36C26119Q0340-001.docx

36C26119Q0340

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 SI

GN 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. SIGN

ATURE 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

612-19-1-290-0001 36C26119Q0340 03-01-2019 Brian Trahan

(925) 372-2273 03-14-2019

1630 PST

612MCP

Department of Veterans Affairs VA Sierra Pacific Network (VISN 21) VA Northern California HealthCare System 150 Muir Road, Bldg, AB7, Rm 36 Martinez CA 94553 X 621492 $38.5 Million

NET 30

X N/A X Department of Veteran Affairs VA Northern California HealthCare System 10535 Hospital Way Mather CA 95655

612MCP

Department of Veterans Affairs Department of Veterans Affairs VA Northern California HealthCare System 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 VA Northern California Health Care System (VANCHCS) Inpatient Dialysis Services IAW Performance Work Statement Location: Mather, CA In accordance with FAR 16.504, the Government intends to award a Single Award Indefinite Quantity Contract as a result of this solicitation.

See CONTINUATION Page X X Brian Trahan 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:

b. GOVERNMENT: Contracting Officer 36C261 Brian Trahan Department of Veterans Affairs VA Sierra Pacific Network (VISN 21) VA Northern California HealthCare System 150 Muir Road, Bldg, AB7, Rm 36 Martinez CA 94553

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.

Department of Veterans Affairs FMS VA-9(101) Financial Services Center

PO Box 149971 Austin TX 78714-9971 ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

B.2 DESCRIPTION/SCHEDULE/ORDERING/PERFORMANCE OF SERVICES

Description of Services This solicitation/contract will establish an Indefinite Delivery/Indefinite Quantity (IDIQ) for Inpatient Dialysis Services in Mather, CA for Department of Veteran Affairs in accordance with Performance Work Statement.

Ordering/Performance Period This IDIQ is for a 5-year ordering period of April 01, 2019 to March 31, 2024.

Minimum/Maximum Values The guaranteed minimum award amount for this contract is $1,000.00. The maximum aggregate value of orders that can be placed under this contract is $4,500,000.00. The Government does not guarantee that it will place any orders under this contract more than the guaranteed minimum award amount.

B.3 PRICE/COST SCHEDULE

Period of Performance 1

April 1, 2019 – March 31, 2020

Period of Performance 2

April 1, 2020 – March 31, 2021

Period of Performance 3

April 1, 2021 – March 31, 2022

Period of Performance 4

April 1, 2022 – March 31, 2023

Period of Performance 5

April 1, 2023 – March 31, 2024

ESTIMATED GRAND TOTAL

36C26119Q0340

B.4 PERFORMANCE WORK STATEMENT

PERFORMANCE WORK STATEMENT

February 13, 2019

1 GENERAL:

1.1 Services Provided: The Contactor shall provide all supervision, personnel, transportation and equipment to perform inpatient acute dialysis treatments to VA patients at the Sacramento VA Medical Center (hereafter known as VAMC), located at 10535 Hospital Way, Mather, CA 95655.

1.1.1 The Contractor shall provide the necessary nurses who have certification, experience, knowledge, skill, and ability to provide hemodialysis, peritoneal dialysis and sustained low efficiency dialysis (SLED) treatments to Veteran patients in accordance with the specifications contained herein. The services will be provided as requested on a 24 hours-per-day, seven days-per-week basis, including holidays.

1.1.2 The VAMC assumes responsibility for associated VAMC staff labor costs. The VAMC will ensure that the Contractor's equipment and supplies will be used according to the Contractor’s policy or mutually established policies and procedures. The VAMC agrees to make no modifications of the VAMC policies and without the Contractor's prior written consent.

1.2 Place of Performance: Services shall be provided on-site at the Sacramento VAMC, 10535 Hospital Way, Mather, CA 95655.

1.2.1 The Contractor shall propose key person to be credentialed and who will be available for scheduling to meet the requirements of the contract. The Contractor shall be required to provide, as a minimum, enough appropriately qualified nurses to be credentialed and privileged that meet or exceed twice the number of services required to fulfill this contract’s obligations.

1.3 Services are as follows:

Hemodialysis treatments up to four hours in duration Differential pay for nights, weekends, and holidays Registered Nurse (RN) Consultation Additional Hours Wait Time (Time that contractor is delayed (on site) by the Agency and total time on site exceeds four hours.)

