36C26119Q0203-004.docx

36C26119Q0203

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

36C26119Q0203 02-14-2019 Durell Salaz 916-923-4546 02-28-2019

12:00 PM

612MCP

Department of Veterans Affairs Network Contracting Office (NCO) 21 5342 Dudley Bldg., Bldg. 209 McClellan CA 95652-2609

X 621111 $11 Million X N/A X Department of Veterans Affairs VA Sierra Nevada Health Care System 975 Kirman Avenue Reno NV 89502-0993

612MCP

Department of Veterans Affairs Network Contracting Office (NCO) 21 3230 Peacekeeper Way, Bldg. 209 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 Nephrology Services to eligible beneficiaries at the VA Sierra Nevada Health Care System in accordance with B.2 Schedule of Services and Price on pages 6 - 7 and B.3 Performance Work Statement (PWS) on pages 8 - 31.

See CONTINUATION Page X X Durell Salaz

CONTRACTING OFFICER

Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

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

a. CONTRACTOR: TBD

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:

a. Quarterly [ ]

b. Semi-Annually [ ]

c. Other [X] Monthly - in Arrears

4. GOVERNMENT INVOICE ADDRESS: Invoices will be electronically submitted to the Tungsten website at http://www.tungstennetwork.com/uk/en/ Tungsten direct vendor support number is 877-489-6135 for VA contracts. The VA-FSC pays all associated transaction fees for VA orders. During Implementation (technical set-up) Tungsten will confirm your Tax Payer ID Number with the VA-FSC. This process can take up to 5 business days to complete to ensure your invoice is automatically routed to your Certifying Official for approval and payment. In order to successfully submit an invoice to VA-FSC please review “How to Create an Invoice” within the how to guides. All invoices submitted through Tungsten to the VA-FSC should mirror your current submission of Invoice, with the following items required. Clarification of additional requirements should be confirmed with your Certifying Official (your CO or buyer). The VA-FSC requires specific information in compliance with the Prompt Pay Act and Business Requirements. For additional information, please contact: 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.

Tungsten Support Phone: 1-877-489-6135 Website: http://www.tungsten-network.com/us/en/ Department of Veterans Affairs Financial Service Center Phone: 1-877-353-9791 Email: vafscched@va.gov ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

B.2 SCHEDULE OF SERVICES AND PRICE

The Contractor agrees to furnish all personnel necessary to perform on-site Nephrology Services to eligible beneficiaries of the Department of Veterans Affairs Medical Center, VA Sierra Nevada Health Care System (hereinafter referred to as VASNHCS). The contractor (s) shall cover the full range of Nephrology services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care be of a quality, meeting or exceeding currently recognized TJC, VA and national standards as establish by the American Society of Nephrology https://www.asn-online.org and American Society of Nephrology (ASN) http://www.asn-online.org/edication/training/fellows/educational-resources.aspx#Guidelines Place of Performance: Services shall be provided onsite, VA Sierra Nevada Health Care System, 975 Kirman Avenue, Reno, NV 89502-0993.

Period of Performance: BASE YEAR: April 1, 2019 through March 31, 2020

Period of Performance: OPTION YEAR ONE: April 1, 2020 through March 31, 2021

Period of Performance: OPTION YEAR TWO: April 1, 2021 through March 31, 2022

Period of Performance: OPTION YEAR THREE: April 1, 2022 through March 31, 2023

Period of Performance: OPTION YEAR FOUR: April 1, 2023 through March 31, 2024

BASE YEAR:

OPTION YEAR ONE:

OPTION YEAR TWO:

OPTION YEAR THREE:

OPTION YEAR FOUR:

GRAND TOTAL AMOUNT FOR BASE YEAR AND ALL OPTION YEARS:

B.3 PERFORMANCE WORK STATEMENT

1. GENERAL:

1.1. Services Provided: The contractor shall provide Board Certified/Board Eligible physicians and Physician Extenders (NP/PA) in the subspecialty of Nephrology on-site in accordance with the specification contained herein to beneficiaries of the Department of Veterans Affairs (VA) Sierra Nevada Healthcare System (VASNHCS). Services include the full range of nephrology medical care for inpatient and outpatient VA beneficiaries including consultation, diagnosis, therapy and treatment, and prognosis of patients with nephrology disorders. The contractor will provide coverage measuring approximately 3120 hours annually (approximately 2288 physician hours and 832 physician extender hours), which includes the following on a weekly basis:

1.1.1. Eight half-day clinics (Physician) and four half-day clinics by NP/PA;

1.1.2. Inpatient consults and rounding;

1.1.3. Weekend rounds;

1.1.4. One telemedicine half day clinic, performed at the Reno VAMC (when implemented);

1.1.5. Call coverage on a 24/7 basis.

1.2. Place of Performance: Contractor shall furnish services at the Sierra Nevada Health Care System located at 975 Kirman Avenue, Reno, NV 89502-0993.

1.3. Authority: Title 38 USC 8153, Health Care Resources (HCR) sharing Authority.

1.4. Policy/Handbooks:

1.4.1. VA Directive 1663: Health Care Resources Contracting - Buying http://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2

1.4.2. VHA Directive 2006-041 “Veterans’ Health Care Service Standards” (expired but still in effect pending revision) https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443

1.4.3. VHA Directive 1192 “Seasonal Influenza Prevention Program” https://www.publichealth.va.gov/docs/flu/VHA_Directive_1192_Sep

1.4.4. VHA Handbook 1100.17: National Practitioner Data Bank Reports - http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135

1.4.5. VHA Handbook 1100.18 Reporting and Responding To State Licensing Boards – http://www1.gov/chapublications/ViewPublication.asp?pub_ID=1364

1.4.6. VHA Handbook 1100.19 Credentialing and Privileging - http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910

1.4.7. VHA Handbook 1907.01 Health Information Management and Health Records: http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791

1.4.8. Privacy Act of 1974 (5 U.S.C. 552a) as amended http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm

1.5. Definitions/Acronyms: Terms used in this contract shall be interpreted as follows unless the context expressly requires a different construction and/or interpretation. In case of a conflict in language between the Definitions and other sections of this contract, the language in this section shall govern.

1.5.1. ACGME: Accreditation Council for Graduate Medical Education

1.5.2. ACLS: Advanced Cardiac Life Support

1.5.3. AOD: Admitting Officer of the Day

1.5.4. ASH: American Society of Nephrology

1.5.5. ASN: American Society of Nephrology http://www.asn- online.org/education/training/fellows/educational-resources.aspx#Guidelines

1.5.6. ATLS: Advanced Trauma Life Support

1.5.7. BLS: Basic Life Support

1.5.8. CCNE: Commission on Collegiate Nursing Education: www.aacn.nche.edu/accreditation

1.5.9. CDC: Centers for Disease Control and Prevention

1.5.10. CR: Contract Discrepancy Report

1.5.11. CEU: Certified Education Unit

1.5.12. CME: Continuing Medical Education

1.5.13. CMS: Centers for Medicare and Medicaid Services

1.5.14. Contracting Officer (CO): The person executing this contract on behalf of the Government with the authority to enter into and administer contracts and make related determinations and findings.

1.5.15. Contracting Officer’s Representative (COR): A person appointed by the CO to take necessary action to ensure the Contractor performs in accordance with and adheres to the specifications contained in the contract and to protect the interest of the Government. The COR shall report to the CO promptly any indication of non-compliance in order that appropriate action can be taken.

1.5.16. COS: Chief of Staff

1.5.17. CPARS: Contractor Performance Assessment Reporting System

1.5.18. CPRS: Computerized Patient Recordkeeping System- electronic health record system used by the VA.

1.5.19. Credentialing: Credentialing is the systematic process of screening and evaluating qualification and other credentials, including licensure, required education, relevant training and experience and current competence and health status.

