontracting commitments incorporated into the contract. To that end, the support contractor(s) may require access to the contractor's business records or other proprietary data to review such business records regarding contract compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor compliance with the subcontracting commitments.

SECTION B.3

SUPPLIES OR SERVICES AND PRICES/COSTS

Contractor shall provide Inpatient Hemodialysis and Outpatient Peritoneal Dialysis Services for beneficiaries of the Department of Veterans Affairs, VA Sierra Nevada Health Care System in accordance with the Performance Work Statement contained herein.

Note: Indefinite Delivery, Indefinite Quantity Contract is being used because it is impossible to determine with any certainty the exact amount of services that will be required under this contract.

It is anticipated that a Firm fixed price, Single Award, Indefinite Delivery/Indefinite Quantity contract, shall be awarded as a result of this solicitation.

The guaranteed minimum, for the contract is $1,000. The maximum shall not exceed $4,500,000.

The Government is not required to place an order in excess of the guaranteed minimum.

PERIOD OF PERFORMANCE:

BASE PERIOD: MAY 01, 2018 THROUGH APRIL 30, 2019

TOTAL FOR BASE PERIOD

OPTION PERIOD ONE: MAY 01, 2019 THROUGH APRIL 30, 2020

TOTAL FOR OPTION PERIOD ONE

OPTION PERIOD TWO: MAY 01, 2020 THROUGH APRIL 30, 2021

TOTAL FOR OPTION PERIOD TWO

OPTION PERIOD THREE: MAY 01, 2021 THROUGH APRIL 30, 2022

TOTAL FOR OPTION PERIOD THREE

OPTION PERIOD FOUR: MAY 01, 2022 THROUGH APRIL 30, 2023

TOTAL FOR OPTION PERIOD FOUR

36C26118Q0002

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B.5 PERFORMANCWE WORK STATEMENT

INPATIENT HEMODIALYSIS AND OUTPATIENT AND

PERITONEAL DIALYSIS SERVICES

I. DESCRIPTION OF DIALYSIS SERVICES

1. Scope of Work.

The Contractor shall provide all personnel, supervision, equipment and transportation of Contractor personnel and equipment to perform inpatient hemodialysis and peritoneal dialysis treatments to VA patients at the VA Sierra Nevada Health Care System (VASNHCS). Services will be provided on a 24-hours per day, seven days per week basis, including holidays. VASNHCS will provide physician oversight services and retain ultimate authority over and responsibility for each patient’s care and treatment.

2. Specific Contractor tasks include:

2.1 Perform all dialysis treatments with Registered Nurses (RN) and/or Patient Care Technicians (PCT) under the direct visual supervision of a RN or in a treatment room immediately adjacent to an RN. Each RN performing services shall be responsible for the composition of the dialysate, administering IV solutions, blood and blood products and medications (as ordered by the VA attending physician) placed into the dialyzer blood line system necessary for treatments. With documented competency and proficiency, PCTs may set up and prime equipment as directed by the RN. Contractor personnel shall be responsible for the provision of the following ordered services:

· Set up and safety check of machine and water treatment system

· Initiating treatment, monitoring of treatment, and termination of treatment

· Documentation of treatment in patient medical records

· Clean up of dialysis equipment and proper storage of machine and supplies

· Connect and disconnect patient from PD machine

· Education of patient and family/care provider(s)

· Dressing changes and care of the catheter site

· Maintenance of the PD machine

2.8.2 Provide education and training for the VA staff, to include:

· Use of the PD machine, to include addressing alarms

· Care of the dialysis catheter

· Signs and symptoms of complications related to the dialysis machine/port malfunctioning

· Documentation needs (procedure note)

· Emergency contact information with specific name(s) and phone number(s) in the event a machine and/or catheter malfunction

3. Qualifications.

3.1 Personnel assigned by the Contractor to perform the services covered by this contract shall be licensed in a State, Territory, or Commonwealth of the United States or the District of Columbia. All licenses held by the personnel working on this contract shall be full and unrestricted licenses.

3.2 Must meet medical staff criteria for initial appointment and REAPPOINTMENT in accordance with VHA Handbook 1100.19, entitled Credentialing and Privileging (Attachment 2) to practice medicine at VASNHCS prior to beginning work. This handbook also describes the process for reappraisal and reprivleging, as well as reduction and revocation of privileges.

II. ADMINISTRATIVE REQUIREMENTS.

1. Credentialing.

1.1 Initial applications for clinical credentialing and applications for renewal of privileges must be submitted to the facility HRMS office who will start review upon notice of contract award. Prior to providing services at VA, all Contractor personnel must be verified by the COR as having been credentialed and privileged (this must be documented by the COR). Additionally, if requested, the Contractor shall make all proposed personnel available for interview prior to commencement of work and during the credentialing and privileging process

1.2 The qualifications of all personnel shall be subject to review by the VASNHCS Chief of Staff and approval by the VASNHCS Director.