Peritoneal Dialysis CCPD Peritoneal Dialysis CAPD

1.4 Period of Performance: See Schedule

1.5 CLIN Structure: The following CLINs (Contract Line Item Numbers) will be used to order services and to invoice for such services.

1.5.1 Hemodialysis Treatments up to 4-hour duration

1.5.2 RN Consultation-1/2 hour

1.5.3 Additional Hours - 1/2 hour

1.5.4 Waiting Time - 1/2 hour

1.5.5 Peritoneal Dialysis treatments CCPD

1.5.6 Peritoneal Dialysis Treatment CAPD

1.6 PRICE/COST SCHEDULE

1.6.1 Please attached Schedule

1.7 Authority: Title 38 United States Code (USC) 8153, Health Care Resources (HCR) Sharing Authority.

1.8 Policy/Handbooks: The contractor shall be subject to the following policies, including any subsequent updates during the period of performance:

1.8.1 42 Code of Federal Regulations (CFR) Part 482: Conditions of Participation Hospitals, including Sub-Part E, Requirements for Specialty Hospitals.

1.8.2 VA Directive 1663: Health Care Resources Contracting – Buying, http://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=347

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

1.8.4 VHA Handbook 1100.18: Reporting and Responding to State Licensing Boards, http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364

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

1.8.6 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

1.8.7 VHA Handbook 1400.01: Resident Supervision, http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2847

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

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

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

1.9.1 AAMI: Association for the Advancement of Medical Instrumentation

1.9.2 ABCP: American Board of Cardiovascular Perfusion

1.9.3 ABIM: American Board of Internal Medicine, http://www.abim.org/

1.9.4 ACGME: Accreditation Council for Graduate Medical Education

1.9.5 ACLS: Advanced Cardiac Life Support

1.9.6 Adjudication: The legal process by which an arbiter or judge reviews evidence and argumentation, including legal reasoning set forth by opposing parties or litigants to come to a decision which determines rights and obligations between the parties involved.

1.9.7 Apheresis: The blood of a donor or patient is passed through an apparatus that separates out one constituent and returns the remainder to the circulation.

1.9.8 ATLS: Advanced Trauma Life Support

1.9.9 BLS: Basic Life Support

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

1.9.11 CDC: Centers for Disease Control and Prevention

1.9.12 CDR: Contract Discrepancy Report

1.9.13 CEU: Continuing Education Unit

1.9.14 CFR: Code of Federal Regulations

1.9.15 CME: Continuing Medical Education

1.9.16 CMS: Centers for Medicare and Medicaid Services

1.9.17 Contracting Officer (CO): The person with the authority to execute this contract on behalf of the government, and has the authority to enter into and administer contracts and make related determinations and findings.

1.9.18 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.

1.9.19 COS: Chief of Staff

1.9.20 CPARS: Contractor Performance Assessment Reporting System

1.9.21 CPRS: Computerized Patient Recordkeeping System, which is the electronic health record system used by the VA.

1.9.22 CRRT: Continuous Renal Replacement Therapy

1.9.23 Credentialing: The process of screening and evaluating qualifications and other credentials, including licensure, required education, relevant training and experience, and current competence and health status.

1.9.24 DEA: Drug Enforcement Agency

1.9.25 ED: Emergency Department

1.9.26 EFT: Electronic funds Transfer

1.9.27 Erythrocytapheresis: An apheresis procedure by which electrolytes (red blood cells) are separated from whole blood. Whole blood is extracted form a donor or patient, the red blood cells are separated and the remaining blood is returned to circulation.

1.9.28 FAR: Federal Acquisition Regulation

1.9.29 FSMB: Federation of State Medical Boards

1.9.30 FTE/FTEE: Full Time Employee/Full Time Employee Equivalent

1.9.31 GBL: Government Bill of Lading

1.9.32 HHS: Department of Health and Human Services

1.9.33 HCR: Health Care Resources

1.9.34 Hemodialysis: A medical procedure to remove fluid and waste products from the blood and to correct electrolyte imbalances.