1.5.20. DEA: Drug Enforcement Agency

1.5.21. ED: Emergency Department

1.5.22. FSMB: Federation of State Medical Boards

1.5.23. Full Time Equivalent (FTE): VA’s definition for full time working the equivalent of 80 hours every two weeks, 2080 hours per year. In calculating FTE, any hours not worked on national holidays shall not be included.

1.5.24. HHS: Department of Health and Human Services

1.5.25. HIPAA: Health Insurance Portability and Accountability Act

1.5.26. HR: Human Resources

1.5.27. ISO: Information Security Officer

1.5.28. Medical Emergency: A sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably result in: Permanently placing a patient's health in jeopardy, causing other serious medical consequences, causing impairments to body functions, or causing serious or permanent dysfunction of any body-organ or part.

1.5.29. MOD: Medical Officer of the Day

1.5.30. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers).

1.5.31. NLNAC: National League for Nursing Accrediting Commission. www.nlnac.org

1.5.32. Non-Contract Provider: any person, organization, agency, or entity that is not directly or indirectly employed by the Contractor or any of its subcontractors

1.5.33. NP: Nurse Practitioner

1.5.34. NPPES: National Plan and Provider Enumeration System

1.5.35. PA: Physician Assistant

1.5.36. PALS: Pediatric Advanced Life Support

1.5.37. POP: Period of Performance

1.5.38. PPD: Purified Protein Derivative

1.5.39. PWS: Performance Work Statement

1.5.40. Privileging (Clinical Privileging): Privileging is the process by which a practitioner, licensed for independent practice; e.g., without supervision, direction, required sponsor, preceptor, mandatory collaboration, etc.; is permitted by law and the facility to practice independently, to provide specific medical or other patient care services within the scope of the individual’s license, based upon the individual’s clinical competence as determined by peer references, professional experience, health status, education, training and licensure. Clinical privileges must be facility-specific and provider-specific.

1.5.41. QA/QI: Quality Assurance/Quality Improvement

1.5.42. QM/PI: Quality Management/Performance Improvement

1.5.43. QASP: Quality Assurance Surveillance Plan

1.5.44. Veterans Health Administration (VHA): The central office for administration of the VA medical centers through throughout the United States. The VHA is located in Washington, D.C.

1.5.45. Veterans Integrated Services Network (VISN): The regional oversight for the VA medical centers in Michigan and Indiana.

1.5.46. VISTA (Veterans Integrated Systems Technology Architecture): A PC based system that will capture and store clinical imagery, scanned documents and other non-textual data files and integrates them into patient’s medical record and with the hospital information system.

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

1.5.48. Veterans Affairs Medical Center (VAMC): Unless identified with the name of a different VA medical Center, for purposes of this contract, this term shall mean the Sierra Nevada Health Care System.

2. QUALIFICATIONS:

2.1. Staff/Facility

2.1.1. License: Contractor’s physician (s) assigned by the Contractor to perform the services covered by this contract shall have a current license to practice medicine in any State, Territory, or Commonwealth of the United States or the District of Columbia where services are being performed.

2.1.1.1. All licenses held by the personnel working on this contract shall be full and unrestricted licenses. Contractor’s physician (s) 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.

2.1.2. Board Certification: All contractor’s provider (s) shall be board certified by the American Board of Internal Medicine in Nephrology http://www.abim.org/specialty/nephrology.aspx, and be currently certified in Basic Life Support (BLS) Advanced Cardiac Life Support (ACLS) or equivalency. All continuing education courses required for maintaining certification must be kept up to date at all times. Documentation verifying current certification shall be provided by the Contractor to the VA COR on an annual basis for each year of contract performance.

2.1.3. Physician Extender (NP/PA): All Contractor’s provider (s) shall be licensed in a State, Territory, or Commonwealth of the United State or the District of Columbia. All licenses held by personnel working under this contract shall be full and unrestricted licenses. The qualifications of such personnel shall be subject to review by the Chief, Medical Service, Chief of Staff, and approval by the Director, VASNHCS.