1.5 Contractor personnel who were previously credentialed and privileged by VASNHCS may be exempt from this contract requirement provided that they can provide documentation to support current and active privileges

1.6 VASNHCS reserves the right to refuse or dismiss contract personnel whose personal or professional conduct jeopardizes patient care or the regular and ordinary operation of the facility. Reasons for refusal or dismissal include, but are not limited to, unsatisfactory performance prior to and/or during the term of the contract, failure to receive favorable adjudication during a VA background investigation, failure to satisfy the requirements of the contract, physical or verbal abuse to patients, staff, or visitors, intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, ethical misconduct, conduct resulting in formal complaints by patients or other staff members, and any other valid reason considered objectionable.

2. Training.

Complete annual mandatory training by using the mandatory packet, attending training in person, or by going-on-line to complete the training. Complete mandatory security training, sign computer security agreement, receive training on the mandatory private policy, and receive copy of the Privacy Directive, VA Directive 6504, Restrictions on Transmission, Transportation and Use of, and Access to VA Data Outside VA Facilities. Compliance and Business Integrity Training & Education—Contract (Revenue Cycle) Employees includes:

3. Contractor Personnel Security Requirements - Information Systems Access All Contractor employees, who require access to VA computer systems and will work more than six (6) months (180 days) under this contract, shall be the subject of a background investigation and must receive a favorable adjudication from the VA SIC. This requirement is applicable to all subcontractor personnel requiring the same access. If the investigation is not completed prior to the start date of the contract, the Contractor will be responsible for the actions of those individuals they provide to perform work for VA.

Contractor personnel who previously received a favorable adjudication as a result of a Government background investigation may be exempt from this contract requirement provided that they can provide documentation to support the previous adjudication. Proof of previous adjudication must be submitted by the Contractor to VA SIC through the VA Contracting Officer. Proof of previous adjudication is subject to verification by the VA SIC. Some positions maybe subject to periodic re-investigation.

For those Contractor employees who will work less than six (6) months (180 days) under this contract, a background investigation is not required; however, such employees will be required to initiate a SAC for Fingerprint Only prior to providing services under this contract.

3.3 Optional Form 306, Declaration for Federal Employment

3.4 Electronic Fingerprint Verification OR FD 258, U.S. Department of Justice Fingerprint Applicant Chart

4. Access to and Safeguard of VA Information/Computer Systems

4.4 If contract personnel are authorized by VA to access VA information/computer systems remotely via non-VA issued computers, the Contractor will ensure that such computers are consistent with VA requirements, and will upgrade those computers (hardware and/or software) if instructed to do so by VA in order to ensure compatibility and security when VA information/computer systems are accessed by the end user. Individually identifiable health information will not reside on the contractor’s computer hard drives. After contract award, VA reserves the right to inspect the contractor’s facilities, installations, operations, documentation, records, databases, and computers to ensure these requirements are met.

4.5 The Contractor shall make its internal policies and practices regarding the safeguarding of medical and/or electronic information available to VA, and any other Federal agencies with enforcement authority over the maintenance and safeguard of such records, upon request.

4.6 The Contractor shall follow all of the previously mentioned statutes and respective regulations implementing these statutes as well as VA Directive 6504 - Restrictions on Transmission, Transportation and Use of, and Access to VA Data Outside a VA Facility, VA Directive 6601 – Removable Storage Media, 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 Information Security (see the Information Security Officer).

4.7 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.

5. CPRS

Contract personnel are required to enter all patient care information into CPRS in accordance with VASNHCS directive MOIC-003-08 – Patient Medical Record Data and Information Standards (see COR to obtain a copy of this document) and any other VHA/medical center polices procedures or memorandums that address this topic.

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.

6. Handling of Records

7. HIPAA Compliance Under HIPAA Privacy and Security Rules, the Contractor providing services under this contract is considered to be a “covered entity,” and thus is not required to enter into a Business Associate Agreement with VA. However, the Contractor must observe Public Law 104-191 and all respective regulations implementing this law while providing services under this contract.

III. QUALITY MANAGEMENT.

1. Quality Assurance

2. Contract Monitoring Procedures In order to adequately document services provided under this contract, a record keeping system of Contractor clinic work completion shall be established and implemented by the COR. The COR is responsible for verifying the completion of clinical assignments through medical records and/or other appropriate methods and certifying payment of monthly invoices for work performed. Documentation of work/clinical performance must be sufficient to ensure proper payment and allow audit verification that services were provided. Moreover, the COR shall monitor the response of contract personnel to all VA calls/pages and requests for callback.

3. Quality Assurance Surveillance Plan – incorporated herein by reference.

IV. Personnel.

1. Emergency Health Services:

The VA will render emergency health services for an incapacitating injury or otherwise serious illness occurring while on duty. All services, to include wages earned during the period of initial medical evaluation provided by the VA, shall be reimbursed by the contractor. The contractor shall furnish the VA with the necessary injury/illness form(s) for reporting purposes. The VA for statistical and/or billing purposes will retain a copy of the complete form(s).