1.9.35 HICPAC: Healthcare Infection Control Practices Advisory Committee is a federal advisory committee that provides advice and guidance to the CDC and the Secretary of the HHS.

1.9.36 HIPAA: Health Insurance Portability and Accountability Act

1.9.37 HR: Human Resources

1.9.38 ICU: Intensive Care Unit

1.9.39 ISO: Information Security Officer

1.9.40 IV: Intravenous

1.9.41 Leukopheresis: A laboratory procedure in which white blood cells are separated from a sample of blood. It is a specific type of apheresis, the more general term for separating out one particle constituent of blood and returning the remainder to the circulation.

1.9.42 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.

1.9.43 National Agency Check with Inquiries (NACI): This is not a security clearance, rather a federal background investigation conducted to determine an applicant's suitability for federal employment and to determine an applicant's or federal or contractor’s eligibility for a Personal Identity Verification (PIV) card required for physical access to federally controlled facilities or logical access to federally controlled information technology systems.

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

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

1.9.46 NIST: Network Information Security & Technology

1.9.47 NM: Nurse Manager

1.9.48 Non-Contract Provider: Any person, organization, agency, or entity that is not directly or indirectly employed by the contractor or any of its subcontractors

1.9.49 NP: Nurse Practitioner

1.9.50 NPPES: National Plan and Provider Enumeration System

1.9.51 OMB: Office of Budget and Management

1.9.52 PA: Physician Assistant

1.9.53 PALS: Pediatric Advanced Life Support

1.9.54 POP: Period of Performance

1.9.55 PD: Peritoneal Dialysis

1.9.56 Plasmapheresis: A method of removing blood plasma from the body by withdrawing blood, separating it into plasma and cells, and transfusing the cells back into the bloodstream. It is performed to remove antibodies in treating autoimmune conditions.

1.9.57 Plateletpheresis: The selective separation and removal of platelets form withdrawn blood the remainder of the blood then being re-transfused into the patient.

1.9.58 PPD: Purified Protein Derivative

1.9.59 PWS: Performance Work Statement

1.9.60 Privileging (Clinical Privileging): The process by which a practitioner who is 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.

1.9.61 QA/QI: Quality Assurance/Quality Improvement

1.9.62 QM/PI: Quality Management/Performance Improvement

1.9.63 QASP: Quality Assurance Surveillance Plan

1.9.64 RN: Registered Nurse

1.9.65 SAC: Security Agency Check

1.9.66 SIC: Security Investigations Center

1.9.67 USC: United States Code

1.9.68 VAAR: Veterans Affairs Acquisition Regulation

1.9.69 VANCHCS: VA Northern California Health Care System

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

1.9.71 Veterans Integrated Services Network (VISN): The regional oversight for the VA medical centers in California, Nevada, Hawaii and Manila, Philippines.

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

1.9.73 VETPro: A federal web-based credentialing program for healthcare providers.

1.9.74 Veterans Affairs Medical Center (VAMC): For the purposes of this contract, this term shall mean the Sacramento VA Medical Center, unless another Medical Center is specifically mentioned.

2 QUALIFICATIONS:

2.1 Staff/Facility: The contractor shall be responsible for ensuring that each registered nurse providing services under this contract is fully trained and completely competent to perform the required services covered by this contract. Copy of the competency record and completed training must be provided to VAMC. The registered nurses must have a Basic Life Support (BLS) certification. Documentation must be updated on an annual basis.

2.1.1 Licenses: All licenses held by the personnel working on this contract shall be full and unrestricted license to provide the services covered under this contract issued in any State, Territory, or Commonwealth of the United States or the District of Columbia. Contract personnel shall submit evidence of current, full and unrestricted licenses, registration, certification, and other relevant credentials for verification prior to appointment and throughout the employment process as requested by the COR. Contractor is responsible for keeping the COR informed of anything that would adversely affect or otherwise limit their clinical privileges. Failure to meet this requirement may result in termination of the contract. While not required, the VAMC prefers that contractor nurses possess a current unrestricted medical license to practice in the state of California.

2.1.2 Credentialing and Privileging: Contract RNs fulfilling the conditions of the contract shall be subject to all bylaws, rules and regulations of the VAMC. All contract RNs must be credentialed to ensure that they have appropriate professional credentials and personal backgrounds to provide care to Veterans.