2.1.4. Credentialing and Privileging: Credentialing and privileging is to be done in accordance with the provisions of VHA Handbook 1100.19 referenced above. The Contractor is responsible to ensure that proposed provider (s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any contractor’s provider (s) prior to obtaining approval by the Sierra Nevada Health Care System (VASNHCS) Professional Standards Board, Medical Executive Board and Medical Center Director.

2.1.4.1. If a contractor’s provider (s) is not credentialed and privileged or have their credentials/privileges suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government within three (3) business days of the suspension or revocation.

2.1.4.2. Prior to acceptance, all contractor’s providers shall comply with VASNHCS credentialing guidelines, providing all required information on the timeline be established by the Reno Health Care System credentialing Officer, Credentialing and privileging shall be completed in accordance with the provisions of the VHA Handbook 1100.19 dated October 15, 2012 and can be found at the following web address: http://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910

2.1.4.3. This VHA Handbook provides updated VHA procedures regarding credentialing and privileging, to include incorporating: VHA policy concerning VetPro; the Expedited Medical Staff Appointment Process; credentialing during activation of the Facility Disaster Plan; requirements for querying the Federation of the Federation of State Medical Boards (FSMB): Credentialing and privileging requirement 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 PAs and advanced practice registered nurses APRNs. The credentialing, but not privileging, requirements of this Handbook apply to physicians, dentists, and other practitioners allowed by law and the facility to practice independently who are assigned to research or administrative positions not involved in patient care.

2.1.5. Technical Proficiency: Contractor’s provider (s) 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. Contractor shall provide documents upon request of the CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed. Contractor’s physician (s) shall have knowledge of professional care theories, principles, practices, and procedures to perform assignments of Nephrology patient/critically ill patient population. Contractor’s physician (s) shall demonstrate knowledge of growth and development, and pathophysiology of disease processes specific to the critical care/nephrology population Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contractor’s provider (s) and contractor’s physician (s) shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior.

2.1.6. Continuing Medical Education (CME)/ Certified Education Unit (CEU) Requirements: Contractor shall provide the COR copies of current CMEs as required or requested by the VAMC. Contractor’s physician (s) registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. Contractor shall report CME hours to the credentials office for tracking. These documents are required for both privileging and re-privileging. Failure to provide shall result in loss of privileges for contractor’s physician (s).

2.1.7. Training (ACLS, BLS, CPRS and VA MANDATORY): Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the contractor’s physician (s) as required by the VA. Training includes, but is not limited to:

2.1.8. Standard Personnel Testing (PPD, etc.): Contractor shall provide proof of the following tests for physicians within five (5) calendar days after contract award and prior to the first duty shift to the COR and Contracting Officer. Tests shall be current within the past year.

2.1.8.1. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative Tuberculosis Skin Test (TST) or interferon-gamma release assays (IGRA) for all Contractor’s physician (s). A negative chest radiographic report for active tuberculosis shall be provided in cases of positive TST or IGRA results. The TST or IGRA testing shall be repeated annually.

2.1.8.2. MEASLES, MUMPS, & RUBELLA TESTING: Contractor shall provide proof of immunity for all contractor’s physician (s).

2.1.8.3. VARICELLA: Contractors shall provide proof of immunity for all Contractor’s physician (s).

2.1.8.4. ACCELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of Tdap vaccination for all Contractor’s physician (s).

2.1.8.5. INFLUENZA: Contractors shall provide proof that all Contractor’s physician (s) have received the annual Influenza vaccine unless it is contraindicated. If the Contractor’s physician (s) has a medical contraindication to the vaccine they shall be required to wear a mask during the Influenza season.

2.1.8.6. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO BLOODBORNE PATHOGENS: Contractor shall provide generic self-study training for all contractor’s physician (s); provide their own Hepatitis B vaccination series at no cost to the VA if they elect to receive it; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident. The VAMC shall notify the Contractor of any significant communicable disease exposures as appropriate. Contractor shall adhere to current CDC/HICPAC Guideline for Infection Control in health care personnel (as published in American Journal for Infection Control- AJIC 1998; 26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf) for disease control. Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.

2.1.8.7. Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.