2. Infection Control Requirements:

2.6. Varicella (chicken pox) testing -. Provide a history' of varicella or, if unknown, results of a varicella antibody test; and if non-immune, vaccination with varivax.

3. Identification, Parking, Smoking and VA Regulations:

4. Security Controls Compliance Testing On a periodic basis, VA, including the Office of Inspector General, reserves the right to evaluate any or all of the security controls and privacy practices implemented by the contractor under the clauses contained within the contract. With a 10 working-day notice, at the request of the government, the contractor must fully cooperate and assist in a government-sponsored security controls assessment at each location wherein VA information is processed or stored, or information systems are developed, operated, maintained, or used on behalf of VA, including those initiated by the Office of Inspector General. The government may conduct a security control assessment on shorter notice (to include unannounced assessments) as determined by VA in the event of a security incident or at any other time.

5. Training

5.1 All contractor employees and subcontractor employees requiring access to VA information and VA information systems shall complete the following before being granted access to VA information and its systems:

5.1.1 Sign and acknowledge (either manually or electronically) understanding of and responsibilities for compliance with the Contractor Rules of Behavior, Appendix E relating to access to VA information and information systems;

5.1.2 Successfully complete the VA Cyber Security Awareness and Rules of Behavior training and annually complete required security training;

5.1.3 Successfully complete the appropriate VA privacy training and annually complete required privacy training; and

5.1.4 Successfully complete any additional cyber security or privacy training, as required for VA personnel with equivalent information system access [to be defined by the VA program official and provided to the contracting officer for inclusion in the solicitation document – e.g., any role-based information security training required in accordance with NIST Special Publication 800-16, Information Technology Security Training Requirements.]

End of Statement

SECTION C - CONTRACT CLAUSES

C.1 FAR 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (JAN 2017)

(a) Inspection/Acceptance. The Contractor shall only tender for acceptance those items that conform to the requirements of this contract. The Government reserves the right to inspect or test any supplies or services that have been tendered for acceptance. The Government may require repair or replacement of nonconforming supplies or reperformance of nonconforming services at no increase in contract price. If repair/replacement or reperformance will not correct the defects or is not possible, the Government may seek an equitable price reduction or adequate consideration for acceptance of nonconforming supplies or services. The Government must exercise its post-acceptance rights—

(1) Within a reasonable time after the defect was discovered or should have been discovered; and

(2) Before any substantial change occurs in the condition of the item, unless the change is due to the defect in the item.

(b) Assignment. The Contractor or its assignee may assign its rights to receive payment due as a result of performance of this contract to a bank, trust company, or other financing institution, including any Federal lending agency in accordance with the Assignment of Claims Act (31 U.S.C. 3727). However, when a third party makes payment (e.g., use of the Governmentwide commercial purchase card), the Contractor may not assign its rights to receive payment under this contract.

(c) Changes. Changes in the terms and conditions of this contract may be made only by written agreement of the parties.

(d) Disputes. This contract is subject to 41 U.S.C. chapter 71, Contract Disputes. Failure of the parties to this contract to reach agreement on any request for equitable adjustment, claim, appeal or action arising under or relating to this contract shall be a dispute to be resolved in accordance with the clause at FAR 52.233-1, Disputes, which is incorporated herein by reference. The Contractor shall proceed diligently with performance of this contract, pending final resolution of any dispute arising under the contract.

(e) Definitions. The clause at FAR 52.202-1, Definitions, is incorporated herein by reference.

(f) Excusable delays. The Contractor shall be liable for default unless nonperformance is caused by an occurrence beyond the reasonable control of the Contractor and without its fault or negligence such as, acts of God or the public enemy, acts of the Government in either its sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions, strikes, unusually severe weather, and delays of common carriers. The Contractor shall notify the Contracting Officer in writing as soon as it is reasonably possible after the commencement of any excusable delay, setting forth the full particulars in connection therewith, shall remedy such occurrence with all reasonable dispatch, and shall promptly give written notice to the Contracting Officer of the cessation of such occurrence.

(g) Invoice.

(1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include—

(i) Name and address of the Contractor;

(ii) Invoice date and number;

(iii) Contract number, line item number and, if applicable, the order number;

(iv) Description, quantity, unit of measure, unit price and extended price of the items delivered;

(v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading;

(vi) Terms of any discount for prompt payment offered;

(vii) Name and address of official to whom payment is to be sent;

(viii) Name, title, and phone number of person to notify in event of defective invoice; and

(ix) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the invoice only if required elsewhere in this contract.

(x) Electronic funds transfer (EFT) banking information.

(A) The Contractor shall include EFT banking information on the invoice only if required elsewhere in this contract.

(B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the Contractor shall have submitted correct EFT banking information in accordance with the applicable solicitation provision, contract clause (e.g., 52.232-33, Payment by Electronic Funds Transfer—System for Award Management, or 52.232-34, Payment by Electronic Funds Transfer—Other Than System for Award Management), or applicable agency procedures.

(C) EFT banking…