2.1.2.1 If any contract personnel are not credentialed and privileged, or have had their credentials or privileges suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government.

2.1.3 Technical Proficiency: Contract personnel 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 provide documents upon request of the CO or COR to verify current and ongoing competency, skills, certification and licensure related to the provision of care, treatment and services performed. The contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contract personnel and contract personnel shall be responsible for abiding by the facility's medical staff bylaws, rules, and regulations (referenced herein) that govern medical staff behavior.

2.1.4 Continuing Education Unit (CEU)/Continuing Medical Education (CME) Requirements: The contractor shall provide the COR copies of current CEUs as required or requested by the VAMC. Contract personnel registered or certified by national and medical associations shall continue to meet the minimum standards for CME to remain current. The contractor shall report CME hours to the COR for tracking. These documents are required for both privileging and re-privileging. Failure to provide shall result in loss of privileges for contract personnel.

2.1.5 Training: All contract personnel shall meet all VA educational requirements and mandatory course requirements defined herein. The contractor’s physician(s) shall meet all VA educational requirements and mandatory course requirements defined herein. All training must be completed by the contractor as required by the VA. Mandatory training requirements are subject to change and include, but are not limited to the following:

2.1.5.1 Contractor Rules of Behavior – VHA Handbook 6500 Appendix D: Department of Veterans Affairs National Rules of Behavior. Acknowledge and sign either manually or electronically, the understanding of and responsibilities for compliance with the Contractor Rules of Behavior, Appendix D, relating to access to VA information and information systems. Failure to complete the mandatory annual training and sign the Contractor Rules of Behavior within the annual timeframe required, is grounds for suspension or termination of all physical or electronic access privileges, and removal from work on the contract until the training and documents are complete. The contractor shall provide a copy of the training certificates and the signed copy of the Contractor Rules of Behavior to the CO and the COR for each applicable employee within one week of the initiation of the contract and annually thereafter, as required.

2.1.5.2 Basic Life Support (BLS)

2.1.5.3 VA Mandatory Training as indicated in Section 5.6.

2.1.6 Health Testing: The contractor shall provide proof of the following tests of their personnel to the CO and COR within five calendar days after contract award and prior to the first duty shift. Tests shall be current within the past 12 months.

2.1.6.1 TUBERCULOSIS: The contractor shall provide proof of a negative reaction to Purified Protein Derivative (PPD) testing for all contract personnel. If PPD results are positive, a negative chest radiographic report for active tuberculosis shall be provided. The PPD test shall be repeated annually.

2.1.6.2 RUBELLA/MEASLES/MUMPS: The contractor shall provide proof of immunization for all contract personnel for measles, mumps, rubella or a rubella titer of 1.8 or greater. If the titer is less than 1.8, a rubella immunization shall be administered with follow-up documentation to the COR.

2.1.7 OSHA regulation concerning occupational exposure to blood-borne pathogens: The contractor must provide generic self-study training for all contract personnel about blood-borne pathogens. They must also provide Hepatitis B vaccination series to contract personnel, at no cost to the VA if their personnel elect to receive it. The contractor will maintain an exposure determination and control plan, maintain all required records, and ensure that proper follow-up evaluations are provided following an exposure incident. The VAMC shall notify the contractor of any significant communicable disease exposures. The contractor shall adhere to current Center for Disease Control and Prevention (CDC) and Healthcare Infection Control Practices Advisory Committee (HICPAC) guidelines for infection control for health care personnel as published in the American Journal for Infection Control (AJIC) 1998; 26:289-354, at http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf for disease control. Documentation stating that personnel are cleared to return to work must be provided by the contractor for any personnel who have been exposed to Hepatitis B.

2.1.8 National Provider Identification (NPI): The contractor must provide their NPI, and their Taxonomy Code confirmations notice to the CO with the proposal. The NPI is a standard and unique 10-digit numeric identifier required by HIPAA. The VHA must use NPIs in all HIPAA-standard electronic transactions for individual health care practitioners and organizational entities such as medical centers. The Taxonomy Code is issued by the Centers for Medicare and Medicaid Services’ (CMS) National Plan and Provider Enumeration System (NPPES).