2.1.9. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers). The Contractor shall have or obtain appropriate NPI and if pertinent the Taxonomy Code confirmation notice issued by the Centers for Medicare and Medicaid Services (CMS) National Plan and Provider Enumeration System (NPPES) be provided to the Contracting Officer with the proposal.

2.1.10. DEA: Contractor shall provide copy of current DEA certificate.

2.1.11. Conflict of Interest: The Contractor and all contractor’s physician (s) 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 must also provide relevant facts that show how it’s organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest. These statements shall be in response to the VAAR provision 852.209-70 Organizational Conflicts of Interest (Jan 2008) and fully outlined in response to the subject attachment in Section D of the solicitation document.

2.1.12. Citizenship related Requirements:

2.1.12.1. The Contractor certifies that the Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to Department of Veterans Affairs patient referrals;

2.1.12.2. While performing services for the Department of Veterans Affairs, the Contractor shall not knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States. Additionally, the Contractor is required to comply with all “E-Verify” requirements consistent with “Executive Order 12989” and any related pertinent Amendments, as well as applicable Federal Acquisition Regulations.

2.1.12.3. If the Contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the Department of Veterans Affairs may, at its discretion, require that the foreign national who failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor, shall be prohibited from working at the Contractor’s place of business that services Department of Veterans Affairs patient referrals; or other place where the Contractor provides services to veterans who have been referred by the Department of Veterans Affairs; and shall form the basis for termination of this contract for breach.

2.1.12.4. This certification concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under 18 U.S.C. 1001.

2.1.12.5. The Contractor agrees to obtain a similar certification from its subcontractors. The certification shall be made as part of the offerors response to the RFP using the subject attachment in Section D of the solicitation document.

2.1.13. Annual Office of Inspector General (OIG) Statement: In accordance with HIPAA and the Balanced Budget Act (BBA) of 1977, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) has established a list of parties and entities excluded from Federal health care programs. Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs.

2.1.13.1. Therefore, Contractor shall review the HHS OIG List of Excluded Individuals/Entities on the HHS OIG web site at http://oig.hhs.gov/exclusions/index.asp to ensure that the proposed contract physician(s) are not listed. Contractor should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty (CMP) for each item or service furnished during a period that the person was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMP’s may also be imposed against the Contractor that employ or enter into contracts with excluded individuals to provide items or services to Federal program beneficiaries.

2.1.13.2. By submitting their proposal, the Contractor certifies that the HHS OIG List of Excluded Individuals/Entities has been reviewed and that the Contractors are and/or firm is not listed as of the date the offer/bid was signed.

2.2. Clinical/Professional Direction: The qualifications of Contractor personnel are subject to review by VA Medical Center COS or his/her clinical designee and approval by the Medical Center Director as provided in VHA Handbook 1100.19. Clinical/Professional direction of all clinical personnel covered by this contract for quality purposes will be provided by the VAMC COS and/or the Chief of the Service or his designee. A clinical COR may be appointed, however, only the CO is authorized to consider any contract modification request and/or make changes to the contract during the administration of the resultant contract.

2.3. Non-Personal Healthcare Services: The parties agree that the Contractor and all contract physician (s) shall not be considered VA employees for any purpose.

2.4. Indemnification: The Contractor shall be liable for, and shall indemnify and hold harmless the Government against, all actions or claims for loss of or damage to property or the injury or death of persons, arising out of or resulting from the fault, negligence, or act or omission of the Contractor, its agents, or employees.

2.5. Prohibition Against Self-Referral: Contractor’s physician (s) are prohibited from referring VA patients to Contractor’s or their own practice (s).

2.6. Inherent Government Functions: Contractor and Contractor’s physician (s) shall not perform inherently governmental functions. This includes, but is not limited to, determination of agency policy, determination of Federal program priorities for budget requests, direction and control of government employees (outside a clinical context), selection or non-selection of individuals for Federal Government employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for Federal employees, approving any contractual documents, approval of Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy.

2.7. No Employee status: The Contractor shall be responsible for protecting Contractor’s physician (s) furnishing services. To carry out this responsibility, the Contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract:

2.7.1. Workers’ compensation

2.7.2. Professional liability insurance

2.7.3. Health examinations

2.7.4. Income tax withholding, and

2.7.5. Social security payments.

2.8. Tort Liability: The Federal Tort Claims Act does not cover Contractor or contractor’s provider (s). When a Contractor or contractor’s provider(s) has been identified as a provider in a tort claim, the Contractor shall be responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor’s (or contractor’s physician (s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.9. Key Personnel:

2.9.1. The VA Full Time Equivalency (FTE) for the services required is 1.5 FTE. FTE is defined by VA as a minimum of 80 hours every two weeks and does not include holidays.

2.9.2. The number of Board Certified/Board Eligible Nephrology physicians or physician extenders (NP/PA) required to be on site on a daily basis is 1.5 FTE, Monday through Friday as defined in paragraph Hours of Operation in this section.

2.9.3. The Contractor shall be responsible for providing coverage to the VASNHCS during periods of vacancies of the Contractor’s personnel due to sick leave, personal leave, vacations and additional coverage as required. In the event a scheduled contractor’s physician(s) is unable to complete an assigned shift, the Contractor shall provide replacement physician coverage within 2 hours and notify the Contracting Office Representative (COR) at the VASNHCS immediately of the schedule change.

2.10. Personnel Substitutions: During the first ninety (90) calendar days of performance, the Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death or termination of employment. The Contractor shall notify the CO, in writing, within 15 calendar day (s) after the occurrence of any of these events and provide the information required below. After 90 days, the Contractor shall submit the information required below to the CO at least 15 calendar days prior to making any permanent substitutions. Contractor shall ensure substitutions are fully credentialed and privileged by the VASNHCS.

2.10.1. The Contractor shall provide a detailed explanation of the circumstances necessitating the proposed substitutions, complete resumes for the proposed substitutes, and any additional information requested by the CO. Proposed substitutes shall have comparable qualifications to those of the persons being replaced. The CO will notify the Contractor within 30 calendar days after receipt of all required information of the decision on the proposed substitutes. The contract will be modified to reflect any approved changes of key personnel.

2.10.2. For temporary substitutions where the key person shall not be reporting to work for two (2) consecutive work days or more, the Contractor shall provide a qualified replacement for the key person. The substitute shall have comparable qualifications to the key person. Any period exceeding two weeks will require the procedure as stated above.

2.10.3. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, 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. Should the VA COS or designee show documented clinical problems or continual unprofessional behavior/actions with any contractor’s physician (s), s/he may request, without cause, immediate replacement of said contractor’s physician (s).

2.10.4. The CO and COR shall deal with issues raised concerning Contractor’s physician (s) conduct. The final arbiter on questions of acceptability is the CO.

2.11. Contingency Plan: Because continuity of care is an essential part of VAMC’s medical services, The Contractor shall have a contingency plan in place to be utilized if the contractor’s physician (s) leaves Contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract.

3. VA HOURS OF OPERATION/SCHEDULING:

3.1. VA Business Hours: The clinic operations of the Nephrology Section, Medical Service is Monday through Friday from 8:00 am to 4:30 pm. The VASNHCS Medical Specialty Clinic is closed on all Federal holidays.

3.1.1. Patients must be seen by a Contractor’s physician (s)/physician extender (s) on-site at VASNHCS in a timely manner in accordance with VA Rules and Regulations on clinic wait times and consult completion. Contractor shall notify the COR immediately about any obstacles to meeting this performance measure.

3.1.2. Contractor’s physician (s)/physician extender (s) shall be available and present in clinic during normal VASNHCS clinic hours, which will be established, and may be revised, as deemed appropriate for patient care by the Chief of Staff. Contractor’s physician (s)/physician extender (s) will be required to take call after hours daily (Monday-Friday) and Weekends. Currently, normal clinic hours for providers are 8:00 am to 4:30 pm excluding weekends and Federal holidays.