2.1.9 Conflict of Interest: The contractor and all contract personnel are responsible for informing the CO and the COR for identified conflicts of interest at the time of proposal, and during the entirety of contract performance. The contractor shall provide a statement at the time of proposal that concisely describes all relevant facts concerning past, present, or currently planned interest such as, financial, contractual, organizational, 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 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.

2.1.10 Citizenship Requirements: The contractor certifies that they must comply with 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 VA patient referrals.

2.1.10.1 While performing services for the VA, the contractor must not knowingly employ, contract or subcontract with an illegal alien or foreign national non-immigrant who is in violation of their status because of their failure to maintain or comply with the terms and conditions of their admission into the United States. The contractor is required to comply with all “E-Verify” requirements consistent with Executive Order 12989 and any related pertinent Amendments and federal acquisition regulations.

2.1.10.2 If the contractor fails to comply with any requirements outlined in the preceding paragraphs or its agency regulations, the VA may require that the foreign-national who failed to maintain their legal status in the United States or 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 VA patient referrals. This includes other places where the contractor provides services to veterans who have been referred by the VA and shall form the basis for termination of this contract for breach.

2.1.10.3 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.

2.1.10.4 The contractor agrees to obtain similar certification from its subcontractors. The certification shall be made as part of the offerors response to the Request for Proposal (RFP) using the subject attachment in Section D of the solicitation document.

2.1.11 Office of Inspector General (OIG) Annual Statement: In accordance with HIPAA and the Balanced Budget Act (BBA) of 1977, the Department of Health and Human Services (HHS), OIG has established a list of parties and entities excluded from working in 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.

2.1.11.1 Therefore, the contractor must review the HHS OIG List of Excluded Individuals/Entities on the HHS OIG website at http://oig.hhs.gov/exclusions/index.asp to ensure that the proposed contract personnel are not listed. The 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. CMPs may also be imposed against the contractor that employs or enters into contracts with excluded individuals to provide items or services to federal program beneficiaries.

2.1.11.2 The contractor certifies that by submitting their proposal that the HHS OIG List of Excluded Individuals/Entities has been reviewed and that the contractor’s personnel or firm is not on the list as of the date the offer or bid was signed.

2.2 Clinical and Professional Performance: The qualifications of contract personnel are subject to review by the VAMC’s Chief of Staff (COS) or their clinical designee and approval by the Medical Center Director (MCD) as provided in VHA Handbook 1100.19. Clinical and professional performance monitoring and review 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 their designee. A clinical COR may be appointed, however, only the CO is authorized to consider any contract modification request and make changes to the contract during the administration of the resultant contract.

2.3 Non- Personal Healthcare Services: The contractor and all parties agree that the contractor and all contract personnel 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, and employees.

2.5 Prohibition Against Self-Referral: Contract personnel are prohibited from referring VA patients to the contractor’s or their own practice(s).

2.6 Inherent Government Functions: The contractor and their personnel 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 their contract personnel who are furnishing services. 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 Income tax withholding

2.7.4 Social security payments

2.7.5 Health examinations to include:

2.7.5.1 Annual TB Skin Test and recent chest X-ray if there is a history of positive TB skin test.

2.7.5.2 Evidence of Hepatitis B immunity (hepatitis immune titer) - if the individual has had the series of shots. If no immunity, provide evidence that the individual has started the Hepatitis B vaccination series.

2.7.5.3 Evidence of a Hepatitis C titer.

2.7.5.4 Varicella titer if contracted employee has not had chicken pox.

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

2.9 Key Personnel:

2.9.1 The contractor will provide Registered Nurses (RN)s to perform inpatient dialysis at VAMC and CLC as stated in this PWS. For urgent and emergent dialysis, the RN will report within two hours of being called.

2.9.2 The contractor shall provide the names of the contracted employee(s) assigned to the performance of this contract:

2.9.3 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 of duties 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 or actions with any contract personnel, they may request immediate replacement of said contract personnel without cause.

2.9.4 The CO and COR shall deal with issues raised concerning the conduct of the contract personnel. The CO is the final arbiter on questions of acceptability.

2.10 Contingency Plan: An essential part of the VAMC’s medical services is continuity of care, so the contractor must have a contingency plan in place to be utilized if the contract personnel leaves the contractor’s employment, or is unable to continue performance in accordance with the terms and conditions of the resulting contract.

2.10.1 Note: Evidence of completion of required licensure, registration, certification, education, relevant training and experience must be verified for all contractor personnel referred to perform services under this contract prior to providing direct patient care. The contractor shall not have any personnel report to duty until written notification is received from the CO advising that any candidate(s) presented have met all requirements for contract performance.

3 HOURS OF OPERATION:

3.1 Hours of operation are 24 hours per day, 365 days per year. The RN is required to perform inpatient dialysis as needed on a 24-hour basis. The requirement is for the contractor to provide sufficient coverage for all federal holidays. The following holidays are observed by the VA:

New Year’s Day Martin Luther King’s Birthday President’s Day Memorial Day Independence Day Labor Day Columbus Day Veterans Day Thanksgiving Day Christmas Day

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

3.2 Cancellations: The contractor will be responsible for providing services unless a state of emergency has been declared, or the facility is closed by decision of the VAMC.

3.3 Contractor Responsibilities – The contactor will:

3.3.1 Perform all dialysis treatments with RNs in accordance with standard healthcare dialysis treatment procedures. Each nurse that performs those services shall be responsible for the composition of the dialysate, administering intravenous (IV) solutions, blood and blood products, and medications as ordered by the VA Nephrologist or attending physician into the dialyzer blood line system necessary for inpatient treatments.

3.3.2 Set up and safety checks of the machine and water treatment system.

3.3.3 Initiate treatment, monitor treatment, and terminate treatment.

3.3.4 Provide information to the VA staff nurse for documentation of treatment into the patient medical records.

3.3.5 Clean the dialysis equipment and properly store the machine and supplies.

3.3.6 Conduct all operator water testing and contractor-supplied equipment maintenance, including the cleaning of the dialysis equipment. The contractor shall be responsible for patient monitoring during the procedure.

3.3.7 Collect, process, and test water specimens for bacterial growth, endotoxins, and heavy metals. The intervals for testing and the acceptable level of water quality shall conform to the Association for the Advancement of Medical Instrumentation (AAMI) standards.

3.3.8 Forward a copy of all water quality tests to the Infection Control Program Coordinator, COR, and the Chief of Nephrology Services at the VAMC. The contractor and the VA will be responsible together for follow-up actions required by the results of the bacteriological or chemical testing.

3.3.9 Provide 24 hours-per-day, seven days-per-week coverage as necessary.

3.3.10 Respond within six hours of notification for the initial treatment for non-emergency dialysis.

3.3.11 Respond to the VA facility within two hours of notification, and ready to begin emergency dialysis treatment when required by the ordering VA physician. Emergency care coverage is 24 hours-per-day, seven days-per-week. The COR shall establish and implement a record-keeping system to monitor the response of contract personnel to all VA calls, pages, and requests for call-back.

3.3.12 Provide contract staff in adequate numbers as determined by the contractor to provide the ordered treatment services. All non-emergency acute dialysis treatment will be scheduled in advance. If more than two treatments are scheduled during an 8-hour period, then the contractor shall provide additional RNs to ensure adequate coverage.

3.3.13 Provide documentation to the VA nurse for inclusion into patient medical records in accordance with the documentation policies of the VA. Documentation shall include: The start time and completion time of the treatments, the patient’s vital signs, the site on the body used for the dialysis, all medications given, and any significant findings. The contractor's biomedical personnel shall provide input regarding bacteriological and chemical water testing, assuring the sterility and cleanliness of the contractor-supplied equipment before each dialysis treatment, and provide input regarding infection control procedures for the prevention and control of hepatitis.

3.3.14 Maintain patient confidentiality in accordance with applicable state and federal confidentiality laws regarding patient information, medical records, test results, and all other procedures.

3.3.15 Designate a coordinator in writing who shall facilitate scheduling, problem solving, and other communication needs related to this contract. The coordinator will work with the COR to assist the contract nurses to in-process into the facility, for such things as completing and submitting security paperwork, scheduling fingerprinting, attending orientation, and license verification.

3.3.16 Provide quality control data for all VA dialysis patients each quarter. Individual patient data may be requested and required more frequently.