3.1.3. Off-hours Coverage: On-call coverage is required. The on-call schedule is on 24-hour/ 7-days a week basis, consisting of 16 hours per 24-hour day, Monday through Friday, and 24 hours per day on weekends (Saturdays and Sundays) and all Federal holidays. When the Contractor’s physician/physician extender is on-call, they shall remain within a thirty minutes arrival time to VASNHCS. All calls with be responded to within fifteen minutes. On -call services are inclusive of this contract and no additional charges will be made. The on-call volume is estimated to be three to five calls per month and will be from the Administrator of the Day (AOD).

3.2. Federal Holidays: The following holidays are observed by the Department of Veterans Affairs:

3.2.1. New Year’s Day

3.2.2. President’s Day

3.2.3. Martin Luther King’s Birthday

3.2.4. Memorial Day

3.2.5. Independence Day

3.2.6. Labor Day

3.2.7. Columbus Day

3.2.8. Veterans Day

3.2.9. Thanksgiving

3.2.10. Christmas

3.2.11. Any day specifically declared by the President of the United States to be a national holiday.

3.3. Cancellations:

3.3.1. Continuity of Services: The Contractor shall ensure that qualified backup providers are available to provide coverage during scheduled and unscheduled absences of primary contract provider. Contractor will ensure that all backup providers participate in the Credentialing and Privileging and training processes. Disaster/emergency Coverage: The Standard of Care should be equal to that provided by the VA if the VA were capable of providing the services required at their location. The Contractor shall provide competent, quality nephrology services to all patients of the Reno VAHCS, in the performance of contract requirements. Contractor shall provide all services specified in this contract for any VA beneficiary, regardless of the race, color, religion, sex, or national origin of the person for whom such services are ordered. The Contractor further warrants that s/he shall not resort to subcontracting as means of circumventing this provision.

3.3.2. Absences: The payment for any leave---including sick leave, holiday, or vacation time, in excess of authorized absences, is the responsibility of the Contractor. Appropriate coverage must be providers in accordance with the contract terms and conditions and must be supplied by the contractor. The Contractor’s employee must be present at the VASNHCS and must be actually performing the required services for the period specified in the contract. Backup coverage is required at all times, In the event a contracted physician does not come to work for a scheduled shift due to weather, illness or other reasons the Contractor must provide a replacement within 3 days of the shift started.

3.3.3. Schedules: Services to be performed by Contractor shall be done on an agreed upon schedule between the Contractor and VASNHCS. Contractor will be expected to be ready for work at the time the shifts starts and stay until the end of the shift. Contractor must be physically present in the Nephrology Department at all times and be awake and alert.

4. CONTRACTOR RESPONSIBILITIES

4.1. Clinical Personnel Required: The Contractor shall provide contractor’s providers (s) who are competent, qualified per this performance work statement and adequately trained to perform assigned duties.

4.1.1. Contractor’s providers (s) shall be responsible for signing in and out when in attendance. Time sheets will be used by the COR to confirm hours/day and services provided against the contractor’s invoices.

4.2. Standards of Care: The contractor’s physician (s) care shall cover the range of nephrology services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized TJC, VA and national standards as established by:

4.2.1. American Society of Nephrology https://www.asn-online.org/

4.2.2. American Society of Nephrology (ASN) http://www.asn-online.org/education/training/fellows/educational-resources.aspx#Guidelines

4.2.3. VA Standards: VHA Directive 2006-041 “Veterans’ Health Care Service Standards” (expired but still in effect pending revision) https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443

4.2.4. The professional standards of the Joint Commission (TJC) http://www.jointcommission.org/standards_information/standards.aspx

4.2.5. The standards of the American Hospital Association (AHA) http://www.hpoe.org/resources?show=100&type=8 and;

4.2.6. The requirements contained in this PWS

4.3. Resident Supervision and Teaching: N/A

4.4. MEDICAL RECORDS

4.4.1. Authorities: Contractor’s provider (s) providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the U.S.C.551a (Privacy Act), 38 U.S.C. 5701 (Confidentiality of claimants records), 5 U.S.C. 552 (FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332 (Confidentiality of certain medical records), Title 5 U.S.C. § 522a (Records Maintained on Individuals) as well as 45 C.F.R. Parts 160, 162, and 164 (HIPAA).

4.4.2. HIPAA: This contract and its requirements meet exception in 45 CFR 164.502(e), and do not require a BAA in order for Covered Entity to disclose Protected Health Information to: a health care provider for treatment. Based on this exception, a BAA is not required for this contract. Treatment and administrative patient records generated by this contract or provided to the Contractors by the VA are covered by the VA system of records entitled ‘Patient Medical Records-VA’ (24VA19). Contractor generated VA Patient records are the property of the VA and shall not be accessed, released, transferred, or destroyed except in accordance with applicable laws and regulations. Contractor shall ensure that all records pertaining to medical care and services are available for immediate transmission when requested by the VA. Records identified for review, audit, or evaluation by VA representatives and authorized federal and state officials, shall be accessed on-site during normal business hours or mailed by the Contractor at his expense. Contractor shall deliver all final patient records, correspondence, and notes to the VA within twenty-one (21) calendar days after the contract expiration date.

4.4.3. Disclosure: Contractor’s provider (s) may have access to patient medical records: however, Contractor shall obtain permission from the VA before disclosing any patient information. Subject to applicable federal confidentiality or privacy laws, the Contractor, or their designated representatives, and designated representatives of federal regulatory agencies having jurisdiction over Contractor, may have access to VA ‘s records, at VA’s place of business on request during normal business hours, to inspect and review and make copies of such records. The VA will provide the Contractor with a copy of VHA Handbook 1907-1, Health Information management and Health Records and VHA Handbook 1605.1, Privacy and Release of Information. The penalties and liabilities for the unauthorized disclosure of VA patient information mandated by the statutes and regulations mentioned above, apply to the Contractor.

4.4.4. Professional Standards for Documenting Care: Care shall be appropriately documented in the electronic medical records in accordance with standard commercial practice and guidelines established by VHA Handbook 1907.01 Health Information Management and Health Records: https://www1.va.gov/vhapublications/publications.cfm?Pub=2 and all guidelines provided by the VAMC.

4.4.4.1. Progress notes. Progress notes should be clearly referenced to a specific health care problem or current treatment plan. Information recorded in the progress note should contain all of the pertinent observations made on the patient during the course of care with an interpretation of significance and a plan for problem resolution and/or recommendations to the attending physicians. All progress notes must be signed before leaving at the end of a shift.

4.4.4.2. Medical records are considered complete as described in VASNHCS Directive 136-05, Health Information Management Directive.

4.4.4.3. The following documents are to be present, signed and co-signed (when appropriate): Doctor’ orders (including telephone/verbal orders); history and physical; discharge summary: Consultative report (when applicable): Operative report (when applicable).

4.4.5. A progress note will be documented by the treating provider for each inpatient/outpatient encounter. This note will be recorded in sufficient detail as to provide all pertinent factors in patient’s health history, extend of exam completed, description of services provided, diagnoses treated, and give precise indication of the present state of his/her health. Progress notes and an encounter will be completed the same day of the patient’s visit before leaving at the end of a shift.

4.4.5.1. Procedure consent will be done electronically utilizing the I-Med Consent.

4.4.5.2. Notes and reports shall be done immediately following treatment or procedure, discharge reports dictated at time of discharge before shift ends and medical records are to be signed as soon as available electronically and before the end of the shift.

4.4.6. Release of Information: The VA shall maintain control of releasing any patient medical information and will follow policies and standards as defined, but not limited to Privacy Act requirements. In the case of the VA authorizing the Contractor to release patient information, the Contractor in compliance with VA regulations, and at his/her own expense, shall use VA Form 3288, Request for and Consent to Release of Information from Individual’s Records, to process “Release of Information Requests.” In addition, the Contractor shall be responsible for locating and forwarding records not kept at their facility.