3.3.17 Ensure compliance with all relevant regulatory agencies and standards for their personnel. This includes, but is not limited to TJC, the Occupational Safety and Health Administration (OSHA) and the State of California, for all acute dialysis services rendered under this contract. The contractor shall maintain full accreditation status through TJC always. The contractor shall be notified immediately of any change to policies by the VA or TJC regarding the delivery or charting of inpatient dialysis treatments to ensure compliance with the new policy. All changes shall be subject to joint development with the contractor by agreement. The standard of care shall be equal to that provided by the VAMC and CLC.

3.3.18 The contractor shall notify the VAMC and CLC staff fellow, attending physician or Chief of Nephrology for any situations wherein the services cannot be performed, including equipment problems, and any situations wherein there may be a concern about the patient’s care.

3.4 VA Responsibilities - The VAMC will:

3.4.1 Provide the area or space at the facility for the contractor to perform dialysis treatments.

3.4.2 Provide associated laboratory services.

3.4.3 Provide blood, medications, and all other supplies.

3.4.4 Safeguard and protect dialysis equipment and supplies that are owned by the contractor while the equipment and supplies are on the VA premises.

3.4.5 Provide patient information as requested by the contractor that is reasonable and necessary to perform dialysis services.

3.4.6 Assume joint responsibility and partner with the contractor for any follow-up actions required because of the bacteriological or chemical testing of the water. See paragraph 3.3.28 above.

3.4.7 Provide a qualified VA physician, as determined by the VA that will be responsible for the selection of suitable treatment modality and dialysis settings for each patient. The Nurse Manager (NM) for the ICU and Medical-Surgical unit shall be the contact person for clinical issues relating to nursing. The VA will designate a point of contact for administrative issues related to patient eligibility.

3.4.8 Provide unit orientation for newly assigned contractor personnel. The newly assigned nurse will receive a section specific orientation on their first work day. Provide all patient transport within the VA Sacramento.

4 SECURITY REQUIREMENTS FOR CONTRACT PERSONNEL – INFORMATION SYSTEMS ACCESS:

4.1 All contractor employees who will work more than six months under this contract shall be the subject of a background investigation and must receive a favorable adjudication from the VA Security Investigations Center (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.

4.1.1 Contractor personnel who previously received a favorable adjudication because of a government background investigation may be exempt from this contract requirement if they can provide documentation to support the previous adjudication. Proof of previous adjudication must be submitted by the contractor to VA SIC through the CO. Proof of previous adjudication is subject to verification by the VA SIC. Some positions maybe subject to periodic re-investigation.

4.1.2 For those contract employees who will work less than six months under this contract, a background investigation is not required, however, such employees will be required to initiate a Security Agency Check (SAC) for fingerprints prior to providing services under this contract.

4.2 Position Sensitivity: The position sensitivity has been designated as: Low Risk.

4.3 Background Investigation: The level of background investigation commensurate with the required level of access is: National Agency Check with Inquiries (NACI).

4.4 Contractor Responsibilities: To conduct a background investigation, the contractor shall submit the following required forms or have their contract personnel submit the following required forms to the COR. Samples of the forms are included but the actual forms to be used will be provided by the COR at time of contract award.

4.4.1 Contract Security Services Request Form 1A

4.4.2 Contractor / Employee Fingerprint Request Instructional Form 2

4.4.3 VHA Service Center PIV Sponsorship Form #3.

4.4.4 Contract Security Verification Request Supplemental Form #1B (used only when extra space is needed for large rosters)

4.4.5 Standard Form 87, Fingerprint and PIV enrollment questionnaire

4.4.6 Optional Form 306, Declaration for Federal Employment

4.4.7 VETPro Enrollment (conducted online)

4.4.8 Rules of Behavior

4.4.9 Initial Hiring Request Form

4.5 The COR will arrange a time for contract personnel to complete fingerprint verification.

5 INFORMATION SECURITY AND MANDADOTRY TRAINING

5.1 General: Contractors, contractor personnel, subcontractors, and subcontractor personnel shall be subject to the same federal laws, regulations, standards, VA Directives and Handbooks as VA personnel regarding information and information system security

5.2 Access to VA Information and VA Information Systems:

5.2.1 All contractors, subcontractors, and…